Introduction:The COVID-19 pandemic has resulted in several issues related to blood donation and supply.A blood transfusion center has to do an in-depth analysis and adapt quickly and effectively, reaching a balance between the patient's needs and the available donations.Contingency plans, the ability to adapt and develop teamwork, the communication and leadership mechanisms, and the optimal management of people must be tested.Our objective is to describe the actions taken by the Valencia Community Transfusion Center (CTCV) in the face of the COVID-19 pandemic situation. Materials and methods:We conducted a SWOT analysis as a tool to evaluate our risks and described communication and decision-making mechanisms, our contingency plan, changes in the organization of work, and blood donation, stock, and distribution evolution.Results: We identified some key points in our quality approach to face this crisis: rapid action of the working group, agile and up-to-date communication, message effectiveness for donors, safe donor selection process, no external supply problems, no increase in BC expiration rates and, the efficacy of protection mechanisms.Conclusion: The implementation of a contingency plan based on a SWOT analysis has been shown as an effective quality tool in times of crisis.

BACKGROUND:COVID-19 convalescent plasma (CCP) is an experimental treatment against SARS-CoV-2. Although there has so far been no evidence of transmission through transfusion, pathogen reduction technologies (PRT) have been applied to CCP to mitigate risk of infectious disease. This study aims to assess the impact of methylene blue (MB) plus visible light PRT on the virus-neutralising activity of the specific antibodies against SARS-CoV-2.MATERIAL AND METHODS:Thirty-five plasma doses collected by plasmapheresis from COVID-19 convalescent donors were subjected to MB plus visible light PRT. Anti-SARS-CoV-2 RBD S1 epitope IgGs antibodies were quantified by ELISA. Titres of SARS-CoV-2 neutralising antibodies (NtAbs) were measured before and after the PRT process. A Spearman's correlation was run to determine the relationship between antibody neutralisation ability and SARS-CoV-2 IgG ELISA ratio. Pre- and post-inactivation neutralising antibody titres were evaluated using a Wilcoxon test.RESULTS:The plasma pathogen reduction procedure did not diminish NtAbS titres and so did not cause a change in the viral neutralisation capacity of CCP. There was a strong correlation between pre-and post-PRT NtAbs and anti-SARS-CoV-2 IgGs titres.DISCUSSION:Our results showed PRT with MB did not impair the CCP passive immunity preserving its potential therapeutic potency. Therefore, PRT of CCP should be recommended to mitigate the risk for transmission of transfusion-associated infectious disease. There is a good correlation between SARS-CoV-2 IgG titres determined by ELISA and the neutralising capacity. This allows blood centres to select CCP donors based on IgG ELISA titres avoiding the much more labour-intensive laboratory processes for determining neutralising antibodies.

Introducción: La pandemia de enfermedad por coronavirus 2019 (COVID-19) ha ocasionado problemas en la donación y el suministro de sangre en todo el mundo.Un centro de transfusión ha de hacer un análisis en profundidad y adaptarse de manera rápida y efectiva, alcanzando un equilibrio entre las necesidades y las donaciones.Se deben probar los planes de contingencia, la capacidad de adaptación y trabajo en equipo, la comunicación, liderazgo y gestión óptima de las personas, sin perder de vista la misión.Nuestro objetivo es describir las actuaciones del Centro de Transfusión de la Comunidad Valenciana (CTCV) ante la situación de pandemia de COVID-19.Material y métodos: Realizamos un análisis DAFO (debilidades, amenazas, fortalezas y oportunidades) para evaluar riesgos y describimos los mecanismos de comunicación, toma de decisiones, plan de contingencia, cambios en la organización del trabajo y evolución de la donación, stock y distribución.Resultados: Identificamos puntos clave en nuestro enfoque de calidad para enfrentar esta crisis: acción rápida del grupo de trabajo, comunicación ágil y actualizada, efectividad del mensaje para los donantes, proceso seguro de selección y eficacia de los mecanismos de protección, entre otros.Conclusión: La aplicación del plan de contingencia basado en análisis DAFO se ha demostrado como una herramienta de calidad eficaz en tiempos de crisis.

BACKGROUND:The risk of transfusion-transmitted infection (TTI) has been minimized by introduction of nucleic acid testing (NAT) and pathogen inactivation (PI). This case report describes transmission of human immunodeficiency virus Type 1 (HIV-1) to two recipients despite these measures.STUDY DESIGN AND METHODS:In March 2009 a possible TTI of HIV-1 was identified in a patient that had received pooled buffy coat platelet concentrate (BC-PLT) in November 2005. The subsequent lookback study found two more patients who had received methylene blue (MB)-treated fresh-frozen plasma (FFP) and red blood cells (RBCs) from the same donation. In November 2005 the donor had tested negative for both HIV antibodies and HIV-1 RNA by 44 minipool (44 MP) NAT. Repository samples of this donation and samples from the recipients were used for viral load (VL) and sequence analysis.RESULTS:HIV-1 RNA was detectable by individual donation (ID)-NAT in the repository sample from the 2005 window period donation and a VL of 135 copies/mL was measured. HIV-1 infection was confirmed in both recipients of both BC-PLT (65 mL of plasma) and MB-FFP (261 mL of plasma), but not in the patient that had received 4-week-old RBCs (20 mL of plasma). The sequence analysis revealed a close phylogenetic relationship between the virus strains isolated from the donor and recipients, compatible with TTI.CONCLUSIONS:Approximately 17,600 and 4400 virions in the MB-FFP and BC-PLT were infectious, but 1350 virions in the RBCs were not. ID-NAT would have prevented this transmission, but the combination of MP-NAT and MB-PI did not.

Several plasma pathogen reduction technologies (PRT) are currently available. We evaluated three plasma PRT processes: Cerus Amotosalen (AM), Terumo BCT riboflavin (RB) and Macopharma methylene blue (MB). RB treatment resulted in the shortest overall processing time and in the smallest volume loss (1%) and MB treatment in the largest volume loss (8%). MB treatment retained the highest concentrations of factors II, VII, X, IX, Protein C, and Antithrombin and the AM products of factor V and XI. Each PRT process evaluated offered distinct advantages such as procedural simplicity and volume retention (RB) and overall plasma protein retention (MB).

The novel HLA‐B*44:130 allele was found in a Spanish donor. B*44:130 differs from B*44:40 by four nucleotide changes at codons 11, 12 and 24, producing three amino acid replacements, 11A>S, 12M>V and 24T>S.

1. Perry HE, Prasad P, Kirwan S, Huang YQ. Core temperature changes in resuspended red blood cells (RBCs) and pediatric RBCs removed from refrigerated storage. Transfusion 2010;50:174-7. 2. Johnson V, Langeberg A, Taye-Makuria A, Sandler SG. Temperature-sensitive labels for containers of RBCs. Am J Clin Pathol 2006;126:406-10. 3. Reid TJ, Babcock JG, Derse-Anthony CP, Hill HR, Lippert LE, Hess JR. The viability of autologous human red cells stored in additive solution 5 and exposed to 25°C for 24 hours. Transfusion 1999;39:991-7. 4. Ruddell JP, Lippert LE, Babcock JG, Hess JR. Effect of 24-hour storage at 25°C on the in vitro storage characteristics of CPDA-1 packed red cells. Transfusion 1998;38:424-8. 5. Hamill TR, Hamill SG, Busch MP. Effects of roomtemperature exposure on bacterial growth in stored red cells. Transfusion 1990;30:302-6.

Umbilical cord blood (UCB) is an alternative source of hematopoietic progenitors for transplantation in the treatment of haematological malignancies, marrow failure, immunodeficiencies, hemoglobinopathies and inherited metabolic diseases. It has greatly contributed to increase the feasibility to transplantation for many patients in need. To date, more than 20,000 UCB transplants have been performed on children and adults, and more than 400,000 UCB units are available in more than 50 public CB banks. One of the most important objectives of banks is to cryopreserve and store high quality UCB units. Volume reduction is a usual process in cord blood banking that has some advantages as reducing the storage space and the DMSO quantity in final product. Volume reduction methodology must guarantee high cell recovery and red blood cell (RBC) depletion by reducing the UCB units to a standard volume. Hydroxyethyl starch (HES) sedimentation was the first method developed for this purpose by the New York Cord Blood Bank and implemented in many banks worldwide. The semi-automated top and bottom system, usually used for blood fractionation was further developed to simplify and short the process. Later, automatic devices as SEPAX and AXP have been developed in last years specifically for UCB volume reduction purpose. This review critically analyses the advantages and disadvantages of the different procedures. All of them have been used in Valencia Cord Blood Bank along 10 years. In general, automatic devices are preferred because of compliance with cGTP, closed systems, higher reproducibility and less influence of technician.

Studies with riboflavin in the 1960s showed that it could be effective at inactivating pathogens when exposed to light. The principal mode of action is through electron transfer reactions, most importantly in nucleic acids. This suggested that it could act as a photosensitizer useful in the inactivation of pathogens found in blood products.Objective: To study the influence of photo-inactivation with riboflavin on the coagulation factors of plasma.Methods: The photo-inactivation procedure of riboflavin plus light was applied. Fifty iso-group pools of two plasmas were made from 100 U of plasma that were derived from whole blood products that had previously been held overnight. Pools were split into two bags. One of them was photo-inactivated, and post inactivation samples were obtained. The second bag was not photo-inactivated and samples were taken. Total protein, fibrinogen, I'll, FV, FVII, FVIII, FIX, FX, FXI, FXIII, antithrombin III, PC, PS, alpha-2 antiplasmin and vWF:Ag, the multimeric structure of vWF and ADAMTS-13 were analyzed.Results: In plasma, the proteins most sensitive to photo-inactivation were fibrinogen, FXI, FVIII, FV, and FIX (33%, 32%, 30%,18% and 18% loss, respectively). Coagulation inhibitors, PS, antithrombin HI and PC showed little decrease (all 2%). Retention of vWF and ADAMTS-13 were 99% and 88%, respectively.Conclusions: As with other pathogen reduction procedures for plasma products, treatment with riboflavin and UV light resulted in reduction in the activity levels of several pro-coagulant factors. Coagulation inhibitors are well preserved. (C) 2009 Elsevier Ltd. All rights reserved.

BACKGROUND:Umbilical cord blood (UCB) banking is a well-established activity supporting the increasing number of UCB transplantations in haematological diseases. Our aim was to analyse the UCB characteristics of UCB units from preterm deliveries and compare them to full-term deliveries.MATERIAL AND METHODS:A prospective study in 194 preterm deliveries occurring at the La Fe University Hospital in Valencia was performed. Patients between 25 and 37 weeks of gestation were included. Those cases were compared to a full-term deliveries control group.RESULTS:The cases were grouped according to the gestational age: between 25 and 33 weeks (group 1), between 34 and 37 weeks (group 2) and between 38 and 42 weeks (group 3). Among obstetric variables, only arterial pH and maternal age variables were similar for all the groups. Higher CD34(+) cell counts were observed in the group 2, while the clonogenic efficiency was higher for the most preterm deliveries.DISCUSSION:UCB from deliveries of at least 34 weeks of gestation contain sufficient hematopoietic stem cell content for unrelated banking and transplantation, even containing higher CD34(+) cell content than UCB units from full-term deliveries. However, UCB from deliveries of less than 33 weeks' gestation contain only sufficient progenitors for children under 20 kg.

BACKGROUND AIMS:Volume reduction is the usual process in cord blood banking that has some advantages regarding reducing the storage space and dimethyl sulfoxide (DMSO) quantity in the final product. The volume reduction methodology must guarantee high cell recovery and red blood cell (RBC) depletion by reducing all the umbilical cord blood (UCB) units to a standard volume.METHODS:We analyzed and compared critically three different volume reduction methods [hydroxyethylstarch (HES), top and bottom with Optipress II and Compomat G4, and AXP] used at the Valencia Cord Blood Bank over 10 years.RESULTS:The highest significant RBC depletion was achieved with the AXP system (P<0.001), while the top and bottom system with Compomat G4 and an adjusted buffy coat (BC) volume to 41 mL enabled the best total nucleated cell (TNC) recovery (P<0.001). TNC recovery and RBC depletion were similar for AXP and HES with an adjusted volume to 21 mL. In the multivariate analysis, when analyzing all cases, the BC volume set significantly influenced TNC, CD34+ and lymphocyte recoveries and RBC depletion (P<0.001). RBC depletion was significantly influenced by the initial volume and initial RBC content of UCB units (P<0.001).CONCLUSIONS:AXP is a highly efficient method for RBC depletion, providing the same TNC recovery as HES method with a final volume of 41 mL. AXP has the advantages of being an automatic and functionally closed system that shortens and better standardizes the proceedings. Top and bottom is a closed system that allows better TNC recoveries when the BC volume set is 41 mL.

Background and Objectives.Platelet concentrates (PC) obtained from Buffy-Coat (BC) may be diluted in a platelet additive solution (PAS).These PCs may reduce plasma-related adverse reactions.We have tried to assess the relationship between PAS PCs and adverse reactions.Materials and Methods.During 6 months, patients treated with intensive chemotherapy, participated in a prospective study and were randomly assigned to receive, on a prophylactic basis, PCs in either plasma or PAS-2.Five iso-group BCs were pooled diluted in either plasma or PAS-2.One hour after each transfusion, corrected count increments (CCIs) were calculated, presence of hemorrhage and adverse reactions were recorded.Results.Platelet increment, 1-hour platelet count, and corrected count increments (CCI) after transfusion in both groups were similar.There were more transfusion-dependent adverse reactions in plasma group.Conclusion.Use of PAS-2 resulted in less transfusion related reactions; therefore, we recommend synthetic additive solutions to dilute PCs.

Introduction: Although there is considerable variability in methodology among umbilical cord blood banks, their common goal is to achieve optimal product quality for transplantation. Cryopreservation is a critical issue for a long-term maintenance of cord blood viability and colony-forming capacities.Materials and methods: We designed a prospective study to compare controlled (CRF) vs. non-controlled freezing (URF) of volume-reduced cord blood units. In addition, the influence of hydroxy ethyl starch (HES) on cryopreservation was also assayed. To assess the efficiency of protocols used, cell recoveries were measured and the presence of hematopoietic colony-forming units was quantified.Results: In the study phase, we observed similar CB haematopoietc recoveries for CRF and URF strategies, except for TNC recovery that was better for HES volume reduced CB units in the URF group. When we analysed the data of routine processed CB units in samples from satellite cryovials, we found better BFU-E, CFU-GM, CFU-GEMM and CFU recoveries for those units processed with HES than without HES, in an URF manner.Conclusions: URF of CB units is a cryopreservation procedure that allows similar hematopoietic progenitor recoveries than CRF with programmed devices. However, our study suggests that those banks that cryopreserve CB units in a URF manner should use HES for volume reduction. On the other hand, for CRF cryopreservation methodology volume reduction with and without HES are equally useful. (C) 2008 Elsevier Inc. All rights reserved.

Umbilical cord blood (UCB) has emerged as an alternative source of hematopoietic progenitor cells for transplantation and its use continues to rise. Since 2000 our laboratory has received, thawed, and washed 133 UCB units, with 30 units processed in 2007. While thawing an UCB unit in a water bath, a break was discovered in the seal of the 20 + 5-mL storage bag (see figure). Blood leaked from the bag into a second sterile bag used to prevent the consequences of the bag breakage as stated in our standard operational procedures (SOP) for thawing of UCB units. The technician attempted to change the orientation of the bag to limit the leakage estimating that 10 to 12 mL of the UCB leaked out.This volume was aspirated with a syringe and the bag was rinsed with thawing solution to improve recovery. Routine visual inspection of the UCB unit had failed to detect any leak either at the moment of its delivery from the cord blood bank or at its reception in our

Umbilical cord blood (UCB) has become an alternative source of hematopoietic progenitors (HSC) for transplantation. Although most CB transplants have been performed in children, unrelated donor-cord blood transplants in adults have been growing steadily in recent years. HSC content of CB units influence significantly the transplantation outcome, as shown by many clinical studies. UCB banks are fundamental to support this increasing clinical activity and one of their main goals must be to store good quality units. Strategies for increasing HSC content of UCB units are reviewed and also its influence on transplantation outcome. Our bank selected the UCB units for cryopreservation on the basis of their total nucleated cells (TNC) and CD34(+) cells content. We also reviewed the results of our UCB bank program.

Background/Aims: Nucleic acid testing (NAT) for hepatitis B virus (HBV) DNA in blood donations identified occult HBV infection (OBI) as a potential threat to blood safety.Methods: A collaborative study was undertaken to explore the molecular basis of OBIs prevalent in Europe in relation to clinical and serological data.Results:Ninety-one percent of 77 donor samples of European origin HBV DNA positive but HBV surface antigen (HBsAg) negative were confirmed. Viral load ranged between unquantifiable and 5640 IU/mL (median 25 IU/ml,). Fifty-two strains were genotyped (14 HBVA2 and 38 HBVD)). Compared to HBsAg+ samples, genotype D was significantly more frequent than genotype A2 in OBIs from Poland or Italy (P < 0.04). Amino acid substitutions were concentrated in the immunologically active parts of the Pre-S/S proteins (P < 0.0001) affecting both cellular CD8 T-cell epitopes and B-cell neutralizing Major Hydrophilic Region epitopes. Substitutions were more frequent in OBIs than in HBsAg+ strains of both genotype D (P < 0.001) and A2 (P < 0.01), in OBIs of genotype D than A2 in the 'a' region (P < 0.001) but not cellular epitopes, and in anti-HBs+ than anti-HBs- OBIs (P < 0.001).Conclusions: Results support the hypothesis that humoral and cellular immune pressure on the HBV envelope proteins are major mechanisms generating OBI. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Several studies have shown the presence of fibroblast-like cells in the stromal fraction of different tissues with a high proliferative and differentiation potential. Platelet alpha granules contain growth factors released into the environment during activation. The effects of different supplements for culture medium (human serum, bovine serum and platelet lysate) on cultured human fibroblast-like cells from bone marrow, adipose tissue, trabecular bone and dental pulp have been compared. Expression of typical stromal and hematopoietic markers was analyzed and proliferative rates were determined. Flow cytofluorometry showed a homogenous pattern in serial-passaged cells, with a high level of stromal cell-associated markers (CD13, CD90, CD105). The presence of platelet lysate in culture media increased the number of cell generations obtained regardless of cell source. This effect was serum-dependent. Cell-based therapies can benefit by the use of products from human origin for “ex vivo” expansion of multipotent cells.

Transfusion MedicineVolume 17, Issue 3 p. 205-206 Stress factors and umbilical cord blood banking Pilar Solves, Corresponding Author Pilar Solves * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainPilar Solves, Umbilical Cord Blood Bank, Transfusion Centre, Avda del Cid, 65A, 46014, Valencia, Spain. Tel.: +34 963 8681161; fax: +34 963502469; e-mail: [email protected]Search for more papers by this authorAlfredo Perales, Alfredo Perales * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this authorVicente Mirabet, Vicente Mirabet * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this authorRoberto Roig, Roberto Roig * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this author Pilar Solves, Corresponding Author Pilar Solves * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainPilar Solves, Umbilical Cord Blood Bank, Transfusion Centre, Avda del Cid, 65A, 46014, Valencia, Spain. Tel.: +34 963 8681161; fax: +34 963502469; e-mail: [email protected]Search for more papers by this authorAlfredo Perales, Alfredo Perales * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this authorVicente Mirabet, Vicente Mirabet * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this authorRoberto Roig, Roberto Roig * Umbilical Cord Blood Bank Transfusion Centre, Valencia, Spain and † La Fe University Hospital, Valencia, SpainSearch for more papers by this author First published: 06 June 2007 https://doi.org/10.1111/j.1365-3148.2007.00740.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References Lim, F.T., Scherjon, S.A., Van Beckhoven, J.M., Brand, A., Kanhai, H.H., Hermans, J.M. & Falkenburg, J.H. (2000) Association of stress during delivery with increased numbers of nucleated cells and hematopoietic progenitor cells in umbilical cord blood. American Journal of Obstetrics and Gynecology, 183, 1144–1151. 10.1067/mob.2000.108848 CASPubMedWeb of Science®Google Scholar Picardi, A., Tamburini, A., Caravita, T. et al . (2006) Diagnosis of acute foetal distress does not preclude banking of umbilical cord blood units. Transfusion Medicine, 16, 349–354. 10.1111/j.1365-3148.2006.00677.x CASPubMedWeb of Science®Google Scholar Shlebak, A.A., Roberts, I.A., Stevens, T.A., Syzdlo, R.M., Goldman, R.M. & Gordon, M.Y. (1998) The impact of antenatal and perinatal variables on cord blood haematopoietic stem/progenitor cell yield available for transplantation. British Journal of Haematology, 103, 1167–1171. 10.1046/j.1365-2141.1998.01093.x CASPubMedWeb of Science®Google Scholar Solves, P., Perales, A., Moraga, R., Saucedo, E., Soler, M.A. & Monleón, J. (2005) Maternal, neonatal and collection factors influencing the haematopoietic content of cord blood units. Acta Haematologica, 113, 241–246. 10.1159/000084677 PubMedWeb of Science®Google Scholar Citing Literature Volume17, Issue3June 2007Pages 205-206 ReferencesRelatedInformation