TRANSMEDCON 2022: Oral Abstracts

This document is a compilation of oral abstracts presented at the TRANSMEDCON 2022 conference, covering diverse topics in transfusion medicine and immunohematology. The abstracts are brief summaries of research studies, case reports, and reviews, each typically structured with an introduction, aims, methods, results, and conclusion. Key findings from selected abstracts are summarized below.

**Background:** The abstracts address a variety of clinical and laboratory challenges in transfusion medicine, including the management of complex obstetric cases like HELLP syndrome, the identification of rare blood group phenotypes, the prevention of transfusion reactions, and the optimization of blood component therapy. The studies are conducted in various Indian healthcare settings, reflecting regional practices and challenges.

**Methods:** The studies employ a range of methodologies, including retrospective and prospective observational studies, case reports, and comparative analyses. For example, one study on HELLP syndrome (OP3) describes a case of a 29-year-old female who underwent therapeutic plasma exchange (TPE) on three consecutive days, with 3000 ml of plasma extracted and 100% replacement each time. Another study (OP4) analyzed 4078 blood donor samples using conventional tube technique and A1-lectin testing to determine the frequency of A2 subgroups. A prospective study (OP8) evaluated biochemical changes in 20 stored blood units over 35 days using Ion Selective Electrode technology. A comparative study (OP10) involved 130 first-time blood donors divided into two groups: one receiving salt water loading with applied muscle tension, and the other plain water ingestion, to assess vasovagal reaction incidence.

**Key Results:** The results are varied across the abstracts. In the HELLP syndrome case (OP3), after three sessions of TPE, the platelet count improved from 35 to 130 ×10³/cumm, AST decreased from 422 to 89 IU/L, ALT from 146 to 58 IU/L, and LDH from 2218 to 855 U/L. The study on A2 subgroups (OP4) found that among blood group A, 2.4% were A2, and among AB, 14.8% were A2B, with a statistically significant higher frequency of A2B (P < 0.00001). The blood storage study (OP8) showed a significant increase in mean potassium from 7.12 mmol/L at baseline to 20.35 mmol/L at 5 weeks (P < 0.0001) and a significant decrease in mean sodium from 150.23 mmol/L to 121.50 mmol/L (P < 0.0001). The study on vasovagal reactions (OP10) reported a decrease in VVR incidence to 2 (3%) in the salt water and AMT group compared to 11 (17%) in the plain water group. Another study (OP14) on seroprevalence of infectious markers among 28,816 blood donors found an overall sero-prevalence of 2.75% in replacement donors versus 1.13% in voluntary donors, with a decline from 2.12% in 2017 to 1.28% in 2021. A study on hepcidin levels (OP16) in 35 beta thalassemia major patients found significantly reduced serum hepcidin levels compared to 35 healthy controls (P < 0.001). The study on FFP effect on INR (OP18) in 200 patients noted a linear relationship between pre-transfusion INR and improvement per unit of FFP, with a net improvement of 69% using the Holland and Brooks formula. A study on red cell transfusions in pediatric patients (OP19) found that out of 300 transfusion episodes, 132 (44%) were appropriate and 168 (56%) were inappropriate. The study on irregular antibodies in blood donors (OP21) found 11 positive samples out of 22,000, with anti-M being the most frequent (n=5). The study on transfusion-related adverse events (OP25) reported a risk estimate of 0.4 per 1000 units for all adverse reactions, with 0.535 per 1000 for WB/PRBC and 0.248 per 1000 for platelets. The study on IgA-associated AIHA (OP26) found that among 214 WAIHA patients, 17 (7.9%) had IgA-associated disease, with a mean hemoglobin of 5.58 gm/dL and 88.2% requiring PRBC transfusion. The study on massive transfusion in peripartum patients (OP29) showed that a 1:1:1 ratio of PRBC:FFP:PC provided better hemostatic control and clinical outcome compared to a non-ratio based group. The study on breast milk induced hemolytic anemia (OP31) reported a case where anti-E and anti-c antibodies were found in breast milk, leading to prolonged anemia in a 32-day-old infant. The study on PBSC transplants (OP32) found a positive correlation between peripheral blood CD34 count and harvested CD34 count (PCC = 0.789). The study on quality control of blood components (OP33) reported that 89.91% of PRBC units met QC criteria, with mean fibrinogen and FVIII values in FFP of 469.17 mg and 217.34 IU for 350 mL units, and 600.21 mg and 273.39 IU for 450 mL units. The study on a novel ABO mutation (OP34) identified a novel allele ABO*A (c.106delTinsGG) responsible for weak A antigen expression. The study on red cell transfusions in cardiac surgeries (OP35) found a statistically significant correlation between red blood cell transfusions, in-hospital length of stay, and comorbidities. The study on complement-associated WAIHA (OP36) found that hemolysis was more severe when C3d was present (P = 0.012). The study on NAT testing (OP37) found that among 12,433 ELISA-negative blood donors, 40 (0.32%) were positive for HBV, 1 (0.008%) for HIV, and 2 (0.01%) for HCV by NAT, with a NAT yield of 1 in 289. The study on automated RBC exchange in sickle cell crisis (OP38) reported a mean reduction of HbS of 37.3% in 22 patients undergoing 30 procedures. The study on blood transfusion in obstetric cases (OP40) found that out of 28,657 total transfusions, 5,227 (18.2%) were in obstetric cases, with the most common indications being ANC with anemia, PNC with anemia, and abortions. The study on after-effects of blood donation (OP42) found that 8 out of 284 donors (2.8%) experienced adverse effects, with first-time donors and females being more vulnerable. The study on panagglutination (OP43) reported a case of a 45-year-old female with AIHA where steroids played a vital role in management. The study on knowledge, attitude, and awareness of blood donors (OP44) found that approximately 60% of 555 respondents had misconceptions about blood donation. The study on RPR test performance (OP45) found that the sensitivity of RPR was 31.8% compared to TPHA as the gold standard, with a seroprevalence of syphilis of 0.2% by ELISA. The study on donor adverse reactions (OP47) reported an overall DAR rate of 2.59 per 1000 blood donations among 72,813 donors. The study on Ki-67 in urothelial neoplasm (OP48) found that Ki-67 expression (>13%) was seen in 40% of invasive cancers and (<13%) in 38.3% of non-invasive cancers, with a statistically significant increase in mean Ki-67 labeling index from papilloma to high-grade tumors (P < 0.001). The study on TPE in pediatric acute liver failure (OP50) reported improvement in a 5-year-old female patient after three daily low-volume TPE sessions. The study on leuko-reduced vs. non-leuko-reduced PRBCs (OP51) found a significant decrease in FNHTR rate from 0.2% to 0.008% after implementation of pre-storage leuko-reduction. The study on immediate transfusion reactions (OP53) reported an ATR incidence of 0.53% among 2,628 transfusions, with allergy being the most common. The study on platelet transfusion in dengue (OP54) found that platelet transfusion was done in 44% of 163 patients, with 30% having a platelet count of 10-20,000/cu mm. The study on lipid profile and magnesium in pre-eclampsia (OP56) found increased cholesterol, triglycerides, and LDL, and decreased serum magnesium in pre-eclamptic women compared to controls. The study on FNAC of head and neck lymph nodes (OP57) found that out of 50 cases, 33 were benign and 17 were malignant, with reactive hyperplasia being the most common cause. The study on minor blood group alleles (OP59) in 50 RhD negative donors found that the most common genotypes were RHCE*e (98%) and RHCE*c (85%), with K-k+ phenotype in 100% of samples. The study on preanalytical errors (OP60) found a requisition error rate of 2.33% among 4,417 requests, with the most common error being date and time of requirement not mentioned (19.41%). The study on autoantibody mimicking anti-f (OP61) is a case report. The study on HDN due to anti-c (OP62) reported two cases of severe HDN in RhD-positive mothers due to anti-c alloimmunization. The study on blood component utilization (OP64) found that out of 1,361 transfusions, 68.8% were PCV, 13.1% platelets, and 16.5% FFP. The study on cardiac surgery in cold AIHA (OP66) reported a case of a 73-year-old female with cold agglutinin titer >10,000 who underwent successful mitral valve replacement under normothermic conditions. The study on therapeutic red cell exchange in sickle cell crisis (OP67) reported a reduction in HbS from 60.70% to 13.9% after two procedures. The study on transfusion support to pediatric patients (OP69) reported that 662 pediatric patients received 1,216 units of blood components over 6 months. The study on joint involvement in hemophilia (OP70) found that among 579 persons with hemophilia, 511 (88.2%) had hemophilia A, with joint bleeding being the most common presenting complaint (404 patients). The study on FFP effect on INR in liver diseases (OP72) found a high linear correlation between pre-transfusion INR and change in INR per unit of FFP, with significant improvement in patients receiving 5 or more units. The study on CCP therapy in COVID-19 (OP73) found that median TLC count increased after CCP transfusion, while CRP and D-dimer were reduced, though not statistically significant. The study on structured training on transfusion knowledge (OP74) found that mean score improved from 52.8% pre-training to 71.08% post-training (P < 0.001). The study on unexpected RBC antibodies in pregnant women (OP78) found a prevalence of 1.85% among 539 samples, with anti-D being the most common (n=6). The study on adverse donor reactions (OP79) reported an overall adverse reaction rate of 3% among 17,013 donations, with vasovagal reaction being the most common (90.4%). The study on ABO grouping discrepancies (OP80) found 28 true discrepancies out of 33,883 blood groupings. The study on haptoglobin and ferritin as biomarkers of chemotherapy-induced anemia (OP82) found that high haptoglobin and high ferritin were independent predictors of severe anemia (odds ratio 3.22 and 2.92, respectively). The study on anemia among deferred blood donors (OP84) found that females (89.70%) had a higher deferral rate due to anemia than males (53.84%). The study on RhD negative donor registry (OP87) found a prevalence of 2.65% RhD negative among 27,654 donations, with O negative being the most common (0.97%). The study on lipid profile and HbA1C in type 2 diabetes (OP90) found positive correlations between HbA1C and total cholesterol (r=0.719), LDL-C (r=0.654), and triglycerides (r=0.548), and a negative correlation with HDL (r=-0.512). The study on TTIs among blood donors (OP92) found a seroprevalence of 2.87% among 13,047 donors, with HBsAg being the most common (1.83%). The study on seizure recurrence after VVR (OP93) found that among 66 donors contacted, 4 had problems post-donation, and 1 had a repeat episode of loss of consciousness with seizure. The study on TPE in SLE (OP96) reported improvement in GCS score from 6 to 14 in a 28-year-old female with neuropsychiatric manifestation. The study on stem cell transplant (OP99) reported a disease-free survival of 69.2% and overall survival of 65.18% in 30 transplants. The study on blood transfusion profile of beta thalassemia major patients (OP100) found that among 238 patients, the most common blood group was B positive (n=81), and the average number of transfusions per patient in those less than 10 years was 2 times per month. The study on antibody screening by pooled cells (OP101) reported two cases where anti-E was missed by pooled O-cell screening but detected by 3 and 11 cell panels. The study on microplate screening of RBC lysis (OP102) found that scanning at 620 nm gave consistent data, and lysis was faster in hypoosmotic salines. The study on iron store in blood donors (OP104) found that first-time donors had higher mean serum ferritin levels than repeat donors, with a significant Pearson correlation between serum ferritin and number of donations (P < 0.05). The study on novel mutations in A4GALT gene (OP105) identified two novel mutations (c.72dupC and c.218delG) leading to P null phenotype. The study on autologous blood transfusion in neurosurgery (OP107) found that mean blood loss was lesser in the autologous group (1104±368 mL) compared to the allogeneic group (1243±378 mL). The study on adsorption columns in ACLF (OP108) reported a transplant-free survival at day 28 in 8 out of 9 patients, with a median change in bilirubin of 9 and bile acids of 56. The study on weak D (OP109) found a prevalence of 0.023% among all donors and 0.354% among RhD negative donors, with Weak D Type 150 being the most common phenotype. The study on uncrossmatched blood (OP110) reported an average turnaround time of 5.5 minutes for URBC and 10.66 minutes for type-specific PRBCs, with no adverse reactions reported. The study on automated blood component processing (OP116) found that the mean volume of buffy coats was 10.2 ± 1.81 ml, and the turnaround time was 18-25 minutes for automated system compared to approximately 2.5 hours for semi-automated system. The study on resurgence of syphilis (OP117) found that the incidence of syphilis rose from 0.03% in 2017 to 0.35% in 2021. The study on bacterial contamination of blood components (OP120) found that out of 533 samples, 23 were positive for bacterial contamination, with packed RBCs showing the highest rate (47.8%). The study on adverse transfusion reactions (OP121) reported a total of 209 transfusion reactions out of 88,972 components issued, with allergic reactions being the most common (74.1%). The study on TMA following snake envenomation (OP122) found that among 45 patients with VICC, 4 (8.9%) developed TMA, and FFP was the most commonly required blood component. The study on RBC alloimmunization in thalassemia (OP123) found that 8 out of 252 patients (3.2%) developed alloantibodies, with anti-E being the most common (50%). The study on risk factors for HIV (OP124) found that among 189 HIV positive patients, the most common risk factor was having an HIV-positive spouse (67.88%). The study on Gram positive bacterial susceptibility (OP125) found that among 1,226 blood cultures, 19.41% were positive, with 55.88% being Gram positive isolates, most commonly CONS (63.9%). The study on adverse events in TPE for liver disease (OP126) reported that adverse events were observed in 254 (10.3%) of 2,470 procedures, with allergic reactions (26.7%) and hypotension (21.43%) being the most common. The study on platelet transfusion efficacy in neonates (OP127) found that the median transfusion trigger for prophylactic transfusions was 16,000/µL and 21,500/µL for therapeutic transfusions, with ELBW neonates identified as a high-risk group. The study on thalassemia major patients (OP129) found that among 125 patients, 62% were on chelation therapy but only 3% were adequately chelated, and seroprevalence of anti-HCV was very high. The study on MRSA susceptibility (OP130) found that among 268 S. aureus isolates, 53.73% were MRSA, with high resistance rates to clindamycin (31.34%) and erythromycin (43.80%). The study on cold agglutinin AIHA (OP132) reported a case of a 70-year-old male with cold agglutinin titer of 64 at 4°C, resolved using pre-warmed saline wash technique. The study on Bombay blood group (OP133) reported a case of a 49-year-old woman with Bombay phenotype managed with oral iron supplementation, achieving Hb of 13.3 gm/dl after two months. The study on thyroid hormones, CRP, and ferritin in psoriasis (OP134) found higher levels of TSH, T3, T4, and CRP, and lower levels of ferritin in psoriatics compared to controls. The study on bacterial screening of ap