RESUMEN
During 3 months, platelet concentrates prepared by "Établissement français du sang Pyrénées-Méditerranée" (Blood bank) were treated with the Intercept process (CERUS©). This study primarily aimed to measure the organizational impact of this technology on transfusion chain. The introduction of Intercept did not raise any major difficulties, but required some adaptations upstream from the deployment. Prior information of health care institutions and physician was essential to anticipate the practical changes, including the prescription of platelet concentrates (CMV negative, irradiation). This study allowed to analyze also the transfusion consequences for patients, in the form of observational studies. The patients transfused with platelet concentrates treated with Intercept received more platelet concentrates (+12.9%), less rich in platelets (-12.8%), the cumulated quantity of platelet being stable.
Asunto(s)
Plaquetas/efectos de los fármacos , Furocumarinas/farmacología , Fármacos Fotosensibilizantes/farmacología , Transfusión de Plaquetas/métodos , Adulto , Anticuerpos Antivirales/sangre , Plaquetas/efectos de la radiación , Citomegalovirus/inmunología , Eritema/etiología , Transfusión de Eritrocitos , Estudios de Factibilidad , Estudios de Seguimiento , Humanos , Recién Nacido , Estudios Observacionales como Asunto , Recuento de Plaquetas , Transfusión de Plaquetas/efectos adversos , Prescripciones , Trombocitopenia Neonatal Aloinmune/terapia , Rayos Ultravioleta , Inactivación de VirusRESUMEN
BACKGROUND: Therapeutic granulocyte transfusion remains an indication for neutropenic sepsis associated with prolonged neutropenia. However, harvest complexity and lack of proved efficacy mark the limits of its development. CASE REPORT: A 58-year old man received allogeneic stem cell transplantation for osteomyelofibrosis. Six months later, after a transplant rejection, he presented with perineal cellulitis from hemorrhoid origin, without any microbiological documentation. The evolution was unfavorable despite antibiotic and antifungal therapy. A set of seven granulocytes transfusions was initiated. Re-circulation of granulocytes analysis showed an initial increase (H2) followed by a decrease (H8) reaching the basal rate at H16. No toxicity has been reported during or following the transfusions. Clinical improvement has been reported five days after the first transfusion, scaring over at D15, without any neutrophil recovery. CONCLUSION: In 2014, granulocyte transfusion therapy is indicated for severe infection associated with long-term neutropenia. Minimal circulation of transfused cells in our observation and fast clinical improvement suggest the concentration of granulocytes on the infected area.
Asunto(s)
Granulocitos/trasplante , Transfusión de Leucocitos , Neutropenia/terapia , Aloinjertos , Antiinfecciosos/uso terapéutico , Celulitis (Flemón)/tratamiento farmacológico , Celulitis (Flemón)/etiología , Celulitis (Flemón)/terapia , Terapia Combinada , Rechazo de Injerto/tratamiento farmacológico , Trasplante de Células Madre Hematopoyéticas , Hemorroides/complicaciones , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Neutropenia/etiología , Nitrilos , Mielofibrosis Primaria/terapia , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/etiología , Infecciones por Pseudomonas/terapia , Pirazoles/efectos adversos , Pirazoles/uso terapéutico , Pirimidinas , Choque Séptico/etiología , Esplenectomía/efectos adversosRESUMEN
The incidence rate of ABO hazards of transfusion remains high in France. In this country, bedside pretransfusion controls include an agglutination test for red cells only, although its validity has scarcely been assessed in the practice. 847 nurses from 9 public hospitals and private clinics in a French region participated in a study aimed at measuring the sensitivity and specificity of pretransfusion bedside agglutination tests within hospital wards. Sensitivity was found to be 93.9% +/- 3%. Nondetection of mismatching was increased by two risk factors only: having worked more than 4 years in the same ward, and not having been trained to use this test. The sensitivity of this test might still be improved. This test is found sensitive enough to be kept. Nevertheless, if used alone, it is not a safe protection against recipient's mismatch. Authors recommend both to improve agglutination test sensitivity and to link it strongly to the bedside checking of both transfusion information and the recipient's identity.