Hasil Pencarian  ::  Simpan CSV :: Kembali

"

Latar Belakang: Setiap individu memiliki antigen sel darah merah (SDM) yang unik pada membrannya. Terdapat lebih dari 300 antigen SDM yang dapat membagi darah ke dalam 36 sistem golongan. Adanya variasi pada antigen sel darah merah menyebabkan uji kecocokan darah antara pasien dengan donor wajib dilakukan guna mencegah terjadinya reaksi antara antigen donor dengan antibodi pasien. Pasien thalassemia memerlukan transfusi darah rutin yang dapat meningkatkan risiko terbentuknya aloantibodi, sehingga seringkali sulit untuk menemukan darah donor yang kompatibel. Unit Transfusi Darah (UTD), dalam rangka menjamin keselamatan pasien, harus mampu menyediakan darah donor tanpa antigen yang dapat menyebabkan reaksi transfusi. Pemeriksaan genotipe akan memberikan gambaran variasi antigen SDM donor, sehingga memudahkan pencarian donor yang sesuai untuk resipien.

Tujuan: Mengetahui adanya variasi genotipe antigen SDM pada donor sehingga dapat diupayakan penyerasian antigen darah donor untuk pasien transfusi berulang.

Metoda: Penelitian ini merupakan penelitian deskriptif observasional dengan desain potong lintang. Subyek pada penelitian ini adalah donor untuk pasien thalassemia. Sampel darah donor dikumpulkan untuk dilakukan pemeriksaan golongan darah ABO, Rhesus, ekstraksi DNA, dan genotipe antigen SDM.

Hasil dan Diskusi: Dari total 161 subyek penelitian, distribusi ABO/Rhesus donor adalah 68 subyek O+(42,24%), 43 subyek A+, 41 subyek B+, dan 9 subyek AB+. Setelah dilakukan pemeriksaan genotipe antigen SDM, didapatkan golongan darah dengan genotipe tersering untuk masing-masing golongan darah sebagai berikut Ce (98%) pada Rhesus, k/k (100%) pada Kell, Jk^a/Jk^b (40,76%) pada Kidd, Fy^a/Fy^a (74,84%) pada Duffy, Di^b/Di^b (99,36%) pada Diego, Do^b/Do^b (80,89%) pada Dombrock, Co^a/Co^a (100%) pada Colton, Yt^a/Yt^a (98.09%) pada Cartwright, MN (47,37%), s (86,54%) pada MNS dan Lu^b/Lu^b (100%) pada Lutheran. Pada studi ini juga ditemukan beberapa antigen darah langka seperti cE (1,33%), cEe (2%), CEe (1,33%), Fy^b (1,29%), Di^aDi^b (0,64%), Yt^aYt^b (1,91%), dan S (1,94%). Perlu diperhatikan antigen darah langka yang ditemukan pada donor/ populasi umum, bila ditransfusikan kepada pasien dengan antigen umum, dapat memicu timbulnya antibodi.

Kesimpulan: Pada penelitian ini ditemukan beberapa variasi genotipe antigen golongan darah pada donor, termasuk antigen langka. Perbedaan variasi antigen sel darah merah donor dan pasien dapat menyebabkan timbulnya aloantibodi, terutama pada pasien transfusi berulang. Oleh karena itu, pemeriksaan genotipe antigen SDM diharapkan dapat mengurangi reaksi transfusi dan meningkatkan keamanan pasien, terutama pasien yang membutuhkan transfusi berulang.

Kata kunci: antigen sel darah merah, genotipe, donor, aloantibodi

---

Background: Every individual has unique antigens on their red blood cells surface. There are more than 300 antigens of red blood cells that differentiate blood into 36 blood group systems. Due to the variation in antigen of red blood cell, it is a must to perform blood group matching between the patients and donors blood to prevent reactions between the donors antigen and patients antibody in the blood. Thalassemia patients require regular transfusions which resulting in the production of alloantibody, hence making it difficult to find compatible blood. Blood Transfusion Units (UTD) is required to provide blood without antigen that can trigger transfusion reaction to ensure patient safety. Red blood cell antigen genotyping from the donor can describe the variation of red blood cell antigen from the donor.

Aims: To identify the genotype variation of the donor red blood cells antigen, hence optimizing the donors antigen matching in patients with regular transfusion.

Methods: This was a descriptive observational study with cross sectional design. Subjects in this study were donor for thalassemia patients. Blood samples from donors underwent several examinations, such as the ABO blood type testing, Rhesus testing, DNA extraction, and red blood cell antigen genotyping.

Results and Discussions: From a total of 161 research subjects, the distribution of ABO/Rhesus blood grouping are 68 of O+(42,24%), 43 of A+, 41 of B+, and 9 of AB+. From the red blood cell antigen genotyping, variations of red cell antigens were found in several blood group systems as follows, Rhesus, Kidd, Kell, Duffy, MNS, Diego, Dombrock, Colton, Cartwright, and Lutheran. Our findings also shown several rare antigens such as cE (1,33%), cEe (2%), CEe(1,33%), Fy^b (1,29%), Di^aDi^b (0,64%), Yt^aYt^b (1,91%), S (1,94%). It is important to note that rare blood antigens were found in donors/ general population, if blood is transfused to patients, it can trigger the alloantibody production.

Conclusion: Our study found there were genotype variations in the blood antigen of donor, some of them were rare types. The difference of red blood cell antigen between donors and patients may lead to the development of alloantibody, especially in patients who need multiple transfusion. Therefore, red blood cell antigen genotyping is expected to decrease the incidence of transfusion reactions and increase patient safety, especially in patients that required multiple transfusions.

Keywords: Red blood cells antigen, genotyping, donor, alloantibody

"

"Darah sangatlah penting demi menunjang keberlangsungan hidup manusia. Di Indonesia masih terdapat kekurangan stok persediaan darah dari jumlah ideal sebanyak 972.522 kantong darah atau sebesar 18,8% belum terpenuhi. Ditambah dengan adanya kondisi pandemik Covid-19 seperti saat ini semakin membuat stok darah di sejumlah daerah berada di ambang batas kekhawatiran. Salah satu faktor permasalahan tersebut dikarenakan rendahnya kesadaran masyarakat dalam menjadi sukarelawan donor darah. Penelitian ini bertujuan untuk meningkatkan minat masyarakat menjadi sukarelawan donor darah dengan cara mensosoialisasikan kampanye gerakan “Suka & Rela Donor Darah” yang peneliti kembangkan menggunakan bantuan media sosial instagram Unit Transfusi Darah Pusat Palang Merah Indonesia @utdpusatpmi. Jenis penelitian yang digunakan adalah penelitian kuantitatif dan dilakukan survei online untuk mengukur minat masyarakat. Hasil penelitian menunjukkan bahwa konten yang diunggah di instagram @utdpusatpmi berdasarkan indikator tingkat kognitif rata-rata skor yakni 4,31, diikuti indikator tingkat afektif 3,67, dan indikator tingkat keperilakuan 3,43. Dari hasil penelitian ini dapat menciptakan respon kognitif positif, yakni responden mengetahui atas informasi kesehatan dan terjadi peningkatan pengetahuan mengenai donor darah. Namun demikian kampanye ini belum mencapai indikator afektif dan keperilakuan sehingga belum terjadinya perubahan perilaku pada masyarakat.

---

Blood is very important to support human life. In Indonesia, there is still a shortage of blood supplies, from the ideal number of 972,522 blood bags or 18.8% that has not been fulfilled. Coupled with the current Covid-19 pandemic conditions, the blood stock in a number of areas is on the threshold of concern. One of the factors of this problem is the low level of public awareness in volunteering for blood donations. This study aims to increase public interest in volunteering for blood donations by socializing the campaign for the “Like & Willing Blood Donation” movement which the researchers developed using social media assistance from the Indonesian Red Cross Central Blood Transfusion Unit @utdpusatpmi. This type of research is quantitative research and online surveys are conducted to measure people's interest. The results showed that the content uploaded on Instagram @utdpusatpmi was based on the average cognitive level indicator score of 4.31, followed by the affective level indicator at 3.67, and the behavioral level indicator at 3.43. From the results of this study, it can create a positive cognitive response, in which the respondents are aware of health information and there is an increase in knowledge about blood donors. However, this campaign has not reached the indicators of affective and behavioral, so there has not been a change in behavior in society."

"Latar belakang: Transfusi komponen Packed Red Cell (PRC) dengan metode pengurangan sel darah putih (PRC leukodepleted) mulai banyak digunakan untuk terapi pasien karena mampu mengurangi kejadian pasca transfusi yang tidak diinginkan. Jumlah perokok aktif di Indonesia yang cukup tinggi sehingga berpotensi besar menjadi pendonor darah karena belum ada regulasi yang mengaturnya. PRC leukodepleted pada perokok aktif beresiko besar mengalami kerusakan membran sel darah merah dan hemolisis akibat stres oksidatif yang terjadi karena akumulasi radikal bebas pada perokok aktif. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh stres oksidatif terhadap ketahanan membran PRC leukodepleted donor perokok aktif selama penyimpanan. Metode: PRC leukodepleted diproduksi dari pendonor yang dikelompokkan menjadi kelompok pendonor non perokok (NP), pendonor perokok ringan (PR) dan pendonor perokok sedang (PS). Sampel penelitian dibagi menjadi 6 aliquot untuk diperiksa kadar malondialdehid (MDA), aktivitas enzim superoksida dismutase (SOD), uji fragilitas osmotik (osmotic fragility test, OFT) dan hemolisis pada hari ke 0, 7, 14, 21, 28 dan 35. Hasil: Berdasarkan uji Kruskal Wallis ketiga kelompok menunjukkan perbedaan bermakna antara H0, H7, H14, H21, H28 dan H35 pada parameter MDA, SOD, OFT dan hemolisis yaitu dengan p<0,05. Dalam larutan NaCl 0,54 % pada uji OFT, terjadi hemolisis kelompok NP sebesar 17,53+12,16% pada H35; kelompok PR sebesar 34,10+7,92% pada H28; dan kelompok PS sebesar 30,92+5,98% pada H0. Kesimpulan: Penyimpanan PRC leukodepleted selama 35 hari meningkatkan stres oksidatif. Stres oksidatif paling tinggi terjadi pada kelompok perokok sedang. Terdapat korelasi antara stres oksidatif dengan ketahanan membran sel darah merah.

---

Background: Packed Red Cell (PRC) transfusion without the leukocyte (leukodepleted PRC) method has begun to be widely used for patient therapy because it can reduce unexpected post-transfusion effects. The number of active smokers in Indonesia is quite high so they have a great opportunity to become blood donors, since there is no regulation yet. Leukodepleted PRC in active smokers are at great risk for red blood cell membran damage and hemolysis due to oxidative stress that occurs caused by accumulation of free radicals in active smokers. Objective: This study aim to determine the effect of oxidative stress on red blood cells membrane resistance of leukodepleted PRC in active smokers donors during storage. Methods: Leukodepleted PRC was produced from donors who were grouped into non-smoker donors (NP), light smoker donors (PR) and moderate smoking donors (PS). The research sample was divided into 6 aliquots to be examined for the malondialdehyde (MDA) level, activity of superoxide dismutase (SOD) enzyme, osmotic fragility test (OFT) and hemolysis on 0, 7, 14, 21, 28 and 35 days of storage. Results: The three groups showed significant differences between D0, D7, D14, D21, D28 and D35 on the parameters of MDA, SOD, OFT and hemolysis (p<0.05, Kruskal-Wallis test). In 0.54% NaCl solution of OFT test, NP group hemolysis was 17.53+12.16% on D35; PR group was 34.10+7.92% on D28; and the PS group was 30.92+5.98% on D0. Conclusion: Storage for 35 days increased the oxidative stress of leukodepleted PRC. The highest oxidative stress occurred in the moderate smoker (PS) group. Oxidative stress has correlation with red blood cell membrane resistance."

"ABSTRAKLatar belakang. Transfusi darah mempunyai resiko untuk menyebabkan transmisi penyakit melalui darah, seperti malaria. Indonesia merupakan daerah endemik malaria terutama jenis P.falsiparum dan P.vivax. Di daerah endemik sulit menyaring kasus malaria hanya melalui wawancara dan keadaan klinis saja sehingga diperlukan pemeriksaan laboratorium untuk menyaring kasus malaria. Pemeriksaan laboratorium terhadap malaria yang ada saat ini adalah pemeriksaan mikroskopik dengan pewarnaan Giemsa, rapid diagnostic tests (RDT) dan PCR. Teknik yang digunakan tersebut memiliki keterbatasan. Perubahan yang terjadi pada permukaan membran eritrosit selama perkembangan parasit malaria intraseluler antara lain diekspresikannya berbagai protein polimorfik yang diketahui dapat memberi respon imun yang kuat. Antibodi terhadap molekul protein ini dapat ditemukan dalam serum penderita segera setelah penyembuhan infeksi malaria primer. Oleh karena itu, dilakukan penelitian ini untuk melihat apakah sediaan apus sel darah merah yang terinfeksi malaria yang diwarnai dengan teknik imunositokimia dapat mendeteksi adanya antigen pada permukaan sel darah merah tersebut menggunakan mikroskop cahaya.Metodologi.Penelitian ini dilakukan pada 42 bahan penelitian yang terdiri dari bahan yang positif dan negatif berdasarkan pemeriksaan mikroskop. Bahan penelitian ini diperiksa dengan teknik PCR sebagai baku emas, lalu dilanjutkan dengan pemeriksaan imunositokimia ( immunocytochemistry,ICC).Hasil. Dari 42 bahan penelitian yang diperiksa dengan PCR , dua bahan tidak dapat dilanjutkan dengan pemeriksaan ICC karena sediaan terlalu kecil.Dari 40 bahan yang diperiksa dengan PCR dan ICC, tiga bahan penelitian menunjukkan hasil positif dengan pemeriksaan PCR maupun ICC. Satu bahan penelitian yang negatif dengan pemeriksaan PCR menunjukkan hasil positif dengan pemeriksaan ICC. Sensitivitas pemeriksaan menggunakan teknik ICC dibandingkan dengan PCR adalah 100% dengan spesifisitas 97%.Simpulan. Pemeriksaan ICC cukup sensitif untuk menyaring adanya sel darah merah yang terinfeksi malaria sehingga dapat dipertimbangkan sebagai pemeriksaan untuk uji saring malaria pada darah donor.

---

ABSTRACTBackground. Blood transfusion are at risk to cause the transmission of blood borne diseases, such as malaria. Indonesia is a malaria- endemic areas , especially P.falciparum and P.vivax. In endemic areas, malaria is difficult to filter out throught interviews and clinical manifestation only. Hence, the laboratory tests to screen cases of malaria are needed. The existing laboratory techniques to detect malaria are microscopic examination with Giemsa staining, rapid diagnostic test and PCR. These technique had limitation . Changes that occur on the surface of the erythrocyte membrane during intracellular malaria parasite development such as the expression of various polymorphic protein, is known to induce a strong immune response. Antibodies to this protein molecule can be found in the serum of patients immediately after primary malarial infection. Therefore this research aims to search if the red blood cells smear of blood infected with malaria using immunocytochemistry technique can detect the presence of antigens on the surface of red blood cells using a light microscope.Methodology. In this study conducted at 42 study material consisting of positive and negative material base on microscope examination. This research material examined by PCR as gold standard, followed by immunocytochemistry examination (ICC).Result. Forty two research material were examined by PCR, two material can not be able to proceed with the ICC examination because the size of preparation are too small. Forty material were examined by PCR and ICC, three material research shows positive result with PCR and ICC . One study material negative with PCR shows positive result with the ICC. Sensitivity checks using ICC compared to PCR technique was 100% with specificity was 97%.Conclusion. ICC technique is sensitive to screen for red blood cells infected with malaria. It can be considered as a screening examination for malaria in blood donor."

"[ABSTRAKLatar belakang. Uji saring darah donor dapat menurunkan risiko tertularnya infeksi HCV. Di Indonesia telah dilakukan uji saring terhadap antibodi HCVdan RNA HCV. Uji saring terhadap Antigen-Antibodi belum dilakukan diIndonesia. Antigen HCV biasanya ditemukan pada 0 sampai 20 hari setelah RNA HCV pertama muncul. Anti-HCV dapat terdeteksi antara 10-40 harisetelah antigen HCV terdeteksi. Atas dasar pemikiran bahwa antigen HCVmuncul didalam darah lebih dahulu daripada anti-HCV, maka penelitian yangdilakukan ingin melihat apakah penggunaan reagensia serologi antigen-antibodi HCV dapat meningkatkan keamanan darah dan apakah sensitivitas serta spesifisitasnya sudah memenuhi standard yang dikeluarkan oleh Kementerian Kesehatan bila dibandingkan terhadap metoda NAT, yaitu sensitivitas 99,8% dan spesifisitas 95%.Metodologi. Pada penelitian ini dilakukan pemeriksaan pada 135 sampel darah donor yang terdiri dari 35 sampel positif dengan NAT HCV dan 100 sampel Positif dengan NAT HCV juga non reaktif terhadap HIV, HBsAg dan Sifilis dengan uji saring anti-HCV dengan metode CMIA, Ab-Ag HCV dengan metode ELISA dan bila ada perbedaan hasil pada pemeriksaan NAT HCV,CMIA HCV dan ELISA Ag-Ab HCV dilakukan pemeriksaan dengan menggunakan imunoblot HCV.Hasil. Dari 135 sampel, pada pemeriksaan ELISA Ag-Ab HCV terhadap 35 sampel positif RNA HCV menunjukkan hasil positif pada 35 sampel tersebut,tetapi pada 100 sampel negatif RNA HCV terdapat 3 sampel reaktif dan 97 nonreaktif. Sedangkan pada 35 sampel positif RNA HCV dengan pemeriksaanCMIA anti-HCV menunjukkan hasil reaktif pada 35 sampel dan pada 100 sampel negatif RNA HCV terdapat 11 sampel reaktif dan 89 sampel non reaktif.Sensitivitas dari perbandingan hasil pemeriksaan metoda NAT HCV dengan CMIA Ab-HCV adalah 100%, spesifisitasnya adalah 89%. Sensitivitas dari perbandingan hasil pemeriksaan metoda NAT HCV dengan ELISA Ag-AbHCV adalah 100%, spesifisitasnya adalah 97%.Simpulan. Pemeriksaan Antigen-Antibodi HCV ELISA memenuhi kriteriastandar untuk digunakan sebagai uji saring darah donor. Pemeriksaan AntibodiHCV CMIA tidak memenuhi kriteria standar untuk digunakan sebagai uji saringdarah donor.

---

ABSTRACTBackground. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCVRNA . Screened against the antigen - antibody has not been done in Indonesia .HCV antigens commonly found in 0 to 20 days after HCV RNA first appears .Anti - HCV can be detected between 10-40 days after HCV antigen wasdetected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether thesensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCVscreening of the CMIA method, HCV Ab-Ag ELISA method and theexamination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the35 HCV RNA positive samples with anti-HCV CMIA examination showedreactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of theresults of the comparison method with CMIA HCV NAT-HCV Ab was 100%,specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodiesCMIA does not meet the standard criteria for use as a screening of donor blood.;Background. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCVRNA . Screened against the antigen - antibody has not been done in Indonesia .HCV antigens commonly found in 0 to 20 days after HCV RNA first appears .Anti - HCV can be detected between 10-40 days after HCV antigen wasdetected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether thesensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCVscreening of the CMIA method, HCV Ab-Ag ELISA method and theexamination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the35 HCV RNA positive samples with anti-HCV CMIA examination showedreactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of theresults of the comparison method with CMIA HCV NAT-HCV Ab was 100%,specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodiesCMIA does not meet the standard criteria for use as a screening of donor blood., Background. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCVRNA . Screened against the antigen - antibody has not been done in Indonesia .HCV antigens commonly found in 0 to 20 days after HCV RNA first appears .Anti - HCV can be detected between 10-40 days after HCV antigen wasdetected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether thesensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCVscreening of the CMIA method, HCV Ab-Ag ELISA method and theexamination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the35 HCV RNA positive samples with anti-HCV CMIA examination showedreactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of theresults of the comparison method with CMIA HCV NAT-HCV Ab was 100%,specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodiesCMIA does not meet the standard criteria for use as a screening of donor blood.]"

"Karsinoma hepatoseluler (KHS) adalah kanker primer liver dan penyebab kedua kematian akibat kanker. Eksosom pada lingkungan mikro KHS berfungsi untuk komunikasi antar sel dan bila endositosis ke sel NK dapat menyebabkan perubahan pada sel NK. Penelitian ini bertujuan menganalisis eksosom dari darah pasien KHS, perubahan fenotipe sel NK, dan uji pewarnaan histologi (peroksidase, toluidine blue) untuk mengamati perubahan granula azurofilik sel NK akibat endositosis eksosom. Metode penelitian meliputi isolasi sel NK dari donor sehat dan eksosom darah pasien KHS, karakterisasi eksosom dengan PSA, stimulasi sel NK dengan eksosom, flow cytometry reseptor pada sel NK dan CD81+ pada eksosom, imunofluoresens endositosis eksosom ke sel NK, pewarnaan toluidine blue dan peroksidase.Hasil menunjukkan eksosom berukuran 34,7 nm, bermuatan -4,33 mV dan positif CD81+. Perubahan reseptor sel NK sehat yang dipaparkan eksosom KHS tidak signifikan (P>0,05). Imunofluoresens memperlihatkan endositosis eksosom ke sel NK. Pewarnaan sel NK toluidine blue menunjukkan metakromasia dan peroksidase negatif. Sel NK+eksosom mengalami perubahan hasil pewarnaan. Peneliti menyimpulkan bahwa eksosom dari darah pasien KHS sesuai kriteria MISEV 2018.Tidak terjadi perubahan fenotipe sel NK sehat yang dipaparkan eksosom dari darah pasien KHS. Pewarnaan peroksidase dan toluidine blue dapat digunakan sebagai metode pengamatan endositosis eksosom ke sel NK.

---

Hepatocellular carcinoma (HCC) is the primary liver cancer and the second leading cause of death from cancer. Exosomes in the HCC microenvironment function for communication between cells and when endocytosed to NK cells can cause changes in NK cells. This study aims to analyze exosomes from the blood of HCC patients, changes in NK cell phenotype, and histological staining tests (peroxidase, toluidine blue) to observe changes in NK cell azurophilic granules due to exosome endocytosis. NK cells from healthy donors and blood exosomes of KHS patients were isolated, exosomes characterized by PSA, stimulation of NK cells with exosomes, and flow cytometry of receptors on NK cells and CD81+ on exosomes were done. Endocytosis of exosomes onto NK cells were observed through immunofluorescence, then metacromasia and azurofilic granules of NK cells were observed after toluidine blue and peroxidase staining. Results showed The exosome is 34.7 nm in size, has a charge of -4.33 mV and is CD81+ positive. Changes in healthy NK cell receptors exposed to HCC exosomes were not significant (P>0.05). Immunofluorescence demonstrates exosome endocytosis in NK cells. Toluidine blue NK cell staining showed negative metachromasia and peroxidase. In NK cell+exosome there is a change in staining results. We concluded exosomes from the blood of HCC patients comply with MISEV 2018 criteria. There is no change in the phenotype of healthy NK cells exposed to exosomes from the blood of HCC patients. Peroxidase and toluidine blue staining can be used as a method of observing exosome endocytosis in NK cells."

"Skripsi ini membahas tentang permintaan produk Packed Red Cell (PRC) di Unit Transfusi Darah Palang Merah Indonesia di DKI Jakarta yang diperkirakan akan membuat rencana produksi guna menurunkan tingkat keluarnya darah yang terjadi akibat jumlahnya. produksi yang melebihi jumlah penggunaan. Penelitian ini berbentuk studi kasus dengan tipe kuantitatif. Dalam peramalan, data time-series penggunaan PRC bulanan digunakan selama lima tahun terakhir yaitu 2014 hingga 2018 yang dihitung dengan menggunakan metode Autoregressive Integrated Moving Average (ARIMA) dan Holt-Winter Exponential Smoothing. Hasil perhitungan dengan menggunakan metode ARIMA memberikan hasil peramalan yang lebih baik sehingga dapat digunakan sebagai acuan dalam membuat perencanaan produksi produk RRT. Dari hasil perencanaan produksi tersebut disarankan agar PMI DKI Jakarta mengalihkan sebagian dari rencana kunjungannya dalam rangka pengambilan darah ke PMI lain di sekitar Jakarta dan juga dapat menyalurkan jumlah produksi darah berlebih ke Bank Darah Rumah Sakit ( BDRS) atau PMI lain yang masih kekurangan suplai darah.

---

This thesis discusses the demand for Packed Red Cell (PRC) products at the Indonesian Red Cross Blood Transfusion Unit in DKI Jakarta, which is expected to make a production plan to reduce the rate of blood loss that occurs due to the amount. production that exceeds the amount of use. This research is in the form of a case study with a quantitative type. In forecasting, time-series data on the use of monthly PRC are used for the last five years, namely 2014 to 2018, which is calculated using the Autoregressive Integrated Moving Average (ARIMA) and Holt-Winter Exponential Smoothing methods. The results of calculations using the ARIMA method provide better forecasting results so that they can be used as a reference in planning the production of Chinese products. From the results of the production planning, it is suggested that PMI DKI Jakarta divert part of its planned visit in the context of taking blood to other PMIs around Jakarta and also be able to distribute the amount of excess blood production to Hospital Blood Banks (BDRS) or other PMIs that still lack blood supply."

"Latar Belakang: Kondisi besi berlebih, dengan feritin dan saturasi transferin sebagai surrogate marker, akan menimbulkan oksigen radikal bebas (ROS) yang menyebabkan stress oksidatif. Malondialdehid (MDA) merupakan ROS yang terbentuk dari peroksidase lemak sedangkan (manganese)superoksid dismutase (MnSOD) sebagai enzim yang mengubah radikal bebas oksigen menjadi oksigen biasa. Transfusi darah sering digunakan untuk mengatasi anemia pada kanker, namun juga berpotensi meningkatkan beban besi pada tubuh. Penelitian ini melihat peran transfusi darah terhadap feritin serum dan saturasi transferin serta kaitannya dengan stres oksidatif pada pasien kanker nasofaring.Tujuan: Mengetahui peranan transfusi sel darah merah (SDM) dalam kaitannya dengan perubahan kadar feritin serum dan saturasi transferin serta korelasinya dengan stress oksidatif pada pasien kanker nasofaring (KNF) yang menjalani kemoradiasi.Metode: Studi kohort prospektif. Pengambilan data dilakukan di klinik Hematologi-Onkologi Medik IPD RSCM Jakarta secara consecutive sampling pada bulan November 2015-Februari 2016. Pasien KNF yang menjalani kemoradiasi diperiksakan kadar feritin serum, saturasi transferin, MDA, MnSOD pra dan pasca terapi. Dilakukan pencatatan jumlah transfusi sel darah merah yang diterima. Analisa data menggunakan T-test/Mann Whitney dan uji korelasi Spearman.Hasil: Total 38 pasien yang menjalani kemoradiasi, usia rata-rata 47 tahun, laki-laki dan perempuan 4:1. Sebanyak 18 pasien (47,4%) menerima transfusi sel darah merah selama pengobatan. Didapatkan peningkatan rerata saturasi transferin sebesar 15,1% (p=0,016) dan MDA sebesar 1,368 (p=0,001) pada pasien yang mendapatkan transfusi SDM dibandingkan yang tidak mendapatkan transfusi. Tidak didapatkan perbedaan yang signifikan pada feritin serum (p= 0,35) dan MnSOD (p= 0,496) antara yang mendapatkan transfusi SDM dengan yang tidak. Didapatkan korelasi lemah antara feritin serum dengan MDA dan MnSOD (r=0,239 dan r= -0,374) dan tidak didapatkan korelasi antara saturasi transferin dengan MDA dan MnSOD (r=0,191 dan r=0,027).Simpulan: Terdapat peningkatan rerata saturasi transferin dan MDA pada pasien yang mendapatkan transfusi SDM. Tidak terdapat peningkatan feritin serum ataupun penurunan MnSOD. Terdapat korelasi yang lemah antara peningkatan kadar feritin serum dengan MDA dan MnSOD pada pasien KNF pasca kemoradiasi dan transfusi sel darah merah. Tidak terdapat korelasi antara kadar saturasi transferin dengan MDA dan MnSOD pada pasien KNF yang mendapat transfusi sel darah merah.

---

Background: The presence of free iron in the circulation will induce the formation of reactive oxygen species (ROS) which result in cell injury. The free radical formed and cause lipid peroxidation which in result cause formation of malondialdehyde (MDA). (manganese)Superoxide Dismutase (MnSOD) as antioxidant enzyme have anti tumor activity and the level often found low in cancer patient. Ferritin and transferrin saturation are predictor of iron overload. Blood transfusion is the therapy often used to resolve anemia in cancer, but also increase iron burden in body. This study focus on the role of blood transfusion to serum ferritin and transferrin saturation and its correlation with oxidative stress in patients with nasopharyngeal cancer (NPC).

Objective: To know the role of red blood cell (RBC) transfusion and its relations to serum ferritin and transferin saturation level and their correlation with oxidative stress in nasopharyngeal cancer patients undergoing chemoradiation.

Methods: Prospective study. Sample obtained with consecutive sampling method collected in the Hematology-Medical Oncology Clinic in Cipto Mangunkusumo Hospital Jakarta November 2015 to February 2015. NPC patients undergoing chemoradiation, blood examination performed to measure ferritin, saturation transferrin, malondialdehyde, MnSOD before and after treatment. During treatment the amount of transfusion received is recorded. Data analysis done using T-test/Mann Whitney and Spearman correlation test.

Results: Total of 38 patients received chemoradiation, mean age 47,97 years old, proportion man compare woman is 4:1. During treatment 18 patients (47,4%) received red blood cell transfusion. Difference in mean found between transferrin saturation 15,1% (p=0,016) and MDA serum 1,358 nM (p=0,001) in patient receiving RBC transfusion compare to subject not receving transfusion. There are no significantly differences in serum ferritin and MnSOD level between both group. We found a weak correlation between raise of serum ferritin to the raise of MDA and the declining of MnSOD (r = 0,239 and r= -0,374). There are no correlation between transferin saturation with MDA nor MnSOD

Conclusions : Increase in transferin saturation and MDA level found in NPC receiving RBC transfusion after chemoradiation. There is a weak correlation found between serum ferritin with MDA and MnSOD in nasopharyngeal cancer undergoing chemotherapy radiation therapy receiving RBC transfusion and no correlation between transferin saturation with MDA and MnSOD changes."

"[ABSTRAKLatar belakang. Pemberian transfusi darah merupakan salah satu tindakan medis untuk penyelamatan nyawa (live saving) dan penyembuhan penyakit, tetapi disisi lain tindakan ini juga memiliki risiko atau komplikasi. Salah satu komplikasiyang dikenal adalah Transfusion-Associated Graft-vs-Host Disease (TAGVHD). TAGVHD ini akan menyebabkan berproliferasinya limfosit T yangkemudian akan diikuti oleh proses engraft (tertanam) didalam tubuh resipien yang umumnya berada dalam kondisi imunokompeten. Kondisi ini umumnya dialami oleh pasien-pasien dengan gangguan sistem imunologi seperti pada pasien kanker atau penyakit-penyakit autoimun. Saat ini, satu ? satunya metode yang dapat diterima untuk mencegah komplikasi itu dengan cara melakukan iradiasi darah. Bervariasinya rekomendasi tentang dosis iradiasi dan waktu penyinaran untukmenurunkan jumlah CD 3+ dan CD 4+ sebagai penyebab terjadinya TAGVHD, menjadi latar belakang dilakukannya penelitian ini. Hasil penelitian ini akan dijadikan rekomendasi untuk prosedur iradiasi terhadap komponen sel darah merah pekatyang akan diberikan pada pasien-pasien imunokompeten di RS Kanker Dharmais Jakarta.Metodologi. Penelitian ini menggunakan disain penelitian eksperimental dengan pemeriksaan time series yang dilakukan terhadap 54 kantong komponen sel darah merah pekat yang memenuhi kriteria inklusi dan ekslusi yang ditetapkan oleh peneliti. Dilakukan pengujian terhadap jumlah CD 3+ dan CD 4+ dalam tiga dosis dengan tiga serial waktu berbeda.Hasil. Terjadi penurunan jumlah CD 3+ dan CD 4+ pada komponen sel darah merah pekat yang dilakukan iradiasi pada dosis iradiasi dan waktu penyinaran yang berbeda.Simpulan. Penurunan jumlah CD 3+ bermakna atau signifikan pada dosis 2500 pada waktu 5 jam setelah penyinaran.

---

ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.; ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.; ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation., ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.]"

"Skrining darah pendonor di Indonesia terhadap malaria belum dilakukan dengan pemeriksaan laboratorium. Kemungkinan resiko penularan malaria melalui darah donor dapat terjadi dan membahayakan jiwa resipien. Malaria di kota Ambon berdasarkan Annual Parasite Incidence adalah 4,49? termasuk High Case Incidence (HCI). Penelitian ini bertujuan mengetahui prevalensi malaria dengan berbagai pemeriksaan laboratorium di kota Ambon. Dikumpulkan sebanyak 550 donor di Unit transfusi darah PMI Ambon dalam kurun waktu 3 bulan dan dilakukan berbagai pemeriksaan. Hasilnya memperlihatkan tidak satupun terdeteksi positif dengan pemeriksaan mikroskopik maupun rapid test antigen Pf HRP2-pan aldolase atau Pf HRP-2- PvLDH. Duapuluh dua donor terbukti mengandung immunoglobulin P. falciparum dengan rapid test antibodi. Lima donor lain positif dengan PCR menggunakan 18S rRNA. Penelitian ini membuktikan adanya potensi penularan malaria dari darah donor sebesar 4.9% di Pulau Ambon.

---

Screening of blood donors in Indonesia against malaria with laboratory tests have not been done. Possible risk of malaria transmission through donated blood may occur and endanger the lives of recipients. Malaria in the city of Ambon by Annual Parasite Incidence was 4.49 - including High Case Incidence (HCI). This study aims to determine the prevalence of malaria with a several laboratory tests in the city of Ambon. Collection of total 550 donors at Red Cross blood transfusion unit Ambon, was carried out for a period of 3 months and followed by various examinations. The results showed none detected positive by microscopic examination or antigen rapid test PfHRP2-aldolase or PfHRP2-LDH. Twenty-two donors were found to contain P. falciparum with immunoglobulin antibody rapid test, in addition five other donors positive by PCR using 18S rRNA. This study showed that the potency of malaria transmission by blood donors was 4.9% in the island of Ambon."