Open Access Review Article

Complications of Allogeneic Blood Transfusion: Current Approach to Diagnosis and Management

Ademola S. Adewoyin, Olayinka A. Oyewale

International Blood Research & Reviews, Page 135-151
DOI: 10.9734/IBRR/2015/17874

Introduction: Blood transfusion remains a vital component of modern medicine, as yet artificial blood or blood substitute is still widely promising. In well-organized health care systems, with standard transfusion services/facilities and safe practices, the risk associated with infusion of allogeneic blood components is minimal or negligible. However, in most developing nations, significant morbidity is still associated with allogeneic blood transfusion.

Objective: This article is a review on diagnosis of transfusion reactions and modalities for treatment, aimed at promoting interest and awareness as well as, providing current knowledge regarding blood transfusion complications among clinical staff involved in transfusion care.

Methodology: Relevant literatures were searched using search engines such as PubMed and Google Scholar, as well as standard textbooks in transfusion medicine. Results were summarized in appropriate sections.

Results: There are several complications associated with allogeneic blood transfusion. Many of these complications can be prevented and controlled through effective donor and recipient haemovigilance, as well as training and re-training of both clinical and blood bank staff.

Conclusion: Improved knowledge regarding these complications, as well as current treatment guidelines is a crucial strategy to their prevention and control in developing nations. This will invariably increase the capacity and ability of the attending clinical staff (physicians/nurses) to correctly identify, manage and report these adverse transfusion reactions.


Open Access Original Research Article

Anti-HBc and HBV-DNA among Blood Donors in North Africa; Western Libya

Mohamed Kaled A. Shambesh, Ezzadin Areaf Franka, Faisal Fathalla Ismail, Nagi Meftah Gebril, Kamel Ahmed Azabi, Fatma Amar

International Blood Research & Reviews, Page 152-159
DOI: 10.9734/IBRR/2015/18364

Background: Post transfusion hepatitis B (PTHB) continues to be an important public health concern with regard to blood transfusion in Libya and in Africa. This concern is related to the screening test which is still used but it is not enough to detect infective cases during window period.

Objectives: To determine the presence of total anti-HBc (hepatitis B core antibodies) and HBV-DNA (hepatitis B viral DNA (in healthy HBsAg (hepatitis B surface antigen) negative blood donors in Tripoli-Libya, North Africa.

Methods: A total of 1256 HBsAg negative blood samples, obtained from healthy blood donors who attended Tripoli’s central blood bank, were tested for anti-HBc using the VITROS® 3600 Immunodiagnostic System. The reactive samples were further tested for the presence of HBV-DNA.

Results: From the sample of 1256, 123 (10%) were total anti-HBc positive. Of the 123 anti-HBc positive samples, 13 (10.5%) tested positive for HBV-DNA by PCR (Polymerase chain reaction). The frequency of anti-HBc positive cases among the voluntary donors was 59.2%, and among the replacement donors was 40.7% (p<0.0001). The number of anti-HBc positive samples was found to be particularly high in the age group 30-39 years 44).7%) (p<0.0001).

All the positive PCR samples were from the age groups 20-39 and 40-59 with highest prevalence among 20-29 (p<0.0001). Most occupation who had positivity with anti-HBc and HBV-DNA were civil governmental workers specially militants, free workers and was less in students. Most positive cases were from east of Tripoli the capital (Tagora, SoqAljomaha).

Conclusion: The frequency of anti-HBc among this sample was 10% which is high compared with the international findings. The current study estimated the expected exclusion rate of anti-HBc positive donated blood, as this would be an important factor to consider before adopting anti-HBc testing in addition to HBsAg testing as a mandatory screening test to further enhance transfusion safety.


Open Access Original Research Article

Haematological Parameters of Adult and Paediatric Subjects with Sickle Cell Disease in Steady State, in Benin City, Nigeria

O. E. Iheanacho

International Blood Research & Reviews, Page 171-177
DOI: 10.9734/IBRR/2015/18339

Background: Sickle cell disease (SCD) remains a major health burden in Sub-Saharan Africa and the management requires regular monitoring of the patients. The monitoring includes routine assessment of haematological parameters and any deviation can best be appreciated when steady state values are previously known. This study evaluated the patients with SCD in steady state to determine certain haematological parameters (particularly the full blood count values).

Methods: This is a cross-sectional study. One hundred and forty-three (known) SCD subjects in steady state and thirty controls (HB phenotype AA) had their full blood count parameters evaluated using haematology auto analyser – white blood cell (WBC), granulocyte (GRA) and platelet (PLT) counts as well as haemoglobin concentration (HB), mean cell volume (MCV) and mean cell haemoglobin (MCH). The participants were regrouped into adult and paediatric groups and their results analysed accordingly.

Results: The adult SCD patients had their mean haematological values as follows: HB 7.7±2.5 g/L, MCV 77.5±19.3 fl, MCH 25.1±6.5 pg, WBC 12.0±5.9x109 /L and PLT 306.6±169.3x109 /L. Their paediatric counterparts had the following mean values: HB 6.9±1.3 g/L, MCV 77.4±11.0 fl, MCH 24.6±3.7 pg, WBC 16.0±6.9x109 /L and PLT 329.1±101.9x109 /L. The adult patients had significantly higher HB (p<0.05) and lower WBC (p<0.05) than the paediatric patients.  

Conclusion: This study has therefore provided some steady state haematological values of both paediatric and adult SCD patients in our locality and could be useful in establishing reference values. 


Open Access Case Study

Cytomegalovirus-induced Pure Red Cell Aplasia Successfully Treated with Ganciclovir: A Case Report

Daisy Ilagan-Tagarda, Flordeluna Zapata-Mesina, John S. Delgado, Jomell C. Julian

International Blood Research & Reviews, Page 160-165
DOI: 10.9734/IBRR/2015/17728

Background: Acquired pure red cell aplasia (PRCA) is a rare disease characterized by anemia, severe reticulocytopenia and absent to low bone marrow erythroid precursor cells. There are well-described associations of this disorder with thymomas, lymphoproliferative disorders, autoimmune disorders, certain drugs, and infectious agents. Among the infectious agents, the most common is parvovirus B19, this was rarely reported in association with Cytomegalovirus (CMV).

Objective: To describe a rare case of acquired PRCA associated with CMV and its response to antiviral therapy.

Methods: We present the clinical and laboratory data of our patient and reviewed the related published literature regarding PRCA, its etiology and response to treatment.

Results: We describe a 64-year-old male who presented with symptomatic anemia. He had a normocytic, normochromic anemia associated with low reticulocyte count. Serum ferritin was elevated. Vitamin B12, folate levels, kidney and liver functions were normal. He was given blood transfusion with packed red cells, hematinics and erythropoietin (EPO) injections for 2 months but there was no response. Bone marrow aspiration and biopsy showed erythroid hypoplasia consistent with PRCA. He was assessed to have PRCA probably EPO-antibody induced. EPO was discontinued and he was started on steroids. After 3 months of steroids there was persistence of anemia and reticulocytopenia. EPO-antibody assay done prior to steroid therapy came out to be negative. He tested negative for Hepatitis A, B and C, Human Immunodeficiency virus, Epstein barr-virus and parvovirus B-19.CMV DNA viral load was elevated. He was started on ganciclovir which resulted to transfusion independence and normalization of hemoglobin.

Conclusion: PRCA may be reversible. High viral load of CMV was detected through PCR. He was treated with antiviral therapy resulting into a favorable response.


Open Access Case Study

Severe Hemolytic Anemia Due to De novo Hemoglobin Sabine in an Argentinian Newborn. First Case in South America

Susana Perez, Irma Bragós, Mariana Raviola, Arianna Pratti, Germán Detarsio, Sandra Zirone, Maria Eda Voss, Luciano Verón, Irma Acosta, Mara Ojeda

International Blood Research & Reviews, Page 166-170
DOI: 10.9734/IBRR/2015/18559

Hemoglobin (Hb) Sabine is an unstable Hb variant that causes hemolytic anemia in heterozygous state, with inclusion bodies in the red blood cells (RBC). This hemoglobin is the result of a point mutation at codon 91(CTG)®(CCG) of the beta-globin gene. We report, for the first time in South America, the identification of Hb Sabine in a nine-month-old female baby, referred to our laboratory bearing a severe hemolytic anemia. We emphasize the need for the correct characterization of this unstable hemoglobin mainly for therapeutic purposes and for genetic counseling.