摘要:

The authors studied the factors responsible for the disproportionate outdating of group A blood compared with group O blood over a 6‐month interval. Distribution, transfusion, and outdate data for 99,251 units of blood were collected from representative hospitals within the region served by the Atlanta Regional Red Cross Blood Center. Factors evaluated included: neonatal transfusion of type O blood to type A recipients; use of type O blood in emergencies or due to group‐specific shortages; demographic donor and recipient differences; and blood importing practices. Of 43,757 group O units (44.1% of total) available for distribution, 2050 (4.7%) were outdated, compared with 3908 (10.7%) of 36,501 group A units (36.8% of total). One thousand two hundred and seventy‐nine units of type O blood were transfused to recipients who were not type O, including 842 group A neonatal patients. A larger inner‐city hospital, where 46.8 percent of recipients were group O and 29.2 percent were group A, accounted for 180 more group O and 509 fewer group A transfusions than would be expected if donor‐recipient ABO distributions were the same. Three hundred and seventy‐four more group A units were imported than were needed. ABO‐mismatched transfusions due to shortage or emergency were insignificant. It was concluded that increased use of group O blood for neonatal transfusions, donor‐ recipient differences in blood group frequencies, and blood importing practices are the major factors that increase the rate of gr

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235623.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

During the first 5 years (1981–1985) of the liver transplantation program in Pittsburgh, a total (preoperative, intraoperative, and postoperative) of 18,668 packed red cell units, 23,627 fresh‐frozen plasma units, 20,590 platelet units, and 4241 cryoprecipitate units was transfused for the procedures. This represents 3 to 9 percent of the total of blood products supplied by the Central Blood Bank to its 32 member hospitals. Six hundred thirty‐six (636) transplants were performed on 485 patients in two hospitals: the Presbyterian University Hospital (564 beds) and Children's Hospital of Pittsburgh (236 beds). All of the blood components used in the operations were procured and released by the Central Blood Bank. This report describes some of these fin

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235624.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

In an attempt to reverse a tendency toward the inordinate use of fresh‐ frozen plasma (FFP), the Transfusion Committee in a large tertiary care hospital distributed guidelines based on those derived at a Consensus Development Conference at the National Institutes of Health in 1984. In addition, the use of FFP was surveyed daily and supplemented by a one‐ on‐one educational program for the attending and house staffs. In 2 years, these steps resulted in a 77 percent decrease in the number of units of FFP trans

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235625.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

Viscosity (eta) in a blood suspension is affected by the total hematocrit (HT) as well as by the deformability of the cells. The impact of these combined factors on the rheologic behavior of sickle cell suspensions and on guidelines for transfusion has not been explored fully. Therefore, the eta of mixtures of washed normal (AA) and sickle (SS) red cells was determined in a rotational viscosimeter as a function of the hematocrit level of SS cells (HS), HT, oxygen tension (PO2), and shear rate. The ratio HT:eta can be taken as an index of potential oxygen delivery. The optimal HT (for maximum HT:eta) became progressively higher as the HS or the HS:HT ratio was lowered: at a given HT, HT:eta rose with a decrease in HS, especially at low HS values. These data support the concept that simple transfusion alone is not as beneficial to the patient as exchange transfusion and that substantial benefit can be obtained by bringing the patient to very low HS levels. The finding that eta rose with HT more steeply when the HS:HT ratio rather than HS was held constant suggested that the absolute level of HS may be more useful than the HS:HT ratio as a guide for a transfusion regimen.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235626.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

This study describes the response to therapeutic plasma exchange in a 60‐year‐old man with Waldenstrom's macroglobulinemia who developed a clinically severe bleeding disorder with laboratory features characteristic of acquired von Willebrand's disease. The patient's plasma levels of factor VIII coagulant activity, von Willebrand's factor antigen, and ristocetin cofactor activity were all less than 15 percent of normal, and the bleeding time was more than 20 minutes. In vitro studies did not demonstrate an inhibitor to factor VIII/von Willebrand factor, nor was a precipitating antibody to von Willebrand's factor antigen found in the patient's plasma. Neither infusions of cryoprecipitate nor combination chemotherapy corrected the clinical or laboratory abnormalities. In contrast, plasma exchange corrected the in vitro coagulation abnormalities and was effective in preventing surgical hemorrhage and controlling severe mucosal bleeding on 11 separate occasions. The current case demonstrates that the clinical and laboratory abnormalities in a patient with acquired von Willebrand's disease can be corrected completely by plasma exchange; it is recommended therefore that plasma exchange be considered as a mode of therapy in symptomatic patients with this disor

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235627.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

Assessment of venous hemoglobin (Hb), serum ferritin, and zinc protoporphyrin (ZPP) levels was carried out in women identified by CuSO4 screening as ineligible to donate blood. The correlation of log ferritin with ZPP was relatively poor (r = −0.580) but significant (p>than 0.01). However, a ZPP level of 2.0 micrograms per g Hb or greater (upper limit of normal for first‐time female donors) showed a predictive value of 0.85 for a ferritin level of 12 ng per ml or less in these donors. The correlation of hemoglobin concentration with ZPP level was significant (r = −0.667; p

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235628.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

The incidence of positive tests for anti‐HBs in 464 staff members of regional blood services between 1980 and 1983 (5.4%) was closer to that in the general population than to that in hospital staffs. Only two of the employees at risk developed antibodies during this interval, but neither seroconversion was attributable to employment in the regional blood center. The administration of hepatitis B vaccine, a recommendation based on data from health care workers potentially exposed to patient samples, may not be pertinent to regional blood center staff members potentially exposed only to volunteer donor product

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235629.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

Immune globulin, prepared as a chemically and enzymatically unmodified solution in 10 percent maltose at pH 4.25, was administered intravenously, at a dose of 0.4 g per kg per day for five consecutive days, to seven alloimmunized patients who had acute nonlymphocytic leukemia. All patients had an approximately threefold rise in IgG level. Five patients showed no change in lymphocytotoxic antibody (LCTAb) activity and no response to random donor platelets that were administered after the immune globulin. The activity of LCTAb either disappeared or diminished after immune globulin infusion in two patients, and they had borderline acceptable corrected count increments 1 hour after transfusion of pooled random‐donor platelet transfusions. Because of the diminished LCTAb activity, the improvements in response to pooled random‐donor platelet transfusions cannot be ascribed to the administration of immune globulin. High‐dose intravenous immune globulin has not been shown to be effective in reversing the effects of alloimmuniz

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235630.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

The authors report a case of passive red cell sensitization caused by antibodies received during an infusion of intravenous immune globulin. The patient had a positive direct antiglobulin test but showed no signs of hemolysis. The intravenous immune globulin product contained antibodies against four red cell antigens. These adverse reactions should be considered in the laboratory evaluation and clinical care of patients who receive intravenous immune globulin.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235631.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY

摘要:

A 53‐year‐old white woman had severe hemolytic anemia while taking nomifensine. A drop of hemoglobin to 61 g per I prompted the transfusion of two units of packed red cells. Nine days later, severe thrombocytopenia with multiple petechiae ensued. Both hemolysis and thrombocytopenia resolved promptly upon withdrawal of the drug and short‐term prednisolone treatment. Serologic studies showed nomifensine‐ dependent, metabolite‐specific red cell antibodies as the cause of immune‐mediated hemolysis and, in serum samples obtained after purpura, strong platelet‐specific PlA1 and weak HLA antibodies suggested a diagnosis of posttransf

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1987.27387235632.x

出版商:Blackwell Science Ltd    

年代:1987

数据来源: WILEY