ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158038.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158039.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

To determine the presence or the absence of human T‐lymphotropic virus type I and/or II (HTLV‐I/II) DNA in at‐risk individuals who were persistently negative for specific serologic assays, polymerase chain reaction with two primer pairs in common and conserved regions of HTLV‐ I and ‐II genomes was used. Seronegative individuals at risk for HTLV‐ I/II infection (15 heterosexual partners of seropositive individuals, 17 breastfed children born to HTLV‐I‐infected mothers, 47 multiply transfused patients, 22 intravenous drug users) were studied (n = 101); 35 seropositive individuals and 25 seronegative low‐risk individuals were used as positive and negative controls, respectively. No positive polymerase chain reaction was observed in the seronegative at‐risk individuals or in the negative controls. Positive controls gave positive results with at least one primer pair in all cases except one. A latent HTLV‐I/II infection with a persistently negative serologic test for HTL

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158040.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

An extensive body of literature has attributed an immunosuppressive, and potentially deleterious, effect to blood transfusion. The possibility of a deleterious effect of transfusion on the subsequent survival of acquired immune deficiency syndrome (AIDS) patients was investigated in a public hospital‐based cohort of 569 AIDS patients not treated with zidovudine and followed in a retrospective cohort study. With controls for the effects of baseline anemia, mode of initial disease manifestation of AIDS, most prevalent cause of death, and several other morbidities, a highly significant (p<0.001) reduction was observed in the subsequent length of survival associated with the transfusion of packed red cells in the first trimester of the illness. However, when the most stringent assumptions with regard to control for illness severity were applied, this association was marginally significant (p = 0.055) only when transfusion was analyzed as a categorical variable. Analysis of transfusion as a continuous variable in this latter case failed to demonstrate a significant association. In this way, the findings substantiated but did not prove the hypothesis that the transfusion of packed red cells may be detrimental in patients with AIDS. There is a need for an experimental study directly comparing currently available alternative technologies to the transfusion of packed red cells to resolve the issu

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158041.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The MN blood group antigens have traditionally been detected by serotyping; however, development of a DNA‐based method offers flexibility in the determination of this highly polymorphic system. Genotyping the MN blood group antigens was performed by polymerase chain reaction amplification of the specific alleles (PASA) in the human genome. In separate paired reactions, M or N allele‐specific oligonucleotide primers were amplified with a common distal primer. Only in the presence of the homologous template was a 781‐base pair polymerase chain reaction amplification product visible after agarose gel electrophoresis and ethidium bromide staining. This method of genotyping could be performed using either 1 μg of extracted DNA or 0.5 microL of whole blood, and the results showed 100‐percent correlation with those obtained by serotyping. PASA‐based genotyping of MN blood group antigens, which requires a small amount of starting material, has application in linkage and population studies and in forensi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158042.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

To determine the optimal dose of gamma radiation necessary to inhibit T‐ lymphocyte function and prevent transfusion‐acquired graft‐versus‐host disease (TA‐GVHD), a donor plateletpheresis component was initially divided into ten 20‐mL samples. One sample was not irradiated, while the other nine samples were treated with gamma radiation at doses ranging from 500 to 4500 cGy. T‐lymphocyte function was subsequently measured by mixed lymphocyte cultures and mitogen stimulation assays. The results were assessed in each test by calculating the percentage of inhibition of each irradiated sample as compared to that of the unirradiated sample. The accuracy of the delivered dose of gamma radiation was measured with thermoluminescent dosimeters. It was concluded that a nominal dose of 3000 cGy (actual dose delivered, 2898 cGy) is the appropriate amount of gamma radiation needed to eliminate T‐ lymphocyte‐mediated graft‐

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158043.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

White cell (WBC) reduction, red cell (RBC) recovery, and filtration time were determined in 1‐day‐old standard and buffy coat‐depleted RBCs filtered in the laboratory through six commercial filters for WBC reduction. Residual WBCs were counted with a Burker chamber (BC), with a Nageotte chamber (NC), and by flow cytometry (FC). Results show that BC counts were 0 in several cases in which WBCs were detected with NC and FC, which indicated that the traditional BC method is too insensitive in use with currently available filters. Calibration curves performed by FC and with NC with samples containing known concentrations of WBCs from 1000 to 1 per microL showed that both FC and NC detected, on average, 67 percent of WBCs present in the samples (efficiency). However, the efficiency of FC showed small variability (61–70%) at different WBC levels, whereas the variability with NC was large (39–91%). This greater variability prevented the correction of NC counts by using a single factor and indicated difficulty in NC standardization. Therefore, because our main aim was to compare different filters rather than to define absolute levels of WBC contamination, uncorrected FC and NC counts were chosen to be reported. True WBC counts per unit should not exceed values that can be obtained by dividing uncorrected counts by the lowest efficiencies (61% for FC and 39% for NC). Uncorrected NC and FC counts were below 2 × 106per unit in all units processed through three of the filters and below 5 × 106per unit in all units processed through the other three. Removal of the buffy coat from RBCs before filtration generally but not invariably caused slightly higher WBC removals. Median RBC recovery in CPD RBCs containing the buffy coat, filtered through four of the filters, was greater than 90 percent, which was significantly higher than that shown by the other two filters. Buffy coat removal prior to filtration involved an additional median loss of 12.4 percent of RBCs. Median filtration time ranged from 5 to 23 minutes per unit. Although NC appears to be less expensive than FC, its performance in experimental and routine conditions requires further evaluation and thorough standardization. Because of the continuous development of more effective filters, more sensitive methods for WBC counting in WBC‐reduced blood componen

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158044.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The mechanism of white cell (WBC) retention by synthetic fiber‐based WBC filters was studied. Filters were made of nonwoven fleece prepared from polyester, surface‐modified polyester, or polypropylene fibers. Human platelet concentrates were filtered through experimental filters consisting of 8 to 54 layers of nonwoven fleece with mean pore sizes from 7.3 to 14.2 microns. Filters made of fleece of smaller pore size removed WBCs less effectively than filters with larger‐pore fleece. Retention of lymphocytes and granulocytes gradually dropped to 0 percent as increasing loads were applied to the filters. The maximal retention capacity for these cell types (i.e., the number of cells retained when “saturating” numbers of WBCs were applied) was proportional to the number of layers of filter material used. Platelet retention did not correlate with WBC retention. Depth filtration, rather than mechanical sieving, seems to be the principal means of WBC removal by nonwoven fiber filters. A low initial number of WBCs in the component to be filtered is important for successful WBC f

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158045.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

To probe recent trends in transfusion practice and their effect on the adequacy of the national blood resource, transfusions and collections in the United States in 1989 were studied, by using data shared by the American Association of Blood Banks, the American Red Cross, and the Council of Community Blood Centers, together with results from a sample survey of the 3600 hospitals that were not members of the national organizations. Statistical methods were used to estimate national activities. The total US supply of blood in 1989 was 14,229,000 units, an increase of 1.2 percent over the supply in 1987. Red cell transfusions were 12,059,000 units. A total of 3,159,000 patients underwent transfusion with whole blood and/or red cells (mean, 3.8 units/patient). Preoperative autologous deposits of 655,000 units by 310,000 patients represented an increase of 65 percent over the level in 1987. However, only 356,000 units (54%) were transfused to the patients who preoperatively deposited them; of the remainder, 13,000 units were crossed over for transfusion to other patients, while 286,000 units were never used. Directed donations, 350,000 units, were provided for 130,000 intended recipients, but only 97,000 units (28%) were transfused to their intended recipients; of the balance, 59,000 units (17%) were crossed over and 194,000 units (55%) were never transfused. Total platelet transfusions were equivalent to 7,258,000 units in 1989, for an increase of 13.7 percent over totals in 1987.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158046.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The treatment of fresh‐frozen plasma (FFP) with a solvent/detergent (S/D) solution to inactivate contaminating viruses has been shown to be effective in reducing virus transmission while maintaining the hemostatic properties of the plasma. FFP is treated with tri(n‐ butyl)phosphate (solvent) and Triton X‐100 (detergent) and then purified; the in vivo effect of the residual S/D has been reported to be minimal. In clinical transfusion practice, ABO‐incompatible, HLA‐ matched, single‐donor platelets may have to be resuspended in ABO‐ compatible plasma. The use of S/D‐treated plasma for this purpose would remove the added risk of transfusion‐transmitted diseases due to the use of another blood component. As there are no data on the use of S/D‐ treated plasma as a platelet‐resuspending medium, the potential toxicity of the residual solvent and detergent on the in vitro function and integrity of platelets stored in S/D‐treated plasma for 5 days was studied. A repeated‐measures analysis of variance was used for statistical analysis. Results showed that, as compared to controls (non‐ S/D‐treated plasma), platelets resuspended in S/D‐treated plasma maintained their functional properties, including morphology score and osmotic recovery, for up to 5 days of storage (p>0.05, NS). No significant changes were seen among S/D‐treated plasma and control groups for platelet count, lactate dehydrogenase discharge, beta‐ thromboglobulin release, glucose utilization, or generation of lactate. Measurement of pO2 and pCO2 values showed some differences between S/D‐ treated plasma and control groups that were significant, but not clinically significant. The pH values for all four groups ranged from 7.1 to 7.4 on Day 5. As compared to plasma controls, platelets resuspended in S/D‐treated plasma and stored for up to 5 days maintain acceptable in vitro storage characteristics f

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33293158047.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY