摘要:

The long‐term survival of serologically incompatible red cell units was measured in five patients with antibodies to high‐frequency antigens. Initially, the survival of 1 ml of51Cr‐labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1‐hour survival times were successful (greater than 70%), each patient then received 5 ml of the same51Cr‐labeled red cells followed by the transfusion of the remainder of the red cell unit. The long‐term T ½ Cr survival for each case was patient 1 (anti‐McCa), 15 days; patient 2 (anti‐JMH), 12 days; patient 3 (anti‐Kna), 31 days; patient 4 (anti‐McCa), 12 days; and patient 5 (anti‐Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti‐JMH was the only antibody to react with IgG subclass antisera and was determined to be IgG4. The macrophage assay, IgG subclass testing, and short‐term (1 hour, 1 ml)51Cr survival studies all indicated that the short‐term survival was good. However, only the measurement of long‐ term survival with transfused units of serologically incompatible red cells was able to determine the actual survival, and “clinical significance” of the alloantibodies. Determining the actual long‐term survival by the method described here can be of importance for patients re

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116499.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

The present study documents immediate and long‐term survival of crossmatch‐incompatible Rh(D)‐negative donor red cells in a patient with anti‐LW. A 67‐year‐old group A Rh(D)‐positive man was admitted for urgent coronary artery bypass surgery. The direct antiglobulin test (DAT) was weakly positive in two of five laboratories. His serum contained anti‐LW (two laboratories); his red cells were LW negative (three antisera). Two siblings were LW‐positive. Surgery was delayed, and 3 ml Rh(D)‐negative crossmatch‐incompatible red cells stored in citrate‐phosphate‐dextrose‐adenine‐one were labeled with 25 μCi of51Cr and injected. Immediate survival was approximately 100 percent with 92 percent survival at 20 hours. Six daily blood samples showed a decreased red cell lifespan, (T ½ = 14 days). Because of medical complications, 4 units of Rh(D)‐negative crossmatch‐incompatible blood were then transfused without clinical or hemolytic reaction. The anti‐ IgG DAT became stronger. In vivo survival of the remaining51Cr‐RBCs became normal (T ½ 28 days over the succeeding 20 days). Following transfusion, no change in serum antibody strength was demonstrated by double‐blind titration of seven coded samples. The observations support modest reduction of lifespan for 3 ml of LW‐positive red cells, but normal survival following subsequent transfusion of a

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116500.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1985.tb03108.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A 27‐year‐old, gravida 3, para 2 woman experienced a delayed hemolytic transfusion reaction. She had anti‐Dobin both serum and eluate 8 days after infusion of 6 units of Do(b+) red cells. No antibody had been detected prior to transfusion. By the 15th day after transfusion, there was no evidence of survival of red cells from any of the 6 units. Anti‐ C and anti‐M were demonstrated later, but 29 months after transfusion, no atypical antibodies were detectable. The evidence suggests anti‐Dobshould be considered an antibody of potential clinical significance until contrary evidence become

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116501.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

Heterologous anti‐lymphocyte globulin (ALG) is known to contain panagglutination activity and may cause a positive direct antiglobulin test in a renal allograft recipient. Three patients are reported in whom the passively acquired antibody showed apparent specificity in the Lutheran blood group system. The sera of these patients and eluates from their red cells displayed reactivity consistent with a Lutheran‐ related antibody. While the neat ALG acted as a panagglutinin, the Lutheran system specificity appeared only following dilution of the ALG. This specificity did not appear to represent a separate, distinguishable antibody in the ALG product. Before considering the utilization of units of the rare Lu(a‐b‐) phenotype for transfusing a renal allograft patient who has a Lutheran‐related antibody, investigation of ALG as a source of that antibody should be

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116502.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A 91‐year‐old man developed a severe bleeding diathesis postoperatively. Laboratory studies showed an inhibitor to factor V which was identified as IgG. The patient failed to respond to fresh‐ frozen plasma and platelet transfusions, but demonstrated both clinical and laboratory improvement after transfusion with an activated prothrombin complex concentrate (Autoplex). Patients with refractory inhibitors to factors VIII or IX have been managed successfully with this concentrate; however, this case demonstrates that is also may be of value in managing patients with refractory inhibitors to fac

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116503.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A pregnant 26‐year‐old woman with Devic's syndrome manifesting as paraplegia and visual loss was treated with multiple courses of lymphocytaplasmapheresis. Clinical improvement was temporally related to the lymphocytaplasmapheresis. She relapsed when treatment was stopped and improved with reinstitution of therapy. Thereafter, further treatments were not required and she delivered a normal inf

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116504.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1985.tb03113.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

Platelet concentrates made with an initial pH of 7.85 or 6.85 by addition of alkali or acid were stored at 22°C on tumbler or horizontal agitators. The combination of a high pH and use of a tumbler rotator was associated with a 40 percent reduction in platelet count, fragmentation of platelets, release of lactate dehydrogenase, and a marked loss in response to adenosine diphosphate. Similar, but less striking changes occurred in acidified platelet concentrates stored on the tumbler rotator. Preservation was good for both alkaline and acidified concentrates stored on the horizontal agitator.These in vitro studies showed that, even at a pH of up to 7.7, gently agitated platelets were relatively undamaged for up to 60 hours, while vigorous agitation destroyed platelets at the same pH

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116505.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

Two hemolytic transfusion reactions related to isoagglutinins present in group O platelet concentrates are reported. The first, a severe reaction in a group A 10‐kg patient, resulted from transfusion of 200 ml of plasma containing a hemolytic anti‐A, titer 16, and an IgG anti‐ A, titer of 32,000. In the second case, a group B adult received between 50 and 70 ml of O plasma with a titer (16,000) of anti‐B. This was followed by hemolysis of approximately 40 percent of the patient's red cell

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25185116506.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY