Gulf Coast Regional Blood Center is an independent, nonprofit blood center that gathers blood through donations and provides blood, blood components and related services. The center meets the blood and blood component needs of patients being treated in more than 170 healthcare institutions in the 26-county Texas Gulf Coast, Brazos Valley and East Texas regions. The Blood Center began operations on Jan. 1, 1975 and is headquartered in the Texas Medical Center in Houston. The Blood Center also has 17 Neighborhood Donor Centers located throughout the greater Houston area, College Station and East Texas.To meet the needs of the area community, The Blood Center established a collection goal of 333,000 units in 2010, with more than 1,000 donations per day. In 2007, the center collected a total of 291,319 units of blood and blood components, exceeding 2006's record by more than 18,000 units. In 2009, The Blood Center collected 331,298 units, surpassing the 2009 goal by more than 11,290 units.Gulf Coast Regional Blood Center is a non-profit 501(c)(3) organization and is accredited, licensed and inspected by AABB, the Food and Drug Administration as well as local and state authorities.
INTRODUCTION:Recent studies have linked trauma patient outcomes to the plasma donor's sex, with premenopausal females associated with improved survival and lower organ failure. Currently, green-colored plasma (due to oral contraceptive use) is removed from the donor pool. We set out to evaluate the hemostatic potential of green plasma. STUDY DESIGN & METHODS:We obtained 90 units of plasma from our regional blood center: 30 units of visible green plasma and 60 units of standard-color plasma divided between male and female donors. We collected clinical data such as age, sex, ethnicity, and number of pregnancies. We then assessed the hemostatic potential through thrombelastography (TEG), calibrated automated thrombography (CAT), and clotting factor levels. RESULTS:Green plasma unit donors were younger than standard-color female and male donor units (median age 27 vs. 58 vs. 54) and had fewer pregnancies than their non-green female counterparts (median 0 vs. 2); (both p < 0.001). All TEG values, as well as CAT lag time, thrombin potential, and peak thrombin were more hypercoagulable in the green plasma group compared to standard-color female and male donor units; all p < 0.05. In addition, the majority of factor levels (including II, VII, IX, X, and fibrinogen) were higher in green donor plasma; all p < 0.05. DISCUSSION:Based on our data, green plasma has superior hemostatic potential without any other aberrant characteristics, possibly justifying the use of green plasma in transfusion medicine. Reintroducing this product will help to expand on the plasma donor pool.
BACKGROUND:Whole blood transfusion is associated with benefits including improved survival, coagulopathy, and decreased transfusion requirements. The majority of whole blood transfusion is in the form of low-titer O-positive whole blood (LTOWB). Practice at many trauma centers withholds the use of LTOWB in women of childbearing potential due to concerns of alloimmunization. The purpose of this article is to review the evidence for LTOWB transfusion in female trauma patients and generate guidelines for its application.STUDY DESIGN:Literature and evidence for LTOWB transfusion in hemorrhagic shock are reviewed. The rates of alloimmunization and subsequent obstetrical outcomes are compared to the reported outcomes of LTOWB vs other resuscitation media. Literature regarding patient experiences and preferences in regards to the risk of alloimmunization is compared to current trauma practices.RESULTS:LTOWB has shown improved outcomes in both military and civilian settings. The overall risk of alloimmunization for Rhesus factor (Rh)- female patients in hemorrhagic shock exposed to Rh+ blood is low (3% to 20%). Fetal outcomes in Rh-sensitized patients are excellent compared to historical standards, and treatment options continue to expand. The majority of female patients surveyed on the risk of alloimmunization favor receiving Rh+ blood products to improve trauma outcomes. Obstetrical transfusion practices have incorporated LTOWB with excellent results.CONCLUSIONS:The use of whole blood resuscitation in trauma is associated with benefits in the resuscitation of severely injured patients. The rate at which severely injured, Rh-negative patients develop anti-D antibodies is low. Treatments for alloimmunized pregnancies have advanced, with excellent results. Fears of alloimmunization in female patients are likely overstated and may not warrant the withholding of whole blood resuscitation. The benefits of whole blood resuscitation likely outweigh the risks of alloimmunization.
BACKGROUND:Mixed reality (MR), a form of virtual reality (VR), provides an immersive and interactive experience for the user. Given VR's benefits in patients undergoing needle insertion procedures, MR's usability, impact on anxiety, and safety were evaluated in the blood donation setting.STUDY DESIGN AND METHODS:Whole blood donors ≥18 years old (yo) were enrolled at two blood centers and provided a MR headset with independently developed software to wear during blood donation. Pre- and post-donation questionnaires were conducted, and reaction data were reviewed. A post-study questionnaire was also completed by staff who assisted donors with MR. Descriptive statistics, bivariate analyses, and multinomial logistic regression were performed, and p values determined statistical significance between variables.RESULTS:A total of 282 donors completed the study. 84% wanted to try MR because it seemed fun/different/cool/interesting, and most staff (69%) and donors (68%) found MR easy to use. Baseline subjective anxiety, reported by 50.3% (more often in females, first-time donors, and donors <20 yo), was reduced by MR in 68.4% of donors, and there was a 3.6 times higher odds of anxiety reduction with MR. 54% of donors with baseline anxiety would use MR again with the highest future interest in young donors. Donor reactions while using MR were mild and included pre-faint reactions and hematomas.CONCLUSION:This study demonstrates the potential of MR in reducing donor anxiety, its feasibility during blood donation, and its safety in blood donors. MR is an innovative technology that holds promise to increase donor engagement, satisfaction, and retention.
