ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165164.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165165.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The immediate‐spin (IS) crossmatch is a method that detects ABO incompatibility. However, under certain circumstances, this test may show unwanted negative or weak results, even though the red cells (RBCs) and serum being tested are ABO incompatible with each other. The present study investigated the potential effect of delayed centrifugation or reading on the IS crossmatch test performance. When the centrifugation step of the IS crossmatch between group O sera and group A1 RBCs was delayed for 2 minutes, 5 of 200 crossmatches showed no agglutination with only trace (n = 2) or moderate (n = 3) hemolysis, and one crossmatch showed only weak, macroscopic agglutination, but moderate hemolysis. All six sera contained A antibodies that were lytic in vitro and, therefore, probably were capable of causing in vivo hemolysis of transfused A1 RBCs. Delaying the reading of the IS crossmatch test for 2 minutes had no apparent effect on test performance. These data demonstrate the importance of technologists’ recognition of hemolysis as a positive result on IS crossmatches, especially if the performance of the centrifugation step of the test is delayed. Furthermore, the unwanted negative agglutination results were abolished by suspending the group A1 RBCs in saline containing EDTA. The authors’ laboratory has modified its IS crossmatch procedure so that donor RBCs are routinely suspended in saline containing EDTA before testing. This procedural change should increase the safety of the IS cross

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165166.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb04228.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

A cohort of 879 blood donors was followed over a 3‐year period. Of the 3858 units of blood collected, 112 (2.9%), obtained from 64 donors, had an alanine aminotransferase (ALT) activity over 45 IU per L; of these, 39 had a single ALT elevation. The incidence of ALT increase was 2.01 per 100 units, or 5.1 per 100 donors, per year. The pattern of elevated ALT was followed in 72 donors, 54 of whom were from the 64 cited above. At the second blood donation (BD2), about 5 months later, 62.5 percent had a normal ALT value, and most (91%) retained those values at blood donation 3 (BD3). However, 19 (70.3%) of the 27 whose ALT levels had not returned to normal at BD2 had an increased value at BD3. These results led to the formulation of the following algorithm to improve the management of blood donors; at the first donation, the ALT assay is done after the blood collection, but, at the next donation, the ALT level is measured before donation if the preceding ALT activity had been abnormal. If ALT is elevated, blood is not collected. Three consecutive ALT elevations are a criterion for permanent exclusion of the dono

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165167.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The possible existence of human immunodeficiency virus type 1 (HIV‐1) infection in asymptomatic seronegative at‐risk individuals was investigated in a prospective study of 55 seronegative high‐risk individuals (42 homosexual men and 13 heterosexual individuals) and 32 seronegative hemophiliacs treated with factor VIII or IX concentrates before viral inactivation by heat treatment and systematic screening of blood donations. Tests used include the polymerase chain reaction assay with three primer pairs (one in the gag region and two in the pol region) and tests for serum p24 antigen, anti‐nef serology (Western blot), and five biologic markers frequently altered by HIV infection (CD4 lymphocyte count, serum beta 2‐microglobulin and neopterin concentration, and serum IgG and IgA concentration). Although 91 of 92 HIV‐1‐seropositive persons were positive in testing with at least one primer pair, no positive result was observed in seronegative at‐risk individuals or in 117 seronegative low‐risk controls. No nef antibody was found in seronegative at‐risk individuals or seronegative controls, but 44 (47%) of 92 HIV‐1‐seropositive persons had nef antibodies. These findings do not support the existence of frequent HIV‐1 infection in seroneg

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165168.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Homologous blood transfusions have been associated in both animals and humans with an increased risk of acute postoperative infectious complications. Eighty‐four patients who underwent hip replacement surgery and were transfused with 2 or 3 units of blood were analyzed to determine whether those receiving homologous transfusions had different outcomes than those receiving autologous blood only. Only patients free of other risks for postoperative infection were studied. Those receiving homologous blood had a 32 percent (16/50) rate of proven or suspected infections, which was significantly higher than the 3 percent (1/34) rate in patients receiving autologous blood (p = 0.0029). Wound infections accounted for only a minority (6/17) of the proven or suspected infections, which suggests that nonsurgical factors contributed to these complications. The patients identified as being infected required significantly more antibiotic therapy (mean, 7.6 days) and lengthier hospital stays (mean, 15.5 days) than the patients who remained free of evidence of infection (means: 2.3 days of antibiotics and 12.3 days in the hospital) (p = 0.0001 for each variable). Other potential risk factors for infection, such as duration of surgical procedure, advanced patient age, amount of blood loss, type of anesthesia, surgeon performing the operation, use of a cemented versus porous‐coat prosthesis, leukocytopenia, anemia, and underlying medical diagnosis, did not account for the differences in infection rates seen in those receiving homologous and autologous transfusions. These results confirm previous reports of an increased risk of postoperative infection in patients receiving homologous transfusions. Homologous transfusion may contribute to an increased risk of infection by immunologic modulation of the recipient. If confirmed by other studies, these results provide another powerful argument in favor of autologous blood transfus

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165169.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The red cell‐monocyte assay (RMA), which has been used to evaluate the clinical significance of red cell (RBC) antibodies, was employed to test the effect of the dialyzable leukocyte extract (DLE) on in vitro adherence to monocytes of human RBCs coated with alloantibodies or autoantibodies. The total association index (TAI) of the RMA, expressing the number of RBCs adhering to or phagocytosed by 100 monocytes, indicated a potent inhibitory activity of DLE in the test system. TAI values of 100.4 +/− 20.1 (mean +/− SD) in the control sample, consisting of RBCs coated in vitro with anti‐D, dropped to 4.0 +/− 2.1 when DLE was present in the assay medium at a concentration of 0.5 U per mL. Similar results were obtained with RBCs coated with IgG antibodies in vivo. The inhibition was dose dependent and was associated with a thermolabile component of DLE. This study establishes that DLE can modulate monocyte function by inhibiting the recognition of IgG sensitized

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165170.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The fourth component of human complement (C4) is one that is essential to the antibody‐mediated classical activation pathway. C4d, present on all normal and most patient red cells (RBCs), may be detected by the human antisera anti‐Rodgers (Rg) and ‐Chido (Ch). A study has been made of the Rg/Ch antigens on normal and patient RBCs in an attempt to understand the mechanism by which C4 is bound to normal RBCs in the absence of RBC antibodies (Abs). Because RBCs from C1q‐deficient patients express Rg/Ch, it seems that C1q is not essential for C4 binding. Treatment of normal RBCs with proteolytic enzymes, including trypsin, eliminated positive reactions with anti‐Rg/Ch even though the C4d fragment is considered to be resistant to cleavage by trypsin. By correlating agglutination reactions with numbers of bound C4d and C3d molecules, it is evident that both C4d and C3d were affected by trypsin treatment and that anti‐Rg/Ch were not capable of agglutinating RBCs with less than 50 molecules of bound C4d. It is concluded that trypsin‐ sensitive and ‐insensitive RBC membrane structures may both act as acceptors for C4. RBCs with null phenotypes of the major blood group systems all expressed Rg/Ch antigens, so none of the structures that carry these antigens act preferentially as a

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31391165171.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb04234.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY