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The blood transfusion services in Malaysia

Lopez CG

Malays J Pathol, 1983 Aug;6:1-7.
PMID: 6599863
Matched MeSH terms: Blood Banks/organization & administration*; Blood Banks/trends
Fulltext Blood transfusion services amidst the COVID-19 pandemic

Noordin SS, Yusoff NM, Karim FA, Chong SE

J Glob Health, 2021 Apr 17;11:03053.
PMID: 33884188 DOI: 10.7189/jogh.11.03053
Matched MeSH terms: Blood Banks/supply & distribution*; Blood Banks/trends
An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia

Jayaranee S, Prathiba R, Vasanthi N, Lopez CG

Malays J Pathol, 2002 Jun;24(1):59-66.
PMID: 16329557

The purpose of this study is to determine the efficiency of blood utilization for elective surgery at the University of Malaya Medical Centre (UMMC). A similar study conducted six years earlier in the same unit resulted in the introduction and implementation in December 1997 of the local Maximum Surgical Blood Order Schedule (MSBOS) and the Group Screen and Hold (GSH) procedure instead of a full crossmatch. This paper compares the findings of the current study with that conducted earlier.

Matched MeSH terms: Blood Banks/methods*; Blood Banks/supply & distribution; Blood Banks/statistics & numerical data
Fulltext Model-based test case prioritization using selective and even-spread count-based methods with scrutinized ordering criterion

Mohd-Shafie ML, Wan-Kadir WMN, Khatibsyarbini M, Isa MA

PLoS One, 2020;15(2):e0229312.
PMID: 32084232 DOI: 10.1371/journal.pone.0229312

Regression testing is crucial in ensuring that modifications made did not introduce any adverse effect on the software being modified. However, regression testing suffers from execution cost and time consumption problems. Test case prioritization (TCP) is one of the techniques used to overcome these issues by re-ordering test cases based on their priorities. Model-based TCP (MB-TCP) is an approach in TCP where the software models are manipulated to perform prioritization. The issue with MB-TCP is that most of the existing approaches do not provide satisfactory faults detection capability. Besides, their granularity of test selection criteria is not very good and this can affect prioritization effectiveness. This study proposes an MB-TCP approach that can improve the faults detection performance of regression testing. It combines the implementation of two existing approaches from the literature while incorporating an additional ordering criterion to boost prioritization efficacy. A detailed empirical study is conducted with the aim to evaluate and compare the performance of the proposed approach with the selected existing approaches from the literature using the average of the percentage of faults detected (APFD) metric. Three web applications were used as the objects of study to obtain the required test suites that contained the tests to be prioritized. From the result obtained, the proposed approach yields the highest APFD values over other existing approaches which are 91%, 86% and 91% respectively for the three web applications. These higher APFD values signify that the proposed approach is very effective in revealing faults early during testing. They also show that the proposed approach can improve the faults detection performance of regression testing.

Matched MeSH terms: Blood Banks/standards*
Role of blood bag temperature indicators in maintaining patent temperature of the returned unused blood bags in blood bank

Nurasyikin Y, Leong CF, Fadhlullah TM, Hafiz WM, Nadiah Z, Atieqah AN, et al.

Clin Ter, 2011;162(1):19-22.
PMID: 21448541

The main objective of the present study was to evaluate the temperature chain of red blood cells (RBC) returned unused blood bags using blood temperature indicator and ascertain the factors like transportation time, type, size of coolant box and number of bags per box.

Matched MeSH terms: Blood Banks/methods*; Blood Banks/standards
Fulltext Diagnostic use of PCR in Carbapenamase-producing Enterobacteriaceae (CPE): An mproved method to overcome the presence of inhibitors for DNA extraction from blood cultures

Zeti Norfidiyati Salmuna, Murnihayati Hassan, Habsah Hasan, Zakuan Zainy Deris

Malaysian Journal of Medicine and Health Sciences, 2019;15(1):1-4.
MyJurnal

Carpanenamase-producing Enterobacteriaceae (CPE) has emerged as a threat to hospitalized patients. Phenotypic test such as Modified hodge test was less sensitive and specific especially to detect blaNDM-1 which is the most predominant genotype in this region. Nucleic acid amplification technology offers improved specificity and sensitivity. Failed amplification due to the presence of inhibitors is a limitation. In this study, we tried to use previous method described by Villumseen et al with some modification using another DNA extraction kit. Methods: Ten mls of sterile whole blood taken from nearly expired blood bag from blood bank was spiked with 200 μl of 0.5mcFarland bacterial suspension from thirty-six confirmed isolates of blaNDM-1 carbapenamase-producing Klebsiella pneumoniae in an aerobic Bactec Plus and incubated until the growth was detected. The blood specimen was subjected to DNA extraction method using Macherey-Nachel, Nucleospin® Blood QuickPure followed with multiplex PCR. Results: Out of the 36 isolates, 12 isolates revealed blaNDM-1 , 9 isolates revealed blaNDM-1 and blaOXA-48, 7 isolates revealed blaNDM-1, blaVIM and blaKPC genotypes that were amplified at cycle threshold of less than 30. Another 8 isolates could not pick up any genotypes possibly due to pipetting error as all the internal control were amplified. Eight true negative gram negative isolates underwent same procedure and none amplified at a cycle threshold less than 30. Conclusion: This modified method was proved to give a high yield of CPE genotypes with the cycle threshold was set at less than or equal to 30 and able to overcome the presence of PCR inhibitors.

Matched MeSH terms: Blood Banks
The modern implementation of patient blood management (PBM) in Malaysia: the use of intravenous iron in severe anaemia with iron deficiency - A Case Report

Krishnamoorthy A, Hadi FA, Naidu A, Sathar J

Med J Malaysia, 2017 02;72(1):53-54.
PMID: 28255141

Anaemia is a common condition in Malaysia, and is mostly due to iron deficiency. In many cases, allogeneic blood transfusion (ABT) is administered unnecessarily to treat anaemia. Patient blood management (PBM) is a concept whereby a patient becomes his or her "own blood bank", instead of receiving ABT. The concept encompasses three pillars namely optimising erythropoiesis, minimising blood loss and harnessing human physiological reserve. We present a safe and fruitful outcome of managing severe anaemia without utilising any ABT, made possible with the PBM approach including administration of intravenous iron.

Matched MeSH terms: Blood Banks
Fulltext A pilot study to Assess Serum Potassium Levels and Haemolysis in Red Cell Units

Nurimatussolehah Sarijan, Sabariah Md Noor, Tun Maizura Mohd Fathullah, Malina Osman, Zainina Seman

Malaysian Journal of Medicine and Health Sciences, 2018;14(103):1-5.
MyJurnal

Percentage of haemolysis is widely used as a quality parameter to assess red blood cell viability in blood banking. In certain blood banks, serum potassium level is used due to the unavailability of the former test. The relationship between these two tests, however, is still unclear. The objective of this study is to determine the association between haemolysis measured using two different methods for quality control. Methods: A total of forty-four samples of packed red cell in citrate-phosphate-dextrose with optisol were randomly selected from donation drives. Nine millilitres of blood was collected weekly starting from day-2 of storage, followed by day-7, 14, 21, 28, 35 and 42 for assessment of red blood cell haemolysis by measuring serum potassium level and percentage of haemolysis.Results: These two parameters were correlated significantly with a positive moderate linear relationship on day 7, 21 and 28 with r = 0.393, 0.448 and 0.425, respectively and p-values less than 0.01. The linear regression analysis showed there was a significant regression equation which could be used to predict the serum potassium level from the percentage of haemolysis. Conclusion: There were significant increases in the percentage of haemolysis and serum potassium level in the packed red cell units with storage. The serum potassium level would be able to be predicted from the percentage of haemolysis using the regression equations on day 7, 21 and 28. The serum potassium measurement could be used as an alternative test to the percentage of haemolysis before issuing blood.

Matched MeSH terms: Blood Banks
Optimization of the storage conditions for coagulation screening tests

Mohammed Saghir SA, Al-Hassan FM, Alsalahi OS, Abdul Manaf FS, Baqir HS

J Coll Physicians Surg Pak, 2012 May;22(5):294-7.
PMID: 22538033 DOI: 05.2012/JCPSP.294297

To determine the optimum storage temperature and time for prothrombin time and activated partial thromboplastin time at various intervals at both room temperature and refrigerator.

Matched MeSH terms: Blood Banks*
WHO plans to improve training for blood-bank personnel

AIDS Policy Law, 2001 Oct 26;16(20):3.
PMID: 11692478
Matched MeSH terms: Blood Banks/manpower*
Hemovigilance in developing countries

Ayob Y

Biologicals, 2010 Jan;38(1):91-6.
PMID: 20133151 DOI: 10.1016/j.biologicals.2009.10.002

Hemovigilance like quality systems and audits has become an integral part of the Blood Transfusion Service (BTS) in the developed world and has contributed greatly to the development of the blood service. However developing countries are still grappling with donor recruitment and efforts towards sufficiency and safety of the blood supply. In these countries the BTS is generally fragmented and a national hemovigilance program would be difficult to implement. However a few developing countries have an effective and sustainable blood program that can deliver equitable, safe and sufficient blood supply to the nation. Different models of hemovigilance program have been introduced with variable success. There are deficiencies but the data collected provided important information that can be presented to the health authorities for effective interventions. Hemovigilance program modeled from developed countries require expertise and resources that are not available in many developing countries. Whatever resources that are available should be utilized to correct deficiencies that are already apparent and obvious. Besides there are other tools that can be used to monitor the blood program in the developing countries depending on the need and the resources available. More importantly the data collected should be accurate and are used and taken into consideration in formulating guidelines, standards and policies and to affect appropriate interventions. Any surveillance program should be introduced in a stepwise manner as the blood transfusion service develops.

Matched MeSH terms: Blood Banks/organization & administration*; Blood Banks/standards; Blood Banks/supply & distribution
Fulltext The management of beta-thalassemia in an urban district hospital

Lyn PCW, Teh HC, Mulvey RF

Med J Malaysia, 1985 Mar;40(1):3-10.
PMID: 3831730

This paper is based on the beta-thalassaemia programme at the Duchess of Kent Hospital, Sandakan, Sabah. It seeks to show that a hypertransfusion regimen which improves the quality of life of children with thalassaemia major can be practised in district and general hospitals if there is an organised blood recruitment programme, at least at departmental level. Such a programme reduces the demand on the hardpressed hospitals' blood banks. Frequent and regular transfusions can be given with minimal interference with the school and family life of affected children and reduces immeasurably the social, emotional and financial strain on the affected families. There is also an urgent need to define the magnitude of the problem of beta-thalassaemia through population studies so that genetic counselling can be given and adequate resources can be allocated to improve the quality of life of affected patients.

Matched MeSH terms: Blood Banks
Fulltext The Prevalence of Transfusion-transmitted Infections among Blood Donors in Hospital Universiti Sains Malaysia

Ramli M, Zulkafli Z, Chambers GK, Zilan RSAR, Edinur HA

Oman Med J, 2020 Nov;35(6):e189.
PMID: 33110633 DOI: 10.5001/omj.2020.86

Objectives: Blood bank centers routinely screen for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) to ensure the safety of blood supply and thus prevent the dissemination of these viruses via blood transfusion. We sought to evaluate the detection of transfusion-transmitted infection (TTI) markers using standard serological methods and nucleic acid testing (NAT) among blood donors in Hospital Universiti Sains Malaysia.
Methods: Donated blood units were assessed for the presence or absence of HBV, HCV, and HIV using two screening method: serology and NAT. Reactive blood samples were then subjected to serological confirmatory and NAT discriminatory assays.
Results: A total of 9669 donors were recruited from September 2017 to June 2018. Among these, 36 donors were reactive either for HBV, HCV, or HIV by serological testing and eight by NAT screening. However, only 10 (three for HBV and seven for HCV) donors tested positive using serological testing and five (two for HBV and three for HCV) by NAT discriminatory assays. Note that all five NAT positive donors detected in the NAT discriminatory assays were confirmed to be serologically reactive. Therefore, the prevalence of HBV, HCV, and HIV was 0.03%, 0.1%, and 0.0%, respectively, in our donor pool.
Conclusions: Both serological and NAT screening and confirmatory assays should be used routinely to reduce the risk of infection transmission via the transfusion of blood and blood components.

Matched MeSH terms: Blood Banks
Fulltext Vasovagal reaction among whole blood donors in Hospital Pulau Pinang. A statistical-epidemiological study

Hasan I, Arshad A, Rahim NA, Soo PY

Asian J Transfus Sci, 2020 07 24;14(1):28-32.
PMID: 33162702 DOI: 10.4103/ajts.AJTS_111_17

CONTEXT: Whole blood donation is generally considered a safe procedure; however, a small percentage of donors could develop vasovagal reactions (VVRs) during or after completion of blood donation.
AIMS: This study was undertaken to establish the prevalence of VVR among whole blood donors in Hospital Pulau Pinang and to investigate factors that lead to its occurrence.
SETTINGS AND DESIGN: A cross-sectional study was conducted involving 27,890 whole blood donations in 2016.
SUBJECTS AND METHODS: For each donation, donor's demographic and blood donation-related information was extracted from the blood bank database.
STATISTICAL ANALYSIS USED: Qualitative data including age group, sex, race, frequency, and location of donation were analyzed using Chi-square tests, while blood pressure was analyzed using t-test.
RESULTS: Overall, 425 cases of VVRs were reported, resulting in a VVR rate of 1.5% (one event in every 65 donations). We found a statistically significant association (P < 0.05) between the occurrence of VVRs with the young age group, female gender, Indian race, first-time donor, lower predonation blood pressure, and donation performed in a mobile donation campaign. The most common vasovagal symptoms are lightheadedness (88%), followed by nausea (5.4%), muscle twitching (3.5%), vomiting (1.4%), loss of consciousness <30 s (1.4%), and paresthesia (0.2%).
CONCLUSIONS: The prevalence of VVRs among whole blood donors in Hospital Pulau Pinang appeared to be low. Our study reaffirms that blood donation is a relatively safe process, and the incidence of VVR can be further reduced by ensuring strict screening procedure before blood donation.

Matched MeSH terms: Blood Banks
Fulltext Medical and laboratory assessment for regular blood donors in Sulaimani Blood Bank, Iraq

Getta HA, Ahmad HA, Rahman HS, Ahmed GA, Abdullah R

Patient Prefer Adherence, 2018;12:939-944.
PMID: 29910607 DOI: 10.2147/PPA.S157221

Introduction: It has been suggested that blood donation reduces risks of developing cardiovascular diseases such as heart failure, atherosclerosis, and stroke. Although there are known benefits of blood donation, the inclination of people of the Kurdistan Region of Iraq to donate blood is not known. Therefore, the aim of this study was to determine demograpic and blood biochemical profiles of regular and first-time blood donors in the Sulaimani province of North Iraq.
Methods: A cross-sectional study was conducted at the Sulaimani Blood Bank, during the period of April 1, 2016 to March 28, 2017, on convenient samples of 100 regular and 100 first-time blood donors. Donor particulars were obtained from blood bank records. The cholesterol, triglyceride, low-density lipoprotein, ferritin, vitamin D3, and uric acid concentrations of blood samples were determined.
Results: The main reason for blood donation by regular blood donors was headache (45%), while for the first-timers it was to help relatives (31%). The low-density lipoprotein and ferritin concentrations were significantly (p=0.001) lower in the blood of regular donors than first-timers.
Conclusion: The study shows that regular blood donation is beneficial for the maintenance of health of donors.

Matched MeSH terms: Blood Banks
Fulltext Computerized Morphometric Analysis of Eryptosis

Jacob SS, Prasad K, Rao P, Kamath A, Hegde RB, Baby PM, et al.

Front Physiol, 2019;10:1230.
PMID: 31649550 DOI: 10.3389/fphys.2019.01230

Eryptosis is the suicidal destruction-process of erythrocytes, much like apoptosis of nucleated cells, in the course of which the stressed red cell undergoes cell-shrinkage, vesiculation and externalization of membrane phosphatidylserine. Currently, there exist numerous methods to detect eryptosis, both morphometrically and biochemically. This study aimed to design a simple but sensitive, automated computerized approach to instantaneously detect eryptotic red cells and quantify their hallmark morphological characteristics. Red cells from 17 healthy volunteers were exposed to normal Ringer and hyperosmotic stress with sodium chloride, following which morphometric comparisons were conducted from their photomicrographs. The proposed method was found to significantly detect and differentiate normal and eryptotic red cells, based on variations in their structural markers. The receiver operating characteristic curve analysis for each of the markers showed a significant discriminatory accuracy with high sensitivity, specificity and area under the curve values. The software-based technique was then validated with RBCs in malaria. This model, quantifies eryptosis morphometrically in real-time, with minimal manual intervention, providing a new window to explore eryptosis triggered by different stressors and diseases and can find wide application in laboratories of hematology, blood banks and medical research.

Matched MeSH terms: Blood Banks
Advantage of induction therapy with all trans retinoic acid in acute promyelocytic leukaemia in a country with limited transfusion resources: a Malaysian experience

Leong KW, Bosco JJ, Teh A

Eur. J. Haematol., 1994 Oct;53(4):237-41.
PMID: 7957809

Induction of remission of acute promyelocytic leukaemia (APL) needs intensive blood support (16) to prevent bleeding attributed to disseminated intravascular coagulation. Between 1989 and 1991, at the University Hospital in Kuala Lumpur, Malaysia, the remission rate of APL was only 27% with conventional chemotherapy as a result of inadequate transfusion resources. The use of all trans retinoic acid in induction therapy followed by consolidation and maintenance chemotherapy has improved the situation dramatically. Twelve patients entered the study. Ten patients achieved remission (83%), indicating how ATRA had significantly improved the results (p = 0.003). Blood component transfusions were also significantly reduced (p = 0.003). Two ethnic Chinese patients developed pulmonary leucostasis. Published Chinese (2, 6) and Japanese (11) studies have not reported this serious adverse effect. We can now state that leucostasis is not a phenomenon limited to the Western population. ATRA has proved to be extremely beneficial for patients at this centre. Early analysis also suggests that consolidation and maintenance chemotherapy has prolonged remission duration. ATRA should be made available for the treatment of APL in all countries where there are inadequate transfusion services.

Matched MeSH terms: Blood Banks/supply & distribution
Organization of a blood transfusion service in tropical areas

Lopez CG

Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):177-83.
PMID: 524138
Matched MeSH terms: Blood Banks/organization & administration
Efficiency of blood usage for elective surgery in the University Hospital Kuala Lumpur

Lim EJ, Lopez CG, Veera SN, Menaka N, Aminah A

Malays J Pathol, 1996 Dec;18(2):107-12.
PMID: 10879231

Provision of quality care, service and blood products to patients while containing costs and the amount of blood used should be the aim of every blood bank. Therefore a prospective audit was carried out over three months to determine how efficiently blood was being used in elective surgery in the University Hospital, Kuala Lumpur. Every case with blood crossmatched was monitored to determine the amount transfused and the posttransfusion haemoglobin level. Overcrossmatching of varying degrees was noted in almost all surgical procedures and overtransfusion in 45.5% of patients transfused. The rate of case postponement was 18.1%. These indicate inefficient utilization of blood and other resources. The transfusion index (TI) and range of units transfused were calculated for each procedure. They can be used as indicators of blood requirement and potential severity of hemorrhage. Suggestions to improve efficiency of blood utilization include the introduction and ongoing monitoring of guidelines on crossmatching and transfusion based on the data obtained here, by the hospital blood transfusion committee; the "group, screen and hold" practice for surgical procedures with high crossmatch transfusion ratios, low transfusion indices and a small range of units transfused could also be adopted.

Matched MeSH terms: Blood Banks/statistics & numerical data*
Fulltext Rate of seroconversion in repeat blood donors at the national blood centre, Kuala Lumpur

Nafishah A, Asiah MN, Syimah AT, Mohd Zahari TH, Yasmin A, Normi M, et al.

Indian J Hematol Blood Transfus, 2014 Jun;30(2):105-10.
PMID: 24839364 DOI: 10.1007/s12288-012-0213-4

The World Health Organization (WHO) recommend that all donated blood are to be screened for at least three viral infections [human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV)]. The National Blood Centre, Kuala Lumpur (NBCKL) aims to reduce transfusion transmitted infections (TTI) as it still remains as one of the major risk for blood transfusion. A cross sectional study was conducted at the National Blood Centre, Kuala Lumpur from 1st January 2009 to 31st June 2010. Data from 581,020 donors were analyzed from year 2004 to 2008. All data were retrieved from NBCKL Blood Bank Information System (BBIS). A total of 201 repeat donors were included in the study based on the inclusion criteria but only 132 repeat donors agreed to participate. Information on sociodemographic, risk factors, knowledge of donors and high risk behavior were extracted from standardize questionnaire. Data were analyzed using SPSS version 14.0. The aim of this study was to determine the predictors of the seropositive infectivity among repeat blood donors at the NBCKL. The results showed Syphilis accounts for the highest and increasing seroconversion rate among other infections from 20.83 % in year 2004 to 44.6 % in year in year 2008. HIV and HCV infection also showed increasing seroconversion rate in 5 years' time from 6.41 % in year 2004 to 17.54 % in year 2008 and 4.8 % in year 2004 to 5.94 % in year 2008 respectively. However, HBV infection alone showed a decreasing seroconversion rate from 20.83 % in year 2004 to 10.4 % in year 2008. Level of donors' awareness regarding high risk factors (activities or behaviour) can lead to higher risk of TTI with significant p value in this predictors model(p blood donors with high risk activities are more likely to have seropositive results for HBV, HIV and Syphilis. This study found that the frequency of HCV seropositivity is higher among lapsed donor. Socio demographic factors such as male and working in the private sector predominates in all TTI markers. Majority of the respondents were aware about relation of high risk activities and risk of TTI.

Matched MeSH terms: Blood Banks

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