ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110747.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110748.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110749.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

A new, multiple‐antigen enzyme immunoassay (EIA‐2) for hepatitis C virus (HCV) antibodies was evaluated in parallel with the previously available c100‐3 HCV EIA (EIA‐1) in 14,068 volunteer blood donors as well as in 25 cases of transfusion‐associated hepatitis C for which recipient and donor samples were available. When compared to EIA‐1, the EIA‐2 was more sensitive in detecting HCV‐infected blood donors. The EIA‐2 detected an additional 1 in 1000 EIA‐1‐negative, surrogate marker‐ negative donors who were infected with HCV as demonstrated by polymerase chain reaction (PCR). The specificity of the EIA‐2 was comparable to that of the EIA‐1, but the two tests appear to detect different populations of false‐positive donors. Recombinant immunoblot assay‐indeterminate donors were detected five times more frequently by the EIA‐2; PCR demonstrated that 21 percent of these donors were infected with HCV. The greater sensitivity of EIA‐2 was also found in 25 transfusion recipients with non‐A, non‐B hepatitis; however, in 16 percent of these cases of posttransfusion HCV infection, the EIA‐2 failed to detect an HCV‐seropositive donor. These data indicate that EIA‐2 testing will significantly reduce, but probably not eliminate, the risk of transfusion‐associated HCV infection; we estimate this residual per‐unit risk to be 1 in 2000 to 1 in 6000 units transfused. On a national level, it is projected that the replacement of the anti‐ HCV EIA‐1 with the EIA‐2 will initially prevent up to 40 additio

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110750.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

In view of the continuing controversy regarding the use of immediate‐ spin crossmatch procedures in preparing blood for transfusion to patients in whom unexpected clinically significant antibodies have not been found by antibody screening by the indirect antiglobulin test (IAT), a review of 8 years' experience with such a policy was conducted. In that period, 54,725 units of packed red cells or whole blood were transfused to 10,146 patients. Four clinically overt delayed hemolytic transfusion reactions and 18 clinically silent delayed serologic transfusion reactions were found. In 3 of the 22 patients, the offending antibody(ies) were detectable in the pretransfusion serum by an enzyme IAT, but none was detectable by routine saline IAT against either a three‐cell screening panel or the transfused cells. Thus, the incorporation of saline indirect antiglobulin crossmatch would not have prevented the delayed reactions. It can be concluded that the use of a saline indirect antiglobulin crossmatch offers no significant advantage over the current policy of using only immediate‐spin crossmatch for those patients whose pretransfusion serum gives negative results in a three‐cell screen using a sal

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110751.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

“Life to Life,” an 11‐minute videotape based on social learning principles, was used by 10 blood centers in presentations to 4970 high school students one week before school blood drives. At each school, some students saw the videotape and others attended a blood center's customary presentation. Students also completed a brief questionnaire assessing donation attitudes, donation history, and intent to donate. The videotape accounted for a relative increase of 18.7 percent in donations even when other factors were not controlled for. Results were analyzed with logistic models and showed a consistently positive effect over all models used. For students who had never donated, the estimated odds ratio for actual donation (videotape:control) was 1.528. When the model included both type of presentation and ethnicity, the relative increase in donation over that after the blood centers' usual presentation was 69.8 percent for first‐time donors. Among previous donors considered alone, the effect on donation was not significant. Whatever their donor history, students who viewed the videotape showed significantly more positive attitudes toward donation and had greater intention to donate than students who saw the blood centers' standard presentations. These results suggest that this videotape is a useful tool for recruitment of high school blood

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110752.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Because of concern about the safety of immune globulins with respect to transmission of hepatitis C, the partitioning of hepatitis C virus (HCV) during alcohol fractionation of a plasma pool prepared exclusively from anti‐HCV‐reactive donations was examined. Quantitation of HCV RNA was accomplished by nested polymerase chain reaction (PCR) at limiting dilutions. One PCR unit was arbitrarily defined as the minimum amount of HCV RNA from which an amplified product could be detected. The starting plasma pool contained 1.4 × 10(5) PCR units per mL. Most of the HCV RNA was found in cryoprecipitate and in Cohn fractions I and III, but it was also detected in fraction II, which is used for immunoglobulin G preparations. A 3.4‐percent solution of IgG prepared from this fraction II contained 30 PCR units per mL. The fractionation process leading to immune globulin resulted in overall reduction in HCV RNA by a factor of 4.7 × 10(4). Although the presence of HCV RNA in the final product does not necessarily imply the presence of infectious virus, this work suggests that the safety of immune globulins with respect to HCV transmission is not due solely to the partitioning of HCV away from the immunoglobulin f

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110753.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Transplantation of ABO‐unmatched livers has been associated with the development of donor‐derived antibody (DDAb) and hemolysis. Nine (22%) of 41 consecutive patients undergoing liver transplantation at our institution received 10 ABO‐unmatched livers. Five (56%) of nine patients developed DDAbs and hemolysis. All five patients were group A1 and received group O livers. DDAbs appeared a mean of 9.2 +/− 2.8 (1 SD) days after surgery and persisted for 15.2 +/− 10.3 days. All patients with DDAbs developed hemolysis. During the period when DDAbs were demonstrable, the hemoglobin dropped by a mean of 4.8 g per dL (48 g/L), and the patients were transfused with a mean of 7.8 +/− 2.3 units of group O red cells. One patient with hemolysis underwent exchange transfusion for acute renal failure. Patients with hemolysis required significantly more red cells postoperatively (15.0 vs. 6.9 units, p = 0.04) than did ABO‐matched patients. None of the parameters examined (age, recipient or donor gender, secretor status, rejection, or donor isoagglutinin titers) were predictive of DDAb or hemolysis, although hemolysis occurred in three of four cases in which donor serum IgG anti‐ A titers were>or = 128, as opposed to one of four cases in which titers were<128. Because recipients of ABO‐unmatched livers are at high risk for transiently developing DDAb and hemolysis with associated morbidity, the prophylactic use of donor‐type red cells for surgery and after ope

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110754.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Expression of the normally cryptic blood group antigen Tn has occasionally been reported in hematologic disease, but the true frequency of this change is not known. A mouse monoclonal antibody (FBT3) and immunohistochemistry were used to examine expression of the Tn antigen. Expression was not detected in 35 normal bone marrow aspirates examined, but it was detected in 5 of 725 abnormal bone marrow aspirates, including 2 (3.6%) of 55 cases of de novo acute nonlymphocytic leukemia and 2 cases that terminated in acute nonlymphocytic leukemia. In two patients, one with acute myeloblastic leukemia and the other in blast transformation of chronic myeloid leukemia, the Tn antigen was expressed on 2 percent of blast cells. In one case of non‐Hodgkin's lymphoma, 4 percent of normal myeloid cells expressed the antigen. In the other two cases, one of acute myelomonocytic leukemia and the other of myelodysplasia, only 2 to 8 percent of myeloid and erythroid cells initially were Tn positive. Subsequent serial immunohistochemical studies of bone marrow aspirates and peripheral blood in these two cases showed increasing numbers of Tn‐ positive erythroid and myeloid cells 8 to 12 months before polyagglutination was detected serologically. Tn‐positive cells increased to>90 percent in the terminal phase in both cases of both diseases. The results suggest that Tn expression in these two patients may have conferred a growth advantage to the cells and could be related to disease progre

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32993110755.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1992.tb02364.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY