ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368330.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368331.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368332.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb03274.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Platelet refractoriness arising from HLA alloimmunization is a serious complication of transfusion therapy. In a prospective randomized trial, white cell (WBC)‐reduced blood components were compared to standard platelet and red cell concentrates with respect to alloimmunization, refractoriness, and platelet increments after transfusion. Sixteen of 31 adult acute leukemia patients received only WBC‐reduced platelet concentrates (PCs) and red cells (RBCs), with fewer than 106WBCs per unit. Fifteen control patients received standard blood components with a mean of 0.1 × 109(PCs) and 1 × 109(RBCs) WBCs per unit. Platelet loss during cotton‐wool filtration averaged 14 percent (range, 3–32%) from fresh PCs and 24 percent (range, 9–62%) from stored PCs. Filtration did not change corrected increments (CI) measured after transfusion of fresh PCs. The Cl 1 hour after filtration of stored PCs diminished by 27 percent, but the difference was smaller after 18 hours, which suggests better survival of WBC‐reduced platelets. The number of platelet units transfused did not differ in the two groups. No patient in the WBC‐reduced group developed permanent platelet refractoriness; transient HLA antibodies of low titer developed in two patients. In the control group, one patient became refractory because of immunization and two developed transient HLA antibodies. It can be concluded that the reduction of WBCs in blood components can effectively prevent a

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368333.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb03276.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Fifty‐three patients receiving long‐term platelet transfusions were regularly screened for platelet‐associated antibodies by a platelet suspension immunofluorescence test (PSIFT) and a lymphocytotoxicity test (LCT). Subsequently, 24 patients became alloimmunized; all of their antibodies were of HLA specificity. Eighty‐two single‐donor platelet transfusions were given, and the clinical responses were considered satisfactory if the 18‐hour corrected count increment was 7.5 × 103per μL or higher. In the meantime, 82 pairs of patient sera and donor lymphocytes were crossmatched. Among 63 crossmatched transfusions, 53 (84%) resulted in a satisfactory increment, with a mean (± SEM) of 17.71 ± 1.96 (× 103/μL), and 10 did not result in a satisfactory increment. The increments after 19 unmatched transfusions and 25 random‐donor (uncrossmatched) transfusions were 0.7 ± 0.3 and 2.39 ± 0.66, respectively. The difference was not significant (p>0.05). The agreement between the LCT results and clinical response was 88 percent. Retrospectively, the corrected count increments showed no significant differences (p greater than 0.05) among three groups of HLA grading: the increments for A/BU/BX, C/D, and random HLA matches were 22.97 ± 4.07, 15.1 ± 1.97, and 14.85 ± 2.04, respectively. These results suggest that platelet crossmatching by LCT is an effective method for use in alloimmunized patients, esp

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368334.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

In spite of growing awareness of the potential risks associated with transfusion, the number of platelet units transfused in the United States continues to increase each year. There is a growing interest in ensuring that all transfusions are administered for appropriate reasons. Prospective review of requests for transfusions has been used to accomplish this goal. Although successful in reducing the number of inappropriate transfusions, this review method requires great time commitments by blood bank personnel and physicians. A knowledge‐based system (ESPRE) that aids hospital blood bank personnel in the review of requests for platelet transfusions has been developed. The system automatically obtains most of the required patient data via a direct link to the hospital's main laboratory computers. The system generates a printed report that includes a list of patient‐specific data, a list of the conditions for which a transfusion would be appropriate for the particular patient (given the clinical condition), and the conclusions drawn by the system. During a preliminary clinical evaluation of ESPRE, 73 randomly selected platelet transfusion requests were evaluated for approval by laboratory personnel and ESPRE. Overall, ESPRE would have approved 71 of the requests and laboratory staff would have approved 72. Forty‐four percent of the requests would have been approved for the same reasons given by the staff. There were only three disagreements on final approval between ESPRE and blood bank personnel. This computerized expert system is a promising approach to the prospective review of all platelet transfu

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368335.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Isotypes and IgG subclasses of ABO antibodies from sera of 235 healthy blood donors were determined by an enzyme‐linked immunosorbent assay (ELISA). Synthetic A and B trisaccharide‐bovine serum albumin glycoconjugates were used for coating and monoclonal antibodies for the detection of heavy chain isotypes. Hemagglutination titers were determined in addition. Blood donors were between 20 and 67 years old, and at least 10 sera per 10‐year age category and ABO blood group were included in this study. Antibody concentrations were expressed as a percentage of an internal standard, and sera with subclass‐restricted anti‐A and/or anti‐B (anti‐A/B) responses were used to normalize the ELISA values of IgG subclasses. A good correlation between the sum of the four subclasses and the total anti‐A/B IgG values (rs= 0.81 for anti‐A and 0.84 for anti‐B) was obtained. IgG1 and IgG2 were the most predominant subclasses, but were found in various proportions in different individuals. Donor‐to‐donor variation exceeded age‐related changes for all measured parameters. The correlation of anti‐A IgM, IgG, IgA, and their sum with the agglutination titers was significant and revealed rsvalues of 0.70, 0.65, 0.65, and 0.80, respectively. For anti‐B as well, the correlation of ELISA values with the agglutination titer was best when all three isotypes were added. We conclude that anti‐A/B IgA, together with IgM and IgG, substantially contributes to the agglutination reaction. Potentially autoreactive antibodies were detected in se

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368336.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Hepatitis C virus (HCV) is the major cause of posttransfusion hepatitis. Two anti‐HCV enzyme immunoassay (EIA) kits and one recombinant immunoblot assay (RIBA) were used to test serum samples of 1476 donations from 692 autologous blood donors to assess the prevalence of anti‐HCV and its relationship to transfusion history. Of all autologous blood donations, 23 (1.6%) reacted when tested with one EIA kit and 29 (2.0%) reacted when tested by the other EIA kit. Of the autologous donors, 12 (1.78%) reacted by the first EIA kit and 14 (2.02%) by the second. Discrepancies in the EIA results from different donations by the same donor were seen in seven donors. The RIBA was positive or indeterminate in 33 percent of the EIA‐reactive donations and in 41 percent of EIA‐reactive donors. All RIBA‐positive and ‐ indeterminate samples reacted with both EIA kits. There was no significant difference in the EIA‐reactive rates of autologous and first‐time homologous blood donors. Previously transfused autologous blood donors had a higher anti‐HCV EIA‐reactive rate than nontransfused autologous donors, but the difference was not significant. In regard to hepatitis C, the use of autologous blood for homologous transfusion appears to be as safe as the use of blood from first‐time homologous donors. Universal testing of previously transfused patients for hepatitis C appears premature at this time. Discrepant anti‐HCV EIA results from different donations from the same individual have implications r

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31791368337.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY