ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116424.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116428.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116437.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

It has been reported previously that platelet concentrates (PCs) prepared from buffy coat pools diluted in a simple, glucose‐free medium (BC‐PCs) are effective in thrombocytopenic patients after 4 to 12 days of storage. Such preparations produce platelet increments similar to those of traditional PCs prepared from platelet‐rich plasma (PRP‐PCs) stored for 1 to 3 days. The purpose of this study was to obtain a series of in vitro measurements during storage to allow a more detailed characterization of BC‐PCs and a more detailed comparison of BC‐PCs with PRP‐PCs. At the beginning of storage, the level of (alpha granule membrane protein‐140 (GMP‐140), a marker of platelet activation, was significantly higher on PRP‐PC platelets, and BC‐PCs were superior in measurements reflecting platelet function, such as osmotic reversal, ATP release, and aggregation with collagen. Compared to PRP‐PCs, BC‐PCs were superior in the percentage of discs, total ATP, and glycoprotein lb expression by Day 7. This superiority became more striking on Day 11. Overall, 15‐day‐old BC‐PCs compared favorably to 7‐day old PRP‐PCs: BC‐PCs were superior in ATP release and aggregation with collagen, but they were not significantly different for all other measurements reflecting platelet quality and function. Thus, the quality of platelets in BC‐PCs was superior on Day 1, and this superiority progressed as storage continued. In addition, the metabolism of BC‐PCs was favorable. During 15 days of storage, pH and bicarbonate concentration did not change significantly In BC‐PCs; moreover, oxygen consumption was higher and glucose utilization and lactate accumulation were markedly slower than in PRP‐PCs. The results of additional experiments performed with pooled PRP‐PCs diluted In the glucose‐free medium and stored In the same fashion as BCPCs were Intermediate between those of experiments with BCPCs and PRP‐PCs, which suggests that the superior quality of BC‐PCs Is due In part to the buffy coat method of pre aration and In part to one or more components of the storage method. This approach to platelet procurement and storage has the disadvantage of a lower platelet yield. However, it can be concluded that it produces platelets of higher quality, contaminated with fewer white cells and less plasma and with bette

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116445.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.tb01817.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Transfusion practices have changed dramatically in recent years as a result of the acquired immune deficiency syndrome crisis. The use of preoperative donation of autologous blood units has gained popularity. Healthy individuals tolerate phlebotomy well, experiencing a 2‐ to 5‐ percent incidence of vasovagal reactions. However, no systematic study of hemodynamic function during phlebotomy exists for patients who have major cardiovascular or multiple organ disease (high‐risk patients). The following protocol examines blood pressure, heart rate, cardiac output, lead II electrocardiogram, and pulse oximetry in 123 patients donating a total of 224 units of blood in a new high‐risk autologous blood donation program that was conducted in a postanesthesia care unit over the past 18 months. Changes in hemodynamic variables during phlebotomy were consistent with mild volume depletion; the changes did not result in overall differences in the courses of the groups. Significant numbers of patients exhibited systolic or diastolic hypotension, dysrhythmias, syncope, and tachycardia. Because tolerance for hypotension (vasovagal reactions) is decreased in patients with coronary artery disease, appropriate monitoring may be warranted to maximize the safety of elective phlebotomy. Further study is required to stratify risks and to determine which hemodynamic variables are predictive of adverse

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116425.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

During the period April 1985 to March 1986, 217 blood donors were found to have moderate (syncopal) to severe (convulsive) reactions. This population was compared to 5630 randomly selected donors who did not have reactions. An examination of demographic, physical, and societal/emotional factors was conducted to determine if any were predictive of reactions in donors. The results of the research supported the hypothesis that first‐time donors have a higher frequency of reactions (1.7%) than do repeat donors (0.19%). A review of the above predictive factors documented that, with regard to demographic factors, 1) the number of prior donations was inversely proportional to the risk of reaction; 2) the gender of the donor was not predictive; and 3) youth was a predictor of reactions. An analysis of the physical factors revealed that donors who reacted were of lower weight (mean, 153.7 lb) than those who did not (mean, 166.4 lb) and that systolic blood pressure was slightly lower in the group with reactions. Although the difference was significant (3 torr), it was not thought to be significant clinically. In a comparison of a group with systolic blood pressure ranging from 80 to 100 torr and a group with systolic blood pressure ranging from 120 to 140 torr, the first group had a 70‐percent higher risk of reaction. Finally, with regard to the last category of societal or emotional factors, the research demonstrates 1) that the ingestion of caffeinated beverages was associated with a reduced risk of reactions; 2) that the food intake of donors who reacred was significantly different from that of those who had no reaction, but this difference was not thought to be clinically significant; and 3) that the duration between registration and the onset of phlebotomy was directly predictive of reaction status. The research indicates that first‐time donor status and several specific demographic, physical, and societal or emotional factors are predictors of donor reac

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116426.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Perioperative homologous blood transfusion has been linked to immune suppression and increased risk of postoperative infection. Autologous blood transfusion may not be associated with increased risk of infection because it presumably is not immunosuppressive. Fifty recipients of preoperatively donated autologous blood were matched to 50 recipients of homologous blood who underwent the same procedure, and the hospital course was reviewed for evidence of postoperative infection in both groups. Postoperative leukocytosis and febrile episodes were more common in homologous blood recipients (17 and 6 vs. 12 and 4, respectively). Sixteen percent of the 50 homologous blood recipients had positive cultures, as compared to 4 percent of the 50 autologous blood recipients (p<0.05). This study suggests that the association of blood transfusion with infection may be partially abrogated by the use of autologous blood.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116427.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

An evaluation of the effects of blood transfusion on recurrence and survival after radical surgery for prostate cancer was performed. Between 1982 and 1986, 315 consecutive patients underwent radical retropubic prostatectomy by a single surgeon; of 309 patients for whom transfusion data were available, 94 received homologous blood (Group I) and 215 received autologous blood or no blood (Group II). At the time of surgery, there were no differences between Group I and Group II with respect to age, preoperative cancer stage, preoperative histologic grade (Gleason grade), prostatic acid phosphatase score, and preoperative potency. At discharge, the groups were similar in the status of neurovascular bundles, capsular involvement, seminal vesicle involvement, lymph node involvement, postoperative Gleason grade, and postoperative potency. No adjuvant hormone therapy or radiation therapy was administered until tumor recurrence. The patients were followed annually by physical examinations and measurements of prostate‐specific antigen. Cancer recurrence was detected in 23 (24.5%) Group I patients and 49 (22.7%) Group II patients. These proportions were not significantly different in univariate or multivariate analysis, and the time to recurrence curves overlapped. It is concluded that homologous blood transfusions are not associated with more rapid tumor recurrence or death after radical surgery for prostate cancer than is seen with autologous transfusions. These results differ from previous reports, which suggested that transfusions may cause recurrence of cancer in patients with colorectal or prostate cancer because of the immunosuppressive effects of blood transfusion

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116429.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

The use of an experimental solution that maintained high ATP levels and produced>70 percent viability of stored red cells (RBCs) for up to 18 weeks has been described by other investigators. This solution differed markedly from conventional storage media in that it lacked sodium; contained high concentrations of potassium, ammonium, and phosphate; and was hypotonic. It was not clear which feature or features were responsible for the observed effects. The effects of ammonium, phosphate, potassium, and hypotonicity on stored RBCs have been examined. It was determined that ammonium and phosphate were the important factors in ATP maintenance. The biochemical mechanism by which ammonium acts was studied. In fresh human blood samples, ammonium was found to relieve phosphofructokinase from inhibition by increased ATP concentrations, to have no significant effect on adenine phosphoribosyl transferase activity, and, unexpectedly, to increase the activity of AMP deaminase. Despite prolonged ATP maintenance by ammonium and phosphate‐containing storage media, satisfactory viability of RBCs stored up to 77 days was not demonstrated in the rabbit transfusion mode

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32192116430.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY