ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306240.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306241.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The ability of two fundamentally different photochemical procedures to inactivate model viruses in platelet suspensions was compared. Merocyanine 540 (MC 540) with visible light was used as an example of an oxygen‐dependent chemical‐directed at the viral membrane, and aminomethyl trimethyl psoralen (AMT) with ultraviolet A light (UVA) was used as an example of a nucleic acid‐directed system. Antiviral conditions in petri dishes were identified and the effects of these procedures on platelet suspensions in plastic storage containers were studied. Concentrations of photochemicals in the 10 to 150 mumol range with 30 to 60 minutes of visible light (MC 540) or 1 to 2 minutes of UVA (AMT) readily inactivated 5 to 6 log10 of vesicular stomatitis virus (VSV) and other model viruses in platelet suspensions, provided the plasma concentration was reduced to about 15 percent by the use of a synthetic platelet storage medium. Extracellular pH, morphology scores, and aggregation response dropped markedly when platelets were treated with MC 540 and visible light. However, treatment with 136 mumol per L of AMT and 1 to 3 minutes of UVA could inactivate 5 log10 of VSV in platelet suspensions with retention of platelet characteristics for 4 days, particularly if oxygen levels were reduced during treatment. These studies demonstrate that AMT‐UVA treatment meets the initial requirements for virus inactivation in platelet susp

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306242.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Ultraviolet B (UVB) irradiation of platelet concentrates (PCs) may prevent the development of posttransfusion HLA alloimmunization. As irradiation performed in a blood center or a hospital will probably be associated with a variable postirradiation delay before transfusion, the ability to store PCs after UVB irradiation becomes important. The effects have been studied of a UVB dose of 10,000 mJ per cm2, the dose used in our institution for UVB clinical trials, on PCs pooled and stored for up to 96 hours after irradiation. Results showed that after 96 hours of storage, though there were no changes in pH, platelet count, white cell count, percent discharge of lactate dehydrogenase, or beta‐thromboglobulin, there were significant decreases in morphology score and osmotic recovery. These changes, however, were not evident after 24 hours of storage. Similarly, there was a 60‐percent decrease in immunoreactive membrane glycoprotein (GP) Ib after 96 hours of storage, but these changes were not seen after 48 hours of storage. No changes were seen in levels of GPIIb/IIIa in either group during the 96 hours of storage. On computer‐analyzed two‐dimensional polyacrylamide gel electrophoresis, PCs irradiated at 10,000 mJ per cm2 and stored for 72 hours had changes in over 50 platelet proteins as compared to those proteins in nonirradiated age‐matched control PCs. It can be concluded that UVB irradiation of PCs at 10,000 mJ per cm2 does not lead to significant platelet deterioration after short‐term storage (24‐48 hours) but is likely to be deleterious after long‐term (72‐96 hours) storage. Moreover, UVB induces rotein‐specific alterations stora in the platelet, such as altering GPlb, while leaving GPllb/lll

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306243.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Packed red cell units (n = 10) were filtered and divided equally. One‐ half unit from each donor was irradiated (x) (3500 cGy). On Days 0, 14, 28, and 42, ATP, K+, Na+, lactate dehydrogenase (LDH), plasma‐free hemoglobin (PFH), and pH were determined. The reduction in ATP was greater in the irradiated than the nonirradiated (y) units by Day 42 (mean x−y: −70, p = 0.0005). The increase in K+ was greater in the irradiated than nonirradiated units on Days 14, 28, and 42 (mean x−y: 17−20, p = 0.0001). Decrease in pH and increases in LDH and PFH were significant (p less than 0.05) on Day 42 only. K+ increases added only 1.7 to 2.0 mmol per unit, a difference felt to be clinically insignificant. The changes noted in ATP, pH, LDH, and PFH are significant but minimal on Day 42 and imply that viability changes would also be minimal. These biochemical data support the storage of irradiated units for at le

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306244.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Recent reports of fatal transfusion‐associated Yersinia enterocolitica sepsis prompted a study of the feasibility of adding a question to the routine donor health history as a method of reducing this risk. In three American Red Cross blood centers, 11,323 donors were asked one of two questions about gastrointestinal symptoms during their health history screenings. Affirmative responses were obtained from 0.6 or 4.0 percent of the donors, depending on how the question was asked. In one center, more than 6 percent of donors gave affirmative answers. The efficacy of asking a relatively simple question about gastrointestinal symptoms as a way of preventing Y. enterocolitica should be evaluated further, because relatively large numbers of donors may respond affirmatively. Other methods of reducing the risk of transfusion‐ associated Y. enterocolitica infection should be purs

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306245.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

In vivo survival studies of human red cells (RBCs) are commonly carried out by using chromium‐51 (51Cr), a gamma‐emitting radionuclide, as the cell label. The effects of labeling human RBCs with PKH‐2, a nonradioactive lipophilic fluorescent dye that binds to the cell membrane, and the feasibility of detecting the labeled cells by flow cytometric analysis were investigated. Optimal labeling, defined as maximum mean fluorescence intensity with minimal cell‐to‐cell variability in fluorescence intensity and minimal cell loss, was achieved with the use of 15.0 × 10(−6) M (15.0 × 10(−6) mol/L) PKH‐2 and a cell concentration of 4.0 × 10(9) RBCs per mL. Both freshly drawn and stored RBCs could be labeled, but RBCs stored for more than 20 days did not take up the label as uniformly as fresher cells. Although labeling with PKH‐2 did not interfere with the detection of ABO, Rh(D), or common minor RBC antigens by routine serologic methods, it resulted in a morphologic appearance resembling echinocytosis and an increased resistance to osmotic lysis by hypotonic saline. RBCs labeled by this method could be quantitated accurately in blood samples in which their proportion was 0.01 percent, or 1 labeled cell in 10,000 cells. This method holds promise as a simple, reliable, and sensitive method for the detection of labeled human RBCs, but the in vivo significance of the label's effects on cell morphology and osmotic fragility is not known. Further studies directly comparing PKH‐2‐labeled and 51Cr‐ labeled RBCs will be necessary to establish the accuracy of the former method in determining the in v

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306246.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The Southern Arizona Regional Red Cross blood program offers preoperative autologous blood deposit to all patients and intraoperative autotransfusion services to all hospitals in the region. During a 5‐year period, the amount of preoperatively deposited autologous blood and intraoperatively salvaged red cells available increased from 0.3 to 19.6 percent of the community's total collections. Further increases in the availability and use of autologous blood may be achieved by community‐wide integration of servi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306247.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The increasing use of preoperative autologous donation (PAD) of blood has led to more frequent donation in settings outside of hospitals, despite concerns that persons making PADs may face increased risks of postdonation reaction. Analysis was conducted of 5660 PADs made at 25 different blood centers, to determine the risks of PAD in nonhospital settings and to search for predictors of severe reactions. Sixteen percent (886) of the donations studied were by persons who did not meet all usual homologous donor criteria. The most common variances were for cardiovascular disease, including the use of cardiac drugs (416 donors, 41% of those not meeting criteria), history of angina (204, 23%), and history of myocardial infarction (192, 22%). Donation by persons not meeting routine criteria was followed by a higher reaction rate than that by donors without any variance (4.3 vs. 2.7%; p less than 0.0001). An increased likelihood of reaction was associated with donor age less than 17 years, female gender, weight less than 110 pounds, and a history of reaction. Four reactions were graded as severe (transient ischemic attack, 1; angina, 3), and all occurred in donors not meeting all criteria (0.4% of 886 donations). A review of these donors' histories failed to identify distinguishing features from which their severe reactions could have been predicted. This study documents the infrequency of severe reactions after PADs by persons referred to a blood center for donation, even those not meeting routine homologous donor criteria, and quantitates the risk to these donors of a severe reaction.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306248.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The effect of an informational program in which the benefits and disadvantages of directed donations are discussed directly with the prospective recipient of the blood and/or that patient's family was examined during a 20‐month period. Data collected for 27 regional Connecticut hospitals that accept directed donations were compared with similar data for Hartford Hospital, an 885‐bed tertiary‐care facility. The number of directed‐donor units (68) collected by the American Red Cross Blood Services for Hartford Hospital during the study period was comparable to the number (average, 62.3) provided for smaller (301–450 beds) institutions in the state. The percentage that directed‐donor units drawn for Hartford Hospital represented of the total number of homologous units provided (0.23%) was less than that for any of the categories of hospitals, by size, in the state. Supplying the patient and/or the patient's family, in a personalized manner, with information concerning the advantages and disadvantages of directed as well as of volunteer donor blood can result in a marked overall reduction in the number of directed donations and also serves to reassure those concerned about blood

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31691306249.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY