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IntroductionThis study aimed to investigate the analytical bias in haematological parameters induced by storage at 33 ºC.Materials and methodsBlood from the diversion pouch of 20 blood donors were collected in K2EDTA vials and stored at 33 ºC. Readings from each vial were taken at 0, 4, 6, 12, 24, 48 and 72 hours after collection on the Sysmex XP-100 analyser (Sysmex Corporation, Kobe, Japan). The percent difference from the baseline readings were calculated and subjected to a Wilcoxon signed rank test at a Holm corrected significance level of 0.05. A median percent difference, which was statistically significant and greater than the maximum acceptable bias (taken from studies of biological variation), was taken as evidence of unacceptable shift. If the median shift was lesser than the maximum acceptable bias, two one-sided Wilcoxon signed rank tests for equivalence were used to determine whether the percent differences were significantly lesser than the maximum acceptable bias.ResultsHaemoglobin, red blood cell count, white blood cell count, mean corpuscular haemoglobin and lymphocyte count showed acceptable bias after storage for at least 24 hours at 33 ºC. Haematocrit, mean corpuscular volume, mean corpuscular haemoglobin concentration, platelet count and mean platelet volume showed unacceptable shift in less than 4 hours when stored at 33 ºC.ConclusionsSince many haematological parameters show unacceptable bias within 4 hours of sample storage at 33 ºC, the recommended limit of time from collection to processing should be revised for areas where high environmental temperatures are common.

Subclinical Iron deficiency appearing in blood donors after blood donation is a recognized problem. Donors at an increased risk of iron deficiency need to be identified. Blood donors meeting national selection criteria were included in the study. Complete blood counts were done using Sysmex XP-100 three part hematology analyzer. Differences in RBC indices among donor groups defined by previous donations were then analyzed statistically. Six hundred and seventy three males and ninety six females were studied. In males, Kruskal-Wallis test showed significant differences between groups defined by number of donations for MCH and MCV (P value \ 0.001), but not for MCHC (P value = 0.09) and RDW (P value = 0.6). Post-hoc tests showed statistically significant difference between donors having six or more donations compared to donors having no previous donations for both MCH as well as MCV. No significant difference was found between donor subgroups in females for any of the indices; however, no female donated blood more than three times in the study. There is increased risk for iron deficiency in donors having six or more previous donations, and evidence for starting an iron screening and supplementation programme for these donors.

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This scientific article emphasizes the importance of a policy for antibody screening of all blood donors as a step to further improve blood safety. We also report the incidence of red blood cell (RBC) alloimmunization in healthy blood donors obtained using a cross-sectional prospective study from September 2017 to January 2019 in the Department of Transfusion Medicine of a tertiary care referral and teaching institute in northern India. The indirect antiglobulin test (IAT) for unexpected RBC antibodies was performed by the conventional tube test with pooled group O RBCs on all donor units irrespective of their D status. Samples with positive IATs were sent to the Immune Hematology Reference Laboratory for further immunohematology workup, maintaining predefined optimal storage and transport conditions. Of the 10,390 donors studied, 9959 were males and 431 were females. The incidence of unexpected antibodies (antibodies other than those of the ABO blood system) among the blood donors was found to be 0.18 percent (19 of 10,390 with 25 alloantibodies). Of the 19 alloimmunized donors, 16 (84.2%) were male (alloimmunization rate 0.16%, 16 of 9959) and 3 (15.8%) were female (alloimmunization rate 0.69%, 3 of 431) (p = 0.01; chi-square test). In our study, the most frequent alloantibodies identified were of the Lewis blood group system (17 of 25 [68%] in 14 of the 19 alloimmunized donors). The second most common allo-antibodies belonged to the Rh blood group system (4 of 25 [16%] in 3 of the 19 alloimmunized donors), followed by those of the MNS blood group system (3 of 25 [12%] in 2 of 19 alloimmunized donors). Anti-K was found in one donor (1 of 25 [4%]). Based on the results of the study, we recommend that a policy of routinely performing IATs on all donor units, irrespective of their D status, be adopted as an essential component of safe blood transfusion practices.

Herein, we report a case of naturally occurring anti-Le b alloantibody identified in the plasma of a first time voluntary blood donor. The immunohematology workup was done on the pilot sample tubes collected during blood donation by the conventional tube technique and using ID-Micro Column System Glass Beads card (anti-IgG, C 3 d; Ortho-Clinical Diagnostics, Raritan, New Jersey, USA). Blood group of the donor was confirmed to be B RhD positive, and the alloantibody in his plasma was identified as anti-Le b , having clinically significant characteristics. Since in this particular case, anti-Le b was IgM and IgG in nature, it was clinically significant and can lead to hemolytic transfusion reaction, especially if such fresh frozen plasma unit is transfused to Le b negative patients.

BACKGROUND: Convalescent plasma has been used to provide passive immunotherapy to patients with Covid-19 with a high level of safety. Very few efficacy studies were available, and COVID being a relatively new disease, exact therapeutic role was unclear. This observational study on impact of Covid convalescent plasma (CCP) on clinical outcomes attempts to evaluate the effectiveness of convalescent Covid 19 plasma therapy in treatment of Covid 19 patients at the tertiary care center in the Uttarakhand state of India. METHODS: CCP was collected by plasmapheresis/ whole blood from willing Covid recovered donors who underwent pre-donation testing including ABO and RhD grouping, mandatory blood screening tests for HIV, HBV, HCV, syphilis and Malaria, Haemoglobin estimation, Covid IgG assay. Hospitalized patients with severe Covid-19 pneumonia who received these CCP units were followed up and outcome (Recovery/death) was observed. RESULTS: A total of 63 patients who received CCP were included in the study. Out of total, 13 (20.7 %) were females and 50 (79.3 %) males and their age ranged from 24 to 80 years with median age of 53 years. The period between the start of symptoms and hospitalization ranged from 1 to 14 days with average duration of 4.7 days. Symptoms on presentation included Fever 53/63 (84.1 %), Tachypnoea 60/63 (95.2 %) and Cough 42/63 (66.7 %). Among these patients, 22/63 (34.9 %) were on non-invasive ventilation (NIV), 6/63 (9.5 %) on non-rebreather mask (NRBM) and 32/63 (50.8 %) were on Ventilator support. The infused convalescent plasma had a Mean IgG value of 57.3 AU with a range of (10-142 AU). A total of 37 (58.7 %) patients were lost to Covid-19 infection and 26 (41.3 %) were discharged from hospital in healthy state. CONCLUSION: The use of convalescent plasma in addition to standard treatment in our study on patients with severe pneumonia due to Covid-19 did not demonstrate reduced mortality of Covid 19 patients amidst numerous variables. The results showed that the use of convalescent plasma as a treatment option in the present conditions needs a serious re-evaluation. Studies on a strictly defined recipient group and transfusion of CCP units, with adequate antibody titer and/or neutralization activity must be analyzed for future works.