• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.273-281
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• 2018

Background: Ferritin is used to detect iron overload in patients with chronic red blood cell transfusions. Although ferritin reflects the amount of iron storage in the body, it may increase nonspecifically in inflammation and infection. This study analyzed the cause of increased ferritin and the association with a red blood cell (RBC) transfusion. Methods: The medical records of patients who visited the authors' hospital from January to December 2017 and underwent a ferritin test were reviewed retrospectively. Hyperferritinemia was defined as a ferritin level more than 1,000 ng/mL. The causes of hyperferritinemia were investigated by examining the laboratory findings and medical records. Results: The results revealed 417 cases of hyperferritinemia in 238 patients during the period. The most common diseases were hematologic malignancies from 125 cases (30.0%) in 31 patients and infectious diseases were the second most common. Iron overload was suspected in 119 cases in 33 patients, and 12 patients (76 cases) were transfused with more than 8 units of RBC for 1 year before the test. Conclusion: In hyperferritinemia, the rate of iron overload is high considering the underlying diseases and chronic RBC transfusion. To determine iron storage status accurately, it will be helpful to measure the C-reactive protein (CRP) and iron saturation in the ferritin test. Careful attention should be paid to habitual iron formulations and frequent transfusions due to the possibility of iron overload.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.1
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• pp.36-40
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• 2016

Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. The discrepancy of RBC antibody screening test occurs when the results of red cell tests do not agree with those of the serum test. In order to select the proper blood units for transfusion, clarification of the cause of discrepancies is essential. The RBC antibody screening test is an easy, quick, and reliable method for detection of clinically significant antibodies. Antibody screening and identification is recommended prior to transfusion to determine whether there is blood group incompatibility. We reported that phenotyping for E, D, M, E+c, and C+e antibody screening test should be extended. Therefore, these results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population. We suggested that its antibody screening be adapted to blood safety interventions. Targeted screening of selected recipients at risk offers less value than universal antibody screening, and more research is needed to determine the real incidence of this national condition.

• Biomedical Science Letters
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• v.23 no.2
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• pp.111-117
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• 2017

Leukocytes in blood components are involved in diverse adverse transfusion reactions such as febrile non-hemolytic transfusion reactions. Therefore, leukocyte reduction is required to reduce these adverse reactions. The objective of this study was to compare the efficiency of pre-storage filtration and post-storage filtration. Filtration time, residual leukocyte count, RBC recovery, and hemolysis were assessed after pre-storage or post-storage filtration. Compared to pre-storage filtration, filtration time was prolonged and hemolysis was dramatically increased when post-storage filtration was performed. Residual leukocytes count and RBC recovery after post-storage filtration were similar with those obtained after pre-storage filtration. These results suggest that pre-storage filtration has better efficiency than post-storage filtration. These are thought to contribute to the production of better quality of leukoreduction blood components.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.95-103
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• 1990

Autologous transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs is very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2/21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean haematocrits before and after hpebotomy were 34.1 % and 31.8 % respectively. It was statically significant(p<0.01). We recommended that autologous blood donation by pregnant women in third trimester is safe for mothers or infants and it should be strongly encouraged for patient with placenta previa and repeated cesarean section.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.108-114
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• 1993

The risks of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. This is a report concerning 29 consecutive adult with no blood conservation patients (Group I) who had an elective cardiac operations. A similar group of 29 patients operated on 1992 but with blood conservation (Group II). In I of Group I patients and 15 of Group II patients, no homologous blood products were required. Group II patients used significantly less fresh frozen plasma (2.05${\pm}$0.68 unit versus 6.52${\pm}$0.72 unit, p<0.05) and the homologous blood transfusion (0.42${\pm}$0.9 unit versus 3.64${\pm}$0.17 unit, p<0.05) than Group I patients. Group II patients had also significantly less postoperative bleeding (338${\pm}$39.9 ml versus 585${\pm}$93.0 ml, p<0.05) than Group I patients. Group II patients recieved 460${\pm}$62.6 ml of mediastinal shed blood in acquired group. In conclusion, a simple and inexpensive blood conservation program, mainly combining autologous blood removal before bypass, retransfusion of the volume remaining in the oxygenator, and consistent autotransfusion of mediastinal shed blood has enabled us to avoid infusion of homologous blood in 15/29 patients of Group II patients. No side effects or complicatinos could be related to the blood conservation program.

• Biomedical Science Letters
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• v.12 no.1
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• pp.35-42
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• 2006

Alloimmunization to red blood cell (RBC) antigens may cause a delayed hemolytic transfusion reactions (DHTR) and a delayed serologic transfusion reactions (DSTR). In the present study, the frequency of alloimmunization and its clinical significance were evaluated. Also, transfusions were correlated with antibody formation. Alloimmunization rate was 0.63%. Alloimmunization rate in multiple transfused patients was 24.5%. The most common clinically significant alloantibodies of alloimmunized patients were found to be Rh antibodies (52.6%). Nine patients out of 38 (23.7%) became undetectable after the first detection. To be positive at antibody screening test after RBC transfusion was mean transfused numbers: 3.7 units, mean transfused periods: 56 days, mean transfused frequencies: 1.7 times. The results from antibody specificity and RBC transfusions were comparatively analyzed and it shows that Rh system antibodies were longer than other antibodies (P<0.05). In case of disease group, malignant diseases was longer than other diseases (P<0.05). In order to prevent the formation of RBC alloimmunization, irregular antibody screening tests were performed at propriety intervals in multiple transfused patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.2
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• pp.180-189
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• 2015

Purpose: The purpose of this study was to identify the types of errors that occurred and were recovered in a simulated transfusion scenario by nursing students. Methods: Twenty-eight teams of a total of 89 nursing students participated in a transfusion simulation using a high fidelity simulator. Data were collected by observing rule based errors and built in errors recovered according to the framework of Eindhoven model. Reflective journaling was used to identify perceived safety-threatening errors and commitment to improvement. Data were analyzed using descriptive statistics. Results: All teams committed the rule based errors in the scenario. The most common errors occurred in the coordination category related to communication with physician. Most of students perceived the transfusion reaction as a safety-threatening error. Conclusion: The findings indicate that students lack patient safety competence. The simulation training to decrease errors and improve safe practice provides nursing students with an effective strategy to develop patient safety competence.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.36-40
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• 2014

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1791-1795
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• 2013

Aims and Background: Prostate cancer is one of the most common malignant tumors in the male reproductive system, which causes the second most cancer deaths of males, and control of angiogenesis in prostate lesions is of obvious importance. This study assessed the effect of apogossypolone (ApoG2) on proliferation and apoptosis of human umbilical vein endothelial cells (HUVECs). Subjects and Methods: HUVECs were treated with different concentrations of ApoG2. The survival rate of HUVECs were determined by MTT assay. Utrastructural changes of HUVECs were assessed with transmission electron microscopy. Apoptosis in HUVECs was analyzed by flow cytometry and cell migration by Boyden chamber assay. Matrigel assays were used to quantify the development of tube-like networks. Results: ApoG2 significantly inhibited HUVEC growth even at 24 h (P<0.05). The inhibitory effect of ApoG2 is more obvious as the concentration and the culture time increased (P<0.05). These results indicate that ApoG2 inhibits the proliferation of HUVECs in a time- and concentration-dependent manner with increase of the apoptosis rate. Besides, ApoG2 reduced the formation of total pseudotubule length and network branches of HUVECs. Conclusions: The results suggest that ApoG2 inhibits angiogenesis of HUVECs by growth inhibition and apoptosis induction.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.