Hans Erik Heier

Motivation, recruitment and retention of voluntary non- remunerated blood donors: a survey-based questionnaire study

Background and Objectives  The aim of this study was to establish which motivational and socio‐demographic factors are important for the development of a long‐term commitment as a voluntary, non‐remunerated blood donor.

Scandinavian guidelines - "The massively bleeding patient"

c. gaarder, Trauma Unit, Ullevål University Hospital, Oslo, Norway p. a. naess, Trauma Unit, Ullevål University Hospital, Oslo, Norway e. Frischknecht christensen, Aarhus Trauma Centre, Aarhus University Hospital, Denmark p. hakala, Department of Anaesthesia and Intensive Care, Helsinki University Hospital, Finland l. handolin, Department of Orthopaedics and Traumatology, Helsinki University Hospital, Finland h. e. heier, Department of Immunology and Transfusion Medicine, Ullevål University Hospital, Oslo, Norway K. ivancev, Endovascular Centre, Malmö University Hospital, Malmö, Sweden p. Johansson, Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark a. leppäniemi, Department of Surgery, Meilahti Hospital, University of Helsinki, Helsinki, Finland F. lippert, Department of Anaesthesia and Intensive Care, Rigshospitalet, Copenhagen, Denmark h. m. lossius, Norwegian Air Ambulance, Drøbak, Norway h. Opdahl, Intensive Care Unit/NBC centre, Ullevål University Hospital, Oslo, Norway J. pillgram-larsen, Department of Cardiothoracic Surgery, Ullevål University Hospital, Oslo, Norway O. Røise, Orthopaedic Centre, Ullevål University Hospital, Oslo, Norway n. O. skaga, Department of Anaesthesia, Ullevål University Hospital, Oslo, Norway e. søreide, Department of Anaesthesia and Intensive Care, Stavanger University Hospital, Stavanger, Norway J. stensballe, Department of Anaesthesia, Rigshospitalet, Copenhagen, Denmark e. Tønnessen, Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark a. Töttermann, Department of Orthopaedics, Uppsala University Hospital, Uppsala, Sweden p. ́́ Ortenwall, Trauma Unit, Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden a. ́́ Ostlund, Department of Anaesthesia and Intensive care, Karolinska University Hospital, Stockholm, Sweden

Evaluation of TEG® and RoTEM® inter-changeability in trauma patients

BACKGROUND Massive haemorrhage is a leading cause of preventable deaths in trauma. Traumatic coagulopathy is frequently present early after trauma, and is associated with increased mortality. A number of recent trials suggest that viscoelastic haemostatic assays (VHA), such as thromboelastography and thromboelastometry, are useful tools in guiding transfusion. Treatment algorithms exist for the use of VHAs but are not validated in traumatic haemorrhage. In this study we examined the inter-changeability of two commonly used VHAs, TEG(®) and RoTEM(®). METHODS A total of 184 trauma patients over the age of 18, requiring full trauma team activation, were included at three different hospitals in three different countries (Copenhagen, Denmark, San Francisco, CA, USA and Oslo, Norway). Blood samples were drawn immediately upon arrival, and TEG(®) and RoTEM(®) analyzed simultaneously. Correlations were calculated using. Spearmans rank correlation coefficient. Agreement was evaluated by Bland-Altman plots and calculation of limits of agreement. RESULTS The mean ISS in the total population was 17, and the mortality was 16.5%. Mean base excess was -2.8 (SD: 4.2). The correlation coefficient for corresponding values for the two devices was 0.24 for the R-time vs CT in all centres combined. For the K-time vs CFT the correlation was 0.48, for the α-angleTEG vs α-angleRoTEM 0.44, and for MA vs MCF 0.76. Limits of agreement exceeded the preset clinically acceptable deviation of 10% for all variables in all centres except for MA/MCF in one centre (Copenhagen). Generally, correlation coefficients were lower and agreement poorer in the one centre (Oslo) where measurements were performed bedside by clinicians. CONCLUSION Inter-changeability between TEG(®) and RoTEM(®) is limited in the trauma setting. Agreement seems poorer when clinicians operate the devices. Development and validation of separate treatment algorithms for the two devices is required.

Gender differences in presentation rates, deferrals and return behaviour among Norwegian blood donors

Background and Objectives  Women are under‐represented among long‐term blood donors. Reasons for this were sought in the donor pool of the Blood Bank of Oslo, Norway, which comprises only voluntary, non‐remunerated donors and has a high degree of stability.

Recruiting and retaining young people as voluntary blood donors

Objectives  Reasons for predonation deferral of young potential donors and prospects of recruiting and retaining young people (age 18–29) as voluntary blood donors were studied.

Additional molecular bases of the clinically important p blood group phenotype

BACKGROUND: The purpose of this study was to explore the molecular basis of the p phenotype by analysis of the recently cloned 4‐α‐galactosyltransferase gene responsible for synthesis of Pk (Gb3) antigen.

Predicting blood donor arrival

BACKGROUND:  Keeping waiting time at blood donation short is important for making donation a good experience for the donors and hence to motivate for repeat donations. At the Blood Bank of Oslo, fixed appointments are used, and few donors arrive without appointments. On average, 59 percent of scheduled donors arrive, but day‐to‐day variations are large. Methods for predicting the number of donors that will arrive on a given day would be valuable in reducing waiting times.

A study of blood transfusion services at a district hospital in Malawi

Background and objectives  Severe anaemia is an important cause of mortality in developing countries. However, few studies have explored the use of and possibilities for blood transfusion services. The aims of this study are to explore the use of blood transfusion services at a hospital in sub‐Saharan Africa and to assess the quality of the transfusion services according to WHO guidelines.

Preserved splenic function after angioembolisation of high grade injury

BACKGROUND After introducing splenic artery embolisation (SAE) in the institutional treatment protocol for splenic injury, we wanted to evaluate the effects of SAE on splenic function and assess the need for immunisation in SAE treated patients. METHODS 15 SAE patients and 14 splenectomised (SPL) patients were included and 29 healthy blood donors volunteered as controls. Clinical examination, medical history, general blood counts, immunoglobulin quantifications and flowcytometric analysis of lymphocyte phenotypes were performed. Peripheral blood smears from all patients and controls were examined for Howell-Jolly (H-J) bodies. Abdominal doppler, gray scale and contrast enhanced ultrasound (CEUS) were performed on all the SAE patients. RESULTS Leukocyte and platelet counts were elevated in both SAE and SPL individuals compared to controls. The proportion of memory B-lymphocytes did not differ significantly from controls in either group. In the SAE group total IgA, IgM and IgG levels as well as pneumococcal serotype specific IgG and IgM antibody levels did not differ from the control group. In the SPL group total IgA and IgG Pneumovax(®) (PPV23) antibody levels were significantly increased, and 5 of 12 pneumococcal serotype specific IgGs and IgMs were significantly elevated. H-J bodies were only detected in the SPL group. CEUS confirmed normal sized and well perfused spleens in all SAE patients. CONCLUSION In our study non-operative management (NOM) of high grade splenic injuries including SAE, was followed by an increase in total leukocyte and platelet counts. Normal levels of immunoglobulins and memory B cells, absence of H-J bodies and preserved splenic size and intraparenchymal blood flow suggest that SAE has only minor impact on splenic function and that immunisation probably is unnecessary.

Risk behavior in Norwegian blood donors

BACKGROUND: Blood banks ensure the safety of blood components by testing them for a set of known infectious agents and by careful selection of donors based on a self‐administered questionnaire and an interview. The purpose of this study is to describe the risk behavior for sexually transmitted diseases in Norwegian blood donors.