ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023489.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023490.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Iron stores were observed in 57 healthy elderly volunteers, between 63 and 77 years of age, who donated 5 units of blood over approximately 1 year. An equal number of nondonors who contributed approximately 7 mL of blood at each visit for iron status measurements only were seen at the same frequency as the donor population. At entrance to the study, iron stores in women and men averaged 724 and 875 mg, respectively. After five donations, mean iron stores dropped to 67 mg in women (n = 27) and 362 mg in men (n = 30); four women (15%) became iron deficient, while two (7%) developed iron deficiency anemia. Three men (10%) developed iron deficiency, but none were found to be anemic. Mean intakes of iron were 23.3 and 22.5 mg per day, respectively, for women and men. Iron intakes were adequate to meet iron requirements of nondonors, but they were not sufficient to halt the steady decrease in iron stores among the donor population, in whom iron absorption increased from approximately 5 percent at entrance to 14 percent at the time of the fifth donation. In summary, healthy elderly persons may contribute to the national blood resource; however, donations should probably be limited to less than five per year or donors should regularly take an iron supplement to preserve reasonable amounts of iron reserves.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023491.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The aging of our society will result in an increased demand for blood components, but it also has the potential to produce a large group of blood donors, the elderly. To study the effects of regular donation by older persons, a randomized, controlled trial is being conducted among 244 healthy, elderly volunteers. This report focuses on the efficacy of the recruiting efforts for that study and describes the resultant population in terms of their demographics, medical status, and donation safety. Of 325 potential subjects, 18 percent were disqualified and 7 percent refused entry into the study. After medical evaluation, only 2 persons were disqualified for conditions not detected by the usual blood services screening protocols. The resultant elderly donor population (n = 244) was well‐educated, middle‐income, and, for the most part, married. The group reported more past and present medical conditions, past surgical procedures, and current medications than would be expected in a younger donor group. Reactions to donation were infrequent and mild. With current screening and donation procedures, blood donation by the elderly appears to be safe and practi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023492.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Transmission of human immunodeficiency virus type 1 (HIV‐1) by homologous blood transfusion in the United States (US) is minimized by the deferral of potential donors who are at risk for HIV‐1 infection and by the screening of all donations for HIV‐1 antibody. HIV‐1‐ seropositive donors at 20 blood centers were studied for information to be used in evaluating the safety of the US blood supply and making recommendations to increase that safety. From June 1988 to August 1989, 829 (0.04%) of 2,192,000 donors were found to be seropositive; 512 were interviewed. Of 388 seropositive men, 56 percent had had sex with men, 10 percent had used drugs intravenously, 8 percent had had sex with intravenous drug users, and 27 percent had no identified risk. Of 124 seropositive women, 58 percent had had sex with men at risk for HIV (81% of whom used drugs intravenously), 5 percent had used drugs intravenously, and 41 percent had no identified risk. Racial and ethnic minorities made up 68 percent of seropositive donors (black, 38%; Hispanic, 30%) and approximately 14 percent of all donors. The 157 persons with no identified risk had demographic characteristics and serologic test results for syphilis and hepatitis B that were more similar to those of HIV‐1‐seropositive donors with recognized risk than to those of seronegative donors. Three health care worker‐blood donors (from an estimated 93,100 health care worker‐donors) had infection that was probably acquired occupationally. The very low HIV‐1 seroprevalence indicated that the current donor deferral process was highly effective and that, even in high acquired immune deficiency syndrome (AIDS) incidence areas, the risk of HIV‐1 transmission via trans‐fusion was minimal. However, further efforts to defer from donation men with ho‐ mosexual contact and persons with heterosexual contact with intravenous drug users, especially among black and Hispanic potential donors, are necessary to i

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023493.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Between May 1988 and September 1989, 829 human immunodeficiency virus type 1 (HIV‐1)‐seropositive donors were identified from 3,919,000 units of blood donated at 20 United States (US) blood centers. Of the 829,512 (62%) were interviewed to assess behavioral characteristics of the largest subgroup, men reporting sex with men, use of the confidential unit exclusion (CUE) and reasons for donation among all donors. Among 216 men reporting sex with men, 97 percent had male and 72 percent had female sexual contact since 1978. The majority identified themselves as bisexual (29%) or heterosexual (26%). Although 61 percent of 512 donors were aware of their risk behavior at donation, including 57 percent of those infected through heterosexual transmission, only 5 percent used the CUE. Reasons for donation included failure to read carefully (46%) or comprehend (15%) the deferral materials, pressure to donate (27%), a desire to be tested for HIV‐1 (15%), and a reliance on screening to identify infected blood (10%). Reasons given for a perception of being at low risk included no recent risk behaviors, infrequent risk behaviors, or modification of risk behaviors. To reach high‐risk donors, centers should assess whether referral materials provide necessary medical information and are clearly written for persons with diverse cultural and language backgrounds. Staff should be encouraged to avoid the use of culturally stigmatized terms and behaviors that may be perceived as high p

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023494.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Allogeneic blood transfusions can result in alloimmunization or immunosuppression. A previous study demonstrated a deleterious effect of allogeneic blood transfusion on tumor growth in mice that was dependent, in part, on the dose of tumor cells with which the host animal was inoculated. The current study examined the effect of a similar allogeneic blood transfusion protocol on survival in a mouse bacterial peritonitis model. C57Bl/6J mice were transfused with 0.2 mL of heparinized fresh whole blood from C57Bl/6J (syngeneic) or Balb/c (allogeneic) mice. Transfusions were given on Days ‐10 and ‐7. On Day 0, mice were injected intraperitoneally with 10(7) Escherichia coli. Survival at Day 7 was 61 percent in the allogeneic blood transfusion group and 55 percent in the syngeneic blood transfusion group (p = 0.52). Experiments using different strains of mice, different transfusion protocols, and different doses of bacteria also failed to demonstrate an effect of allogeneic blood transfusion on survival. The results demonstrate that blood transfusion does not influence survival after a septic challenge with bacteria. The data obtained in the present study, together with those obtained in the tumor model, suggest that the mechanisms by which the allogeneic blood transfusion impedes host defense against bacterial infections is different from the mechanisms involved in tumor gro

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023495.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

To evaluate whether blood transfusion exerts an adverse influence on cancer evolution, a prospective clinical and immunologic investigation was carried out on 58 surgical patients with gastric or colorectal adenocarcinoma. None had had previous transfusion; 35 received perioperative transfusion. Among preoperative variables, only red cell count and hemoglobin concentration were significantly reduced in the patients transfused at operation. Other clinical characteristics and immunologic functions (except interferon‐gamma release) did not differ significantly from those of untransfused patients. The survival rate of transfused patients, although shorter, was not significantly different from that of untransfused patients. Immunologic tests done after surgery on 30 patients (17 transfused and 13 untransfused) did not show significant differences in the two groups. Significant increases in interleukin‐2‐stimulated production and immunoglobulin M synthesis were observed in transfused patients after surgery. Patients transfused perioperatively with more than 3 units of blood had some evidence of decreased immune function, but differences were not significant. While shorter survival and some immunologic changes may correlate with the number of transfusions, more patients must be studied to determine whether this relationship will be conf

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023496.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

To evaluate the relative safety of blood donations given in response to a major disaster, donor demographics and infectious disease test results were compared for donations made during the 10 days following the October 17, 1989, San Francisco Bay Area earthquake and those made during the preceding 6 months. These comparisons were made for donations given to the regional blood center in the area that was immediately affected by the disaster (Irwin Memorial Blood Centers) and for those given in an unaffected region (Los Angeles/Orange Counties Region, American Red Cross Blood Services). The rate of donation increased more than 200 percent during the 5 days following the earthquake in both the disaster‐affected and unaffected regions. Both the disaster‐affected and unaffected regions observed significant increases in the proportions of donations by first‐time donors, by persons aged 20 to 39 years, and by women. The rates of confirmed positivity for infectious disease markers for post‐earthquake donations did not differ significantly from rates for homologous donations given during the preceding 6 months, particularly when the rates were adjusted for the increased representation of first‐time donors. Approximately 39 percent of post‐earthquake first‐time donors gave blood again within the following 6‐month period. It is concluded that donations given after major disasters are essentially as safe as routine donations and that active efforts to recruit these donors again can be undertaken wit

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023497.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

A concentrate of mononuclear bone marrow cells is often desired for ex vivo treatment with pharmacologic agents, monoclonal antibodies, cytokines, and other agents prior to transplantation. A method has been developed for automated separation of mononuclear cells from large volumes of harvested bone marrow. A programmable instrument originally designed for clinical ex vivo cell separation and the plasma‐pheresis of patients and blood donors was adapted to permit rapid preparation, in a closed sterile system, of a bone marrow product enriched with mononuclear cells. A mean (±/− SEM) of 53 ±/− 30 percent of the original mononuclear cells was recovered in a volume of 125 ±/− 42 mL containing 82 ±/− 12 percent mononuclear cells. This technique removed 95 ±/− 9 percent of the red cells in the original marrow. No density gradient materials or sedimenting agents were employed in this process. Of 36 marrows processed by this technique, 19 autologous (6 of which were purged with 4‐hydroperoxycyclophosphamide) and 7 allogeneic marrows have been transplanted, with all evaluable patients achieving a neutrophil count of 0.5 × 10(9) per L in a mean (±/−

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31892023498.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY