ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284133.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1989.tb00298.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Passenger lymphocytes in platelet concentrates (PCs) may induce the formation of lymphocytotoxic antibodies (LCTAbs) and subsequent refractoriness to platelet transfusions. Ultraviolet (UV) irradiation can prevent lymphocytes' acting as stimulator or responder cells in mixed‐lymphocyte reactions (MLRs) and could theoretically prevent LCTAb formation in vivo. A system has been devised for the delivery of UV irradiation to PCs: platelet storage characteristics and MLRs were evaluated in UV‐irradiated PCs harvested from healthy donors with the Haemonetics V50 and PCS cell separators. MLR and response to phytohemagglutinin stimulation were abolished by a dose of 3000 joules per m2at a mean wavelength of 310 nm. Platelet aggregatory responses to adenosine diphosphate (ADP), ristocetin, collagen and epinephrine, hypotonic shock response, and pH showed no important differences when control PCs and PCs irradiated as above were compared during 5 days of storage in Fenwal PL‐1240 packs. Lactate production during storage was significantly higher in UV‐treated PCs (p<0.001), but values did not exceed 20 mmol per L. UV transmission at 310 nm in standard blood product containers, including the Fenwal PL‐146, PL‐1240, and PL‐732, was low (50%). UV irradiation may provide a simple and inexpensive means of producing nonim

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284134.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1989.tb00299.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Sixty consecutive patients with untreated acute leukemia alternately received either ABO‐matched or ABO‐mismatched random‐donor platelet transfusions prepared from pooled platelet concentrate stored for 1 to 3 days. Patients were assigned randomly to receive matched or mismatched platelets as their first transfusion, and the first four transfusions were analyzed. In 40 evaluable patients, there was no significant difference (pairedttest) between the 10‐minute posttransfusion corrected count increments (CCI) of the initial transfusions of matched and mismatched platelets. In contrast, the second matched transfusion was significantly better than the second mismatched transfusion. This effect of ABO compatibility was particularly pronounced in a subset of patients. Six patients in whom mismatched transfusions were consistently inferior to matched transfusions had either a significant increase in anti‐A or ‐B isoagglutinin titers following the first transfusion or elevated titers before or at the conclusion of the study. Conversely, in five patients in whom there was no apparent effect of ABO mismatching, only one had an increase in isoagglutinin titer. Platelet survival was not altered as the ratio of 18‐hour to 10‐minute posttransfusion CCI was 0.6 for both matched and mismatched platelet transfusions. These data demonstrate that ABO compatibility can affect the results of random‐donor platelet transfusions and that patients who experience poor increments from ABO‐mismatched platelets may benefit from a trial of ABO‐compatible platelets before the initiation of HLA‐match

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284135.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

The use of sterile connecting devices will permit up to 5‐day storage of pooled platelet concentrates (PCs). However, there are no data evaluating long‐term storage of PCs pooled from multiple donors. Four units of ABO‐compatible or ‐incompatible PCs were pooled and stored in single 300‐ml PL‐732 storage bags for up to 5 days. Results of in vitro assays showed acceptable storage values regardless of the ABO types in the pool. Pool pH on Day 5 was 6.83 ± 0.3 (mean ± 1 SD). The in vitro storage characteristics were comparable to those of unpooled age‐matched platelets reported previously from our laboratory. For in vivo studies, 4‐unit pools of ABO‐compatible random‐donor PCs stored for up to 96 hours in 1000‐ml PL‐732 bags were transfused into patients who were thrombocytopenic due to bone marrow failure, and the corrected count increments (CCI) were determined. In vivo results showed a mean 1‐hour CCl of 11,368 ± 5824 for the pooled stored platelets and 7819 ± 5189 for unpooled controls (p>0.05). To evaluate the possibility that passenger lymphocytes in the concentrates would generate mixed lymphocyte reactions (MLR) in the pooling bag during storage, lymphocytes were studied over 5 days of storage by the use of monoclonal antibodies against activated T‐cell markers and by3H thymidine uptake. Results failed to show evidence of either the generation of activated T‐cell markers or the uptake of3H thymidine. We conclude that pooled stored PCs show acceptable in vitro and in vivo characteristics and do not generate MLR in the storage bag under routine blood bank storage conditions. Pooled stored PCs are acceptable for use

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284136.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Liver transplant patients frequently require large amounts of blood. The frequency and nature of their red cell (RBC) antibody problems were examined. Records were reviewed in 496 adults and 286 children undergoing 1000 consecutive transplants. Twenty‐two percent of adults and 14 percent of children had RBC alloantibodies. Antibodies of potential clinical significance were found before transplant in 6.3 percent of adults and 1.0 percent of children; despite immunosuppression, they appeared 1 to 5 weeks after transplant in an additional 7.5 and 5.2 percent respectively. These antibodies probably represented secondary immune responses. Of 58 transplant patients with prior potentially significant antibodies, 8 required 7 to 110 units of antigen‐untyped blood after 8 to 28 units of antigen‐negative blood; of these patients, one had subsequent hemolysis. Positive direct antiglobulin tests in 24 percent of adults and 10 percent of children were most often thought to be due to nonspecific adsorption of IgG. Anti‐recipient ABO antibodies developed in 22 of 60 (37%) evaluable ABO‐unmatched grafts; 13 cases had associated hemolysis. In all, 36 percent of adults and 20 percent of children had diverse RBC antibody problems. Resolution of these problems is an important part of the laboratory support necessary for a liver transplantatio

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284137.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Attitudes toward blood donation are frequently assumed to vary along a single dimension from unfavorable to favorable. In contrast, theories of attitude structure specify three distinct attitude components: affect, cognition, and behavior. This article describes the development of three new scales for the measurement of affective, cognitive, and behavioral components of attitudes toward blood donation. The scales were developed using the method of equal‐appearing intervals and were administered to both donors of blood and nondonors. Correlations among the scales were relatively small and supported the three‐component distinction. Affect was more strongly correlated with the number of prior donations than was cognition, which suggested an important role for emotional factors in blood donation. Scores on all three scales showed the attitudes of blood donors to be more favorable than those of nondon

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284138.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Current platelet crossmatch procedures to select compatible donors for alloimmunized thrombocytopenic patients are hampered by the lack of a convenient platelet storage method. This study examined the feasibility of using washed apheresis donor platelets stored for up to 1 year in a modified Hank's buffer solution at 4° C as crossmatch reagents in an indirect IgG‐enzyme immunoassay. Pooled and monospecific HLA and PlA1antisera were used to determine the antigenic reactivity of donor platelets in relation to duration of storage. There were no significant differences between mean HLA and PlA1antigen expression in fresh and stored platelets. HLA reactivity was detected on 12 of 13 donor platelet samples stored for 3 to 9 months and on 14 of 17 platelets stored for 12 to 14 months. PlA1reactivity was maintained at 12 to 14 months for all 12 donor platelet samples tested. In addition, incompatibility remained in 23 of 24 paired fresh and stored platelet crossmatches using individual alloimmunized patient plasmas. These data indicate that both HLA and platelet‐specific PlA1antigen reactivity can be maintained adequately in liquid storage at 4° C for up to 1 year. The availability of a convenient platelet storage method should facilitate the general application of platelet crossmatching procedures for alloimmunized pat

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284139.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY

摘要:

Removal of white cells (WBCs) from platelets may reduce alloimmunization to WBC antigens, prevent febrile reactions, and improve platelet increments in multiply transfused patients receiving HLA‐matched platelets. A new surface‐modified fibrous polyester filter was evaluated; it requires no special processing of pooled platelet concentrates and can be used at the patient's bedside. The studies were designed to measure WBC removal, platelet function, in vitro platelet recovery, and in vivo platelet survival. WBC mean removal was 99.8 percent ±0.56 (n = 37) when a pool similar in volume to 6 platelet concentrates was tested. The mean number of residual WBCs after filtration was 5.6 × 105. In vitro mean platelet recovery was 86.9 percent for a pool size of 6 units (n = 37). Clot retraction and platelet aggregation were unaffected by filtration. Survival studies of111Indium‐labeled platelets done with filtered autologous platelets showed no reduction in the normally expected survival. These studies indicated that the filter efficiently removes WBCs without substantially decreasing platelet number, survival, or function. This device offers the potential of considerably improving platelet transfusion

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1989.29589284140.x

出版商:Blackwell Science Ltd    

年代:1989

数据来源: WILEY