Australian Red Cross Lifeblood

To meet the long-term demand for blood products while preserving donor health in the long run, blood establishments must recruit a sufficient number of new donors annually. To determine what will suffice, it is essential to be able to forecast future blood donation volumes as a function of new donors using estimates based on historical donation activity. Donor (n = 11,629,873) and donation data (n = 64,510,294) extracted from operational information systems of seven blood establishments were transformed into anonymous donation activity data (grouped by blood establishment, sex and blood group) in the form of time series of mean number of donations per donor, indexed by years since first donation. Linear models were fitted to the time series using ordinary least squares. Out of the various estimated models, the best fit (mean R2 over blood establishments 99.95%) for past mean donation activity was achieved when regressing the logarithm of cumulative donation activity on the logarithm of years since first donation and an indicator variable for the year of first donation. In addition to the predictions, comparison of the estimated parameters revealed that there are significant differences between blood establishments, translating to differences in the expected number of donations accumulated over the lifetime of a donor. Average donation activity can be modelled using a few variables and simple models, with high precision. The estimates can be used to create forecasts of future donation volumes, which in turn can be useful in long-term blood donation management.

Cultural diversity in a blood donor panel is vital for healthcare, especially in countries where multiple cultural groups are growing in representation and have unique phenotypes. Word-of-mouth (WOM) is considered a potentially powerful way to recruit diverse donors; however, donors seldom talk about blood donation. This study explores factors influencing positive WOM about blood donation among people within Chinese and Indian communities in Australia. Six online focus groups were conducted with 35 donors (20 Chinese and 15 Indian) aged 18-57 who had donated in the past 12 months. Using thematic analysis, the factors that contributed and inhibited sharing WOM about blood donation were identified. Participants shared their WOM experiences, motivations, perceived barriers, and supports needed to enhance their WOM activities. Donors from both cultural groups recognized the benefits of discussing blood donation, however their engagement varied. Most were reactive, responding to inquiries rather than initiating conversations. Their WOM behaviors were influenced by personal experiences, conversational context, and social connections. The main concern was being perceived as bragging, while motivators included altruism and professional links to healthcare. Significant cultural differences emerged: Indian participants were cautious about WOM to avoid personal health disclosures from recipients, while Chinese donors highlighted cultural perceptions of loss of vitality from donating, especially among older individuals, as a barrier to discussing donation. A proposed model of willingness to share WOM was developed based on individuals' goals for sharing WOM and perceived agency to do so. Strategies are needed to help donors view their role as including active support for blood donation. Tools and resources that give donors a "license" to initiate WOM discussions about blood donation, while addressing cultural misconceptions, may strengthen their confidence and agency to discuss blood donation.

Cytomegalovirus (CMV) causes harm in at-risk populations. Selection of seronegative donors has been used to prevent transmission. Leucodepletion reduces the potential for CMV transmission; however, the residual risk is uncertain, leading to variability in practice. This study systematically reviews the risk of CMV transmission in leucodepleted blood products compared to seronegative blood products. A systematic review identified comparative studies of CMV infection rates following transfusion of leucodepleted blood from CMV-negative or unselected donors. Preclinical studies on blood product CMV transmission, reported cases and studies that informed population risk were also reviewed. Meta-analysis was performed on comparative studies. There was no difference in the rate of infection following transfusion of leucodepleted cellular products with or without donor CMV seronegativity selection, with a relative risk of 1.21 (95% confidence interval [CI]: 0.42-3.49). No confirmed cases of CMV transmission were found. Preclinical studies showed a significant reduction in transmissible virus with leucodepletion, although no threshold could be defined. Cell-free CMV is not removed by filtration, and although it may remain a potential source of infection, there was no evidence of transmission through plasma, possibly due to detectable virus not reflecting intact transmissible virus. Selecting CMV-seronegative donors did not reduce the risk of transmission when transfusing leucodepleted blood products because of the high efficiency of filters in removing transmissible cellular virus. This finding suggests CMV donor negative selection does not substantially contribute to donor safety.

Platelets are transfused to patients to prevent and stop bleeding. Conventionally, platelets are stored at room temperature (RT; 20–24 °C), however, this limits their shelf life to 5–7 days, due to an increased risk of bacterial proliferation at RT. In recent years, cold storage (2–6 °C) of platelets has regained interest, largely due to the potential to extend the shelf life up to 21 days. The historical use of cold-stored platelets and decades of foundational research has made their (re)implementation possible, with cold-stored platelets already being transfused in several countries, including the United States and Norway. However, as efforts continue to expand implementation, it is becoming increasingly evident that variations in processing methods from collection to transfusion, including the collection platform, storage solution and additional component modifications, may alter platelet characteristics during cold storage. This variability is largely overlooked and there is a need to recognize how these differences may affect clinical outcomes post-transfusion. This review outlines the assumptions that have been made regarding cold-stored platelets and discusses areas that require further consideration in an effort to inform future research and best practice.

Two prior publications have identified a novel RHD variant in the Australian population with the pattern of single nucleotide variation (SNV) c.186G>T, c.410C>T, c.455A>C, c.602C>G, c.604G>A, c.733G>C, and a deletion or rearrangement with RHCE exon 9. The Australian Red Cross Lifeblood provides testing across Australia, and over a period of 8 years, this same RHD variant has been noted, with some cases presenting with allogeneic anti-D. Cases with the combination of SNVs were identified with the RHD BeadChip™ panel and massively parallel sequencing, and were collated. Clinical presentation, phenotype and the specificity of any antibodies were also reviewed. Twelve cases of the same pattern of SNV and exon change were identified. There was consistent finding of c.186G>T, c.410C>T, c.455A>C, c.602C>G, c.604G>A and c.733G>C, in association with RHCE replacement of exon 9. All cases except one were phenotypically D-positive. Nine of 12 cases presented with anti-D antibodies, often associated with pregnancy. Where ethnicity was reported, all individuals were of Australian Indigenous ethnicity. This RHD variant is observed to date only in people of Australian Indigenous ethnicity and has clinical relevance. With wider knowledge of the variant, it is anticipated that there will be increased screening in this population, especially in women of childbearing age.

Refrigeration and cryopreservation are attractive alternatives that could support an extension of the current room temperature shelf life of platelets. As transfusion of cold-stored platelets (CSP) is currently limited to bleeding patients, multiple platelet inventories will be required, which may lead to expiry and wastage. To avoid this, it may be beneficial to freeze CSP to further extend their shelf life. As such, the aim of this study was to determine whether cryopreservation of expiring CSP adversely affects in vitro platelet quality. On Day 1 following collection, double-dose single-donor plateletsharvested apheresis (60% PAS-E/40% plasma; n = 10) were frozen (-80°C with 5%-6% dimethylsulfoxide) or refrigerated (2-6°C without agitation) for 14 days. The CSP was then frozen. In vitro platelet quality was measured prior to freezing, and after thawing and reconstitution in plasma. Platelet recovery was lower in the thawed CSP (70 ± 5%), compared to standard thawed components (77 ± 8%; p = .0340). However, the recovery of all thawed platelets was above the minimum specification of 50%. Platelet glycoproteins (GPIIIa, GPIbα, and GPVI) were equivalent between thawed groups. Thawed CSP had higher P-selectin exposure, but less externalized phosphatidylserine and extracellular vesicle release, compared to standard thawed platelets. Functional parameters, including ADP-induced PAC-1 activation and thromboelastography were similar after thawing, regardless of pre-freeze storage conditions. These data suggest that cryopreservation may be a suitable way to further extend the shelf life of CSP, thus offering a strategy to reduce wastage and enhance inventory management.

Severe dry eye disease is a commonly diagnosed condition that can be treated with serum eye drops (SEDs). SEDs are manufactured from the serum obtained from whole-blood donation. Patient information provided with SEDs has not been evaluated so far. This study aims to understand patients' views on SED materials and identify possible improvements. The study period was between 1 November 2021 and 30 June 2022. Eligible patients were supplied with either autologous SED (AutoSED) or patient-tailored (allogeneic) SED (PT SED) manufactured by Australian Red Cross Lifeblood. Patients were invited to participate via email or post and completed an online survey or participated in a semi-structured telephone interview. A total of 64 patients supplied with AutoSED and 18 with PT SED completed the survey, of whom 10 and 8, respectively, were interviewed. More AutoSED (89.1%) than PT SED (58.8%) patients reported that the instructions on the carton were helpful. More AutoSED patients (78.1%) than PT SED (55.6%) reported receiving the SED brochure and that the information was easy to understand. Information on how to dispose the eye drops and the risk of treatment was easy to understand. Sixteen patients reported accessing the quick-responsecode to view the SED video and indicated that it was easy to understand. Patient views on the materials provided with SEDs were generally positive. Suggested improvements included changing the location of sealing stickers on the carton, providing further detailed information on shelf-life after power supply challenges and natural disasters and storage and handling during travel.