International Blood Research & Reviews

Penetrating Stab Wounds of the Spine: Two Cases and Review of the Literature

2023-07-15T13:11:55+00:00

Penetrating wounds of the spine caused by edged weapons are on the increase due to the growing insecurity, violence, availability and accessibility of these weapons, which are generally objects of everyday use (knife, axe, machete, screwdriver, bicycle spoke, scissors, garden fork, sickle and sharpened broom handle, etc.). These objects may be the cause of penetrating wounds responsible for neurological deficits with breaches of the dura mater, or they may be without neurological deficits due to the level of the weapon in the spine. We present two clinical cases of patients with penetrating knife wounds of the spine. One at cervical level with pneumorrhagic emphysema, spinal cord compression and pneunemoencephaly, with neurological deficit who had a surgical intervention followed by physiotherapy and a progressive recovery, the other with a penetrating wound at L5 crossing the blade to the vertebral body without neurological deficit in whom the knife was extracted at the emergency department without secondary deficit.

Penetrating wounds of the spine are caused by stab wounds, including knives. In particular, emphysema, diffuse pneumorrhagia and pneumoencephalus are extremely rare in the same patient, this being due to the knife extraction technique. These lesions, associated with neurological deficit and cerebrospinal fluid (CSF) leakage, constitute a neurosurgical emergency.

Platelet Storage: Time to Rethink the Cold

2023-08-24T09:08:37+00:00

Platelet concentrates (PCs) are widely used in transfusion medicine for therapeutic purposes and their demand is constantly on the rise. Current storage regulations make this product highly susceptible to bacterial contaminations and platelet storage lesions (PSL) causing the need for alternative storage methods to be considered. The implementation of cold storage not only reduces unnecessary wastage of valuable donations and overall costs but also decreases both the risk of bacterial contamination and the occurrence of PSL. The current study aimed at determining how a prolonged cold storage may affect PCs. This was accomplished by investigating two different PC cohorts of 10 units each. One of the cohorts, labelled as ‘Room Temperature’, was stored at 22℃±2℃ for 5 days and then transferred to a temperature of 4℃±2℃. The other cohort, labelled as ‘Cold’, was stored directly at 4℃±2℃. Both cohorts were stored for a total of 21 days and platelet indices, platelet counts, pH, and platelet factor IV (PF4) were measured at different time intervals. Sterility was performed on Day 21. The key findings showed no significant difference in mean platelet count, platelet distribution width (PDW), mean platelet volume (MPV), platelet-large cell ratio (P-LCR), and plateletcrit (PCT) between the two cohorts. On the other hand, a significant difference in mean pH and PF4 resulted between the two cohorts. Moreover, no significant difference in mean platelet count, and PCT was found between Days 1, 5, or 10, and Day 21 in both cohorts. However, an overall significant difference in mean PDW, MPV, P-LCR and pH was discovered between Days 1 and 21, Days 5 and 21, and Days 10 and 21 in both cohorts. Regards PF4, a significant difference was detected between Days 1 and 21, and Days 10 and 21; however, no significant difference was found between Days 5 and 21 in both cohorts. Corynebacterium freneyi and Microbacterium liquefaciens, were cultured from 1 unit of the room temperature cohort after it was flagged positive during the sterility testing. In conclusion, through the implementation of a delayed cold storage system, PCs can be safely administered to the patient.

Systematic Review of Genetic-Related Risk Factor and Inhibitor Epidemiology in People with Severe Hemophilia a from Africa: A 2023 Update

2023-10-09T13:24:40+00:00

Background and Aims: Prevalence of factor VIII inhibitors in patients with hemophilia A varies from study to study, ranging from 15% to 30%. The important risk of inhibitor development is factor VIII mutation responsible for hemophilia A. Few studies have reported factor VIII mutations in Africa. The aim of this study was to review on FVIII gène mutations of severe hemophilia A in Africa and those associated with inhibitor development.

Study Design and Methodology: A systematic review was carried out using the electronic databases Pubmed, Science Direct, Index Medicus Global and African Journals online and the key words "hemophilia A", "inhibitor", "genetic" and "Africa". Studies written in French or English on the African continent and published between 2012 and 2023 were included. Publications relating to acquired hemophilia and duplicates were excluded. In the end, 17 articles were selected.

Results: The factor VIII mutations involved in severe hemophilia A in Africa are variable, consisting of intron 22 inversion, large or point deletions, nonsense and missense mutations and splicing abnormalities. Among the latter, numerous previously unrecorded mutations have been identified, and a single case of intron 1 inversion has been found in Algeria. Prevalence of factor VIII inhibitors in severe hemophilia A in Africa varies between 7,8% and 30%. Genetic abnormalities associated with inhibitors include intron 22 inversion, large deletions such as exon 1-13 deletion, nonsense mutations and c.1010-2A>G mutation.

Conclusion: A better knowledge of the factor VIII mutations involved in severe hemophilia A in Africa will help improve patient management.

Risk Factors of avascular Osteonecrosis of the Femoral Head in Children at the National Reference Center for Sickle Cell Disease in Brazzaville, Congo

2023-05-02T11:30:51+00:00

Introduction: The avascular osteonecrosis of the femoral head (AOFH) is a common complication of sickle cell disease (SCD). It exposes to lameness and sometimes to a very debilitating handicap. It is a source of desocialization, particularly in developing countries where prosthetic surgery remains inaccessible to the majority. This survey aimed to identify the risk of occurence AOFH.

Materials and Methods: It was a case-control study carried between october 2017 and september 2021 at the National Reference Center for SCD « Antoinette Sassou Nguesso » in Brazzaville. It concerned 31 children with clinical and radiographic signs of AOFH. Clinical (age at diagnosis of SCD, frequency of vasoocclusive crises and hospitalization for vasoocclusive crises, number of blood transfusion) as well as hematological examination (blood count in the intercritical period) and hydroxyurea treatment were compared with those of 62 children with no clinical and radiographic signs of AOFH. The chi2 statistical test and the odds ratio were used for the comparison (P ˂ 0.05).

Results: The sex ratio was 1.38 versus 0.93 (p = 0.50). The mean age of diagnostic of SCD was 3.76 ± 2.56 years versus 3.94 ± 2.01 years (p = 0.81). Logistic regression showed that SCD children with AOFH had a significantly higher rate of annual frequency of VOC (4.16 ± 1.18 vs 2.91 ± 1.68; P = 0.015), annual frequency of hospitalization for VOC (3.74±1.65 vs 1.45 ± 1.28; P = 0.000) and number of blood transfusions (3.38 ± 2.69 vs 2.42 ± 2.32; P = 0.03).

Conclusion: Emphasis should be placed on the prevention and early management of acute complications of SCD. The role of hydroxyurea should be clarified by further work.

Serum Ferritin as an Indicator of Neonatal Anaemia

2023-05-15T12:01:55+00:00

Introduction: Haemoglobin levels are usually used to diagnose neonatal anaemia. By the time haemoglobin levels drop, body iron is depleted. Serum ferritin is the standard measure for assessment of iron levels in neonates and detects iron deficiency earlier than haemoglobin levels.

Aims: To determine the prevalence of low haemoglobin and ferritin levels amongst term and preterm newborn babies. To determine the value of serum ferritin in the diagnosis of low iron stores amongst term and preterm newborns.

Methodology: This was a cross sectional descriptive study carried out at the Neonatal Intensive Care Unit of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria between June and December 2014. The study included 140 newborns of all birth weights delivered at the UNTH. These were categorized into preterm (gestational age <37 completed weeks) and term (gestational age ≥37 completed weeks. Babies with C-reactive protein levels > 10mg/dl, who were intra-uterine growth restricted, and whose mothers had conditions associated with low iron stores were excluded from the study. Anthropometric measurements were done for all subjects. Haemoglobin estimation and ferritin assay were carried out and the prevalence of neonatal anaemia was determined using each of these.

Results: The range of haemoglobin concentration in the study population was 12.22g/gl – 22.80g/dl. The mean serum haemoglobin concentrations were 15.69mg/dl ± 1.58 and 16.45 ± 1.92 in the preterm and term babies respectively (t = 2.557, P = .0116). The prevalence of low haemoglobin concentrations amongst both preterm and term babies was zero= .024). The range of serum ferritin level in the study population was 20.6µg/l - 296µg/l. The mean serum ferritin levels were 63.13µg/l ± 23.93 and 133.67µg/l ± 50.14 in the preterm and term babies respectively (t = 10.623, P < .001). The prevalence of low serum ferritin in the study population was 22.14%, but was higher in preterm than term babies 35.7% vs 8.6%: (OR – 5.926, 95% C.I OR = 2.248 – 15.619)(P<.001).

Conclusion: Serum ferritin assay is more useful than haemoglobin as an indicator of anaemia during the neonatal period.

A Gift of Blood: Opinions and Experience of Voluntary Blood Donors on Repeat Blood Donation

2023-06-05T12:22:19+00:00

Donating blood is an essential practice that can help save lives. Effective strategies are necessary to attract and keep blood donors to meet the demand for safe blood. To evaluate the experience of voluntary blood donors in Zanzibar, a survey was conducted, and purposive sampling was used to select participants who had donated blood multiple times. The study involved interviewing 15 repeat blood donors, and the data collected was analyzed thematically. Two main themes emerged from the analysis: motivators and barriers. Despite a few negative effects, most participants had positive experiences with repeat blood donation, and only few experienced physical reactions during or after the process. The study concludes that blood donors in Zanzibar generally have good experience towards repeat blood donation, although community participation, education, and sensitization are needed to recruit and maintain more donors.

Evaluation of Some Haematological Metrics among Smokers in Port Harcourt, Rivers State, Nigeria

2023-06-23T11:25:38+00:00

Introduction: Smoking is extremely toxic and has had a significant negative impact on society. One of the leading contributors to preventable illness and mortality has been found to be cigarette smoking.

Aim: The goal of this study is to evaluate a few haematological metrics among smokers in Port Harcourt, Rivers State, and to verify the idea that smoking cigarettes either has a negative or favorable impact on these variables.

Methodology: In this cross-sectional study, 100 participants between the ages of 20 and 45 were included, 50 of whom were smokers and 50 non-smokers. Venipuncture was used to obtain blood samples from the patients, which was then put into an EDTA vial for a full blood count (FBC) and other haematological analysis. The full blood count and erythrocyte sedimentation rate (ESR) were done using Haemo Auto Analyzer, Model XP-300 KOBE Japan by SYSMEX and the Westergreen method respectively. In order to analyze the data, Graph Prism Pad 6.2 and Microsoft Office Excel 2016 were both used. Using the student's independent t-test, a comparative study of mean and standard deviation values for the various parameters for test and reference ranges was conducted.

Results: According to the findings, the average age of 50 smokers was 43.6200± 9.7250 years and that for the 50 non-smokers was 42.7800± 6.5440 years, which was statistically insignificant with p valve of 0.6130. Smokers’ haemoglobin level was 14.5080 ± 1.5590 (g/dL) and non-smokers was 12.1340 ± 0.70410 (g/dL). According to statistics, the level of Hb was significantly higher in smokers compared to non-smokers (P<0.0001). In comparison to non-smokers, the RBC count dramatically increased in smokers (P<0.0001) greater than in non-smokers at 5.2550 ± 0.6629 (x10¹²/L) and 4.6340 ± 0.5530 (x10¹²/L) respectively. While the total leucocyte count (TLC) in smokers is 8.0500 ± 1.8796 (x10⁹/L), compared to 6.8580 ± 1.2454 (x10⁹/L) in non-smokers. Statistics show that smokers have a higher total leucocyte count than non-smokers (P<0.0002). Smokers' platelet count is 255.7600±61.8351 (x10⁹/L) while non-smokers' is 216.5800±35.5752 (x10⁹/L).The study has statistically shown that smokers' platelet counts rose considerably in comparison to non-smokers (P<0.012).

Conclusion: It may be concluded that uninterrupted smoking has an undue negative impact on haematological parameters such that increase occur in values of Hb, RBC, TLC and platelets. Significantly, these changes may increase the risk of serious health issues such as heart related defects, hardening of the arteries, Vaquez-Osler disease. It is recommended that smokers have these metrics regularly monitored.

Statistical Analysis of Monocyte Monolayer Assay Validation in Brazilian Blood Donors

2023-07-22T10:20:54+00:00

Aims: To validate the monocyte monolayer assay (MMA) technique concerning its suitability for blood donor screening and its cost per test performed. The MMA is an in vitro simulation of the behavior of the antibodies, demonstrating the reactions that would occur in the endothelial reticulum system after a transfusion of incompatible red blood cells, indicating the risk of a hemolytic transfusion reaction and therefore of the clinical significance of the antibodies.

Study Design: Blood samples of alloimmunized patients, selected at random from a blood donation bank, were submitted to validation tests recommended by the Brazilian National Health Surveillance Agency for the approval of new testing procedures.

Place and Duration of Study: The following Brazilian institutions were involved between June 2009 and July 2010: Immunohematology laboratory of the Hematology and Hemotherapy Center of Santa Catarina state in Florianópolis, Department of Medicine (Medical Unit IV) and Department of Radiology of the Institute of Medical Sciences, Hospital Lahore in São Paulo.

Methodology: Ninety samples of alloimmunized patients treated by the Santa Catarina blood donors were used. The validation tests evaluated the selectivity, linearity, precision, and accuracy of the MMA method and determined the limits of detection and quantification. External validation of the method was performed by comparing these results with those of an independent laboratory in São Paulo, while making sure that the latter was blind to the results of the former. The coefficient of variation was used to express the MMA testing precision of 5 replicates across 5 different concentration levels. Type I error for evaluating statistical significance was set at 5%.

Results: Selectivity assessment of the impact of multiple alloantibodies on the MMA test result showed no statistically significant difference (P>0.05) across the titers of 64, 256, and 2048, each with three replications, thus confirming the test specificity. Homoscedasticity of the monocyte index (MI) data was not refuted by Levine's test with the F-value of 0.746, much below the value of 3.056 needed to achieve a statistical significance level of P<0.05. MI linearity against the logarithm of the alloantibody concentration was shown in a simple linear regression where the latter predicted 83% of the variation in the former, and the regression slope of 0.4 (95% confidence interval 0.32, 0.48). The limits of detection and quantification on the logarithm scale were 0.28 and 0.84, respectively. External validation found no statistically significant difference between the MMA test results from the two independent laboratories. The coefficient of variation of <15% indicated good MMA testing precision under routine laboratory conditions.

Conclusion: The assay met all validation criteria and was therefore effective in assessing the clinical significance of alloantibodies.

Prevalence of Hepatitis D Virus among Hepatitis B Positive Blood Donors in Port Harcourt, Nigeria

2023-08-24T06:33:58+00:00

Introduction: The Prevalence of Hepatitis D Virus among Blood Donors in Port Harcourt, Nigeria is a maiden epidemiological study of Hepatitis D or delta hepatitis among the donors’ population in Port Harcourt, Rivers State. Hepatitis D (Hepatitis Delta) is a disease caused by the hepatitis D virus (HDV). It is considered to be a sub viral satellite because it can propagate only in the presence of the hepatitis B virus. The prevalence of HDV in Port Harcourt has not been reported; hence this study, bridge that knowledge gap.

Methods: Using a qualitative cross sectional study design, a general serological screening test was performed on a total of 300 blood donors recruited; 222(74.00%) males and 78 (26.00%) females, all within 20-59years. Of this number, 86(28.70%) were positive for HBV while 214(71.30%) Hepatitis B negative served as control. Samples collected were analysed at blood bank unit of the Haematology Department of the Rivers State University Teaching Hospital, Port Harcourt (RSUTH). Hepatitis B surface antigen (HBsAg), and anti-hepatitis D antibodies (anti-HDV) for the presence of HBV and HDV infections were detected by one step Hepatitis B surface antigen (HBsAg) in serum, and enzyme linked immunosorbent assay for the detection of HDV as described by the www.elabScience.com (16).

Results: Of the 300 subjects, 86(28.6%) were positive for Hepatitis B surface antigen (HBsAg). Of these HBV positive subject, 9(10.4%) were positive for Hepatitis D virus (HDV). Age and gender of the study participants were not found to be risk factors for its prevalence (p > 0.05). There was no statistically significant difference in the PCV of those infected when compared with the non infected group. Using Pearson correlation analysis, HDV was not found to associate significantly with PCV (r = 0.2849, p > 0.05). This study recorded HDV prevalence rate of 10.4% among the HBsAg positive blood donors.

Conclusion and Implications for Translation: There is a 10.4% prevalence of HDV among the HBsAg positive blood donors. To increase the safety level of blood products, the screening process should therefore be extended to the HDV.

Hematological Profile of Adult Haemoglobin SS and SC Sickle Cell Patients in Stationary Phase: Evidences from National Teaching Hospital of Cotonou in Benin

2023-08-28T11:09:02+00:00

Background and Objective: Sickle cell disease is a major public health problem. The aim of this study was to determine the hematological parameters in the inter-critical period of adult sickle cell patients at the National Teaching Hospital CNHU-HKM of Cotonou.

Materials and Methods: This is a descriptive study with analytical aims carried out from July 2021 to December 2021 in the hematology department of the National Teaching Hospital CNHU-HKM of Cotonou. An hemogram was performed using Sysmex XT 4000i on a total of 181 sickle cell patients including 119 Hb SS and 62 Hb SC. Data were analyzed using R software.

Results: Patients studied had a mean age of 32 ± 13 years. The mean of hemoglobin level was 7.7 ± 1.9 g/dL in Hb SS patients versus 11.27 ± 1.79 g/dL in Hb SC patients (p = 0.001). The mean leukocyte count was 13.2 ± 4.4 G/L in Hb SS patients versus 7.3 ± 3 G/L in Hb SC patients (p = 0.003); the mean neutrophil count was 6.93 ± 3.24 G/L in Hb SS patients versus 3.96 ± 1.72 G/L in Hb SC patients (p = 0.001). Platelet counts averaged 426 ± 213 G/L in Hb SS patients versus 223 ± 103 G/L in Hb SC patients (p = 0.001).

Conclusion: This study revealed a higher mean hemoglobin level, mean leukocyte count and mean platelet count in Hb SS patients compared to Hb SC patients in the stationary phase.

Distribution of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) Immunoglobulins G and M among Frontline Health Workers in Eleme Local Government of Rivers State, Nigeria

2023-09-14T07:54:05+00:00

Background: The fight against Corona Virus Disease (COVID-19) globally among front line health workers has been a challenging task, it encompasses working lengthy hours at the isolation Centre’s, intensive care units, emergency departments and molecular laboratories, and also been exposed to pathogens, fatigue, and psychological distress. This has led to high morbidity and mortality rate among front line health workers all over the globe.

Aim: This study aimed at determining the distribution of SARS CoV -2 IgG and IgM among frontline health workers in Eleme Local Government of Rivers State, Nigeria.

Materials and Methods: A total of 100 frontline Covid-19 health workers were recruited for this study comprising 48 males and 52 females with ages between 23 and 49 years and included janitors, hygienist, nurses, data Officers, logistics and ambulance drivers, physicians, and medical laboratory scientists, working at the molecular laboratories, sample collection booths and isolation center. The bio-data of the subjects were obtained using a well-structured questionnaire. Only subjects who gave informed consent were recruited for this study. 60ul of capillary blood was collected from each participant using an aseptic technique and immediately followed by the analysis of SAR-CoV-2 IgM and IgG using a lateral flow immunochromatographic assay technique.

Results: Results from this study showed a total of forty-two (42) 42% subjects were reactive to IgG antibodies while fifty-eight (58) 58% subjects were non-reactive to IgG antibodies also a total of Twenty-One (21) 21% subject were reactive to IgM antibodies while a total of seventy-nine (79) 79% subjects were none reactive to IgM antibodies. A total of nine (9) subjects who were exposed to SAR-CoV-2 for more than one year were reactive to SAR-Cov-2 IgM and IgG antibodies, while a total of two (2) subjects who were exposed to SAR-CoV-2 for less than one year were reactive to SAR-Cov-2 IgM and IgG antibodies and the difference (p ₌ 0.013) was statistically significant. Also, a higher number of subjects within the 20-29 age bracket were reactive to SAR-CoV-2 IgM antibodies while subjects with in the age bracket of 30-39 were more reactive to IgG antibodies.

Conclusion: This study reveals that serological testing is an ideal approach in assessing the proportion of frontline health workers who might have been exposed to SARS-CoV-2 as part of effort in combating COVID-19 disease globally.

Interaction of Red Cell Indices and Blood Group in Diabetic Patients above 50 Years of Age

2023-09-29T06:36:17+00:00

Introduction: A group of metabolic diseases with a hyperglycemic phenotype known as diabetes mellitus impact both industrialized and developing nations. It is brought on by deviations in insulin synthesis, action, or both.

Research Objective: This study seeks to associate the interaction of red cell indices and blood group in diabetic patients above 50 years of age. This is a case control study in which a convenient sample size of 100 individuals were recruited from a consenting population at a private hospital in Port Harcourt, Rivers State, 50 of whom were diabetic, and the remaining 50 were not.

Methods: Using the automated 3-part differential hematology analyzer Sysmex KX-21N, a Full blood count (FBC) and differential was obtained using (Sysmex Corporation Kobe, Japan) Standardization, instrument calibration, and analysis of sample was achieved in line with accordance with the manufacturer's manual to determine the red cell indices and grouping of cells using the tile approach to determine the ABO Blood Groups. Blood samples were taken from the veins using a vacutainer tube and needle according to Chesbrough's instructions, and then put in EDTA anticoagulated bottles with clear labelling. These samples were transported right away using the triple packing procedure to the lab and stored until testing at 4°C. Inferential statistics utilizing the students' statistical t-test were employed to compare the results.

Results: Blood group O, with a total of 25 (50%), had the highest prevalence of diabetes mellitus, followed by blood group A with a total of 12 subjects (24%) and blood group B with a total of 8 subjects (16%) and blood group AB came in last with a total of 5 participants (10%), respectively. In this study, blood group O predominated over blood groups A and B (47% against 25% versus 17%, respectively). The least common blood type in this study was AB (11%). When the Packed Cell Volume, Haemoglobin, Red Blood Cell, Mean Cell volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration, and Red cell Distribution Width were examined between diabetic and non-diabetic participants, no statistically significant (p<0.05) difference was found.

Conclusion: The findings of this study suggest that blood types O and AB are more prevalent in diabetics. We can deduce that a person's blood type may be a risk factor for developing this condition and may be useful in diagnosing it.

Blood Transfusion Request and Utilization: The Trend in a Tertiary Health Care Centre in North Central Nigeria

2023-10-05T06:46:56+00:00

Background: An effective blood transfusion service is anchored on an adequate supply of safe blood and its components as well as its accessibility and appropriate clinical use. There is a contrast in blood supplies and utilization between the high, middle and low-income countries necessitating the formulation of appropriate modalities to ensure judicious use of blood while minimizing wastage.

Aims: This study was aimed at assessing the blood transfusion request trend in our institution and its utilization with the intent of curtailing the wastage of safe blood for transfusion.

Study Design: It is a retrospective study.

Place and Duration of Study: Jos University Teaching Hospital Blood Bank from January 2022 to December 2022.

Methodology: Appropriately filled blood transfusion request forms of the Jos University Teaching Hospital compared with the blood bank In-house records from January 2022 to December 2022 were reviewed. Request dates, requesting Department, Unit or Specialty, indications for request, Number of units requested, and number eventually utilized were used to determine blood transfusion indices which are indicative of efficient and significant blood use.

Results: Eight thousand, five hundred forty-eight (8,548) blood transfusion request forms from the blood bank and patients' folders were reviewed and compared with the Blood Bank's in-house records. Requests for blood transfusion for over 460 indications were received from twenty-six (26) departments and units. There was a general Crossmatch: Transfusion ratio (C: T) of 1.7 with a transfusion index (TI) of 1.2 and transfusion probability (TP) of 48.0%.

Conclusion: Transfusion requests were characterized by low utilization across departments and units. This calls for the establishment of a transfusion protocol for the determination of blood volume required for every indication so that this limited commodity will be made available and accessible when needed.

Determining the Genotype of the RH Blood Group System in Maltese Blood Donors

2023-10-11T11:05:53+00:00

Aims: The Rh blood group system is a complex protein based system having the D, C, c, E and e as the most immunogenic antigens. This blood group system has a vital role in transfusion medicine thus by DNA typing, important medical issues in transfusion practice can be resolved when serological techniques fail. The aim of the study was to determine the frequency of the RH genotype in the Maltese blood donors using molecular techniques.

Methodology: 797 blood donor samples were enrolled in this study. An allele-specific polymerase chain reaction (AS-PCR) method was used to determine the presence of RHD, RHCE*E and RHCE*e, while multiplex PCR was used to test for RHCE*C/c.

Results: Out of 797 samples studied, the most common allele was RHCE*e with a percentage of 98. The most common genotype in RhD positive samples was DCcee and in RhD negative samples, the most common was dccee. The most frequent haplotype was DCe.

Conclusion: Like in previous studies, this research also concludes that the distribution of the RH genotype varies in different geographical areas. Further studies working with larger sample size and better techniques would share better light on the molecular function of these loci.

Umbilical Cord Blood Processing Techniques and Their Comparative Advantages: A Review

2023-09-14T10:57:14+00:00

Background: Umbilical Cord Blood (UCB) has steadily gained prominence in haematopoietic stem cell transplantation (HSCT). Despite UCB advantages, the main disadvantage of UCB in haematopoietic stem cell transplantation (HSCT) is its limited cell dose. Initially, UCB used to be processed and then made to undergo cryopreservation as whole cord blood banking leading to the problem of storing sufficiently large number of cryoprotected UCB units which requires vast amounts of costly storage space in liquid nitrogen. The sole purpose of processing is to concentrates the stem cells and reduce the volume for storage. Different UCB processing methods have been developed.

Aim: This review is aimed at bringing together the literature on the different processing methods and highlighting the underlying principles of each method, the relative efficiency and advantages of the methods.

Methodology: The work involved mainly the critical review of all available academic, professional and industry documents on cord blood processing. The relevant information was obtained from textbooks, academic journals, conference proceedings, the internet among others. The major UCB processing methods include Plasma Depletion, Density Gradient Centrifugation (DGC), Hetastarch, PrepaCyte-CB and Sepax. A study of the potential impact of Hetastarch and PrepaCyte processing methods on transplantation outcomes revealed no difference that was significant was observed between patients receiving cells after the processing regimens were compared.

Results: A comparison of the engraftment time of PrepaCyte-CB with five other processing methods revealed a quicker engraftment time for PrepaCyte-CB processed cord blood units compared to other processing methods. PrepaCyte-CB also recovers significantly more viable stem cells than AutoXpress (AXP) and hydroxyethyl starch (HES) processing methods. Other workers demonstrated that Sepax depletion produces higher recovery of cells that are nucleated. The effect initial volume of cord blood had on the recovery of nucleated cells for the different method of processing were also compared. Recovery when using Sepax is reduced as the unit size processed increases. Hetastarch, which is a density gradient, and plasma depletion separation is also affected in like manner, however, processing done using PrepaCyte-CB was not affected by the initial volume of the collected unit. The advantage of Sepax is that it is fully automated and this allows for mass processing of samples, suitable for bigger cord blood banks. For erythrocyte removal, density gradient separation is a better method that is effective. PrepaCyte-CB is the second most efficient method for removing RBC. The result of Total Nucleated Cells (TNC) and Mono Nucleated Cells (MNC) recovery rate of Hespan and Sepax against AXP processing methods shows that both Hespan and Sepax reproducibly recover greater than 95% of the cord blood stem cells in a typical collection and result in a reduced final volume for final storage.

Conclusion: The five most popular processing techniques are Plasma Depletion, Density Gradient, Hetastarch, PrepaCyte-CB and Automated Centrifugal Machine (Sepax). Most methods involve centrifugation, sedimentation and/or filtration for reducing the red cell content, plasma volume, or both. The different UCB processing methods each has its advantages and disadvantages.