Search PubMed⌕ Search

Biomedical subjects

M Kuriyan

Publications and source records attributed to M Kuriyan.

13 recordsLinked to original sources
PubMed2000

Pretransfusion testing without serologic crossmatch: approaches to ensure patient safety.

BACKGROUND AND OBJECTIVES: A crossmatch is usual in pretransfusion testing, but we eliminated it at our tertiary care university hospital. In place of the crossmatch, we have introduced a system where, if an antibody screen is negative, two technologists confirm the ABO of the same patient sample, and we release blood of the patient's type without a serologic or electronic crossmatch. MATERIALS AND METHODS: In 65,628 samples received for pretransfusion testing, we studied the effect of common errors that occur from the time of receipt of a sample until release of the blood unit, in order to decide if elimination of the serologic crossmatch would affect patient safety. All sample labels were inspected for acceptability. RESULTS: A total of 1,082 (1.64%) samples were rejected for mislabeling. Discordance in patient ABO typing results between two technologists was 0.43%. Such discrepancies were resolved before the release of blood units. No donor unit mislabeling or unit release errors were detected. CONCLUSION: Elimination of the crossmatch for red cell antibody-negative patients is safe provided a system of error detection is used. This enhances patient care through the quicker release of blood, increased laboratory efficiency and decreased costs.

ABO Blood-Group System↗
PubMed1995

Matching blood donations to type-specific product needs: a recruitment technique.

The conversion of multiple whole blood donors to apheresis donors is a challenge since a rapidly expanding apheresis donor base could erode homologous collections. We addressed this concern with a plan to enhance apheresis recruitment as well as donations among homologous donors with types O and B blood. Focusing the donor's attention on blood type as it relates to type-specific product needs was the basis of our approach. A matrix was used to recruit the desired types for the desired procedures (whole blood, platelet/plasma apheresis). The matrix instructed donors of blood types O, A-, and B- to primarily give whole blood and to give apheresis as a secondary donation. Donors AB, A+, and B+ were primarily directed to apheresis donations, whole blood donation being secondary. A+ and O- donors only gave their secondary donation if they were at maximum donations with the primary donation. The collections by blood type in percentages for 12 months of 1992/93 for whole blood were O+ 38.9, 0- 7.3, A+ 29.5, A- 5.7, B+ 11.9, B- 2.1, AB+ 3.7, AB+ 0.7. For apheresis it was 0+ 36.2, O- 6.7, A+ 33.0, A- 6.6, B+ 10.4, B- 1.2, AB+ 4.9, AB+ 1.0. In 1992/93, A+ and B+ apheresis collections as compared to total apheresis collections increased by 4.9% and 13.7%, respectively. For O group apheresis donations, a decrease of 2.5% was shown and A+ whole blood donations decreased by 5.35%. During the same period of time, total apheresis collections increased by 3,058 units. We demonstrated that integration of apheresis recruitment with type-specific whole blood recruitment yielded significant increases of type-specific products.

Blood Component Removal↗
PubMed1995

Leukoreduced platelet apheresis production with a modified COBE spectra collection protocol.

A platelet apheresis product or single donor platelet (SDP) with a white blood cell content of 5 x 10(6) or below is considered optimal for transfusion. We modified the COBE spectra platelet collection protocol as follows: increased AC infusion rate of 1.1 ml/min/LTBV, setting the inlet: AC ratio configuration at high, and maintained the inlet flow rate of this setting with a maximum of 80 ml/min. The collection time varied with single dose or double dose production. The aim was to consistently obtain a platelet yield above 3 x 10(11) and a WBC content less than 5 x 10(6). The results were tabulated on 64 donations. The platelet yield was > 3 x 10(11) for 59 donations with a mean of 4.89, median of 4.72, and a range of 3.02 to 8.14; and < 3 x 10(11) for 5 donations with a mean of 2.74, median of 2.84, and a range of 2.14 to 2.96. The WBC content was < 5 x 10(6) for 60 donations with a mean of 0.52, median of 0.20, and a range of 0.06 to 0.71; and > 5 x 10(6) for 4 donations with a mean of 59.9, a median of 48.9, and a range of 8.12 to 62. We conclude that 93.8% of the donations yielded a SDP that met or exceeded leukoreduction standards.

Humans↗
PubMed1989

Blood component transfusion audit: a comprehensive microcomputer program.

Blood usage review is an essential aspect of hospital quality assurance. As part of a system for reviewing transfusion practices, the American Red Cross/New Jersey Blood Services has developed a series of microcomputer programs called the Blood Component Transfusion Audit. The programs use transfusion data collected on a standardized form to produce reports of utilization and analyses of transfusion practices, including the extent to which transfusions are justified by established criteria.

Blood Transfusion↗
PubMed1989

Regional blood usage review: a quality assessment study from New Jersey hospitals.

In 1986, the American Red Cross/New Jersey Blood Service (NJBS) conducted a blood utilization review of the use of red blood cells (RBCs), platelets, and fresh frozen plasma (FFP) in nine hospitals in the NJBS region. The director of NJBS analyzed the collected data and categorized the justification criteria for blood transfusion. Their study found that female patients and patients over 60 years of age are the largest users of blood products, the average number of RBC units used is three, and the most common indication for RBC use is hypovolemia due to surgery. There was a high degree of compliance with justified criteria of use for RBC transfusion, although platelet and FFP use and pretransfusion nursing documentation require improvement.

Blood Transfusion↗
PubMed1987

Blood donation by the elderly. Clinical and policy considerations.

At present, healthy potential blood donors older than the age of 66 years often leave the donor pool for reasons of age alone, despite the fact that this demographic group is growing, is a potentially willing source of blood products, and constitutes the cohort with highest per capita use of blood and its derivatives. There is no clinical or physiological rationale for this. We performed a controlled study to measure the feasibility and safety of blood donation by healthy elderly donors aged 66 years and older, compared with a younger cohort aged 55 to 65 years of age. A study group of prior donors aged 66 years and older and a control group of prior donors between the ages of 50 and 65 were sent letters inviting them to donate blood. The volume donated did not differ between the two groups. In the older group, there were eight immediate reactions, seven mild and one moderate. The control population experienced seven immediate reactions, six mild and one severe. We conclude that it is both clinically feasible and efficient to recruit healthy prior donors older than the age of 66 years for blood donation. As a group, this population is potentially able to donate large volumes of blood and do so without any difference in immediate or short-term reactions. Further study of hemodynamic variables as more objective markers of safety is needed.

Adult↗