Abstract Background Maintaining an adequate and safe blood supply is a major challenge in low‐ and middle‐income countries, where donor lapse and low voluntary donation rates hinder sustainability. Mobile communication technologies such as short message service (SMS), WhatsApp and telephone calls offer scalable approaches to donor outreach, but their comparative effectiveness in re‐engaging lapsed and inactive donors in sub‐Saharan Africa remains insufficiently studied. Objectives This study assessed the effectiveness of these communication tools in re‐engaging lapsed (no donation within 12 months despite donation within the prior 24 months) and inactive donors (no donation for >24 months) at Lagos University Teaching Hospital (LUTH), using re‐donation within 30 days as the primary outcome. Study Design and Methods A stratified, randomised interventional study with computer‐generated allocation, stratified by age, sex and donor status, was conducted among lapsed and inactive voluntary blood donors at LUTH. Donors were allocated to one of four groups: SMS, WhatsApp message, telephone call or no‐intervention control, and followed for 30 days. Secondary outcomes included message delivery and donor response. Sociodemographic variables and self‐reported barriers to return were also assessed. Results Of 3014 donors identified, 2809 met eligibility criteria and were randomised. Among 2107 donors who received attempted contact, 1546 (73.4%) were successfully reached. SMS achieved the highest delivery rate (95.4%), followed by telephone calls (63.8%) and WhatsApp messages (60.8%). Positive responses were recorded in 429 (27.7%) donors, with 421 (98.1%) arising from telephone outreach. SMS generated eight positive responses (1.9%), and WhatsApp produced none. Only one donor, belonging to the telephone group, returned to donate during follow‐up, yielding an overall re‐donation rate of 0.04%. Reported barriers included time constraints, occupational demands and long distance to the donation centre. Conclusion Telephone calls elicited the strongest immediate engagement, but single‐contact reminders, regardless of modality, were insufficient to generate meaningful short‐term donor return. Effective donor retention strategies in Nigeria will require multi‐contact outreach, personalised communication and interventions addressing structural barriers such as scheduling and distance.
Abstract Assessing the function of transfused blood components within the dynamic environment of the vascular system remains challenging, as conventional assays are largely static and poorly represent the dynamic mechanical and biochemical interactions between blood cells and the vessel wall. Microfluidic approaches, which study blood flow within small‐scale channels, provide an opportunity to bridge this gap by introducing physiologically relevant flow and shear rates into experimental models. This review synthesises the current literature describing the application of microfluidic technologies to the assessment of transfused blood components, with particular emphasis on platelet concentrates, red cell concentrates and plasma‐derived products. Across existing studies, microfluidic models have demonstrated differences in component function related to storage conditions, manufacturing methods and emerging transfusion products that are not always detected using conventional bulk assays. These approaches have provided new insights into platelet haemostasis at defined shear rates, red cell deformability and gas exchange, and plasma‐mediated coagulation in trauma and critical illness. However, substantial diversity in device design, experimental conditions and analytical endpoints limits direct comparison between studies and constrains translation into routine practice. The development of more standardised platforms, alongside integration with endothelialised and organ‐on‐a‐chip models, may help to overcome these challenges. Overall, microfluidics represents a promising tool for improving functional assessment of blood components and supporting future advances in transfusion medicine research and personalised transfusion strategies.
Abstract Phototherapy remains the first‐line treatment of haemolytic disease of the newborn (HDN), a potentially life‐threatening condition caused by maternal alloimmunisation. Intravenous immunoglobulin (IVIG) has been proposed as an adjunct to reduce the need for exchange transfusion (ET), a procedure associated with significant risks. This meta‐analysis aims to evaluate the safety and efficacy of IVIG combined with phototherapy versus phototherapy alone in neonates with HDN. A comprehensive search of MEDLINE, EMBASE, CINAHL and the Cochrane Library was conducted up to 24 April 2025. Eligible studies included randomised controlled trials and observational cohorts evaluating IVIG in HDN. Data were pooled using random‐effects models. This study was prospectively registered in Prospective Register of Systematic Reviews (CRD420251025766). Nineteen studies involving 3673 neonates met the inclusion criteria. IVIG reduced the need for ET (odd ratio [OR] = 0.34; confidence interval [CI]: 0.2–0.8; I 2 = 88%) when used as an adjunct to phototherapy compared to phototherapy alone. Subgroup analysis suggested that the reduction in ET was more consistent in Rh‐mediated HDN (OR = 0.2; CI: 0.1–0.8; I 2 = 81%) than in ABO‐mediated HDN (OR = 0.76; CI: 0.1–4.1; I 2 = 89%). There were no differences in the length of hospital stay (mean difference [MD] = −0.1 days; CI: −0.8 to 0.6; I 2 = 98%), duration of phototherapy (MD = −5.1 h; CI: −15.7 to 5.4; I 2 = 98%) or incidence of adverse events (OR = 1.32; CI: 0.2–10.5; I 2 = 91%) between groups. Despite reducing ET requirements, adjunctive IVIG with phototherapy may not provide additional clinical benefits compared with phototherapy alone. Further high‐quality trials are needed to clarify optimal timing, dosing and patient selection.
Abstract Background Subjective, inconsistent clinician judgement on red blood cell (RBC) transfusion demand causes unnecessary blood wastage, increased perioperative safety risks, and poorly balanced hospital blood inventory. To tackle these persistent clinical limitations, we developed a workflow‐adapted clinical decision support tool: a one‐dimensional convolutional neural network (1D CNN) trained on routinely acquired haematological and clinical variables to stratify inpatient RBC transfusion volume categories. Methods Using a retrospective cohort of 7,250 patients from Beijing Friendship Hospital (April 2024–June 2025), we trained a 1D CNN on 19 standardised pre‐transfusion variables to predict transfusion volume categories (1, 2, 3, 4, ≥5 units). The model was optimised with Adam and evaluated on a 30% hold‐out test set. Comprehensive characterisation of the cohort's baseline clinical features was also performed to clearly define the transfusion contexts and clinical indications of the study population. Results On the 30% hold‐out test set, the 1D CNN reached an overall accuracy of 0.7314 and converged without overfitting. The model accurately identified the predominant 2 units transfusion class (68.03% of cases, precision 0.7314). However, performance was limited in minority classes (≥5 units and 3 units), which showed low prevalence (< 5%) and overlapping haemoglobin values (60–80 g/L), indicating a critical safety limitation. Conclusions The 1D CNN reliably forecasts routine transfusion requirements in a single‐center setting but under‐detects high‐volume transfusion events. External validation across diverse clinical centers, targeted data enrichment for minority classes, and development of indication‐specific sub‐models are mandatory to improve the model's generalizability and clinical utility.
Abstract Background Patient blood management (PBM) including appropriate red blood cell (RBC) transfusion underpins the management of severe anaemia and haemorrhage during pregnancy, delivery and postpartum. However, there is marked variation in practice despite guidelines and standards. Key performance indicators (KPIs) can identify deviation from agreed standards, support benchmarking and guide efforts to improve outcomes. We aimed to develop a set of obstetric PBM KPIs which may be measured from routinely collected electronic health records. Methods We undertook a three‐stage process. First, we completed a scoping review to identify potential KPIs from relevant literature and clinical guidelines. Second, we conducted a modified RAND consensus process with a multidisciplinary panel of medical professionals. The consensus panel rated potential KPIs according to importance and feasibility. Third, our research team undertook a ‘sense check’ to refine and make the final selection of the KPIs. Results Out of 25 candidate KPIs initially identified, we derived a final set of 10 KPIs covering PBM in obstetrics and the RBC transfusion practice. Fifteen candidate KPIs were rejected: 6 KPIs were judged neither important nor feasible, 2 not feasible for further study at the current time, 2 not important to the general obstetric population and 5 represented organisation of care, rather than clinical practice. Conclusions Using a systematic, stepwise, transparent approach, we have developed a set of 10 KPIs based on routine health data sources to monitor and guide improvement of PBM implementation, particularly RBC transfusion practice in obstetrics. These KPIs now require further field testing using routinely collected data.
