ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04595.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04596.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

Platelet concentrates prepared from freshly drawn blood were infused into patients with thrombocytopenic complicating disease. All exhibited a prolonged bleeding time, no clot retraction of a whole blood clot, platelet counts between 20,000 to 100,000 per cu. mm., usually, abnormal platelet ultrastructure and prothrombin consumption times under 15 seconds. Detection of platelet antibodies was attempted and the ultrastructure with a differential platelet count under the electron microscope of the patient's own platelets was documented. The platelet concentrates were given and it was possible to follow the fate of the donor's platelets by ultrastructural changes. Parallel studies of the coagulation mechanisms of the patients were followed serially. We found that some platelets survived up to seven days, although in some patients, platelets circulated but did not survive. Therefore immediate circulation of platelets cannot be equated with survival. In one patient with hypersplenism and a positive platelet agglutinin test no transfused platelets appeared to circulate. The ultrastructure of transfused platelets is greatly altered in bleeding patients. In the two patients with aplastic anemia and one with leukemia surviving platelets circulated which did not enter into the mechanisms of prothrombin activation, but which continued to circulate for some days with no improvement in the prothrombin consumption time over the pretransfusion level. Ultra‐structural studies of these platelets showed that the circulating platelets possessed their granules which contain platelet factor 3 activity. The differential platelet count under the electron miscroscope becomes abnormal as the donor platelets are stored. Our work suggests that the ultrastructure and differential platelet count of a platelet concentrate must be essentially normal for survival to be achieved.We confirmed the work of others indicating that donor platelets do not survive if stored or, if the recipient has detectable platelet antibodies. Donor platelets did not survive in some patients for reasons we could not explain. This may be dependent on utilization of platelets in hemostatic plugs, in thrombin production or for the endothelial supporting function but to date we cannot estimate to what extent or in what fashion a thrombocytopenic patient utilizes donor platelet

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04597.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04598.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

An antibody, anti‐Bua, defining a “new” antigen, Bua, is described. The antigen is of low frequency in a Caucasian population. It is inherited in a simple Mendelian manner and is demonstrable in the heterozygote. A study of three families indicates that it segregates independently of the ABO, MNSs, P, Rh, Kell, Kidd and Duffy systems and of the X chromosome. The antigen is apparently fully developed at birth. Both fresh and frozen cells reacted by the usual indirect Coombs technics; cells stored in the refrigerator for a month reacted by the capillary indirect Coombs technic

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04599.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

Renal shutdown is a most serious complication of transfusion reactions. Urine flow is a reliable indicator of renal function in patients during stress and should be considered a vital sign. When oliguria is observed resuscitative procedures, including mannitol infusion, should be applied promptly. Even when oliguria has been present for several hours and the signs of renal shutdown are present, mannitol is capable, in many instances, of restoring sufficient renal function to prevent the complications and mortality associated with oliguric renal failure. When oliguria persists, early transport to a Renal Center is indicated.

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04600.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

Heparinized blood not used at operation may be salvaged by transfer to Acid‐Citrate‐Dextrose (ACD) within 24 hours after collection. Collection and transfer must be done in a closed system and adequate refrigeration maintained from collection to transfusion. In five experiments, post‐transfusion survival studies have shown the percentage of viable cells to fall to 70 per cent in about 12 days. PlasmapH, hemoglobin, and potassium levels were within the same range as those of ACD bloods stored for similar periods. Of 180 heparinized bloods not used because of changes in operative schedules, 158 were salvaged and transfused, within this limit, in other

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04601.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

An electronic computer (UNIVAC 1105) is used in a simulation study to determine ordering and usage policies for a hospital blood bank. It is assumed that only type specific transfusions are given, and all use of fresh blood obtained for specific cases is excluded. A ratio of 25:4 is taken as the ratio of the cost whenever the bank is “short” of a unit for actual transfusion to the cost of an outdated unit.Optimal inventory levels are determined for a particular bank when the oldest blood is used first and the random volunteer donor input is maintained at current levels, when this input is doubled, and when the entire input is composed of ordered blood having life of 15 days. If the random input is doubled the losses are almost quadrupled. The losses would be least if the input were completely ordered and the life of the ordered blood were not restricted; but when the ordered blood has a life of only 15 days the losses are somewhat higher than when the random input remains unchanged. Consequences of always using the freshest blood first are also examined. This policy does not appear to be feasible unless the bank contains an excessive amount of bl

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04602.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

A hemolytic transfusion reaction due to interdonor incompatibility is reported. In a Kell negative recipient without irregular antibodies, Kell positive erythrocytes from one transfusion reacted with high‐titered anti‐Kell antibodies present in a unit of blood transfused subsequently. It was possible to demonstratein vitrosensitization of mixed populations of Kell positive and Kell negative red cells exposed to antibody dilutions analogous to those in the pati

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04603.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY

摘要:

Three alarm systems, one warning of temperatures above and below the acceptable range for blood preservation, the other two designed to prevent temperature rises due to unclosed refrigerator doors and power supply failure, are described and diagrammed. The temperature alarm gives its audible and visual signal in a constantly manned, distant area, identifies the refrigerator which failed, automatically signals the restoration of proper temperature after repairs, and is independent of building electric power supply. The door alarm is automatically turned on and off so it is operating only when the blood bank staff is absent. The power supply interruption alarm anticipates a temperature rise due to power failure by as much as an hour. The installation cost $160.

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1963.tb04604.x

出版商:Blackwell Publishing Ltd    

年代:1963

数据来源: WILEY