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"[ABSTRAKLatar belakang : Salah satu reaksi transfusi lambat yang bersifat fatal adalah TA GVHD (Transfusion Associated Graft Versus Host Disease). Kejadian TA GVHD pada pasien immunocompromised diperkirakan sebesar 0,1- 1,0% dengan angka kematian sekitar 80- 90%.7 Upaya radiasi komponen darah seluler saat ini merupakan cara yang paling efisien dan dapat diandalkan untuk mencegah TA-GVHD. Penelitian ini bertujuan untuk mengetahui pengaruh efek berbagai dosis radiasi terhadap sel darah merah selama penyimpanan. Metodologi : Penelitian ini menggunakan desain deskriptif analitik pada 72 sediaan sel darah merah yang memenuhi kriteria inklusi dan eksklusi. Sediaan sel darah merah dibagi menjadi 4 grup, yaitu grup yang mendapat dosis 2500,3000,5000 cGy dan kontrol. Dilakukan pengujian OFT dan kadar kalium pada hari pertama, ketiga dan kelima penyimpanan.Hasil : Terjadi peningkatan kadar kalium yang bermakna secara statistik mulai dari hari pertama setelah dilakukan radiasi pada semua dosis. Tidak ditemukan perbedaan bermakna ketahanan membran sel darah merah terhadap semua dosis radiasi selama penyimpanan sampai hari kelima.Simpulan : Radiasi pada dosis 2500-5000 cGy dapat menyebabkan peningkatan kadarkalium dan tidak menyebabkan perubahan fragilitas sel darah merah yang disimpan selama 5 hari setelah radiasi. Perlunya penelitian lebih lanjut mengenai mutu sediaan sel darah merah selama penyimpanan setelah dilakukan radiasi seperti melihat tingkat hemolisis (hemolisis rate).

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ABSTRACTBackground: One of the delayed transfusion reactions that are fatal is TA GVHD (Transfusion Associated Graft Versus Host Disease). TA incidence of GVHD in immunocompromised patients is estimated at 0.1 to 1.0% with a mortality rate of approximately 80-90% .7 Efforts irradiation of cellular blood components is currently the most efficient way and a reliable way to prevent TA-GVHD. This study aims to determine the effect of various doses of irradiation effects on red blood cells during storage.Method: This study used a descriptive analytic design at 72 red blood cell preparations that meet the inclusion and exclusion criteria. The preparation of red blood cells were divided into 4 groups, ie the group that received 2500,3000,5000 cGy dose and control. OFT testing and potassium levels on the first day, the third and fifth storage.Results: An increase in potassium levels was statistically significant from the first day after irradiation at all doses. Found no significant differences in red blood cell membrane resistance to all doses of irradiation during storage until the fifth day. Conclusion: Irradiation at doses of 2500-5000 cGy can cause increased pottasium level and does not cause changes fragility of red blood cells stored for 5 days after irradiation. The need for further research on the quality of the preparation of red blood cells during storage after irradiation as seen levels of hemolysis (hemolysis rate).;Background: One of the delayed transfusion reactions that are fatal is TA GVHD (Transfusion Associated Graft Versus Host Disease). TA incidence of GVHD in immunocompromised patients is estimated at 0.1 to 1.0% with a mortality rate of approximately 80-90% .7 Efforts irradiation of cellular blood components is currently the most efficient way and a reliable way to prevent TA-GVHD. This study aims to determine the effect of various doses of irradiation effects on red blood cells during storage.Method: This study used a descriptive analytic design at 72 red blood cell preparations that meet the inclusion and exclusion criteria. The preparation of red blood cells were divided into 4 groups, ie the group that received 2500,3000,5000 cGy dose and control. OFT testing and potassium levels on the first day, the third and fifth storage.Results: An increase in potassium levels was statistically significant from the first day after irradiation at all doses. Found no significant differences in red blood cell membrane resistance to all doses of irradiation during storage until the fifth day. Conclusion: Irradiation at doses of 2500-5000 cGy can cause increased pottasium level and does not cause changes fragility of red blood cells stored for 5 days after irradiation. The need for further research on the quality of the preparation of red blood cells during storage after irradiation as seen levels of hemolysis (hemolysis rate)., Background: One of the delayed transfusion reactions that are fatal is TA GVHD (Transfusion Associated Graft Versus Host Disease). TA incidence of GVHD in immunocompromised patients is estimated at 0.1 to 1.0% with a mortality rate of approximately 80-90% .7 Efforts irradiation of cellular blood components is currently the most efficient way and a reliable way to prevent TA-GVHD. This study aims to determine the effect of various doses of irradiation effects on red blood cells during storage.Method: This study used a descriptive analytic design at 72 red blood cell preparations that meet the inclusion and exclusion criteria. The preparation of red blood cells were divided into 4 groups, ie the group that received 2500,3000,5000 cGy dose and control. OFT testing and potassium levels on the first day, the third and fifth storage.Results: An increase in potassium levels was statistically significant from the first day after irradiation at all doses. Found no significant differences in red blood cell membrane resistance to all doses of irradiation during storage until the fifth day. Conclusion: Irradiation at doses of 2500-5000 cGy can cause increased pottasium level and does not cause changes fragility of red blood cells stored for 5 days after irradiation. The need for further research on the quality of the preparation of red blood cells during storage after irradiation as seen levels of hemolysis (hemolysis rate).]"

"ABSTRAKLatar belakang. Cryoprecipitate digunakan sebagai terapi pengganti pada pasien Hemofilia A. Untuk meningkatkan kandungan F VIII dan proses inaktivasi patogen dilakukan mini pooled cryoprecipitate S/D-F. Telah diketahui bahwa kadar vWF dan aktivitas F VIII dalam golongan darah O lebih rendah dari Non O. Tujuan utama penelitian ini adalah ingin mengetahui apakah kadar vWF dan aktivitas F VIII dalam mini pooled cryoprecipitate S/D-F dari golongan darah O lebih rendah dari Non O.Metodologi. Penelitian ini menggunakan desain potong lintang pada 14 kantong mini pooled cryoprecipitate S/D-F, 7 kantong golongan darah O dan 7 kantong Non O. Sampel berasal dari UDD PMI DKI Jakarta. Pembuatan mini pooled cryoprecipitate S/D-F di UTD Pusat dan pemeriksaan kadar vWF dan aktivitas FVIII di laboratorium Patologi Klinik RSCM. Pemeriksaan vWF dengan alat Mini Vidas (Vidas vWF bioMerieux) dan pemeriksaan FVIII dengan alat Sysmex CA ? 560.Hasil. Hasil penelitian pada mini pooled cryoprecipitate S/D-F didapatkan kadar vWF dalam mini pooled cryoprecipitate S/D-F pada golongan O rerata 238,6 IU/kantong dengan SD 145,92 IU/kantong, pada Non O rerata 408,68 IU/kantong dengan SD 261,08 IU/kantong. Aktivitas FVIII pada golongan darah O rerata 179,86 IU/kantong dengan SD 68,65 IU/kantong, pada Non O rerata 258,1 IU/kantong dengan SD 106,70 IU/kantong. Secara statistik terbukti bahwa kadar vWF dan aktivitas F VIII dalam mini pooled cryoprecipitate S/D-F pada golongan darah O lebih rendah dari darah Non O.Simpulan. Penelitian ini menunjukkan bahwa kadar vWF dan aktivitas F VIII dalam mini pooled cryoprecipitate S/D-F pada golongan darah O lebih rendah dari Non O.

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ABSTRACT

Background. Cryoprecipitate is used as replacement therapy in patients with hemophilia A. In order to improve the content of factor VIII and pathogen inactivation process has been developed mini pooled cryoprecipitate S/D-F. It is known that vWF levels in blood type O is lower than blood type Non O. Therefore the main objective of this study was to find out whether vWF and F VIII in mini pooled cryoprecipitate S/D-F derived from blood type O is lower than non-O blood type.

Methodology. This study used a cross-sectional design of the 14 mini pooled cryoprecipitate S/D-F bag consists of seven bags of blood type O and 7 bags of blood type Non O. Blood samples derived from UDD PMI Jakarta. Manufacture mini pooled cryoprecipitate held at UTD Center and examination of vWF and factor VIII has done at the laboratory of Clinical Pathology RSCM. Examination by means of the Mini Vidas vWF (vWF Vidas bioMerieux) and F VIII examination by means of Sysmex CA - 560.

Results.The results of this research on mini pooled cryoprecipitate S/D-F obtained at the level of vWF in cryoprecipitate mini pooled S/D-F in type O average of 238.6 IU / bag with SD 145.92 IU / bag, in type Non O averages 408.68 IU / bag with SD 261.08 IU / bag. Activity of factor VIII in the blood type O average of 179.86 IU / bag with SD 68.65 IU / bag, in the type of Non O averages 258.1 IU / bag with SD 106.70 IU / bag. On statistically proven that the levels of vWF and factor VIII activity in the S/D-F cryoprecipitate mini pooled blood type O is lower than Non O blood type.

Conclusions. This study shows that vWF levels and the activity of factor VIII in the mini pooled cryoprecipitate S/D-F on blood type O is lower than non-O blood type."

"Penyelenggaraan Fraksionasi Plasma merupakan salah satu kebijakan yang dilakukan Pemerintah Indonesia dalam rangka memenuhi akses masyarakat terhadap Produk Obat Derivat Plasma (PODP). Sebagaimana diketahui sampai saat ini kesediaan PODP di Indonesia masih 100% impor, hal tersebut menyebabkan PODP masih sulit di akses masyarakat. Permenkes No. 4 tahun 2023 tentang Penyelenggaraan Fraksionasi Plasma merupakan revisi kedua dari peraturan sebelumnya, dimana tidak adanya implementasi yang dicapai pada peraturan-peraturan sebelumnya. Pentingnya melakukan analisis kesiapan kebijakan ini diharapkan dapat memberikan informasi terkait faktor yang berdampak positif dan negatif serta mampu memberikan rekomendasi kepada para pemangku kepentingan agar pelaksanaan implementasi kebijakan penyelenggaraan fraksionasi plasma dapat berjalan dengan baik dan sesuai dengan target waktu yang ditetapkan. Faktor yang mempengaruhi dari implementasi penyelenggaraan fraksionasi plasma tersebut antara lain terkait tata kelola, sistem informasi, teknologi, pembiayaan, sumber daya manusia, layanan, dan politik yang didapati dapat memberikan dampak terhadap keberhasilan implementasi penyelenggaraan fraksionasi plasma lokal sehingga mampu menciptakan kemandirian farmasi dalam rangka mewujudkan pilar ketahanan kesehatan dalam transformasi kesehatan di Indonesia. 

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Implementing Plasma Fractionation is one of the policies carried out by the Government of Indonesia to fulfill public access to Plasma Derivative Medicinal Products (PDMPs). As is well known now, PDMPs readiness in Indonesia is still 100% imported, which causes PDMPs to be difficult for the public to access. Permenkes No. 4/2023 concerning the Implementation of Plasma Fractionation is the second revision of the previous regulation, where implementation has yet to be achieved in the previous regulations. The importance of conducting a policy readiness analysis is expected to provide information regarding factors that have positive and negative impacts and to be able to provide recommendations to stakeholders so that the plasma fractionation implementation policy can run well and in accordance with the set time targets. Factors that influence the implementation of plasma fractionation include governance, information systems, technology, financing, human resources, services, and politics, which are found to have an impact on the successful implementation of local plasma fractionation to create pharmaceutical independence in order to realize pillar of health resilience in health transformation in Indonesia."

"ABSTRAKLatar belakang. Pelayanan transfusi darah merupakan penunjang pelayanan kesehatan yang sangat penting, karena hingga saat ini masih terdapat beberapa kondisi kesehatan yang hanya dapat diatasi dengan pemberian transfusi darah. Salah satu strategi World Health Organization (WHO) dalam pelayanan darah yang aman adalah transfusi darah atas indikasi medis secara rasional. Febrile non-haemolytic transfusion reaction (FNHTR) telah dilaporkan sebagai reaksi transfusi yang paling umum terjadi dengan insidensi 6,8% setelah transfusi produk komponen packed red cell (PRC). Data di Pusat Thalassemia Rumah Sakit Dr. Cipto Mangunkusumo (RSCM) Jakarta, dari 73% pasien yang mendapat PRC leucoreduction, 15% di antaranya mengalami reaksi transfusi, sedangkan dari 14% pasien yang mendapat PRC biasa, 65% di antaranya mengalami reaksi transfusi. Di Indonesia, PRC yang tersedia umumnya adalah produk PRC leucoreduction dengan metoda buffy-coat depleted. Penelitian ini bertujuan untuk mengetahui efektifitas penurunan jumlah leukosit dan sitokin pada produk PRC dari metoda buffy-coat depleted dibandingkan dengan metoda modifikasi bed-side leucocyte filtration. Metodologi. Penelitian ini menggunakan desain potong lintang pada subjek berupa 30 produk PRC yang dibuat dengan metoda buffy-coat depleted dan 30 produk PRC yang dibuat dengan metoda modifikasi bed-side leucocyte filtration pada <48 jam masa penyimpanan. Pada semua produk dilakukan pemeriksaan hematologi dan pemeriksaan sitokin pirogen IL-6 dan TNF-α. Hasil. Satu (3,33%) subjek kantong komponen PRC yang dibuat dengan metoda buffy-coat depleted memenuhi standar leukoreduction (<5x108 leukosit/unit), dan 29 (96,7%) subjek kantong komponen PRC yang dibuat dengan metoda modifikasi bed-side leucocyte filtration pada waktu < 48 jam penyimpanan memenuhi standar leukodepleted (<5x106 leukosit/unit). Pada penelitian ini tidak didapatkan perbedaan bermakna kadar IL-6 dan TNF-α pada kedua kelompok komponen PRC ( p > 0,05 ). Simpulan. Terdapat penurunan jumlah leukosit komponen PRC yang dibuat dengan metoda modifikasi bed-side leucocyte filtration pada < 48 jam masa penyimpanan PRC sangat signifikan dibandingkan dengan metoda buffy-coat depleted. Hal ini disebabkan oleh peranan filter polyurethane yang selektif menyaring leukosit sedangkan penurunan jumlah leukosit pada metoda buffy-coat depleted dipengaruhi oleh kecepatan dan waktu putaran sentrifus serta pemisahan lapisan buffy coat dari komponen PRC. Tidak bermaknanya perbedaan kadar sitokin pirogenik IL-6 dan TNF α pada kedua kelompok PRC dikarenakan masa penyimpanan PRC < 48 jam tidak menyebabkan akumulasi sitokin pirogenik IL-6 dan dan TNF-α.

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ABSTRACTBackground. Blood transfusion is an essential part of health services, that can safe lifes. One of the World Health Organization (WHO) strategy on safe blood. White blood cells/leukocytes are present in all cellular blood components that are prepared by standard technique. Febrile non-haemolytic transfusion reaction (FNHTR) has been reported as a common transfusion reaction with the incidence of 6,8% after Packed Red Cell (PRC) transfusion. Data in Thalassemia Center DR. Cipto Mangunkusumo Hospital in Jakarta, from 73% of patients who received PRC leucoreduced component, 15% of them had a transfusion reaction, whereas 14% of patients who received PRC component, 65% of them had a transfusion reaction. In Indonesia, the common PRC component available is a leucoreduced PRC developed by buffy-coat depleted method. The study is aim to evaluate the effectiveness of leucocyte reduction and cytokine on the PRC components developed by buffy-coat depleted method compare to the PRC products developed by modified bed-side leucocyte filtration method. Methodology. The study is a cross sectional study on the subject of 30 PRC components developed by buffy-coat depleted method and 30 PRC component developed by modified bed-side leucocyte filtration method in < 48 hour of storage. Haematology testing and pyrogenic cytokine of IL-6 and TNF-α titer was analyzed on all subjects.Result. There was only one (3.33%) subject of PRC developed by buffy-coat depleted method showed to be leucoreduced (<5x108 leucocyte/unit), mean while there was 29 (96,7%) subject of PRC developed by modified bed-side leucocyte filtration method showed to be leukodepleted (<5x106 leucocyte/unit).No significant difference of IL-6 and TNF-α titer on both of PRC components. (p > 0,05 ).Conclusion. Reduction of leucocyte on the PRC components developed by modified bed-side leucocyte filtration is more effective compare to that on the PRC components developed by buffy-coat depleted method. The adhesion principle of leucocyte into polyurethane filter was more effective in reducing the number of leucocyte compare to centrifugation principle. The leucocyte filtration that was run on the PRC components with the storage time of < 48 hour did not caused the accumulation of pyrogenic cytokine such as IL-6 and TNF-α."

"Latar belakang. PMI merupakan suatu organisasi yang mendapat penugasan dari pemerintah untuk menyediakan darah bagi keperluan pengobatan dan terapi. Darah serta komponen yang dibutuhkan untuk transfusi harus memenuhi kriteria darah yang aman (bebas dari infeksi penyakit), dan kualitas darah yang baik, agar proses transfusi menjadi efisien dan efektif. Salah satu faktor yang dapat mempengaruhi kualitas darah yaitu adanya variasi donor, seperti adanya kelainan genetik pada sel darah merah. Thalasemia dan hemoglobin varian (Hb varian) merupakan kelainan genetik yang mempengaruhi sintesis dan kualitas Hb yang berfungsi sebagai pengangkut oksigen dari paru-paru ke seluruh tubuh. Prevalensi thalasemia dan Hb varian yang cukup tinggi di Indonesia, memungkinkan ditemukannya donor pembawa sifat thalasemia dan Hb varian. Seperti diketahui, pembawa sifat thalasemia dan Hb varian tidak mempunyai gejala klinis dengan konsentrasi Hb normal, sehingga dapat lolos seleksi donor. Penelitian ini bertujuan untuk mengetahui frekuensi pembawa sifat thalasemia dan Hb varian pada donor darah serta kualitas darahnya.Metodologi. Penelitian ini menggunakan desain potong lintang dengan sampel berasal dari 138 donor darah. Dilakukan skrining thalasemia dan Hb varian pada keseluruhan sampel, yang meliputi pemeriksaan hematologi rutin, analisis Hb metode HPLC dan analisis DNA (terutama pada suspek pembawa sifat thalasemia ?). Disertai dengan uji kualitas darah donor melalui pemeriksaan persentase hemolisis terhadap Whole Blood (WB) donor pada hari ke-1 dan ke-7 penyimpanan darah.Hasil. Berdasarkan hasil skrining terdeteksi pembawa sifat thalasemia dan Hb varian sebesar 7,97%, dengan rincian, pembawa sifat thalasemia ? 5 subjek ( 3,62%) yang salah satu diantaranya disertai dengan kelainan darah ovalositosis herediter tipe Asia Tenggara (South East Asian Ovalositosis / SAO), pembawa sifat thalasemia ? 3 subjek ( 2,17%), dan HbE 3 subjek ( 2,17%). Donor pembawa sifat thalasemia dan Hb varian serta SAO tersebut mempunyai persentase hemolisis pada darah simpan hari ke-7 kurang dari satu persen.Simpulan. Frekuensi total pembawa sifat thalasemia dan Hb varian pada populasi donor darah di UTD PMI DKI Jakarta adalah sebesar 7,97%. Keseluruhan sampel pembawa sifat thalasemia dan Hb varian serta SAO mempunyai kualitas darah simpan hari ke-7 cukup baik yang ditunjukkan dengan persentase hemolisis < 1%.

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Background. Red Cross Indonesia/Palang Merah Indonesia (PMI) is an organization that gets an assignment from the government to provide blood for the purposes of treatment and therapy. Blood and components needed for transfusion must meet the criteria for safe blood (free from infectious diseases) and the quality of blood transfusion should also be good, so that the process of transfusion becomes more efficient and effective. One of the factors that can affect the quality of blood storage is donor variations, such as genetic abnormalities in red blood cells. Thalassemia and Hemoglobin (Hb) variant is a genetic disorder that affects the synthesis and quality of Hb which serves as a carrier of oxygen from the lungs throughout the body. The prevalence of thalassemia and Hb variant are quite high in Indonesia, allow the identification of the donor carrier of thalassemia and Hb variant. As we known, thalassemia and Hb variants carier have no clinical symptoms with normal Hb concentration that can pass the donor selection. The aim of this study was to determine the frequency of Thalassemia and Hb variant among blood donors coming to Blood Centre Unit in Jakarta. It was also reviewed the quality of blood from donors identified as a carrier of thalassemia and Hb variant.

Methods. This cross-sectional study was conducted on 138 blood samples obtained from blood donors in the Blood centre unit in Jakarta. All samples were tested for Thalassemia and Hb variant by Complete Blood Count (CBC) and Hb analysis with HPLC method and DNA analysis for the detection of ? thalassemia carrier, and for the quality of blood storage by hemolysis rate of red blood cells (RBCs) in Whole Blood (WB) on days 1 and 7.

Results. Out of the 138 donors, 5 (3,62%) were diagnosed for ? thalassemia carrier which one of them is ? thalassemia carrier co-inherited with ovalositosis hereditary (Southeast Asian Ovalositosis / SAO) , 3 (2.17%) for ? thalassemia carrier, and 3 (2, 17%) for HbE carrier. Donors were detected carrier of thalassemia and Hb variant also SAO have hemolysis percentage until seven days storage is below one percent.

Conclusion. The total number of thalassemia carrier and Hb variants in blood donors at blood centre unit red cross Indonesia in Jakarta is 7,97%. The quality of blood storage in seven day from donor with thalassemia and Hb variants carrier also SAO, have the quality of blood storage were quite good. Hemolysis frequency did not seem to be donor dependent."