Croatian Institute of Transfusion Medicine

Petrova, Croatia

Croatian Institute of Transfusion Medicine

Petrova, Croatia

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PubMed | Red Cross, Blood Consult GF, Sanquin Blood Supply, National Institute of Health and 2 more.
Type: Journal Article | Journal: Blood transfusion = Trasfusione del sangue | Year: 2016

Transfusion-transmissible infections have made both blood bankers and health authorities overly cautious. The general public expects and hence reinforces this policy. To obtain a high level of blood product safety, blood and plasma donors have to meet increasingly stringent eligibility criteria; however, it is not known whether this policy translates into improved outcomes for patients. There is a risk that the management of donors does not match the ambition of greater safety for patients. European directives related to the collection process and donor selection will probably be reconsidered in the next few years.The development of European directives on donor selection and their basis in the literature were reviewed with an emphasis on the background and considerations for eligibility criteria to be included in the directives.The precautionary principle appears to be the predominant reason behind the set of eligibility criteria. However, the formal eligibility criteria, put into force in 2004, do not balance with the developments of the past decade in laboratory tests and measures that have substantially reduced actual infection risks. In no cases were the effects of eligibility criteria on the donor pool and donor well-being quantified. Regional differences in the epidemiology of transfusion-transmissible infections were not taken into consideration either.First, the Authors promote the collection of epidemiological data on the incidence and prevalence of conditions in the general population and in blood and plasma donors which could pose a risk for transfused patients, in order to use these data as a basis for decision-making in donor-selection policies. Second, the Authors suggest including allowance for differential deferral criteria throughout Europe, based on factual risk levels. There should be an accepted balance between donor and patient welfare, and also between risk to transfusion safety and risk of compromising the blood supply.


PubMed | University of Zagreb and Croatian Institute of Transfusion Medicine
Type: | Journal: Transfusion medicine (Oxford, England) | Year: 2016

The aim of this study was to assess the appropriateness of using combined cell index (CCI) in the assessment of iron stores in blood donors. This index is calculated by the formula: red blood cell distribution width (RDW) 10Ferritin measurement is a reliable method for estimating iron stores in blood donors. The sensitivity of red blood cell (RBC) parameters of complete blood count in detecting non-anaemic iron deficiency is significantly lower. Consequently, there were several attempts to increase the detection sensitivity by combining these parameters in different indices.This study included 1084 male and 792 female whole blood donors accepted for blood donation. For six RBC parameters with the highest level of correlation relative to ferritin [Hgb, MCV, MCH, mean corpuscular haemoglobin concentration (MCHC), RDW and CCI], diagnostic efficacy in the detection of iron depletion (ferritin <12gLCCI showed the highest degree of correlation with ferritin (r=-0373 for men and r=-0590 for women) and the highest area under the curve (0961 for men and 0864 for women). Using the cut-off value of 526 for men and 506 for women, the corresponding Youden index was the highest for CCI in both genders (0851 for men and 0612 for women). The sensitivity and specificity of CCI in the population of male donors were higher in comparison to female donors (0941 and 0910 vs 0851 and 0761, respectively).Study results confirmed the satisfactory diagnostic value of CCI in detecting depleted iron stores in blood donors.


PubMed | Institute for Medical Research and Occupational Health, Ruder Boskovic Institute, Czech Institute of Macromolecular Chemical, University of Zagreb and Croatian Institute of Transfusion Medicine
Type: | Journal: Beilstein journal of nanotechnology | Year: 2016

Silver (AgNPs) and maghemite, i.e., superparamagnetic iron oxide nanoparticles (SPIONs) are promising candidates for new medical applications, which implies the need for strict information regarding their physicochemical characteristics and behavior in a biological environment. The currently developed AgNPs and SPIONs encompass a myriad of sizes and surface coatings, which affect NPs properties and may improve their biocompatibility. This study is aimed to evaluate the effects of surface coating on colloidal stability and behavior of AgNPs and SPIONs in modelled biological environments using dynamic and electrophoretic light scattering techniques, as well as transmission electron microscopy to visualize the behavior of the NP. Three dispersion media were investigated: ultrapure water (UW), biological cell culture medium without addition of protein (BM), and BM supplemented with common serum protein (BMP). The obtained results showed that different coating agents on AgNPs and SPIONs produced different stabilities in the same biological media. The combination of negative charge and high adsorption strength of coating agents proved to be important for achieving good stability of metallic NPs in electrolyte-rich fluids. Most importantly, the presence of proteins provided colloidal stabilization to metallic NPs in biological fluids regardless of their chemical composition, surface structure and surface charge. In addition, an assessment of AgNP and SPION behavior in real biological fluids, rat whole blood (WhBl) and blood plasma (BlPl), revealed that the composition of a biological medium is crucial for the colloidal stability and type of metallic NP transformation. Our results highlight the importance of physicochemical characterization and stability evaluation of metallic NPs in a variety of biological systems including as many NP properties as possible.


Bojic M.,University of Zagreb | Debeljak Z.,University of Zagreb | Debeljak Z.,Laboratory Diagnostics | Tomciic M.,Croatian Institute of Transfusion Medicine | And 2 more authors.
Nutrition Journal | Year: 2011

Background: Among natural compounds, present in every day diet, flavonoids have shown beneficial effect in prevention of cardiovascular diseases that can be attributed, at least partially to the described antiaggregatory activity i.e. antiplatelet effects of flavonoids. Due to the ever increasing pharmacological interest in antiplatelet agents a systematic experimental evaluation of large flavonoid series is needed. Methods. A set of thirty flavonoid aglycones has been selected for the evaluation. All measurements of aggregation were done under standardized and firmly controlled in vitro conditions. The whole blood samples, multiple platelet functional analyzer and adenosine diphosphate (ADP) as a weak agonist of aggregation were selected for this purpose. Results: The results were expressed as minimal concentration of flavonoid that can significantly lower the platelet aggregation compared to the corresponding untreated sample (minimal antiaggregatory concentration - MINaAC). All analyzed flavonoids exhibited antiaggregatory activity MINaAC ranging from 0.119 M to 122 M, while the most potent representatives were 3,6-dihydroxyflavone (0.119 M) and syringetin (0.119 M). Conclusions: Measurable antiplatelet activity established at submicromolar flavonoid concentrations suggests that even a dietary consumption of some flavonoids can make an impact on in vivo aggregation of platelets. These findings also point out a therapeutical potential of some flavonoids. © 2011 Boji et al; licensee BioMed Central Ltd.


Banovic M.,University of Zagreb | Bordukalo-Niksic T.,Ruder Boskovic Institute | Balija M.,Croatian Institute of Transfusion Medicine | Cicin-Sain L.,Ruder Boskovic Institute | Jernej B.,Ruder Boskovic Institute
Platelets | Year: 2010

The present study had two goals: first, to give a detailed description of a reliable method for full kinetic analysis of serotonin transporter (5HTt) on the membrane of human platelets, and second, as a main issue, to report on physiological influences on kinetic characteristics of this transmembrane transport on a large population of healthy individuals. Full kinetic analyses of platelet serotonin uptake were performed on 334 blood donors of both sexes by the use of 14C-radioisotopic method, which was first optimized according to assumptions of enzyme kinetic analyses, with regard to platelet concentration, duration of uptake, concentration of substrate as well as important technical parameters (underpressure of filtration, blanks, incubating temperature, etc). Kinetic parameters of platelet serotonin uptake in the whole population were for Vmax: 142 ± 25.3 pmol 5HT/108 platelets/minute and for Km: 0.404 ± 0.089 M 5HT. Besides the report on kinetic values of 5HT transporter protein, we have also described major physiological influences on the mentioned parameters, Vmax, Km and their derivative, Vmax/Km (transporter efficiency): range and frequency distribution of normal values, intraindividual stability over time, lack of age influence, gender dependence and seasonal variations. The report on kinetic values and main physiological influences on platelet serotonin transport kinetics, obtained by the use of thoroughly reassessed methodology, and on by far the largest human population studied until now, offers a reliable frame of reference for pathophysiological studies of this parameter in various clinical fields. © 2010 Informa UK Ltd.


Hojsak I.,University of Zagreb | Strizic H.,University of Zagreb | Strizic H.,Zagreb Medical Center | Misak Z.,University of Zagreb | And 4 more authors.
Clinical Nutrition | Year: 2012

Background & aims: The aim was to assess the rate of central venous catheter (CVC) related sepsis in patients on parenteral nutrition (PN) at our hospital center during a period of 21 years. Methods: Data on all children hospitalized at our tertiary hospital center during the 1989-2010 period, who received PN for more than 4 weeks (n = 62) were retrospectively analyzed. Results: The mean age at the time of introducing PN was 2.9 years (range 6 days-17.4 years), male/female ratio 26/36. Out of these 62 patients, nine (14.5%) patients continued home PN (HPN) after discharge from the hospital. Altogether 86 CVCs were used (mean 1.39 per patient) and total CVC time was 21,459 days, which makes 243.9 days per CVC. During the study period, there were 36 CVC related sepsis episodes (1.7/1000 days of PN). Total number of septic episodes was significantly lower in HPN compared to hospital PN (0.94/1000 vs. 2.75/1000 days of PN; P < 0.001). Septic episodes led to removal of 11 (12.8%) catheters. Two patients died due to CVC related septic shock (0.93 deaths/10,000 days of PN), one in HPN patient (0.79 per 10,000 days of HPN). Conclusion: The rate of CVC related sepsis in our PN cohort was exceptionally low in both hospital and home setting. © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.


Tomicic M.,Croatian Institute of Transfusion Medicine | Starcevic M.,University of Zagreb | Ribicic R.,University of Zagreb | Golubic-Cepulic B.,University of Zagreb | And 2 more authors.
American Journal of Reproductive Immunology | Year: 2014

Problem: The aim of this study was to estimate the incidence of the disease and to analyze laboratory data of 23 newborns undergoing serologic testing for alloimmune neonatal neutropenia (ANN) during the 1998-2008 period in Croatia. Method of study: Laboratory data on 23 newborns undergoing serologic testing for ANN during the 1998-2008 period and epidemiologic data on the number of live births in Croatia were analyzed. Laboratory testing for ANN included serologic screening of maternal and neonatal sera and granulocytes (neutrophils) by immunofluorescence (IF) method. The monoclonal antibody immobilization of neutrophil antigens (MAINA) was employed to determine anti-HNA antibody specificity. Results: Anti-HNA antibodies were detected in seven (54%) of 13 cases of serologically positive ANN. Only anti-HLA class I antibodies were demonstrated in four (31%) of 13 cases In the 2007-2008 period of prospective data collection, the number of serologically verified ANN cases was one case per 17,323 live births. Results of the prospective study conducted at Maternity Ward, Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center yielded the ANN incidence of one case per 2843 live births. Conclusion: Monitoring of neutrophil count in neonatal blood and serologic testing for ANN in case of isolated neutropenia in the newborn contributed considerably to timely detection of ANN. Descriptors: Neonatal alloimmune neutropenia-incidence, serologic diagnosis, antineutrophil antibodies, anti-HNA, anti-HLA class I, Croatia. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


Starcevic M.,University of Zagreb | Tomicic M.,Croatian Institute of Transfusion Medicine | Malenica M.,University of Zagreb | Zah-Matakovic V.,University of Zagreb
Acta Paediatrica, International Journal of Paediatrics | Year: 2010

Neonatal alloimmune thrombocytopenia (NAIT) occurs as a result of maternal alloimmunization against paternally inherited antigens on foetal platelets. Platelets express platelet specific antigens (HPA) along with human leucocyte antigens (HLA) class I. Although anti-HLA class I antibodies are often detectable in pregnant women, their role in NAIT is considered controversial. We report a case of NAIT where the most sensitive serological analysis and molecular methods could not detect platelet specific antibodies. Only HLA incompatibility and presence of anti-HLA-A24 antibodies in both the mother's and the newborn's serum were proven. Conclusion: This case supports the idea that some anti-HLA class I antibodies could cause NAIT. © 2009 Foundation Acta Pædiatrica.


Balija M.,Croatian Institute of Transfusion Medicine | Bordukalo-Niksic T.,Ruder Boskovic Institute | Mokrovic G.,Ruder Boskovic Institute | Banovic M.,University of Zagreb | And 2 more authors.
Clinica Chimica Acta | Year: 2011

Background: Although it is known that platelet serotonin level (PSL) depends directly on platelet serotonin uptake (PSU) through the plasma membrane, reports on their interrelation are inconsistent. The aim of this study was to systematically explore the relationship between these two platelet serotonin parameters in large human population. Methods: PSL and full-kinetics of PSU were determined on 318 blood donors (276 males, 42 females; 20-67. years). Results: The overall correlation coefficient between PSL and maximal velocity of PSU was highly significant but unexpectedly low (r=0.269). Further analyses revealed lack of correlation among females, and variable association among males, depending on the subject age and season of measurements. Highly significant correlations were observed in spring-winter, while association was absent during summer-autumn. Lowering of PSL-PSU correlation with increased age was also demonstrated, showing modest interrelation among younger men and no interrelation in older population. By multiple regression analyses season was identified as the only independent predictor of PSL-PSU relationship. Conclusions: The results show prominent influence of biological (sex, age) and, especially, environmental (seasons) physiology on the intraindividual relationship between PSL and PSU. Although serotonin transporter activity plays an important role in determining PSL, the observed correlations indicate that other factors may predominate. © 2010 Elsevier B.V.


PubMed | University of Split and Croatian Institute of Transfusion Medicine
Type: Journal Article | Journal: Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie | Year: 2016

To evaluate the incidence, the consequences, and the prevention strategy of anti-D alloimmunizations of D variant carriers in the obstetric population of Split-Dalmatia County, Croatia.RhD immunization events were evaluated retrospectively for the period between 1993 and 2012. Women were tested for RhD antigen and irregular antibodies. Those with anti-D antibody who were not serologically D- were genotyped for RHD. They were evaluated for their obstetric and transfusion history and their titer of anti-D. The neonates were evaluated for RhD status, direct antiglobulin test (DAT), hemoglobin and bilirubin levels, transfusion therapy as well as phototherapy and outcome.Out of 104,884 live births 102,982 women were tested for RhD antigen. Anti-D immunization occurred in 184 women which accounts for 0.9% of individuals at risk of anti-D formation. 181 cases occurred in women serologically typed as D-. Three women were partial D carriers (DVa n = 2, DNB n = 1), initially typed RhD+, and recognized as D variant carriers after the immunization occurred. Anti-D titer varied from 1:1 to 1:16. Six children were RhD+, four had positive DAT, and two underwent phototherapy.Anti-D immunization occurred in pregnant partial D carriers (DVa, DNB). RhD+ children had serologic markers of hemolytic disease of the fetus and newborn (HDFN), with no cases of severe HDFN.

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