ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391029.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

In New York State, significant incidents involving the collection, processing, or transfusion of blood must be reported. Incident reports received over a 22‐month period involving transfusion of blood to other than the intended recipient or release of blood of an incorrect group were analyzed. Among 1,784,600 transfusions of red cell components; there were 92 cases of erroneous transfusion that met study criteria (1/19,000). There were 54 ABO‐incompatible transfusions (1/33,000); three of these (1/600,000) were fatal. Correction for underreporting of ABO‐compatible errors resulted in an estimate of 1 per 12,000 as the true risk of transfusion error. National application of New York State data results in an estimate of 800 to 900 projected red cell‐associated errors in the United States annually. The majority of reported errors occurred outside of the blood bank (43% resulted solely from failure to identify the patient and/or unit prior to transfusion and 11% resulted from phlebotomist error), while the blood bank was responsible for 25 percent of errors and contributed, with another hospital service, to 17 percent. The risk of transfusion of ABO‐incompatible blood remains significant, and additional precautions to minimize the likelihood of such events should be c

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391030.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Red cells (RBCs) of individuals with the In(Lu) gene are characterized by suppression of the Lutheran, P1, i, and other blood group antigens, acanthocytosis, and abnormal electrolyte metabolism. To determine the clinical significance of these abnormalities, the survival of autologous RBCs was determined by 51Cr in two siblings with the dominant Lu(a‐b‐) [In(Lu)] phenotype. Both subjects studied had normal hemoglobin, hematocrit, reticulocyte count, haptoglobin, and ferritin values. RBC indices were mildly hypochromic. Examination of the peripheral smear showed mild acanthocytosis in one individual. Analysis of RBC distribution on discontinuous density gradients showed a shift to lighter fractions than normal control RBCs. Storage of these Lu (a‐b‐) RBCs at 4 degrees C showed significant hemolysis within a few days; this was confirmed by increased autohemolysis, which was reduced by glucose and ATP. RBC cation content (sodium and potassium) was higher than that in control cells, which indicated increased cell hydration, which explains the lighter density and mild hypochromia of the Lu(a‐b‐) RBCs. 51Cr survival of autologous Lu(a‐b‐) RBCs was normal in both subjects studied. The data indicate that the morphologic and cation abnormalities of RBCs of persons with the In(Lu) gene are clinically insignificant, as these cells have normal in vivo survival. Such RBCs, however, are susceptible to increased hemolysis in vitro under standard blood banking storage conditions. Individuals of the Lu(a‐b‐) phenotype, associated with In(Lu), may not be suitable candidates for rou

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391031.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

The transmission of cytomegalovirus (CMV) by blood transfusion may have a major effect on certain immunocompromised patients. To protect susceptible blood recipients from infection, it is advisable to use blood components from CMV‐seronegative donors. However, serologic tests are not capable of indicating which blood component actually harbors infectious virus and can transfer it to the recipient. Therefore, a sensitive method is needed for the detection of the virus itself. There have been three reports on the detection of CMV in healthy volunteer blood donors by the polymerase chain reaction (PCR). CMV DNA was found in all seropositive and most seronegative blood donors. However, many other authors have failed to confirm these data. A highly sensitive and specific PCR assay was developed for the detection of CMV DNA in peripheral blood leukocytes. With this protocol, blood samples from 116 volunteer blood donors were investigated. None of these samples proved to be positive for CMV DNA. In contrast, CMV DNA was detected in 10 of 10 renal transplant patients early in the course of active CMV infection. It can be concluded that the CMV genome copy number in the peripheral blood leukocytes of healthy individuals is beyond the detection limit of current PCR technolog

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391032.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

An enzyme‐linked immunosorbent assay (ELISA) was developed to estimate the amount of material carrying blood group A activity in biologic samples. A soluble synthetic form of the A antigenic determinant (A trisaccharide, ATS) conjugated to peroxidase competes with the blood group A substance present in a biologic sample for anti‐A attached to a solid phase by a second antibody coating the plastic micro‐wells. A reference curve is constructed by using known quantities of ATS to compete with a fixed amount of ATS‐peroxidase conjugate. The A substance activity in a sample is obtained by extrapolating the degree of inhibition of the binding of the ATS‐peroxidase conjugate to an equivalent amount of ATS in the reference curve. The assay is reproducible, specific, and sensitive. It has been used in pharmacologic studies to estimate the concentration of ATS in the blood and urine of rats, rabbits, and baboons and in a study with human samples, testing the potential clinical use of ATS to neutralize anti‐A when therapeutically indicated. It is also useful for the detection of ABO natural products in secretions, thus allowing the accurate classification of secretor and nonsecretor

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391033.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Platelets collected by using a two‐stage automated blood cell separator were evaluated after 5 days of storage. The procedure caused no unanticipated physiologic changes in donors and produced greater than 3 × 10(11) intact platelets in 200 mL of plasma, plus an additional 400 mL of plasma with intact coagulation factors. Posttransfusion recovery of autologous radiolabeled platelets was comparable to that seen in platelets prepared by manual centrifugation techniques. Corrected count increments in 14 patients showed results similar to those with control transfusions. This device, which involves a collection time of less than 90 minutes, provides an option for platelet‐pheresis in a variety of settings including blood mob

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391034.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

Chinese hamster ovary (CHO) cells were transfected with the wild‐type, M allele of glycophorin A cDNA. The binding of human alloantibodies to recombinant glycophorin A was assessed with a modified hemagglutination‐ inhibition assay. Patient sera were incubated with acetone powders derived from CHO cells, and the adsorbed supernatants were tested in standard hemagglutination assays. Five M antibodies and one sample containing anti‐En(a) bound to transfected CHO cells expressing glycophorin A but did not bind to untransfected CHO cells. Three N antibodies as well as 21 other alloantibodies (representing other major red cell blood group specificities) bound to neither CHO cell line. The M allele specificity of recombinant glycophorin A was further verified by the demonstration that a high‐titer D alloantibody maintained the same titer of agglutination after incubation with recombinant glycophorin A. Transfected CHO cells thus express an M blood group antigen that appears to be serologically equivalent to that found on human red cells. A panel of cell lines expressing mutant glycophorin A molecules with defined variations in amino acid sequence and carbohydrate composition will be useful in studies of the fine specificity of human glycophorin alloantibodies. This approach may also provide an abundant source of artificial antigens for clinical use in blood group s

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391035.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

A multi‐site clinical study compared platelets chosen for refractory patients by prospective platelet crossmatching using stored donor platelets and HLA‐based selection. Seventy‐three patients who were refractory to random‐donor platelets received two plateletpheresis components, one chosen by HLA‐based criteria and the other by crossmatching. Patients were carefully evaluated to exclude nonimmune factors that could adversely affect transfusion results. Each of the five study sites used a crossmatch procedure with which it had experience. Results from this study indicate the following: 1) The overall rate of successful transfusion was similar when an HLA‐based method of donor selection that includes all grades of matching and mismatching was compared to a crossmatch‐based method of donor selection. 2) HLA‐based selection that restricts recipients to grade A and BU matches was superior to a selection method based upon crossmatching alone. Donor selection based on HLA matching (grades A or BU) was also superior to selection based on any degree of HLA mismatching (grades BX, C, or D). 3) Selection of donors based on HLA‐ cross‐reactive groups (defined by in vitro serologic crossreactivity) was no more successful than that based on grade C and D mismatches and was no more successful than selection by crossmatching alone. 4) Lymphocytotoxic and platelet antibodies were not detected in many of the enrolled patients, even though patients demonstrating nonimmune factors were eliminated from the study. It can be concluded that HLA‐ compatible (grades A and BU) platelets provide optimal support for refractory patients, but that crossmatch‐selected platelets are acceptable as a

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391036.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

A method is described for preparing fibrin glue from fibrinogen obtained by double cryoprecipitation of plasma collected by plasmapheresis. Plasma (average volume, 528.8 +/− 86 mL), collected from 12 plasmapheresis donors was cryoprecipitated twice. When the cryoprecipitated pellet was resuspended in 0.5 to 2 mL of saline (total volume of saline‐resuspended fibrinogen: 5 mL), the average yield of fibrinogen was 78.4 +/− 18.3 mg per mL. This is comparable to commercial preparations, is suitable for clinical use, and offers greater safety at a reduced

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391037.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY

摘要:

In an effort to determine whether residence in a foreign country increases the risk of hepatitis B and C and cytomegalovirus (CMV) infection in United States (US) Armed Forces blood donors, 5719 volunteer donors at four US Navy blood banks were evaluated. Most participants were repeat donors (68%) and were young (mean age, 25 years), male (88%), and white (80%), black (10%), or Hispanic (7%). Birth outside of the United States was reported by 6 percent of subjects, and 34 percent had lived in a foreign country for more than 3 months. Twenty (0.3%) subjects had hepatitis B surface antigen (HBsAg), and 100 (1.7%) had antibody to hepatitis B core antigen (anti‐HBc). Thirty‐four (0.6%) were repeatably reactive in enzyme‐linked immunosorbent assay for antibody to hepatitis C virus (anti‐HCV); 11 (0.2%) had anti‐HCV in immumoblot assay. Of the 3484 donors tested for anti‐CMV, 1117 (32.1%) were positive. When demographic characteristics were controlled for both anti‐HBc and anti‐CMV seropositivies were independently associated in male blood donors with residence in the Philippines. Geographic factors were not associated with HBsAg and anti‐ HCV positivity. These findings indicate that the prevalence of serologic markers for viral hepatitis is low in military blood donors, but that residence in the Western Pacific is a risk factor for hepatitis B

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1992.32792391038.x

出版商:Blackwell Science Ltd    

年代:1992

数据来源: WILEY