Neonatal stromal cells from umbilical cord blood (CB) are promising alternatives to bone marrow- (BM-) derived multipotent stromal cells (MSCs). In comparison to BM-MSC, the less mature CB-derived stromal cells have been described as a cell population with higher differentiation and proliferation potential that might be of potential interest for clinical application in regenerative medicine. Recently, it has become clear that cord blood contains different stromal cell populations, and as of today, a clear distinction between unrestricted somatic stromal cells (USSCs) and CB-MSC has been established. This classification is based on the expression of DLK-1, HOX, and CD146, as well as functional examination of the adipogenic differentiation potential and the capacity to support haematopoiesis <i>in vitro</i> and <i>in vivo</i>. However, a marker enabling a prospective isolation of the rare cell populations directly out of cord blood is yet to be found. Further analysis may help to reveal even more subpopulations with different properties, which could be useful for the directed application of these cells in preclinical models.

Simone Maria Kluth

Teja Falk Radke

Gesine Kogler

Potential Application of Cord Blood-Derived Stromal Cells in Cellular Therapy and Regenerative Medicine

Anemia is common in critically ill patients. As a consequence packed red blood cell (PRBC) transfusions are frequent in the critically ill. Over the past two decades a growing body of literature has emerged, linking PRBC transfusion to infections, immunosuppression, organ dysfunction, and a higher mortality rate. However, despite growing evidence that risk of PRBC transfusion outweighs its benefit, significant numbers of critically ill patients still receive PRBC transfusion during their intensive care unit (ICU) stay. In this paper, we summarize the current literature concerning the impact of anemia on outcomes in critically ill patients and the potential complications of PRBC transfusions.

M. Kamran Athar

Nitin Puri

David R. Gerber

Anemia and Blood Transfusions in Critically Ill Patients

<i  >Background</i>. Infections with human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C virus (HCV) are currently major public health problems. <i  >Methods</i>. A retrospective study was conducted from January to June 2008 at the Blood Bank of the Central Hospital, Yaound&#xe9;  (Cameroon). The objective was to study the prevalence of HIV, HBV, and HCV and their coinfections among blood donors. <i  >Results</i>. A total of 4650 donors were identified, and the sex ratio (male/female) was 14/1. The median age of donors was 28 years (range: 16 to 69 years). Among blood donors, HBV, HIV, and HCV infection prevalences were 12.14&#x25;&#x2009;&#x2009;<svg style="vertical-align:-2.3205pt;width:64.324997px;" id="M1" height="15.0875" version="1.1" viewBox="0 0 64.324997 15.0875" width="64.324997"      xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
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</svg>
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			<g transform="matrix(.017,0,0,-.017,.062,12.138)"><use xlink:href="#x28"/></g><g transform="matrix(.017,0,0,-.017,5.944,12.138)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,0,0,-.017,19.186,12.138)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,0,0,-.017,33.89,12.138)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z"/></g><g transform="matrix(.017,0,0,-.017,42.049,12.138)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xD;&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z"/></g><g transform="matrix(.017,0,0,-.017,50.209,12.138)"><use xlink:href="#x36"/></g><g transform="matrix(.017,0,0,-.017,58.368,12.138)"><use xlink:href="#x29"/></g>

		
	
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</svg>,
 respectively. Coinfection with HIV and HBV was observed among 0.77&#x25; donors, followed by hepatitis B and C co-infection (0.21&#x25;) and HIV and HCV coinfection (0.06&#x25;). Co-infection with HIV-HBV-HCV was encountered in 2 donors. The HIV, HBV, and HCV infections lead to a destruction of one out of six sets of blood collected. <i  >Conclusion</i>. There is a need to review policies for blood collection from donors, by modifying the algorithm of blood donors testing. Pretesting potential donors using rapid tests could help to avoid collection and destruction of (infected) blood.

Florent Fouelifack Ymele

Basile Keugoung

Jeanne Hortense Fouedjio

Nadege Kouam

Sandrine Mendibi

Jacqueline Dongtsa Mabou

High Rates of Hepatitis  B and C and HIV Infections among Blood Donors in Cameroon: A Proposed Blood Screening Algorithm for Blood Donors in Resource-Limited Settings

Stem cells divide by asymmetric division and display different degrees of potency, or ability to differentiate into various specialized cell types. Owing to their unique regenerative capacity, stem cells have generated great enthusiasm worldwide and represent an invaluable tool with unprecedented potential for biomedical research and therapeutic applications. Stem cells play a central role in the understanding of molecular mechanisms regulating tissue development and regeneration in normal and pathological conditions and open large possibilities for the discovery of innovative pharmaceuticals to treat the most devastating diseases of our time. Not least, their intrinsic characteristics allow the engineering of functional tissues for replacement therapies that promise to revolutionize the medical practice in the near future. In this paper, the authors present the characteristics of pluripotent stem cells and new developments of transdifferentiation technologies and explore some of the biomedical applications that this emerging technology is expected to empower.

Giuseppe Maria de Peppo

Darja Marolt

State of the Art in Stem Cell Research: Human Embryonic Stem Cells, Induced Pluripotent Stem Cells, and Transdifferentiation

Despite advances in the fields of prevention, medical intervention and surgical therapy, cardiovascular disease remains a major public healthcare issue. A promising area of research is the potential application of regenerative therapies with pluripotential stem cells to reduce the burden of heart disease and its sequelae. Umbilical cord blood, a rich source of multiple populations of nonembryonic stem cells, will be a valuable resource and has the potential to advance therapeutic options for patients with acquired and congenital heart disease.

Ralph S. Mosca

Potential Uses of Cord Blood in Cardiac Surgery

<i>Background.</i> The explosive growth of Hispanics in the US makes this population a significant and untapped source for blood donation. <i>Methods.</i> A cross-sectional study was performed to evaluate blood donation behaviors and demographics of foreign-born and US-born Hispanic donors between 2006 and 2009 in metropolitan Atlanta, GA, USA. Bivariate analyses and multivariate logistic regression were used to assess factors associated with foreign-born donors. <i>Results.</i> 5,119 foreign-born and 11,841 US-born Hispanics donated blood.  Foreign-born Hispanic donors were more likely than US-born donors to be blood group O (57.6% versus 52.0%; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>P</mml:mi><mml:mo>&#x003C;</mml:mo><mml:mn>.001</mml:mn></mml:mrow></mml:math>) and more frequent donors (2.2 versus 2.0; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>P</mml:mi><mml:mo>&#x003C;</mml:mo><mml:mn>.001</mml:mn></mml:mrow></mml:math>). Cuban-born donors had the highest rates of return donation (63.2%).  In contrast, Mexicans, the most prevalent subpopulation among foreign-born Hispanic donors (31.8%), had the lowest rates of return donation (42.0%). <i>Conclusions.</i> The heterogeneity found among Hispanic donors in this study is valuable for the design of recruitment strategies to increase blood donations.

Adelbert B. James

Cassandra D. Josephson

Marta I. Castillejo

George B. Schreiber

John D. Roback

Epidemiological Profiles of Foreign-Born and US-Born Hispanic Blood Donors in a Major Metropolitan Area in the United States

Red blood cells (RBCs) from cord blood contain fetal hemoglobin that is predominant in newborns and, therefore, may be more appropriate for neonatal transfusions than currently transfused adult RBCs. Post-collection, cord blood can be stored at room temperature for several days before it is processed for stem cells isolation, with little known about how these conditions affect currently discarded RBCs. The present study examined the effect of the duration cord blood spent at room temperature and other cord blood characteristics on cord RBC quality. RBCs were tested immediately after their isolation from cord blood using a broad panel of quality assays. No significant decrease in cord RBC quality was observed during the first 65 hours of storage at room temperature. The ratio of cord blood to anticoagulant was associated with RBC quality and needs to be optimized in future. This knowledge will assist in future development of cord RBC transfusion product.

Mariia Zhurova

John Akabutu

Jason Acker

Quality of Red Blood Cells Isolated from Umbilical Cord Blood Stored at Room Temperature

Intravenous iron therapy is a useful treatment for the rapid correction of iron deficiency anaemia and can be used to avoid or reduce the requirement for allogeneic blood transfusion.  Several intravenous iron preparations are available commercially which differ in cost, mode of administration and side effect profile.  There are few data directly comparing the efficacy of these preparations.  In this retrospective single-centre study, we present the results from two hundred and eight patients treated using three different iron preparations (iron dextran, iron sucrose and ferric carboxymaltose) and compare the effect on haemoglobin levels and other measures of iron deficiency six weeks after treatment.  Within the limitations of our study design, we show a statistically and clinically significant difference in efficacy between these preparations.

Richard Dillon

Ibrahim Momoh

Yvonne Francis

Laura Cameron

Claire N. Harrison

Deepti Radia

Comparative Efficacy of Three Forms of Parenteral Iron

To date medical care is inextricable based on blood donors and blood products. The continuing increase and intensification of tests and guidelines also results in a change in deferral and abnormal test results. Donors and recipients of their blood are faced with this information and are confronted with a kaleidoscope of thoughts and emotions. The discussion with respect to paid versus nonpaid donation is not new, but other aspects are less often discussed. We describe these other aspects for donors and recipients of their blood and hope to open the ethical discussion; if and to what extent we should have limits?

P. J. M. van den Burg

K. Magnussen

Ethical Aspects of Blood Donors and the Recipients of Their Blood

Pursuit of pharmaceutical purity of the blood in the bag has led to a shrinking donor base and a significantly more expensive product. Decisions regarding new infectious marker testing and donor deferrals have typically been made emphasizing decreasing one specific risk without considering the effect the intervention will have on the overall safety and availability of blood transfusion. Regulations have been formulated by governmental agencies with limited input from the medical community. The decision making process has lacked risk benefit analyses and has not had the robustness associated with spirited discussions. Policies made in this manner may result in certain risks being decreased but can also have adverse unintended consequences. Being guided by the ethical principles of nonmaleficence, beneficence, autonomy, and justice, we need to evaluate our actions in the context of overall blood safety rather than narrowly focusing on any one area.

Jay P. Brooks

Using Basic Ethical Principles to Evaluate Safety Efforts in Transfusion Medicine

Voluntary donation is a key issue in transfusion medicine. To ensure the safety of blood transfusions, careful donor selection is important. Although new approaches to blood safety have dramatically reduced the risks for infectious contamination of blood components, the quality and the availability of blood components depend on the willingness to donate and the reliability of the information given by the donors about their own health, including risk behavior. As donors who are deferred by the blood bank will be less motivated to return for donation, it is important to reduce the number of deferrals. The aims of the present study were to investigate the reasons for deferral of registered donors coming to the blood bank for donation, in order to identify areas of importance for donor education&#x2014;as these deferrals potentially could be avoided by better donor comprehension. Deferral related to testing of donors is not included in this study as these deferrals are dependent on laboratory results and cannot be indentified by questionnaire or interview. Data were collected from all blood donors in a period for 18 months who came for blood donation at a large university hospital in Norway. 1 163 of the 29 787 regular donors, who showed up for donation, were deferred (3.9&#x25;). The main reasons were intercurrent illness (<svg style="vertical-align:-0.17555pt;width:50.724998px;" id="M1" height="10.9125" version="1.1" viewBox="0 0 50.724998 10.9125" width="50.724998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
		<g transform="translate(72,-63.27)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑛</tspan>
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</svg>) (15.6&#x25;), skin ulcers (<svg style="vertical-align:-0.17555pt;width:50.724998px;" id="M2" height="10.9125" version="1.1" viewBox="0 0 50.724998 10.9125" width="50.724998"  xmlns="http://www.w3.org/2000/svg">
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		<g transform="translate(72,-63.27)">
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</svg>) (14.6&#x25;), and risk behaviour (<svg style="vertical-align:-0.10033pt;width:50.724998px;" id="M3" height="10.8125" version="1.1" viewBox="0 0 50.724998 10.8125" width="50.724998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.8125)">
		<g transform="translate(72,-63.35)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑛</tspan>
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				<tspan style="font-size: 12.50px; " x="21.71771" y="0">1</tspan>
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</svg>) (10.9&#x25;). In a community, intercurrent illnesses, skin ulcers, and potential risk behavior are the most frequent reasons for deferral of regular donors. Strategized effort on donor education is needed, as &#x201c;failure to donate&#x201d; reduces donor motivation.

Håkon Reikvam

Kjersti Svendheim

Anne S. Røsvik

Tor Hervig

Questionnaire-Related Deferrals in Regular Blood Donors in Norway

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Journal of Blood Transfusion