This January @NHSBT are focussing on recruiting more male donors but why are men so important as blood donors? Which components are specifically made from donations from men and why? @bloodmed challenged me to a tweetorial on this topic, so here it is!
@NHSBT@bloodmed 2/ There are a number of differences between men and women (we’ll focus on those having a direct influence on blood donation here!);
@NHSBT@bloodmed 3/ Men can’t be pregnant. This means they are not at risk of making human leucocyte antibodies, unless they have been transfused; anyone who has had a transfusion since 1980 cannot donate blood in the UK transfusionguidelines.org/dsg/wb/guideli…
@NHSBT@bloodmed 4/ 1-14% women have HLA abs after their 1st pregnancy, 20-50% multiparous women have HLA abs (rates vary according to the type of test used). #haemSpRs should bear this in mind when requesting HLA ab testing in the setting of platelet refractoriness... karger.com/Article/FullTe…
@NHSBT@bloodmed 5/ Next question: What transfusion reactions are caused by donor HLA antibodies?
@NHSBT@bloodmed 6/ HLA antibodies are implicated in TRALI and FNHTR. HLA antibodies are found in plasma, so to reduce the risk of HLA antibodies being present in blood components, @NHSBT only provide plasma donated by men.
@NHSBT@bloodmed 7/ Imported plasma is from men or HLA-tested women. Plasma from men is used to suspend pooled components such as platelets and granulocytes. Apheresis platelets are taken from men, or women who do not have HLA antibodies.
@NHSBT@bloodmed 8/ Since using male-only plasma and cryo for transfusion, the incidence of TRALI has reduced from to 15.5 per million units of FFP to 3.2 per million.
@NHSBT@bloodmed 9/ Plasma is the most commonly known component to be made from males, but are male donations useful for anything else?
@NHSBT@bloodmed 10/ Men have higher iron stores than women (as they do not menstruate) so they can donate red cells more often than women (every 12 vs 16 weeks).
@NHSBT@bloodmed 11/ Men tend to have a larger circulating blood volumes. This means they are more likely to be able to be an apheresis platelet donor. Check out the donor eligibility for platelet donation here platelets.blood.co.uk/pdf/PD_eligibi…
@NHSBT@bloodmed 12/ Finally, red cells for intrauterine transfusion are from male donors, as are red cells for neonatal exchange and for large volume transfusions and for neonates and infants. Details of the requirements for all NHSBT components can be found here nhsbtdbe.blob.core.windows.net/umbraco-assets…
@NHSBT@bloodmed 13/ Last year, for every 100 women who started donating, only 70 men started donating. Currently, only 43% of donors in England are male. If more of our regular donors were men this would help to ensure a safe and secure blood
supply now and in the future.
I had a personal request to do a tweetorial for the #haemSpRs on haemovigilance. Here goes. A #blooducation 🧵
Haemovigilance is a systematic surveillance of adverse reactions and adverse events related to transfusion’ with the aim of improving transfusion safety. transfusionguidelines.org/transfusion-ha…
We are very lucky in the UK to have @SHOTHV1, one of the first in the world to collate adverse events relating to transfusion - since the 1990s.
This morning I met with the chair and vice chair of the Midlands Regional Transfusion Committee, the Midlands Patient Blood Management Practitioner and the Customer Services Manager. What are their roles and what does the RTC do?
A #blooducation 🧵
RTCs serve to bring together Hospital Transfusion Committees to discuss best practice, implement new guidance and provide educational resources and events. They are run by clinicians and scientists working in hospitals, supported by @NHSBT.
Teaching our incoming haematology doctors today about transfusion in haematology patients. So who needs irradiated blood and why? A #blooducation🧵
All blood in the UK is leucocyte reduced (except granulocytes, but that’s another story). Despite this, a unit of red cells or platelets can have around a million residual white cells, mostly lymphocytes.
Every doctor starting in a new trust does transfusion training as part of their mandatory training. But why?
50ml ABO incompatible blood can kill a patient. ABO antibodies are naturally occurring (“everyone” has them) and they are IgM; they can activate complement and cause *immediate* intravascular haemolysis, causing release of free haem, endothelial activation, renal failure and DIC.
In most hospitals, blood banks require 2 samples (one may be historic) before releasing group specific (non-O) blood for a patient. This is to increase the chances of identifying a *wrong blood in tube* (pt whose blood's in the tube is not the pt whose details are on the outside)
It can be difficult to know where to start with transfusion – you can’t go on a ward round to find patients. BUT you do start with lab induction and your helpful #BMSes will show you around.
Excellent session on emergency paediatric transfusion #AABB20. Cyril Jacquot talking on pre hospital transfusion and summarising the literature.
28 day mortality following haemorrhage is higher in children than adults (unpublished data and substudies from PROPPR and PROMMTT)
Observational studies of large numbers of patients but with only very small numbers of paediatric patients suggest that pre hospital blood is not associated with an excess of transfusion reactions and in some studies is thought to have improved survival.
Whole blood, group O, high titre neg, used in paediatrics in Pittsburgh appears to be safe with no haemolysin-mediated haemoylsis in non group O patients (Leeper et al JAMA Pediatrics 2018) ncbi.nlm.nih.gov/pmc/articles/P…