thesis topics in blood banking

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• HHS Author Manuscripts

Current advances in transfusion medicine 2020: A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee

Elizabeth s. allen.

1 Department of Pathology, University of California San Diego, La Jolla, California, USA

Claudia S. Cohn

2 Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA

Sara Bakhtary

3 Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA

Nancy M. Dunbar

4 Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA

Thomas Gniadek

5 Department of Pathology, NorthShore University Health System, Chicago, Illinois, USA

Courtney K. Hopkins

6 Vitalant, Scottsdale, Arizona, USA

Jessica Jacobson

7 Department of Pathology, New York University Grossman School of Medicine, New York, New York, USA

Parvez M. Lokhandwala

8 American Red Cross, Biomedical Services, Baltimore, Maryland, USA

9 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Ryan A. Metcalf

10 Clinical Pathology Division, Department of Pathology, University of Utah, Salt Lake City, Utah, USA

Colin Murphy

11 Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA

Micah T. Prochaska

12 Department of Medicine, University of Chicago, Chicago, Illinois, USA

Jay S. Raval

13 Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA

14 Department of Pathology, Stanford University, Stanford, California, USA

Emily K. Storch

15 Office of Blood Research and Review, Food and Drug Administration, Silver Spring, Maryland, USA

Monica B. Pagano

16 Transfusion Medicine Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA

Background:

The AABB Clinical Transfusion Medicine Committee (CTMC) compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine (TM), which has been made available as a manuscript published in Transfusion since 2018.

CTMC committee members reviewed original manuscripts including TM-related topics published electronically (ahead) or in print from December 2019 to December 2020. The selection of topics and manuscripts was discussed at committee meetings and chosen based on relevance and originality. Next, committee members worked in pairs to create a synopsis of each topic, which was then reviewed by two additional committee members. The first and senior authors of this manuscript assembled the final manuscript. Although this synopsis is extensive, it is not exhaustive, and some papers may have been excluded or missed.

The following topics are included: COVID-19 effects on the blood supply and regulatory landscape, COVID convalescent plasma, adult transfusion practices, whole blood, molecular immunohematology, pediatric TM, cellular therapy, and apheresis medicine.

Conclusions:

This synopsis provides easy access to relevant topics and may be useful as an educational tool.

1 |. INTRODUCTION

The Clinical Transfusion Medicine Committee (CTMC) of the AABB was charged by its Board of Directors to write an annual review of significant developments in transfusion medicine (TM). The committee chose topics based on new developments in the field and/or recent interest within the transfusion community; however, not all topics could be covered. Medical literature for the year 2020 was dominated by the pandemic caused by the novel coronavirus SARS-CoV-2 (COVID-19), and although the majority of publications this year focused on COVID-19, other important developments occurred in areas such as adult and pediatric transfusion practices, molecular immunohematology, cellular therapy, and therapeutic apheresis.

2 |. MATERIALS AND METHODS

CTMC members chose topics that were of significant interest and/or had high-impact developments. For each topic, an attempt was made to cover all literature published in English, scour news bulletins, and in some cases, solicit expert input to select manuscripts that the committee members considered notable in the field; however, this was not a systematic review of the literature, and the risk of bias and strength of the evidence were not addressed. After committee consensus regarding which manuscripts to include, committee members with expertise in that field wrote a synopsis of the literature. These synopses were reviewed by two to three other committee members, and the final manuscript content is reviewed and assembled by the first and last authors of this manuscript.

3 |. COVID-19: EFFECTS ON THE BLOOD SUPPLY AND REGULATORY LANDSCAPE

• The 2020 pandemic impacted the supply and demand for blood components and led to temporary and permanent changes by the U.S. Food & Drug Administration (FDA) in blood donor eligibility criteria.

When the World Health Organization declared the pandemic a national emergency, there was an initial reduction in blood collections of approximately 30% due to canceled blood drives. 1 , 2 This decreased supply was matched by a decreased demand as surgeries were canceled. 2 Since the initial decline, there have been sporadic, geographical shortages in the blood supply secondary to an increase in COVID cases along with weather events.

In response to the pandemic, the FDA provided guidance that included revising the donor eligibility criteria. 3 , 4 In April 2020, the FDA released the guidance “Alternative Procedures for Blood and Blood Components During the COVID-19 Public Health Emergency” to address the urgent need for blood during the public health emergency. 4 The FDA also released guidance on reduced deferral periods and policies relating to human immunodeficiency virus (HIV) risk (August 2020), transfusion-transmitted malaria (April 2020), and revised recommendations regarding Creutzfeldt–Jakob Disease and Variant Creutzfeldt–Jakob Disease (August 2020) ( Table 1 ). 5 – 7

Select changes by the US Food & Drug Administration in donor deferral criteria designed to reduce the risk of transmission of infectious diseases

Abbreviations: CJD, Creutzfeldt–Jakob Disease; HIV, human immunodeficiency virus; MSM, men who have sex with men.

SARS-CoV-2 has been investigated for transmissibility by blood transfusion, and studies have demonstrated that the risk of transfusion-transmission is negligible. 8 , 9 The REDS Epidemiology, Surveillance, and Preparedness of the Novel SARS-CoV-2 Epidemic (RESPONSE) study is evaluating the incidence of SARS-CoV-2 RNA in asymptomatic blood donors and seroincidence of SARS-CoV-2 in blood donors to assist in epidemiologic and longitudinal studies of SARS-CoV-2. 10

4 |. COVID CONVALESCENT PLASMA

• Blood centers manufactured and distributed COVID-19 convalescent plasma (CCP) under investigation of new drug (IND) applications, expanded access programs (EAP), and emergency use authorization (EUA) for use in COVID-19 patients and also performed SARS-2-CoV IgG antibody testing on blood donors for seroprevalance studies and to qualify donors for CCP collection.
• Despite widespread CCP use, its efficacy remains controversial, with possible benefit shown for high titer CCP used early in course of disease.
• A major limitation to evaluating CCP efficacy has been widespread use outside of randomized control trials in the US.
• Heterogeneity in CCP antibody measurement and recipient selection remains challenges.

4.1 |. Access and regulatory guidance

As convalescent plasma for the treatment of COVID-19 has not yet been approved for use in the U.S., FDA guidance 11 confirmed that it is regulated as an investigational product and administered under IND or EUA; the latter continues to be updated as evidence emerges. 11 During spring 2020, the Mayo Clinic-led National Expanded Access Program (EAP) provided a mechanism for U.S. clinicians to administer CCP as an IND to hospitalized adult patients with moderate to severe COVID-19 disease. Without a control arm or centralized data collection on COVID patients who did not receive CCP, the analysis of EAP data was limited to comparison with previously published rates of COVID-19 mortality as well as transfusion-related adverse events. Reports indicated no unexpected increase in adverse events. 12 , 13 The EAP ended in late August 2020 with the announcement of EUA by the FDA for hospitalized patients with COVID-19.

Numerous blood donor centers in the US implemented SARS-CoV-2 IgG antibody testing of blood donors in spring/summer 2020 to assist in the recruitment and collection of CCP. 11 , 14 – 20 The FDA requires CCP to contain anti-SARS-CoV-2 antibodies; to ensure that the donors have sufficient antibodies, they must have had symptoms of COVID-19 and a positive test for COVID-19 or a reactive (positive) result in two different tests approved, cleared, or authorized by the FDA to detect SARS-CoV-2 antibodies. There is an additional recommendation to measure neutralizing antibody (nAb) titers if possible. 21 Published data report that 82%–93.5% of donors with prior SARS-CoV-2 infection have demonstrable IgG antibodies with a positive correlation detected between the level of SARS-CoV-2 IgG antibodies and nAb titers. 14 – 20 A time-dependent decline has been shown in both nAb titers and detectable IgG in CCP donors and the general population post-infection. This may impact the maximum time a recovered person may donate CCP and also has important implications for durability of immunity. 20

4.2 |. Retrospective STUDIES

Retrospective case–control studies with or without propensity matching have suggested potential efficacy for CCP. 22 , 23 Although these studies were limited by selection bias, some showed improved survival (adjusted hazard ratio in plasma recipients 0.13–0.89, p = .027). 22 Finally, a retrospective subgroup analysis of patients in the Mayo EAP showed a dose-dependent correlation between 30 days survival and anti-spike IgG antibody levels in administered CCP, but only among patients not receiving mechanical ventilation (relative risk 0.48–0.91 between high titer and low titer CCP recipients). 24

4.3 |. Randomized controlled trials

A limited number of randomized controlled trials (RCT) have been reported investigating the safety and efficacy of CCP in COVID-19 ( Table 2 ). 25 – 29 The only trial to date that has shown positive effect after CCP administration enrolled patients early in the course of disease, prior to hospitalization or moderate/severe respiratory compromise. 29 Conversely, no improvement in symptoms or survival benefit has been proven for CCP in hospitalized patients with moderate to severe COVID-19 prior to CCP administration. In the largest RCT to date, the RECOVERY trial in the United Kingdom found no mortality benefit to high-titer CCP versus usual care, both in the full study population and in the subgroup of those not receiving invasive mechanical ventilation at randomization. 28

Select randomized controlled trials of COVID-19 convalescent plasma

Abbreviations: ELISA, enzyme-linked immunosorbed assay; RBD, receptor binding domain.

One significant limitation of these trials is lack of standardization for evaluation of anti-SARS-CoV-2 antibody potency. Most studies used binding anti-spike protein antibody assays, which are correlated, to a degree, with nAb titer. However, due to lack of standardized calibrators, comparing titer results from one assay to another is problematic.

4.4 |. Known and potential risks of CCP

The correlation between high burden of disease with COVID-19 and high titer binding anti-spike antibodies raises the question of whether antibody-dependent enhancement (ADE) may play a role in disease progression in a subset of patients. 30 Similarly, it is unclear if a subset of CCP donors may induce ADE in a subset of recipients. Furthermore, anti-interferon-1 autoantibodies have been associated with severe COVID-19 disease and it remains unclear whether transfused anti-INF-1 autoantibodies (or others) within CCP represent a risk to recipients. 31

5 |. ADULT TRANSFUSION PRACTICE

• The TRIST trial evaluated a restrictive (7 g/dl) versus liberal (9 g/dl) red blood cell (RBC) transfusion strategy for hematopoietic stem cell transplant (HSCT) patients. The restrictive strategy was noninferior based on the primary outcome, health-related quality of life (HRQOL) at day 100, supporting a restrictive approach to transfusion in this population.
• The Haemorrhage Alleviation with Tranexamic Acid-Intestinal System (HALT-IT) trial was an international, randomized, placebo-controlled trial evaluating the efficacy of tranexamic acid (TXA) in patients with gastrointestinal (GI) bleeding. The primary endpoint, death from bleeding within 5 days of randomization, was not different between the TXA and placebo groups. However, thromboembolic events were greater in the TXA group, suggesting that TXA should not be routinely used to treat GI bleeding outside of a clinical trial.

5.1 |. Trist trial

The Liberal Versus Restrictive Red Cell Transfusion Thresholds in Hematopoietic Cell Transplantation (TRIST) RCT evaluated a restrictive transfusion approach in a multicenter, chronic transfusion-dependent patient population. 32 Investigators used a non-inferiority design and randomized 300 HSCT patients to receive RBC transfusion for hemoglobin levels below either 9 or 7 g/dl. TRIST used HRQOL at day 100 measured by the Functional Assessment of Cancer Therapy—Bone Marrow Transplantation (FACT-BMT) instrument. The restrictive transfusion strategy was noninferior to the liberal strategy with respect to patients' FACT-BMT scores at day 100. The restrictive group also received fewer RBC transfusions (mean 2.73 vs. 5.02). There was no difference in other secondary outcomes, including transplant-related mortality and bleeding.

Most of the large RCTs evaluating RBC transfusion thresholds include mortality as the primary outcome. This crude outcome measure, while important, requires a large sample size because death is infrequent over a short follow-up period and transfusion is one of many interventions and aspects of patient care in this complex patient population. The TRIST trial's sample size of 300 is smaller than many of the well-known RBC transfusion threshold trials, since detecting a clinically significant change in HRQOL in response to transfusion did not necessitate such a large sample size. Importantly, however, by using HRQOL as the primary outcome, TRIST has begun to address a critical question about the effect of transfusion on patient-centered outcomes. The study design involved two-unit transfusions rather than the single-unit transfusion approach that is now standard for hemodynamically stable inpatients. Despite this limitation, the TRIST trial provides much needed evidence in a key patient population and ultimately does not support the need for a liberal transfusion strategy.

5.2 |. Halt-It trial

Antifibrinolytic agents, such as TXA, are commonly used to reduce bleeding in the setting of trauma, cardiac surgery, orthopedic surgery, and obstetric hemorrhage. Additionally, several small clinical trials have shown TXA reduces mortality in patients with upper GI bleeding, but were too small to assess the impact of TXA on thromboembolic adverse events. The HALT-IT trial was a large international RCT evaluating the effect of TXA on patients with GI bleeding. 33 Investigators enrolled over 12,000 patients in 15 different countries to receive TXA or placebo. The primary outcome was death from bleeding within 5 days of randomization, which was not different between the control or intervention groups (risk ratio 0.99, 95% confidence interval [CI] 0.82–1.18). Importantly, the TXA group had a higher rate of thromboembolic events compared with the placebo group. Overall, the findings from this study support the author's conclusion that TXA should not be used for treatment of GI bleeding outside of an RCT.

It is worth noting that the primary outcome of HALT-IT was changed during the trial from all-cause mortality to death due to bleeding within 5 days. The authors stated the change was due to a greater proportion of deaths occurring due to reasons other than bleeding than expected and because it was realized that TXA would not be expected to prevent re-bleeding after several days based on its short two-hour half-life.

6 |. WHOLE BLOOD FOR TRAUMA RESUSCITATION

• Low-titer group O whole blood (LTOWB) was adopted by more institutions, and studies continued to support its safety, with no detectable signal of deleterious effects.
• Multiple prospective and retrospective observational studies suggested that LTOWB may decrease mortality compared with component therapy in adult and pediatric trauma patients and those receiving massive transfusion; most studies were small and will require confirmation in RCTs.

There has been resurgence in the use of whole blood (WB) for trauma and massive transfusions. Advocates state that compared with component therapy, WB contains less anticoagulant, has less dilution of coagulation factors, and is logistically easier to manage. 34 Opponents have been concerned that even with LTOWB, ABO isohemagglutinins could have adverse effects on non-group-O recipients, and that platelets could be lost or become dysfunctional during leukoreduction or storage. 34 Over time, proponents of WB have countered these arguments by developing platelet-sparing leukoreduction filters, 34 showing equivalent safety of WB compared with components, 35 , 36 and with emerging evidence regarding its efficacy. Overall, WB continues to be validated as safe for adult and pediatric trauma. Recent observational data provides a rationale for current limited use with a trend toward superior outcomes.

6.1 |. Safety data

Harrold et al retrospectively examined 77 trauma patients (23 group O, 54 non-group O) at two hospitals who received at least 4 units of LTOWB. 37 Laboratory markers of hemolysis were measured, and there were no statistically significant differences between the group O and non-group O recipients.

The authors cautioned that right-censoring from patients who died within 24 h of transfusion and were excluded could have biased the results. They used ABO antibody titer cutoff of 50, but noted that it would be interesting to see similar data from hospitals that use higher titers for their cutoff and allow unlimited numbers of units of LTOWB for non-group O recipients.

6.2 |. Efficacy in adult civilian trauma

Retrospective and prospective observational studies in 2019–2020 have sought to associate WB use with improved outcomes in trauma patients when compared with component therapy. Data drawn from the Trauma Quality Improvement Database showed that trauma patients receiving WB had significantly decreased 24-hour and in-hospital mortality in both unadjusted and adjusted analyses. 38 In another study of 350 patients receiving prehospital or emergency department transfusions, 198 patients received WB and had significantly decreased risk of adjusted 30-day mortality. 39 A third study of 44 patients receiving WB in a massive transfusion setting showed a decrease in adjusted mortality at 24 hours and 28 days. 40

These three studies are limited by the nature of retrospective or observational design. While all three attempted some degree of adjustment for physiology, low incidence of the outcome of interest limits the generalizability of their adjusted models. Nevertheless, it is compelling that all three studies point in the same direction toward a probable benefit for WB in trauma.

6.3 |. Efficacy in pediatric trauma

Leeper et al. performed a propensity-matched analysis of injured pediatric patients who received component therapy (2013–2016, n = 28) versus LTOWB (2016–2019, n = 28). 41 The groups demonstrated no differences in in-hospital mortality, functional disability, hospital length-of-stay, or intensive care unit length-of-stay. However, the WB group had faster time to resolution of base deficit, lower post-transfusion INR, and lower amounts of RBCs, plasma, and platelets administered after adjusting for body weight.

No mortality benefit was seen in this study, which could be due to the fact that traumatic brain injury rather than hemorrhage was the predominant cause of death, and the relatively small amounts of WB used (median 15 ml/kg) could have been insufficient to yield significant benefit.

7 |. MOLECULAR IMMUNOHEMATOLOGY

• An array-based test for determining RBC, HLA, and HPA antigens was developed and validated using DNA samples from 7477 European blood donors and demonstrated 99.82% concordance with antigen types using other established methods.
• The genetic bases of several blood group systems were established: CTL2, PEL, and MAM. These systems were provisionally assigned the designations of IBST 039–041.

7.1 |. Large-scale genotyping

RBC genotyping is possible by various test platforms, 42 , 43 and mass genotyping of patients and donors holds the potential for multiple improvements in clinical TM. 44 However, for genotyping platforms to be universally adopted, a test has to be comprehensive, scalable, cost-effective, and paired with a software that can provide automated interpretation.

An international Blood Transfusion Genomics Consortium employed an array-based technology to develop and validate an inexpensive and nearly comprehensive genotyping approach. The UK BioBank version 2 Axiom Array (UKBBv2 array) tests genetic variants known to predict most RBC antigens, human platelet antigens (HPA), and human leukocyte antigens (HLA), reportedly at a cost of about $40 per sample. 45 They tested DNA samples from 7477 blood donors in England and the Netherlands, and analyzed the data using versions of the published bloodTyper algorithm 46 , 47 and freely available Applied Biosystems HLA Analysis tool. Array-based typing was then compared with the known “clinical” antigen types, which were established by both serological and DNA-based testing methods. The investigators found an overall 99.82% concordance in 103,326 comparisons across 28 RBC antigens, 10 HPA, and 6 HLA loci. Among the RBC antigen types, only 72 of 89,371 comparisons (0.08%) were discordant, and 33 of those (46%) were ultimately explained by erroneous serologic typing. The authors also attribute six discrepancies to newly identified alleles that they predict alter the expression of the antigens. Additionally, a total of seven ABO-related discrepancies were noted. Given the clinical significance of ABO-misinterpretation, the authors recommend typing for ABO using antibody-based methods.

To examine the clinical impact of the array-based genotyping, investigators retrospectively evaluated 3146 complex immunohematology cases (at least 3 RBC alloantibodies) and searched their pool of array-typed donors for matches. Compared with clinical typing alone, array-based typing yielded a 2.6-fold greater probability of identifying compatible donors. The benefit was greater for patients with rare combinations of antibodies, whereas for common antibody profiles, array-typed and clinically typed approaches were equivalent.

7.2 |. New blood group systems

For a blood group antigen to be designated as a new blood group system, International Society of Blood Transfusion (ISBT) requires that the gene encoding the antigen must be identified and sequenced. In 2019, Omae et al. showed that mutations in prion protein (PrP, CD230) are responsible for the KANNO-negative phenotype. 48 Stenfelt et al. and Veldhuisen et al. identified mutations on B4GALNT2-encoded galactosyl transferase as the genetic basis of the Sd(a)-negative phenotype. 49 , 50 ISBT thus assigned KANNO and SID as ISBT 037 and ISBT 038 blood group systems, respectively.

In 2020, the genetic basis of three additional blood group systems was discovered. Vrignaud et al performed whole exome sequencing on seven serologically compatible individuals to identify mutations in SLC44A2 gene. 51 Individuals from Moroccan ethnicity had a missense mutation in exon 14 of the gene, while the proband of European ancestry exhibited a large deletion of the gene. Using flow cytometric and western blot analysis, authors demonstrated that the antibody reactivity in the probands was targeted against the SLC44A2 (also known as CTL2) protein. The SLC44A2/CTL2 protein is highly expressed on human neutrophils and bears the human neutrophil antigen 3. ISBT has provisionally assigned the designation of ISBT 039 to the CTL2 blood group system.

Azouzi et al. established the genetic basis for the PEL-negative phenotype. 52 Using a combination of whole exome sequencing on four unrelated PEL-negative French-Canadian individuals, and a comparative proteomics approach to analyze the differential expression of proteins in RBC membranes from three PEL-negative and three PEL-positive individuals, the authors identified a large deletion of the ABCC4/MRP4 gene as the basis of the PEL-negative phenotype. Using flow-cytometry, CRISPR-Cas9 technology, western blotting, and immunoprecipitation, they demonstrated that mutations in ABCC4 are responsible for the absence of PEL antigen, and the specificity of the alloantibody seen in the PEL-negative individuals is directed against the ABCC4 protein. The PEL-negative individuals demonstrated impaired platelet aggregation in vitro; however, none showed easy bruising or increased bleeding. PEL blood group has provisionally been assigned ISBT 040 designation.

Thornton et al described the molecular basis of the high-prevalence MAM antigen. 53 Anti-MAM has been shown to cause severe hemolytic disease of the fetus and newborn. Whole exome sequencing on 10 MAM-negative individuals identified a variety of inactivating mutations in the EMP3 gene, ranging from whole gene deletion to single exon deletion and nonsense mutation. A combination of approaches including short hairpin RNA, CRISPR-Cas9, and transfected cells demonstrated that the expression of MAM antigen is dependent upon intact EMP3 gene. MAM blood group has provisionally been assigned ISBT 041 designation.

8 |. PEDIATRIC & NEONATAL TRANSFUSION

• The age of RBC products transfused in pediatric intensive care patients did not impact the incidence of new or progressive multiple organ dysfunction syndrome.
• Liberal blood transfusions compared with restrictive RBC transfusions in extremely low-birth-weight infants did not reduce the likelihood of death or disability at 24 months of corrected age.
• A prophylactic platelet transfusion threshold of 25 × 10 9 /Ldid not increase the likelihood of bleeding in preterm neonates over that of 50 × 10 9 /L.

8.1 |. RBC trials

The Age of Blood in Children in Pediatric Intensive Care Unit Trial published by Spinella et al. 54 found that the age of RBCs did not impact the incidence of new or progressive multiple organ dysfunction syndrome including mortality in critically ill children (3 days–16 years). Subjects were followed for up to 28 days or until discharge or death, whichever came first. The primary objective of the trial was to determine whether fresh (≤7 days old) RBCs were superior to standard issue RBCs, and no significant differences were found in 1538 randomized patients. Seven-hundred and twenty-eight subjects who received fresh and 733 who received standard issue RBCs were included in the primary analysis. The median storage duration of RBCs was 5 days (IQR, 4–6 days) in the fresh and 18 days (IQR, 12–25 days) in the standard issue group ( p < .001). New or progressive multiple organ dysfunction was found in 20.2% of the fresh versus 18.2% of the standard issue groups (unadjusted absolute risk difference 2%, 95% CI, 2.0% to 6.1%, p = .33). The prevalence of acute respiratory distress-syndrome was 6.6% in the fresh versus 4.8% of the standard issue group. Intensive care unit mortality was 4.5% in the fresh versus 3.5% in the standard issue group ( p = .34).

The Effects of Transfusion Thresholds on Neurocognitive Outcomes of Extremely Low Birth-Weight Infants Trial published by Franz et al., 55 demonstrated no statistical difference between outcomes based on receiving liberal or restrictive RBC transfusion therapy in extremely low-birth-weight infants (<1000 g at birth). The incidence of transfusion was 81.3% in the liberal versus 60.5% in the restrictive group. The RBC transfusion threshold varied by the weight of the patient. The median volume transfused was 40 ml versus 19 ml. The mean weekly hematocrit was 3% points higher with the liberal threshold. The primary outcome, defined as death or neurodevelopmental impairment by 24 (+/−1) months of corrected age, was not statistically different between the groups ( p = .72), nor were the secondary outcomes of death, cognitive deficit, or cerebral palsy. No differences were observed between those that developed necrotizing enterocolitis requiring surgical intervention, bronchopulmonary dysplasia, or treatment for retinopathy of prematurity. Liberal blood transfusions compared with restrictive transfusions did not reduce the likelihood of death or disability at 24 months of corrected age.

8.2 |. Platelet trial

The Platelets for Neonatal Thrombocytopenia trial previously reported a 7% absolute-risk reduction using a prophylactic transfusion threshold of 25 × 10 9 /L compared with 50 × 10 9 /L for major bleeding and/or mortality in preterm neonates. 56 Fustolo-Gunnink et al. 57 assessed whether the findings were heterogeneous across different subpopulations. Neonates were categorized into 4 risk quartiles based on their baseline risk of major bleeding and/or death ( N = 653). A total of 146 neonates died or developed major bleeding. The 25 × 10 9 /L threshold was associated with an absolute-risk reduction in all risk groups varying from 4.9% in the lowest risk group (those predicted least likely to experience major bleeding and/or death) to 12.3% in the highest risk group. The authors concluded that the 25 × 10 9 /L transfusion threshold should be adopted for all neonates.

9 |. CELLULAR THERAPY

• Allogeneic chimeric antigen receptor (CAR)-NK-cells were successfully used to treat CD19-positive lymphoid tumors without significant toxicity.
• Anti-CD19 CAR-T cells were successful in treating mantle cell lymphoma resistant to Bruton Tyrosine Kinase (BTK) inhibitors.

9.1 |. CAR-NATURAL killer (NK) cells in CD19-POSITIVE lymphoid tumors

Autologous derived T-cells engineered to target CD19-positive cells have emerged as a promising new treatment option for patients with B-cell malignancies. This has led to the FDA approval of two CAR T-cell products . 58 , 59 CAR T-cell therapy, however, has numerous limitations. Typically, it requires a patient with relapsed or refractory disease to forego lymphodepleting chemotherapy for a period in order to undergo autologous collection of mononuclear cells, which then require complex and time-consuming manufacturing.

Liu et al performed a phase-1/2 clinical trial to test the safety and efficacy of engineered NK cells that were derived from an allogeneic source. 60 NK cells from cord blood were transduced with a vector expressing genes that code for anti-CD19 CAR, interleukin-15 to enhance in vivo expansion and persistence, and an inducible caspase 9 to be deployed as a safety switch. Of the 11 patients with relapsed or refractory B-cell malignancies (CLL and non-Hodgkin's lymphoma) who were infused with ex vivo expanded anti-CD19 CAR NK-cells, 8 (73%) patients showed a rapid clinical response with 7 (64%) patients exhibiting a complete remission. No significant toxicities attributable to NK cells were noted in these patients. Durability of response after CAR NK-cell therapy could not be assessed, as the patients underwent post-remission treatment at the discretion of treating physicians.

While patients in this trial received freshly manufactured CAR NK-cells, the successful use of allogenic derived NK cells creates the possibility of these cellular therapy products being stored and readily administered to a patient in need.

9.2 |. CAR-T cells in mantle cell lymphoma

Patients with mantle cell lymphoma resistant to BTK inhibitors have a very poor prognosis. The ZUMA-2 clinical trial was a multicenter, single-arm, phase 2 trial evaluating the safety and efficacy of KTE-X19 in adult patients with refractory or relapsed mantle cell lymphoma who were previously treated with BTK inhibitors. 61 KTE-X19 is an autologous derived in vitro expanded anti-CD19 CAR T-cell therapy. Of the 74 patients enrolled, 68 received KTE-X19 CAR T-cell therapy. Analysis of primary efficacy in 60 patients demonstrated that 93% had an objective response and 67% exhibited complete remission. In an intention-to-treat analysis of all enrolled patients, 85% demonstrated objective response and 59% entered remission. At 12 months, the progression-free and overall survival rates were 61% and 83%, respectively. The authors did report serious adverse events, including grade 3 or higher cytokine release syndrome and neurologic events in 15% and 31% of the patients, respectively. Other serious side effects included cytopenias and infections.

While the trial showed that the majority of patients with relapsed or refractory disease demonstrated a clinical response and went into remission, serious adverse events like those reported with use of CAR T-cell therapies were also noted. The FDA approved KTE-X19 in July 2020. 62

10 |. THERAPEUTIC APHERESIS

• The study examining plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (PEXIVAS) demonstrated that plasma exchange did not reduce the incidence of death or end-stage kidney disease (ESKD) among patients with severe disease. This prompted the Journal of Clinical Apheresis ( JCA ) Special Issue Writing Committee to release an updated fact sheet changing the category recommendation from I to II.
• A multicenter, double-blind, randomized, placebo-controlled trial of Alzheimer's disease management by plasma exchange with albumin replacement and intravenous immunoglobulin dosing (AMBAR) demonstrated that plasma exchange could slow cognitive and functional decline in mild-to-moderate Alzheimer's disease.

10.1 |. PEXIVAS study

The results of the Plasma Exchange and Glucocorticoid Dosing in the Treatment of ANCA-Associated Vasculitis (PEXIVAS) study were recently published. 63 This international RCT enrolled 704 patients with ages 15 years or older from 95 centers in 16 countries. It is the largest study published to date on the role of therapeutic plasma exchange (TPE) in ANCA-associated vasculitis (AAV). The 2 × 2 factorial study design compared TPE versus no TPE and standard versus reduced-dose steroid regimen on the primary composite outcome of ESKD or death in patients with AAV. The study concluded that TPE did not reduce the incidence of ESKD or death and that a reduced-dose regimen of glucocorticoids was non-inferior to a standard dose regimen. The study included 191 patients with pulmonary hemorrhage (61 severe) and did not observe a beneficial treatment effect in this subset of patients.

There are at least two important limitations of this study that may influence the interpretation of the results. 64 First, kidney biopsy was not required for trial participation. In a chronic disease that leads to irreversible kidney scaring, the effect of TPE on the subset of patients with acute disease that may be more responsive to possible short-term improvement in kidney function, as shown in the MEPEX study, 65 remains unknown. Second, the trial was not designed to assess the role of TPE in patients with pulmonary hemorrhage and may have been underpowered to detect a difference in this subset of patients. 66 – 68

Based on the results of this study, the JCA Special Issue Writing Committee released an updated fact sheet in August 2020 incorporating this newly available evidence. 69 The category recommendation for rapidly progressive glomerulonephritis (RPGN) and Cr ≥5.7 mg/dl in the setting of microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), or renal-limited vasculitis (RLV) was changed from category I to II to support use of TPE in select patients with biopsy-proven acute RPGN. Diffuse alveolar hemorrhage (DAH) in the setting of AAV remained a category I indication for TPE due to the life-threatening nature of this complication and the lack of alternative treatments.

10.2 |. AMBAR study

The results of the Alzheimer's Management By Albumin Replacement (AMBAR) study were recently published. 70 This phase 2b/3, double-blind trial randomized 347 Alzheimer's disease (AD) patients from 41 sites in the United States (22) and Spain (19). Subjects between 55 and 85 years of age with a probable diagnosis of mild-to-moderate AD (Mini-Mental State Examination [MMSE] score of 18–26) and receiving stable doses of acetylcholinesterase inhibitors and/or N-methyl-D-aspartate receptor antagonists were assigned to one of three TPE treatment groups with varying doses of albumin and intravenous immune globulin (IVIG) or a placebo group that included sham TPE. The primary endpoint assessed changes from baseline to 14 months in two measures: the AD Cooperative Study-Activities of Daily Living (ADCS-ADL) and the AD Assessment Scale-Cognitive Subscale (ADAS-Cog). The study concluded that the TPE-treated patients had significantly less decline compared with placebo (ADCS-ADL, 52% less decline, p = .03; ADAS-Cog, 66% less decline, p = .06). In subgroup analysis, there were no significant differences between the three TPE treatment groups, nor between those subjects with mild AD (MMSE 22–26) versus the placebo group. While these results are encouraging, future studies should further investigate the mechanism by which AD progression was slowed, the necessity of IVIG, the impacts of various demographic and AD parameters on treatment response, and the durability of treatment response after cessation of therapy. 71

ACKNOWLEDGMENTS

We acknowledge Margaret A. Keller, PhD, of the American Red Cross National Molecular Laboratory for input regarding manuscript selection.

Abbreviations:

CONFLICT OF INTEREST

CSC has disclosed professional relationships with Grifols, Terumo BCT, and Instrumentation Laboratory. NMD has disclosed financial relationship with Verax Biomedical. TG has disclosed professional relationship with Fresenius Kabi. JSR has disclosed financial relationships with Terumo BCT and Sanofi Genzyme. ESA, SB, CKH, JJ, PML, RAM, CM, MTP, HS, EKS, and MBP have disclosed no conflicts of interest.

• Frontiers in Medicine
• Research Topics

Transfusion Medicine and Blood

Total Downloads

Total Views and Downloads

About this Research Topic

Transfusion medicine is in perpetual evolution and has faced several challenges from donors screening to clinical practices through blood preparation. Nowadays, blood is mainly processed in its different components that are red blood cells, platelets, plasma and some therapeutics. This incredible story ...

Keywords : Blood, blood products, donors, hematology, transfusion medicine

Important Note : All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Topic Editors

Topic coordinators, recent articles, submission deadlines.

Submission closed.

Participating Journals

Total views.

• Demographics

No records found

total views article views downloads topic views

Top countries

Top referring sites, about frontiers research topics.

With their unique mixes of varied contributions from Original Research to Review Articles, Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author.

Immunohematology and Blood banking

Principles and Practice

• © 2020
• Pritam Singh Ajmani 0

Ruxmaniben Deepchand Gardi Medical College, Surasa, India

You can also search for this author in PubMed   Google Scholar

• Provides latest updates on various test procedures
• Presents the fallacy errors in the test procedures
• Simplifies content with the help of numerous boxes tables and high quality photographs

11k Accesses

9 Citations

This is a preview of subscription content, log in via an institution to check access.

Access this book

Subscribe and save.

• Get 10 units per month
• Download Article/Chapter or eBook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime
• Available as EPUB and PDF
• Read on any device
• Instant download
• Own it forever
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info
• Durable hardcover edition

Tax calculation will be finalised at checkout

Other ways to access

Licence this eBook for your library

Institutional subscriptions

About this book

Similar content being viewed by others.

Transfusion Medicine

Red Blood Cell Transfusion

Modern Blood Banking

• Blood Group

Table of contents (15 chapters)

Front matter, introduction.

Pritam Singh Ajmani

Blood Group and Immunology

Donor blood collection, storage of blood, transfusion of blood & its components, blood component preparation, blood test in immunohematology and blood banking, hemolytic disease of the newborn, history of blood transfusion, massive blood transfusion, autologous blood transfusion, blood management, blood bank protocols, blood bank inventory, transfusion reactions, back matter, authors and affiliations, about the author, bibliographic information.

Book Title : Immunohematology and Blood banking

Book Subtitle : Principles and Practice

Authors : Pritam Singh Ajmani

DOI : https://doi.org/10.1007/978-981-15-8435-0

Publisher : Springer Singapore

eBook Packages : Medicine , Medicine (R0)

Copyright Information : The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2020

Hardcover ISBN : 978-981-15-8434-3 Published: 03 November 2020

Softcover ISBN : 978-981-15-8437-4 Published: 04 November 2021

eBook ISBN : 978-981-15-8435-0 Published: 02 November 2020

Edition Number : 1

Number of Pages : XXIII, 208

Number of Illustrations : 2 b/w illustrations, 6 illustrations in colour

Topics : Pathology

• Publish with us

Policies and ethics

• Find a journal
• Track your research

• Search Menu
• Sign in through your institution
• Cytogenetics
• Cytotechnology
• Histotechnology
• Management/Administration
• Microbiology
• Molecular Pathology
• Molecular Biology
• Transfusion Medicine
• Advance articles
• COVID-19 articles
• Current Virtual Issue
• Cover Archive
• Author Guidelines
• Open Access
• Submission Site
• Why publish?
• Advertising and Corporate Services
• Advertising
• Reprints and ePrints
• Sponsored Supplements
• Branded Books
• About Laboratory Medicine
• About the American Society for Clinical Pathology
• Editorial Board
• Self-Archiving Policy
• Journals on Oxford Academic
• Books on Oxford Academic

Article Contents

• < Previous

Basic and Applied Concepts of Blood Banking and Transfusion Practices (3 rd Edn.)

• Article contents
• Figures & tables
• Supplementary Data

Roslyn Yomtovian, Basic and Applied Concepts of Blood Banking and Transfusion Practices (3 rd Edn.), Laboratory Medicine , Volume 44, Issue 2, May 2013, Pages e35–e36, https://doi.org/10.1309/LM675IDGQXQRELIF

• Permissions Icon Permissions

Basic and Applied Concepts of Blood Banking and Transfusion Practices is intended for those who require detailed knowledge and an understanding of immunohematology to perform their jobs—namely, medical technologists and technicians working in a blood bank or transfusion-medicine laboratory. The text begins on a strong note with the first chapter, “Immunology: Basic Principles and Applications in the Blood Bank,” which provides an excellent overview of the basic concepts of immunohematology, including the reactivity of antibodies and antigens. One of the characteristics of this text is its ability to be comprehensive yet concise and clear. The text emphasizes the importance of understanding historical terminology while presenting the most up-to-date immunohematology techniques. This is particularly true for the section on Rh, which combines just enough history of the nomenclature while covering the many aspects needed to delineate today’s methodology. The text is organized to provide detailed didactic information, beginning with a chapter outline and followed by learning objectives. Also, essential terms are defined in the margins near their use in the text. Further, each chapter is reinforced with a chapter summary, critical-thinking exercises, and study questions with answers. Each section is replete with tables and figures to further reiterate and illustrate important concepts. A comprehensive glossary is also provided. Although the book is well-stocked with references, many of the references are older and could have been updated to correspond with the 2013 edition of the text.

Nearly all of the technical sections are well written and clear; the section on the ABO, H, and Se blood groups is particularly articulate, practical, and concise. This should make the understanding of the typically difficult topic of blood banking and transfusion accessible to most students of medical technology.

I recommend this text to medical technology students and technologists; however, the text has certain shortcomings. This is particularly evident in the chapter on adverse complications of transfusions. Unlike the previous chapters, which deal with technical issues, this chapter focuses on clinical issues and tries to convey too much information in a short span of pages.

Also, there are notable contradictions in the text. For example, when the text describes blood-group antibodies associated with delayed hemolytic reactions, it mentions, in decreasing order of frequency, antibodies in the Kidd, Duffy, Kell, and MNS systems. Actually, the most common antibodies are those in the Rh system, particularly anti-C and anti-E. Another example is that the text notes that there are no major complications for delayed hemolytic transfusion reactions compared with acute reactions. I argue that the development of severe anemia associated with a delayed reaction could be a clinically significant event. In contrast, regarding an even more minor reaction, the text notes that febrile nonhemolytic transfusion reactions are usually not life-threatening for the recipient—by definition, this type of reaction should never be life-threatening for the recipient because other significant causes of fever have been excluded. Another problem is inconsistent information between the text and tables. For example, under the heading of Transfusion-Related Acute Lung Injury, the text notes this injury as occurring 1 to 2 hours after transfusion. The table immediately adjacent to this portion of the text notes a 6-hour window of occurrence (this is the correct time interval). Several other examples can be cited in the text, such as the statement that transfusion should be completed in 4 to 6 hours—it should take 4 hours—and attribution of instances of platelet bacterial contamination to improper cleansing of the donor’s skin during blood collection. The latter may rarely occur; however, in most cases, proper skin cleansing has been accomplished despite instances of platelet bacterial contamination.

Thus, for those using this text as an instructional manual, I recommend that the chapter “Adverse Complications of Transfusions” be replaced with more accurate clinical material. Despite this, the technical chapters of this text contain much useful information for the teaching and training of technologists and technicians in blood-bank operations.

Email alerts

Citing articles via.

• Recommend to your Library

Affiliations

• Online ISSN 1943-7730
• Print ISSN 0007-5027
• Copyright © 2024 American Society for Clinical Pathology
• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• My Bibliography
• Collections
• Citation manager

Save citation to file

Email citation, add to collections.

• Create a new collection
• Add to an existing collection

Add to My Bibliography

Your saved search, create a file for external citation management software, your rss feed.

• Search in PubMed
• Search in NLM Catalog
• Add to Search

Current advances in transfusion medicine: a 2019 review of selected topics from the AABB Clinical Transfusion Medicine Committee

Affiliations.

• 1 Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington.
• 2 Department of Pathology, University of California San Diego, La Jolla, California.
• 3 Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
• 4 Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
• 5 NorthShore University Health System, Chicago, Illinois.
• 6 Transfusion Medicine Division, Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
• 7 Division of Hematology/Oncology, Simmons Cancer Institute at Southern Illinois University School of Medicine and Mississippi Valley Regional Blood Center, Springfield, Illinois, USA.
• 8 Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont.
• 9 Vitalant, Scottsdale, Arizona.
• 10 Department of Pathology, New York University Grossman School of Medicine, New York, New York.
• 11 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
• 12 Clinical Pathology Division, Department of Pathology, University of Utah, Salt Lake City, Utah.
• 13 Transfusion Medicine Service, Department of Pathology, University of New Mexico, Albuquerque, New Mexico.
• 14 Transfusion Medicine & Cellular Therapy, Department of Pathology & Cell Biology, Columbia University, New York, New York.
• 15 Department of Pathology, Stanford University, Stanford, California.
• 16 Division of Pediatric Critical Care, Washington University in St Louis, St Louis, Missouri, USA.
• 17 Office of Blood Research and Review, Food and Drug Administration, Silver Spring, Maryland.
• 18 Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
• PMID: 32472580
• DOI: 10.1111/trf.15848

Background: The AABB Clinical Transfusion Medicine Committee (CTMC) compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine (TM) for the board of director's review. This synopsis is now made available as a manuscript published in TRANSFUSION.

Study design and methods: CTMC committee members review original manuscripts including TM-related topics published in different journals between late 2018 and 2019. The selection of topics and manuscripts are discussed at committee meetings and are chosen based on relevance and originality. After the topics and manuscripts are selected, committee members work in pairs to create a synopsis of the topics, which is then reviewed by two committee members. The first and senior authors of this manuscript assembled the final manuscript. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed.

Results: The following topics are included: infectious risks to the blood supply, iron donor studies, pre-transfusion testing interference and genotyping, cold agglutinin disease (CAD), HLA alloimmunization in platelet transfusions, patient blood management, updates to TACO and TRALI definitions, pediatric TM, and advances in apheresis medicine.

Conclusion: This synopsis provides easy access to relevant topics and may be useful as an educational tool.

© 2020 AABB.

PubMed Disclaimer

Similar articles

• Current advances in transfusion medicine 2020: A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee. Allen ES, Cohn CS, Bakhtary S, Dunbar NM, Gniadek T, Hopkins CK, Jacobson J, Lokhandwala PM, Metcalf RA, Murphy C, Prochaska MT, Raval JS, Shan H, Storch EK, Pagano MB. Allen ES, et al. Transfusion. 2021 Sep;61(9):2756-2767. doi: 10.1111/trf.16625. Epub 2021 Aug 22. Transfusion. 2021. PMID: 34423446 Free PMC article. Review.
• Current advances in transfusion medicine 2021: A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee. Metcalf RA, Cohn CS, Allen ES, Bakhtary S, Gniadek T, Gupta G, Harm S, Haspel R, Hess A, Jacobson J, Lokhandwala PM, Murphy C, Poston J, Prochaska MT, Raval JS, Saifee NH, Salazar E, Shan H, Zantek N, Pagano MB. Metcalf RA, et al. Transfusion. 2022 Jul;62(7):1435-1445. doi: 10.1111/trf.16944. Epub 2022 Jun 17. Transfusion. 2022. PMID: 35713186 Review.
• Current advances in 2022: A critical review of selected topics by the Association for the Advancement of Blood and Biotherapies (AABB) Clinical Transfusion Medicine Committee. Metcalf RA, Cohn CS, Bakhtary S, Gniadek T, Gupta G, Harm S, Haspel RL, Hess AS, Jacobson J, Lokhandwala PM, Murphy C, Poston JN, Prochaska MT, Raval JS, Saifee NH, Salazar E, Shan H, Zantek ND, Pagano MB. Metcalf RA, et al. Transfusion. 2023 Aug;63(8):1590-1600. doi: 10.1111/trf.17475. Epub 2023 Jul 5. Transfusion. 2023. PMID: 37403547
• Critical developments of 2018: A review of the literature from selected topics in transfusion. A committee report from the AABB's Clinical Transfusion Medicine Committee. Cohn CS, Allen ES, Cushing MM, Dunbar NM, Friedman DF, Goel R, Harm SK, Heddle N, Hopkins CK, Klapper E, Perumbeti A, Ramsey G, Raval JS, Schwartz J, Shaz BH, Spinella PC, Pagano MB. Cohn CS, et al. Transfusion. 2019 Aug;59(8):2733-2748. doi: 10.1111/trf.15348. Epub 2019 May 30. Transfusion. 2019. PMID: 31148175
• Critical developments of 2017: a review of the literature from selected topics in transfusion. A committee report from the AABB Clinical Transfusion Medicine Committee. Cushing MM, Kelley J, Klapper E, Friedman DF, Goel R, Heddle NM, Hopkins CK, Karp JK, Pagano MB, Perumbeti A, Ramsey G, Roback JD, Schwartz J, Shaz BH, Spinella PC, Cohn CS, Cohn CS, Cushing MM, Kelley J, Klapper E. Cushing MM, et al. Transfusion. 2018 Apr;58(4):1065-1075. doi: 10.1111/trf.14520. Epub 2018 Mar 9. Transfusion. 2018. PMID: 29520794 Review.
• Haass KA, Sapiano MRP, Savinkina A, et al. Transfusion-transmitted infections reported to the national healthcare safety network hemovigilance module. Transfus Med Rev 2019;33:84-91.
• Jones SA, Jones JM, Leung V, et al. Sepsis attributed to bacterial contamination of platelets associated with a potential common source - multiple states, 2018. MMWR Morb Mortal Wkly Rep 2019;68:519-23.
• [accessed 2020 May] Available from http://www.choosingwisely.org/societies/american-association-of-blood-ba... . [monograph on the internet].
• [accessed 2020 May] Available from https://www.aabb.org/programs/publications/bulletins/Documents/ab19-02.pdf .
• Learoyd P. The history of blood transfusion prior to the 20th century-part 1. Transfus Med 2012;22:308-14.

Publication types

• Search in MeSH

Related information

Linkout - more resources, full text sources.

• Ovid Technologies, Inc.

Research Materials

• NCI CPTC Antibody Characterization Program

Miscellaneous

• NCI CPTAC Assay Portal

• Citation Manager

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

• Featured Feed
• Collections
• Become A Contributor
• Account Settings
• My Public Profile
• Feed Subscriptions
• Change My Institution

Use the journals feature with a free QxMD account.

Use Read by QxMD to access full text via your institution or open access sources.

Read also provides personalized recommendations to keep you up to date in your field.

Existing User

New to Read

Sign up for a free QxMD account to keep track of pertinent research with access to hundreds of Journal Publications.

Transfusion Medicine

All material on this website is protected by copyright, Copyright © 1994-2024 1994-{new Date().getFullYear()} by WebMD LLC. By using this service, you agree to our terms of use and privacy policy .

Save your favorite articles in one place with a free QxMD account.

Search tips.

Use Boolean operators: AND/OR

diabetic AND foot diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer" (heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.

On Medicine

Topics in blood transfusion

Today marks World Blood Donor Day and so we asked Deputy Editor for Journal of Intensive Care , Hiroshi Morisaki, to explain more about the importance of blood transfusion, and how research in this area is progressing.

Hiroshi Morisaki 14 Jun 2016

To date, humans have uncovered a number of natural principles and issues such as the origin and mysteries of the universe, the earth and even life. We have simultaneously developed innumerable non-natural products for human use.

However, we have not yet succeeded in creating a man-made, cost-effective alternative to red blood cells (RBCs) despite the performance of extensive research and numerous clinical trials.

A life-saving intervention

The cellular health of the host requires an oxygen (O 2 ) supply that matches the O 2 requirements of its tissue. An insufficient O 2 supply results in ischemia, subsequently inducing tissue and/or organ injury, frequently observed in critically ill patients.

RBC transfusion, first performed over 300 years ago, remains a fundamental life-saving intervention in medicine.

Hemoglobin, which is enclosed in RBCs as an O 2 carrier, plays the most important role in supplying O 2 to the tissues. Accordingly, RBC transfusion, first performed over 300 years ago, remains a fundamental life-saving intervention in medicine.

Until the early 1980s, RBC transfusion was considered to be practically risk-free and a truly effective intervention in patients with active bleeding or anemia due to a variety of reasons in the intensive care field.

However, the threat of potentially-fatal transfusion-related infections, i.e., human immunodeficiency virus, has led physicians throughout the world to obviate this conventional intervention to the extent that is possible.

Research in the literature

In 1999, Canadian investigators examined the effects of a restrictive RBC transfusion strategy in comparison to a liberal strategy in critically ill patients. They indicated that a restrictive strategy was at least as effective as and possibly superior to a liberal transfusion strategy in critically ill patients with some exceptions.

Although several debates are currently ongoing, most physicians now agree that a restrictive strategy to limit RBC transfusion is a valuable approach in the treatment of stable patients with anemia.

However, we need to be cautious when interpreting the results of the Canadian study as it indicated some exceptions.

Even though we have seen extraordinary advances in medical science and related technology over the last several decades, clinical practices have been determined based on the balance between the benefits and related risks of intervention.

They found that a restrictive transfusion strategy was significantly associated with reduced mortality in younger patients and in those with less severe conditions. In other words, a liberal RBC transfusion strategy might be more effective for older patients and patients with more severe conditions.

RBC transfusion by itself is not an exception. The level of hemoglobin that works in some patients may not work in others. Indeed, a previous cohort study of intensive care unit patients suggests that restrictive RBC transfusion policies may not be uniformly applicable in the clinical setting.

World Blood Donor Day

In 2012, the World Health Organization (WHO) released a document entitled, “ Blood donor selection – Guideline on assessing donor suitability for blood donation ”. In this guideline, the authors noted that a careful process to assess the suitability of donors is essential for protecting the safety and sufficiency of the blood supply, and safeguarding the health of both ‘recipients’ and ‘donors’. We should therefore understand that blood transfusion not only improves the recipients’ conditions but also affects the donors’ health.

Away from the discussion of whether restrictive or liberal RBC transfusion strategies should be applied, natural human blood is needed to save the lives in emergency and long-term treatment settings, even in the 21 st century.

If you believe yourself to be in good health, you should donate your blood to prove it and to save lives at the same time.

View the latest posts on the On Medicine homepage

• Latest Posts

Hiroshi Morisaki

Latest posts by hiroshi morisaki ( see all ).

• Topics in blood transfusion - 14th June 2016

Recommended posts

Popular on medicine tags.

• BMC Medicine
• clinical trials
• medical evidence
• Genome Medicine
• ISRCTN Registry
• Alzheimer's
• Alzheimer's Research & Therapy
• breast cancer

Popular posts

• Most shared

Sorry. No data so far.

Most Shared Posts

• Photobiomodulation therapy to prevent chemotherapy-induced oral mucositis
• A unique approach. A unique population. Investing in nurses’ mental health
• Does the midwife-led continuity of carer model improve birth outcomes and maternal mental health in vulnerable women?
• A proactive diabetes review model: from concept to nurse-led research
• Clinical Trials Day 2023: what about the trial participant?
• September 2024  (1)
• March 2024  (1)
• February 2024  (2)
• January 2024  (1)
• November 2023  (1)
• October 2023  (1)
• September 2023  (7)
• July 2023  (1)
• June 2023  (1)
• May 2023  (4)
• April 2023  (1)
• March 2023  (2)

• Research note
• Open access
• Published: 06 November 2019

Blood donors’ knowledge and attitude towards blood donation at North Gondar district blood bank, Northwest Ethiopia: a cross-sectional study

• Bamlaku Enawgaw   ORCID: orcid.org/0000-0002-3828-5318 1   na1 ,
• Aregawi Yalew 1 &
• Elias Shiferaw 1   na1  

BMC Research Notes volume  12 , Article number:  729 ( 2019 ) Cite this article

18k Accesses

21 Citations

7 Altmetric

Metrics details

Blood transfusion saves millions of lives. But, the need and the actual number of donations are not balanced in Ethiopia. The actual reason is not clearly assessed; however, level of knowledge and attitude may be the main contributing factors. Thus, the current study aimed to assess blood donors’ knowledge and attitude towards blood donation at North Gondar district blood bank.

Of 401 blood donors, 142 (35.4%) and 379 (94.5%) were had adequate knowledge and positive attitude towards blood donation, respectively. About 343 (85.5%) of study participants had no previous experience of blood donation. Perceptions of fear of pain, medically unfitness to donate and lack of information on when, where and how to donate blood were mentioned as a reason for not donating blood. Educational status and residence were significantly associated with knowledge of blood donors. On the other hand, participants with secondary and higher education were more likely to have good attitude towards blood donation. Thus, blood banks should design strategies for health education about blood donation and transfusion.

Introduction

Blood donation is remained the major source of blood and blood components worldwide. Even though extensive promising research have come up, a true substitute for blood and blood components is not available [ 1 ]. Donated blood is an essential component in the management of many diseases. It is the main lifesaving for an individual with loss of large volumes of blood from accidents, hemorrhages or surgery [ 2 ].

The source for blood to be transfused relies mainly on voluntary non-remunerated blood donors [ 3 ]. Even though over a million of blood units are collected every year, many more millions still need to be collected to meet the global demand, ensure the sufficient and timely provision of blood [ 4 ]. However, the demand and supply are not being balanced; the demand is escalating. This is the reason why in Sub-Saharan Africa replacement and paid donors are common in contrary to voluntary and non-remunerated donors [ 5 ].

Evidences showed that the annual global blood collection is 112.5 million units of blood. Over half of these units of blood are collected in developed countries. The blood donation rate per 1000 people in high income countries is more than fivefold compered to low income countries (33.1 vs 4.6 donations). Voluntary blood donors cover over 90% of donations in developed countries while they account below 50% in developing countries [ 6 ].

Ethiopia is a country with high maternal mortality (676 per 100,000) and high motor accident and with a large nonimmune population for malaria [ 7 ]. There is insufficiency and in-equitability in access to blood. The average annual national requirement for blood in Ethiopia is 100,000 units per year, but only 43% is collected [ 8 ]. From WHO African countries, Ethiopia has the least number of voluntary blood donors (VBD) with 22% which is extremely very low [ 9 ].

The availability and safety of blood still remain inadequate to meet the increased demand of blood and blood components particularly in Sub-Saharan Africa like Ethiopia [ 5 , 10 ]. As a result, these countries try to compensate their blood demand from family replacement or paid donors. But in this type of donors, higher rates of transfusion-transmitted infections have been documented [ 6 ]. It is explained that healthy VBD donate their blood by their own free will without any pressure, whereas family replacement donors donate blood for fear of loos of their relatives without considering their health status [ 11 ].

The actual reason why large proportion of the potentially eligible population do not actively donate blood is not clearly assessed in Ethiopia. The blood donors’ attitude, beliefs, and knowledge may be a factor for not being a blood donor. Thus, the current study was aimed to assess blood donors’ knowledge and attitude towards blood donation at North Gondar blood bank district, Northwest Ethiopia. The findings will be used as a baseline information for the blood banks to plan an effective strategy to increase and maintain safe and adequate blood supply.

Study setting and population

A cross-sectional study was conducted on 401 blood donors at North Gondar blood bank district, Northwest Ethiopia. This blood bank is the only blood bank center located in Gondar for North Gondar, Amhara regional state, at 738 km far from Addis Ababa, capital city of Ethiopia. The blood bank gives serves for the surrounding hospitals in the district.

Sample size determination and sampling technique

To determine the required sample size for study, a single population proportion formula was used as denoted below.

where z α/2 = 1.96 at 95% confidence interval, p = 50% because there is no previous study, d = 5% which is tolerable error between the sample and true population.

Considering 5% non-response rate (384 × 5% = 19), the final sample size becomes 403. The study participants were selected randomly from the blood donors in the blood bank.

Data collection

The study participants were interviewed during blood donation after obtaining written informed consent. We used a structured pretested questionnaire to collect socio-demographic data, knowledge, attitude, previous blood donation history and reasons for not donating blood previously. In addition to pretest, training was given for data collectors about data collection procedures and objectives of the study. Consistency of the collected data was also checked daily.

Knowledge assessment towards blood donation

We used nine questions to assess knowledge of blood donors. For the “correct” and “incorrect” response, “1” and “zero” score were used, respectively. Then the total score was obtained by summing up of the nine knowledge questions score. The scoring ranges from 0 to 9. Those blood donors who answer “five” and more questions correctly from 9 (> 50%) were considered as knowledgeable.

Attitude assessment towards blood donation

In this study, attitude was assessed using eight questions. Similar to knowledge scoring “1” and “zero” were used for favorable and unfavorable attitude, respectively. The total score was calculated up to determine the total attitude score. The score was ranged from 0 to 8. Attitude score of half and more (50%) was considered as favorable attitude.

Data analysis and interpretation

Data were entered with Epi info 3.5.1 and transported to SPSS 20 for analysis. Descriptive results were summarized and presented with tables. The association of the independent variable with the categorical outcome variable was measured by calculating odds ratio with 95% confidence interval using bivariate and multivariate logistic regression. P value < 0.05 was considered as statistically significant.

Sociodemographic characteristics of study participants

In this study a total of 401 (259 male and 142 female) study participants was included. The response rate was 99.5% (401/403). The mean age of study participants was 26.2 ± 8.2 years ranging from 18 to 57 years old. The majority 212 (52.9%) of them was in the age group of 18–23 years. More than half 235 (58.6%) of the donors had been attending higher education. Majority 188 (46.9%) and 281 (70.1%) of the study participants were students and single in marital status, respectively (Table  1 ).

Knowledge of study participants

From the total study participants, 142 (35.4%) had adequate knowledge towards blood donation. The mean knowledge score of the participants was 4.03 ± 1.44. All of the study participants argued that the importance of blood donation is to save life. From the total study participants, 380 (94.8%) of them had information regarding screening of donated blood for infectious disease before transfusion. But only 20 (5.0%) of the study participants knew HIV, hepatitis virus and syphilis are considered as transfusion transmittable infections (Additional file 1 ).

Attitude of the study participants

Nearly all [379 (94.5%)] of the study participants had favorable attitude towards blood donation. The mean attitude score of the participants was 7.48 ± 1.23. Majority 365 (91.0%) of the participants had a plan to donate blood voluntarily in the future and about 360 (89.8%) of the study participants had plan to become a regular blood donor. Majority 373 (93%) of the study participants had a perception of donation is not harmful to donors (Additional file 1 ).

Previous practice of blood donation

Less than one quarter 58 (14.5%) of study participants had previous history of donation and more than half 229 (57.1%) of them were replacement type of donors. Several factors have been mentioned as a reason for not donating blood previously. About 139 (40.5%) of the blood donors mentioned lack of information (when, where and how to donate) as the main reason for not donating blood previously. Fear of pain, perceptions of unfitting to donate and consideration of donation as harmful practice had also been mentioned as a reason for not donating blood previously (Additional file 2 ).

Factor associated with knowledge of blood donors

In multivariate logistic regression analysis educational status, residence, previous donation history and donor type were significantly associated. Study participants who attained higher education (AOR = 2.8, 95% CI 1.35, 6) and those who lived in urban (AOR = 2.5, 95% CI 1.26, 4.81), history of previous donation (AOR = 2.2, 95%CI 1.13, 4.48) and being volunteer blood donors (AOR = 3.1, 95%CI 1.5, 6.56) were more likely to have adequate knowledge. Age, gender, marital status and occupation were not showed a statistically significant association (Table  2 ).

Factor associated with attitude of blood donors

Bivariate logistic regression analysis showed that age, educational status, occupation, residence and marital status were significantly associated with attitude of participants. While in multivariate logistic regression analysis none of them were statistically significant. Variables such as gender, previous donation history and donor type did not fulfil the criteria for logistic regression analysis and were excluded from analysis (Table  3 ).

In this study about one-third of blood donors had adequate knowledge towards blood donation. The result was slightly higher than a study conducted in Jordan which reported that 28.6% of them had adequate knowledge towards blood donation [ 4 ]. The possible reason for this discrepancy might type of blood donors. In our study, the number of replacement type of blood donors was relatively low (229 vs 348). It is strongly believed that volunteer blood donors are more likely to have good knowledge towards blood donation compared to replacement type donors and it is considered as major contributing factor for blood donation. This study showed that 61% of voluntary and 16.2% of replacement blood donors had adequate knowledge.

On the other hand, the level of knowledge in this study was lower than studies from Gondar [ 12 ], Bahir Dar [ 13 ], Wolita Sodo [ 14 , 15 ], Tigray [ 16 ], Birbir Town [ 17 ], Harar [ 18 ], Basrah, Iraq [ 19 ] and India [ 20 ]. The difference may be associated with the type of study subjects included in the studies. The above-mentioned studies include medical and health science students and also health care workers. Thus, it is expected that this group of people have high level of knowledge towards blood donation.

In the current study, all of the participants argued that the importance of blood donation is to save life. But a previous report from Gondar town showed a slight deviation result of 88.3% [ 21 ]. Similarly, it was higher than a study conducted in Democratic Republic of Congo which showed that only 183 (44.1%) of the study participants strongly advocates this idea [ 22 ]. The difference might be due to variation in study subjects (blood donors vs general population in the community).

In this study, participants who attained higher education and lived in urban were more likely to have adequate knowledge towards blood donation. This is supported by studies in Birbir Town [ 17 ] and Harar [ 18 ] in which individuals with higher education has high level of knowledge. Similarly, those donors who were donate blood previously and volunteer donors were had adequate knowledge compared to their counterparts. This is true that if someone had experience, he/she has high level of knowledge. Thus, it is not surprise that if the donors with previous history had adequate knowledge.

Regarding to attitude, nearly all of the respondents had a good attitude towards blood donation. The finding was slightly higher as compared to the previous report from Gondar [ 12 , 21 ], Bahir Dar [ 13 ], Wolita Sodo [ 14 , 15 ], Tigray [ 16 ], Birbir Town [ 17 ], Harar [ 18 ], Basrah, Iraq [ 19 ] and India [ 20 ]. The difference might be due to variation in study method and subjects since the current study was institutional based study conducted among the blood donors.

We tried to assess the association of blood donors’ characteristics with their attitude. Variables such as age, educational status, occupation, residence and marital status were assessed, but none of them showed statistically significant association. Nearly all (94.5%) of the study participants had favorable attitude towards blood donation.

In this study, attitude towards blood donation was high, but the level of knowledge was inadequate. Education, residence, previous blood donation and donor type were statistically associated with adequate knowledge. To increase the level of knowledge towards blood donation, health education to the community is recommended.

Limitations

The findings in this study are from one district and only interview-based data were collected. There was no focus group discussion for further analysis of the knowledge and attitude of the participants.

Availability of data and materials

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Abbreviations

Adjusted Odds Ratio

confidence interval

Crude Odds Ratio

hepatitis B virus

hepatitis C virus

voluntary blood donors

World Health Organization

voluntary non-remunerated blood donors

Nwogoh B, Aigberadion U, Nwannadi AI. Knowledge, attitude and practice of voluntary blood donation among healthcare workers at the university of Benin teaching hospital, Benin city. Nigeria. J Blood Transfus. 2013;2013:797830.

PubMed   Google Scholar  

WHO. WHO AFRO: blood safety. 2013. https://www.afro.who.int/health-topics/blood-safety . Accessed 25 Oct 2019.

Uma S, Arun R, Arumugam P. The knowledge, attitude and practice towards blood donation among voluntary blood donors in Chennai,India. J Clin Diagn Res. 2013;7(6):1043–6.

Google Scholar  

Abderrahmana BH, Salehb MY. Investigating knowledge and attitudes of blood donors and barriers concerning blood donation in Jordan. Procedia Soc Behav Sci. 2014;116:2146–54.

Article   Google Scholar  

Osaro E, Charles AT. The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood. J Blood Med. 2011;2:7–21.

WHO. Blood safety and availability. Geneva: WHO; 2016.

Central Statistical Agency. Ethiopia demographic and health survey. Addis Ababa: Central Statistical Agency; 2012.

World Health Organization. Regional Office for Africa. Status of blood safety in the WHO African region: report of the 2010 survey. 2014. https://apps.who.int/iris/handle/10665/104446 . Accessed 25 Oct 2019.

Bates I, Chapotera GK, McKew S, van den Broeka N. Maternal mortality in sub-Saharan Africa: the contribution of ineffective blood transfusion services. BJOG. 2008;115(11):1331–9.

Article   CAS   Google Scholar  

Sanayaima DH, Jalina L, Shantibala K, Vijaya E. Knowledge, attitude and practice (KAP) of blood safety and donation. Ind Med Gaz. 2012;145(1):1–5.

Messih IYA, Ismail MA, Saad AA, Azer MR. The degree of safety of family replacement donors versus voluntary non-remunerated donors in an Egyptian population: a comparative study. Blood Transfus. 2014;12:159–65.

PubMed   PubMed Central   Google Scholar  

Melku M, Asrie F, Shiferaw E, Woldu B, Yihunew Y, Asmelash D, et al. Knowledge, attitude and practice regarding blood donation among graduating undergraduate health science students at the University of Gondar, Northwest Ethiopia. Ethiop J Health Sci. 2018;28(5):571–82.

Abera B, Mohammed B, Betela W, Yimam R, Oljira A, Ahmed M, et al. Knowledge, attitude, and practice towards blood donation among health care providers in hospitals at Bahir Dar City Ethiopia. Transfus Apher Sci. 2017;56(3):434–8.

Malako D, Yoseph F, Bekele ML. Assessment of knowledge, attitude and practice and associated factors of blood donation among health care workers in Ethiopia: a cross-sectional study. BMC Hematol. 2019;19:10.

Obsa MS, Weji BG, Dedecho AT, Worji TA. Assessment of knowledge, attitude and practice of graduating health science students towards blood donation at Wolaita Soddo University. J Blood Disord Transfus. 2018;9:1.

Tadesse T, Berhane T, Abraha TH, Gidey B, Hagos E, Grum T, et al. Blood donation practice and associated factors among health professionals in Tigray regional state public hospitals, northern Ethiopia. BMC Res Notes. 2018;11:677.

Addisu AG, Sultan H, Deginet T, Addishiwot Z, Samuel T. Assessment of knowledge, attitude and practice of voluntary blood donation and associated factors among residents of Birbir town. J Community Med Health Educ. 2017;7(504):2161-0711.

Urgesa K, Hassen N, Seyoum A. Knowledge, attitude, and practice regarding voluntary blood donation among adult residents of Harar town, eastern Ethiopia: a community-based study. J Blood Med. 2017;8:13–20.

Al-Asadi JN, Al-Yassen AQ. Knowledge, attitude and practice of blood donation among university students in Basrah, Iraq: a comparison between medical and non-medical students. Asian J Med Sci. 2018;9(6):62–7.

Das K, Geetanjali, Sachdev S, Kaur B, Singh CI, Nongbri D. Knowledge, attitude and practice of blood donors toward blood donation. J Postgrad Med Edu Res. 2014;48(3):123–7.

Melku M, Terefe B, Asrie F, Enawgaw B, Melak T, Tsegay YG, et al. Knowledge, attitude, and practice of adult population towards blood donation in Gondar Town, Northwest Ethiopia: a community based cross-sectional study. J Blood Transfus. 2016. https://doi.org/10.1155/2016/7949862 .

Article   PubMed   PubMed Central   Google Scholar  

Kabinda JM, Miyanga SA, Ramazani SY, Dramaix M-W. Assessment of knowledge, attitude and practice of the general population of bukavu in the democratic republic of congo on blood donation and blood transfusion. Transfus Med Health care Oct. 2014;6(18):2525–34.

Download references

Acknowledgements

The authors would like to express a great gratitude to staffs of North Gondar District Blood Bank for their contribution during the data collection. The authors are also grateful to thank all the study participants and the University of Gondar for giving this opportunity to conduct this study.

The author(s) received no specific funding for this work.

Author information

Bamlaku Enawgaw and Elias Shiferaw equally contributed to the research

Authors and Affiliations

Department of Hematology& Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia

Bamlaku Enawgaw, Aregawi Yalew & Elias Shiferaw

You can also search for this author in PubMed   Google Scholar

Contributions

BE and ES participated in designing the study, supervised the data collection, analyzed, interpret and write up the manuscript. AY involve in proposal development, data collection and entry of data for analysis. BE and ES are the joint first authors of the paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bamlaku Enawgaw .

Ethics declarations

Ethics approval and consent to participate.

The research was conducted after securing ethical approval letter from Research and Ethical Review Committee of School of Biomedical and Laboratory Science, University of Gondar. Permission was asked from North Gondar District blood bank and written informed consent had been obtained from each study participant. To ensure confidentiality of participants’ information, anonymous typing was applied whereby the name of the participant and any identifier of participants were not written on the questionnaire, and during the interview to keep the privacy, they were interviewed alone.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Additional file 1..

Knowledge and attitude questions response of blood donors towards blood donation at North Gondar District Blood Bank, Northwest Ethiopia.

Additional file 2.

Blood donation practice of blood donors North Gondar District Blood Bank, Northwest Ethiopia.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Enawgaw, B., Yalew, A. & Shiferaw, E. Blood donors’ knowledge and attitude towards blood donation at North Gondar district blood bank, Northwest Ethiopia: a cross-sectional study. BMC Res Notes 12 , 729 (2019). https://doi.org/10.1186/s13104-019-4776-0

Download citation

Received : 08 July 2019

Accepted : 01 November 2019

Published : 06 November 2019

DOI : https://doi.org/10.1186/s13104-019-4776-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Blood donation
• Blood donors
• Northwest Ethiopia

BMC Research Notes

ISSN: 1756-0500

• General enquiries: [email protected]

• Bibliography
• More Referencing guides Blog Automated transliteration Relevant bibliographies by topics
• Automated transliteration
• Relevant bibliographies by topics
• Referencing guides

Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

• Vaccines  
• Masking Guidelines
• Visitor Guidelines  

Blood Banking

What is blood banking.

Blood banking is the process that takes place in the lab to make sure that donated blood, or blood products, are safe before they are used in blood transfusions and other medical procedures. Blood banking includes typing the blood for transfusion and testing for infectious diseases.

Facts about blood banking

According to the American Association of Blood Banks as of 2013:

About 36,000 units of blood are needed every day.

The number of blood units donated is about 13.6 million a year.

About 6.8 million volunteers are blood donors each year.

Each unit of blood is broken down into components, such as red blood cells, plasma, cryoprecipitated AHF, and platelets. One unit of whole blood, once it's separated, may be transfused to several patients, each with different needs.

Annually, more than 21 million blood components are transfused.

Who are the blood donors?

Most blood donors are volunteers. However, sometimes, a patient may want to donate blood a couple of weeks before undergoing surgery, so that his or her blood is available in case of a blood transfusion. Donating blood for yourself is called an autologous donation . Volunteer blood donors must pass certain criteria, including the following:

Must be at least 16 years of age, or in accordance with state law   

Must be in good health

Must weigh at least 110 pounds

Must pass the physical and health history exam given before donation

Some states permit people younger than 16 or 17 years to donate blood, with parental consent.

What tests are done in blood banking?

A certain set of standard tests are done in the lab once blood is donated, including, but not limited to, the following:

Typing: ABO group (blood type)

Rh typing (positive or negative antigen)

Screening for any unexpected red blood cell antibodies that may cause problems in the recipient

Screening for current or past infections, including:

Hepatitis viruses B and C

Human immunodeficiency virus (HIV)

Human T-lymphotropic viruses (HTLV) I and II

West Nile virus

Chagas disease 

Irradiation to blood cells is performed to disable any T-lymphocytes present in the donated blood. (T-lymphocytes can cause a reaction when transfused, but can also cause graft-versus-host problems with repeated exposure to foreign cells.)

Leukocyte-reduced blood has been filtered to remove the white blood cells that contain antibodies that can cause fevers in the recipient of the transfusion. (These antibodies, with repeated transfusions, may also increase a recipient's risk of reactions to subsequent transfusions.)

What are the blood types?

According to the American Association of Blood Banks, distribution of blood types in the U.S. includes the following:

O Rh-positive - 39%

A Rh-positive - 31%

B Rh-positive - 9%

O Rh-negative - 9%

A Rh-negative - 6%

AB Rh-positive - 3%

B Rh-negative - 2%

AB Rh-negative - 1%

What are the components of blood?

While blood, or one of its components, may be transferred, each component serves many functions, including the following:

Red blood cells. These cells carry oxygen to the tissues in the body and are commonly used in the treatment of anemia.

Platelets. They help the blood to clot and are used in the treatment of leukemia and other forms of cancer.

White blood cells. These cells help to fight infection, and aid in the immune process.

Plasma. The watery, liquid part of the blood in which the red blood cells, white blood cells, and platelets are suspended. Plasma is needed to carry the many parts of the blood through the bloodstream. Plasma serves many functions, including the following:

Helps to maintain blood pressure

Provides proteins for blood clotting

Balances the levels of sodium and potassium

Cryoprecipitate AHF.  The portion of the plasma that contains clotting factors that help to control bleeding.

Albumin, immune globulins, and clotting factor concentrates may also be separated and processed for transfusions.

Find a Doctor

Specializing In:

• Immunohematology
• Bone Marrow Transplant
• Blood Transplant
• Blood and Bone Marrow Transplant
• Blood Disorders
• Aplastic Anemia

Find a Treatment Center

• Bloodless Medicine and Surgery Program

Find Additional Treatment Centers at:

• Howard County Medical Center
• Sibley Memorial Hospital
• Suburban Hospital

Request an Appointment

Blood Donations / Blood Banking

Special Topic

101CE: Look Before You Leap with Rich Haspel

CE episode! New thoughts or ideas seem to pop up in transfusion medicine all the time. Dr. Rich Haspel has thoughts on how to evaluate the evidence, including his take on "low-titer group O whole blood" in trauma.

Read the Post

 May 5, 2023 |  1

100CE: Pearls of Wisdom (Centennial Episode!)

CE episode! This centennial episode marks a return of many previous guests, offering concise learning "pearls" for listeners of all levels.

 Mar 29, 2023 |  11

098CE: “Simply REDS” with Steve Kleinman & Cassandra Josephson

CE episode! The REDS research project has transformed transfusion medicine, and the REDS-IV-P phase co-chairs say the best is yet to come!

 Jul 18, 2022 |  2

096CE: Navigating Blood Shortages with Claudia Cohn

CE episode! Blood shortages happen, but the one associated with COVID-19 is unique. AABB Chief Medical Officer Dr. Claudia Cohn explains.

 Mar 30, 2022 |  5

094CE: Thalassemia Essentials with Sujit Sheth

CE episode! Thalassemia is an enormous global problem! Dr. Sujit Sheth is passionate about caring for patients with thalassemia, and he shares his passion with us on this special episode.

 Mar 2, 2022 |  5

084: COVID-19 Convalescent Plasma with Pampee Young and Ralph Vassallo

In the midst of the COVID-19 pandemic, does convalescent plasma from recovered patients offer fresh hope for those who are critically ill?

 May 4, 2020 |  6

083CE: Building the Perfect Transfusion Committee with Carolyn Burns

Is your hospital transfusion committee doing what it should be doing? Carolyn Burns is back to help guide you to a better experience! NOTE: CE credit has expired for this episode.

 Apr 27, 2020 |  2

082: COVID-19 and the Blood Supply with Louis Katz

Emergency episode! Blood banks, hospitals, and blood donors need to know what to do about COVID-19 now. Lou Katz explains. Recorded 3/16/20.

 Mar 16, 2020 |  10

081CE: Top Ten Changes in the NEW AABB Standards with Rich Gammon

April 1, 2020 brings another AABB Standards update, and Standards Committee Chair Rich Gammon walks you through your action items. NOTE: CE credit has expired for this episode.

 Mar 11, 2020 |  0

079: Pioneering Pathogen Reduction with Ray Goodrich

Long ago, pathogen reduction was just a dream, but pioneers like Ray Goodrich figured it out. He talks the past, present and future of PRT.

 Jan 30, 2020 |  2

073: Implementing Trauma Whole Blood with David Oh and Mike Goodman

What's cold is hot again! You need to hear how one large US center implemented cold-stored whole blood for trauma transfusion.

 Jul 10, 2019 |  3

065: Transfusion and Jehovah’s Witnesses with Jed Gorlin

Jehovah's Witnesses refuse transfusion based on religious beliefs, but blood bankers are still important in their care. Jed Gorlin shows us why.

 Mar 18, 2019 |  6

061CE: Better AABB Assessments with Anne Chenoweth

You know all about AABB Standards, but how do you make them practical? Anne Chenoweth gives us tips to make your next AABB assessment better! NOTE: CE credit has expired for this episode.

 Dec 12, 2018 |  9

055CE: 2017 Critical Developments with Claudia Cohn and Melissa Cushing

"I never KNEW about that paper!" All too common, right? Two editors of a synopsis of 2016-17 BB/TM literature summarize what you should know. NOTE: CE credit has expired for this episode.

 Aug 17, 2018 |  3

046: Top 5 Changes in the NEW AABB Standards with Pat Ooley

Pat Ooley, Chair of the BBTS Standards Committee, outlines the top 5 changes in the 31st edition of AABB Standards (which went live April 1, 2018).

 Feb 6, 2018 |  17

045: Past, Present, & Future with Harvey Klein

In 40+ years at the NIH, Dr. Harvey Klein has seen it all in Transfusion Medicine! Hear his fascinating stories and opinions on the Past, Present, & Future.

 Jan 24, 2018 |  0

037: How to Learn with Justin Kreuter

What if everything we "know" about learning is wrong, and we need to change how we teach? Justin Kreuter "flips the classroom" to help us.

 Aug 21, 2017 |  2

031: Why All Blood Bankers Should Be on Twitter

Twitter is great for both young and "old" blood bankers. This roundtable discussion explains why you should dive in!

 May 15, 2017 |  5

009: Awesome Presentations with Kristine Krafts

It's easy to give a lousy presentation, but doing it right is SO much better! Kristine Krafts has 5 tips for AMAZING presentations!

 May 23, 2016 |  0

000: Introduction with Joe Chaffin

Welcome to the Blood Bank Guy Essentials Podcast, a new project from Joe Chaffin! This quick episode tells you what to expect and learn.

 Mar 30, 2016 |  4

Pin It on Pinterest