ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342741.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The pattern of hepatitis C virus (HCV) viremia in blood donors who are positive for antibody to HCV (anti‐HCV) according to the level of transaminase activity is unclear. A polymerase chain reaction‐based HCV RNA detection method was used to study two clearly defined groups of anti‐HCV‐positive blood donors with repeatedly normal (n = 27) and elevated (n = 17) alanine aminotransferase (ALT) levels. HCV RNA was detected in only 4 of 27 blood donors with normal ALT values and 15 of 17 with elevated ALT values. These results indicate that anti‐HCV‐positive blood donors with normal ALT levels constitute a heterogeneous group, as HCV viremia is detectable in only a small proportion of cases. Polymerase chain reaction should be useful in the surveillance of anti‐HCV‐positive blood donors with normal ALT levels, by identifying those who might benefit from further investigatio

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342742.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

To establish the value of the second‐generation recombinant immunoblot assay (RIBA‐2) and cDNA polymerase chain reaction (cDNA PCR) for confirmation of hepatitis C virus (HCV) infection, anti‐HCV reaction patterns and the presence of HCV RNA were examined in 610 blood donors and 255 non‐A, non‐B hepatitis patients who were positive or indeterminate in RIBA‐2. Of RIBA‐2‐positive donors (n = 191) and patients (n = 224), 75.4 and 89.7 percent, respectively, were HCV RNA positive. The most frequently observed anti‐HCV recognition patterns in HCV RNA‐positive donors and patients were c22, c33c, and c100 and/or 5‐1‐1 (67.3%, 57.7%) and c22, c33c (24.8%, 29.3%). Among subjects with a RIBA‐2‐indeterminate result, HCV RNA was detected more often in patients (n = 31) than in donors (n = 419): 67.7 and 2.1 percent, respectively. In viremic persons with single‐band reactivity in RIBA‐2, this reactivity was always directed against either c22 or c33c. HCV RNA was detected by cDNA PCR in none of 162 persons with only anti‐c100 and/or anti‐5‐1‐1 reactivity. Therefore, RIBA‐2 reactivity against c100 in combination with 5‐1‐1 should not be considered positive but indeterminate. In RIBA‐2‐indeterminate persons, HCV RNA detection is nec

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342743.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

A new system for typing and screening blood, based on the sieving effect of glass bead microparticles, has been developed. The test is performed in a microcolumn in which the red cell agglutinates are trapped in the glass bead matrix during centrifugation, and unagglutinated cells form a pellet at the bottom of the column. Anti‐human globulin reagents were incorporated in the diluent and the new test system, column agglutination technology, was compared to conventional tube tests and low‐ionic‐strength method. Sera and plasmas (228 samples) were screened for red cell antibodies with two anti‐human globulin reagents: one containing only anti‐IgG and the other containing both anti‐IgG and anti‐C3b, ‐C3d. After initial testing, there was 94‐percent agreement between column agglutination technology and tube tests, and after repeat testing, there was 97‐percent agreement. The column agglutination technology anti‐human globulin test eliminates the need to wash red cells, which decreases the overall test time. The test is easy to perform, and the results are more objective than those with tube a

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342744.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

A latex agglutination assay was evaluated for the purpose of identifying compatible platelet donors for alloimmunized recipients. Assay reagents were prepared by adsorbing detergent‐solubilized, donor‐specific platelets to polystyrene latex beads. Semiquantitative results for up to 30 donors can be completed in less than 1 hour. These reagents retained their immunoreactivity for at least 3.5 months. A retrospective study has established the assay's upper limit of compatibility. The prospective study evaluated transfusions to a group of multiply transfused patients. Part I evaluated 143 crossmatched, single‐donor platelet transfusions given to 50 patients. In 96 percent of the cases, a positive crossmatch was associated with an unsuccessful transfusion outcome; in 84 percent of the transfusions, a negative crossmatch predicted a satisfactory platelet increment. The overall predictability, sensitivity, and specificity were 87, 62, and 99 percent, respectively. Part II evaluated 105 transfusions given to the 43 patients (of 50) in whom no incidence of fever, sepsis, or bleeding could be documented. A positive crossmatch was 96‐percent efficient in predicting an unsuccessful transfusion, whereas a negative crossmatch was associated with an adequate platelet increment following 89 percent of the transfusions. The overall predictability was 91 percent, the sensitivity was 72 percent, and the specificity was 99 percent. Within‐run and between‐run variations were 6.3 and 6.2 percent, respectively. These results demonstrate that detergent‐solubilized platelet antigens, immobilized on latex particles, can be used in a cost‐effective crossmat

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342745.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The use of lymphokine‐activated killer (LAK) cell therapy in delayed treatment requires the use of cryopreserved effector cells. The purpose of this study was to determine the optimal cryopreservation protocol for the maintenance of cytotoxic activity in mononuclear cells (MNCs). MNCs were cryopreserved with dimethyl sulfoxide or 1,2‐propanediol before and after 3 days of culture with recombinant interleukin 2. The effects of cryopreservation on cell recovery, LAK cell and natural killer (NK) cell cytotoxic activities, and surface antigen markers were studied. Recovery of nonactivated MNCs was higher with 1,2‐propanediol than with dimethyl sulfoxide (p<0.05). Cytotoxic activities, measured with a51Cr release assay, significantly decreased after thawing, on both activated cells (76.3%; range, 35.8–92.2%) and fresh cells (54.6%; range, 17.5–75.4%). A 6‐day kinetic test was used to compare the cytotoxic activity of cryopreserved and fresh cells. The results showed different patterns for NK cells (cryopreserved cells had lower levels of activity than fresh cells) and LAK cells (cryopreserved cells had higher levels of activity than fresh cells). Phenotype changes of effector cells in culture, with and without cryopreservation, were monitored by flow cytometry using monoclonal antibodies. These results were compared with changes in the cytotoxicity of cells with and without cryopreservation. After thawing, there was a decrease in MNCs expressing CD14 and CD56. Recovery of the CD56 marker correlates with increased cytotoxic activity. Despite some loss of NK cell activity, it is concluded that MNCs may be successfully cryopreserved before their use in immunotherapeuti

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342746.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The neutrophil‐specific NB antigen system has been serologically characterized with human alloantisera. Two alleles,NB1andNB2, have been described. NB1 is expressed on a subpopulation of peripheral blood neutrophils in 97 percent of healthy donors. Human alloantibodies have been used to identify the 58‐ to 64‐kDa glycoprotein (GP) on which NB1 is located. NB1 can usually be detected by both a granulocyte immunofluorescence (GIF) assay and a granulocyte agglutination (GA) assay, but neutrophils from some donors have been found to react with anti‐NB1 in GIF but not in GA assays. To determine if the latter neutrophils express NB1 and the corresponding 58‐ to 64‐kDa GP, these neutrophils were probed with rabbit and human sera specific for NB1. First, the proportion of neutrophils that express NB1 was quantitated. Neutrophils from donors that typed as NB1‐positive in both GA and GIF assays were analyzed by flow cytometry with antisera to NB1. Human and rabbit anti‐NB1 reacted with 71 ± 17 percent and 70 ± 17 percent of neutrophils, respectively. There was no difference in the expression of NB1 in NB1‐homozygous and NB1‐heterozygous individuals. In contrast, significantly fewer neutrophils from four donors that typed as NB1‐positive in GIF assay but not GA assay reacted with human (27 ± 12%; p<0.001) and rabbit (26 ± 12%; p<0.001) anti‐NB1. When neutrophils from these same four donors were probed with rabbit and human anti‐NB1 by immunoblotting and immunoprecipitation, the 58‐ to 64‐kDa GP was identified. No difference in the electrophoretic mobility of the 58‐ to 64‐kDa GP could be detected in donors with low or high percentages of NB1‐positive neutrophils. These studies show that some neutrophils that are not agglutinated by NB1 antibody

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342747.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Decrements in platelet function and recovery are known to accumulate during the 5‐day storage period, and the clinical response to platelets transfused after several days' storage has been suggested by some researchers to be less than that seen with platelets stored for shorter periods. The clinical response to single‐donor platelet (SDP) units (as measured by corrected count increments [CCIs] and intertransfusion intervals) was investigated in autologous bone marrow transplant patients. Twenty‐seven consecutive autologous bone marrow transplant patients with a variety of hematologic and solid organ malignancies were evaluated for posttransfusion CCIs after 419 SDP transfusions of units stored for 1 to 5 days. Patients were not excluded from the study because of clinical condition, such as fever or sepsis. The mean 15‐minute posttransfusion CCI for SDP units stored for only 1 day (11,006 ± 5,157) was no different than that for units stored for 5 days (10,225 ± 4,481; p>0.05); 24‐hour posttransfusion CCIs were also not different if the SDP unit had been stored for 1 day or 5 days (6229 ± 4489 vs. 4786 ± 2759; p>0.05) or for any intermediate period. Nor were intertransfusion intervals affected by storage time. While platelets may exhibit a progressive lesion during the 5‐day storage period, these changes do not result in a decreased cl

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342748.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The objective of this study was to compare the cost and cost‐effectiveness of three transfusion strategies in the treatment of acute myelogenous leukemia: 1) the use of unfiltered pooled platelets until alloimmunization developed and of crossmatch‐compatible single‐donor platelets thereafter; 2) the use of filtered blood components until alloimmunization occurred and of crossmatch‐compatible single‐donor platelets thereafter; and 3) the use of single‐donor platelets from the beginning. The data sources were English language articles on transfusion medicine in acute leukemia and the management of acute leukemia and review of the transfusion experience at the H. Lee Moffitt Cancer Center. The method was decision analysis with a software program for cost‐effectiveness, sensitivity analysis, threshold evaluation, and Monte Carlo sensitivity analysis. In the basic models, the total costs of the first, second, and third strategies are, respectively, $12,557.14, $11,406.17, and $13,016.16 without bone marrow transplant and $14,002.72, $12,281.89, and $13,727.48 with bone marrow transplant. The threshold between the first and second strategies in regard to risk of refractoriness to filtered blood components and pooled platelets was 0.30 and 0.27, respectively, without bone marrow transplant and 0.28 and 0.40 with bone marrow transplant. According to a Monte Carlo sensitivity analysis of 500 samples, the second strategy is more cost‐effective than the first in 76 percent of cases. It is concluded that the use of filtered blood components is unlikely to increase the co

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342749.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Lawsuits related to transfusion‐associated human immunodeficiency virus infections have increasingly resulted in requests for the release of confidential information about volunteer blood donors. Concern that loss of confidentiality might change blood donor behavior led to a survey of donors at collection sites within an American Red Cross Blood Services Region. Of the 361 respondents, 50.3 percent (181) indicated reduced intent to provide accurate medical and personal history information under conditions of reduced confidentiality. Ten percent (34) indicated that they were not sure whether they would or would not donate blood in the future under this condition. The results indicate that the possibility of release of donors' medical and personal information may have a negative effect on the safety and adequacy of the nation's volunteer blood suppl

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33893342750.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY