ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219897.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A new polyvinyl chloride container plasticized with tri(2‐ethylhexyl) trimellitate (PL 1240 plastic) was evaluated for use in extended platelet storage. Six leukocyte‐rich platelet concentrates (mean, 0.6 × 109white cells per bag; range, 0.3 to 1.0 × 109per container) were prepared by removing as much of the platelet‐rich plasma from blood as possible. The cells were stored at 22°C on an end‐over‐ end agitator. An average of 1.04 ± 0.19 × 1011platelets was recovered, and the mean pH dropped from 7.23 on day 0 to 6.68 by day 5. At the completion of the storage period. PO2averaged 80 torr,PCO2was 35 torr, bicarbonate concentration was 0.5 mM, and lactate concentration 29.5 mM. Thirty‐one additional units of platelet concentrates, not deliberately prepared to be leukocyte‐rich, on day 5 had a pH of 6.75 ± 0.39 (mean platelet yield, 0.97 ± 0.21 × 1011; PO2and PCO2averaged 50 and 48 torr, respectively). Following storage, the cells had an average phase microscopic morphology score of 244 (n = 17). Platelets appeared to be preserved well throughout storage when assessed by transmission and scanning electron microscopy. We conclude that platelets can be stored for 5 days in PL 1240 plastic containers with good preservation of pH an

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219898.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A new blood container material (PL 1240 plastic) made of polyvinyl chloride containing a tri(2‐ethylhexyl) trimellitate plasticizer was evaluated in three laboratories. When platelet concentrates (50–60 ml) were stored on a variety of agitators for 7 days at 22 ± 2°C, poststorage pH (mean ± SD) ranged from 7.29 ± 0.05 (6 rpm elliptical rotator) to 6.87 ± 0.8 (70 cycles per minute flatbed agitator). The platelet counts ranged from 1.51 ± 0.12 to 0.95 ± 0.36 × 106per μ|. Morphology scores and hypotonic shock response values of platelets stored 7 days in PL 1240 plastic containers were better than those noted following 3‐day storage of control platelets in PL 146 plastic containers. The percent discharge of lactic dehydrogenase from platelets stored 7 days in PL 1240 plastic containers for 3 days (p<0.05). Mean platelet recoveries of 44 ± 15 percent (n = 11;111Indium) and 39 ± 8 percent (n = 29;51Chromium) were seen when autologous platelets were infused following 5‐day storage in PL 1240 plastic bags. Platelet half‐lives of 3.6 ± 0.4 (n = 9) 4.1 ± 0.4 (n = 20) days were reported in the two laboratories which used51Cr labeling, while survival values of 7.0 ± 1.0, 2.8 ± 0.8, and 5.4 ± 1.9 days were seen when data from the111Indium studies (n = 11) were analyzed using linear, exponential, and multiple hit programs, respectively. Platelets stored for 5 days also were administered to 13 thrombocytopenic oncology patients. In eight instances, a second (control) transfusion of platelets stored 2 to 5 days in PL 732 plastic containers was given to the recipient. There was no difference seen in postinfusion corrected platelet increments (15.6 ± 12.1 × 103/μ| versus 15.2 ± 10.4 × 103/μ| per m2/1011platelets infused) for cells stored in PL 1240 and PL 732 plastic containers, respectively. Hemostatic efficacy was seen posttransfusion in all four bleeding recipients. We conclude that platelets stored in PL 1240 plastic containers for 5 days are safe and efficacious for use i

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219899.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

The rate and extent of platelet mobilization from the spleen were measured, and their relationship to the removal of platelets from the peripheral blood during discontinuous flow platelet apheresis was determined in four normal volunteers. Autologous platelets were labeled with Indium‐111‐oxine and in vivo whole body and organ In‐111 radioactivity quantitated with a scintillation camera and a computer‐ assisted imaging system. Dynamic changes in splenic radioactivity were monitored during 12 cycles of platelet apheresis. The number of platelets harvested and changes in whole body and blood In‐111 activity were determined during the procedure. The platelet life‐span was estimated, and the sites of sequestration of labeled platelets was measured. Platelet apheresis removed a mean of 64 percent of platelets in the circulation; i.e., 48 percent of all platelets in the body. During the procedures, 28.0 ± 9.4 percent In‐111‐labeled platelets in the body were removed, splenic radioactivity decreased by 36.5 ± 13.2 percent, and whole body activity decreased by 34.5 ± 9.7 percent. In‐ 111 activity in the spleen and whole body decreased in parallel, indicating a dynamic equilibrium between these pools. The life‐span of the labeled platelets was 226 ± 25 hours, similar to that of normal subjects. The major sites of sequestration of senescent platelets were the spleen (37.9 ± 20%) and liver (30.3 ± 5.6%); this is similar to that found in normal subjects. We conclude that as platelets are removed from the peripheral blood, the blood pool is rapidly and effectively replenished from the splenic platelet pool. These two pools are in dynamic equilibrium and permit removal of large numbers of platelets without resultant thrombocytopenia. Platelet apheresis does not adversely effect platelet life‐span, and the sequestration pattern in the reticuloe

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219900.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A case of posttransfusion purpura is reported in which the laboratory determination of the specificity of the causative antibody was initially confused by the presence in the patient's serum of HLA‐ directed antibodies. The patient was a multiparous 65‐year‐old woman with a previous history of blood transfusion. She developed the typical clinical features of posttransfusion purpura 8 days following the transfusion of 6 units of packed red cells. The patient was P1A1negative, and her serum reacted strongly in a radiolabeled monoclonal antibody assay with both P1A1‐positive and ‐negative platelets. Radioimmunoprecipitation demonstrated that the patient's serum contained antibodies both of anti‐P1A1and anti‐HLA specificity. Western blotting of normal platelets incubated with the patient's serum verified that the anti‐P1A1antibody was directed against platelet membrane g

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219901.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

The immunotoxicity of hydroxyethyl starch (HES), a reagent used in leukocytapheresis or as a plasma expander, was assessed. HES did not significantly alter host resistance toListeria monocytogenesorStreptococcus pneumoniae. HES (4–32 ml/kg), as well as a physiological saline solution (32 ml/kg), did inhibit the in vitro lymphoproliferation of spleen cells from mice intravenously injected 1 hour prior to removal of the spleens; the proliferation induced by a T‐ cell and B‐cell mitogen was suppressed. However, this suppression was transient, in that, HES and saline injections given 4 and 24 hours prior to removal of the spleens produced no significant inhibition. Unlike the HES effects on lymphoproliferation, HES did suppress the in vivo humoral immune response to sheep erythrocytes (SRBC) when given 24 hours prior to antigen, but this inhibition was obtained only with the 32 ml per kg dose. Interestingly, a similar dose of mouse albumin significantly enhanced the response. In vitro analysis of humoral and cell‐mediated immune responsiveness with in vivo treated spleen cells produced results that were not dose dependent. Although HES was more suppressive than saline, both saline and HES were inhibitory. The lack of a dose‐dependent effect suggests that the in vitro analysis of in vivo treated cells was not a good index of their in vivo reactivities. The greater variability and apparent sensitivity of the in vitro analysis probably reflect the transient effects of in vivo dilution of serum factors by relatively large intravenous injections and/or the transient effects of injecti

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219902.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

The effects of hydroxyethyl starch on the final stages of hemostasis were investigated in vivo and in vitro. When compared to control solutions of either 5 percent albumin or isotonic (0.9%) NaCl, 6 percent hydroxyethyl starch (HES) exerted several effects. Results of in vivo studies were as follows: following infusion of 1 liter of 6 percent HES into healthy subjects, fibrinogen and antithrombin‐III concentrations fell slightly due to plasma volume expansion and consequent dilution. Concentrations of fibrin monomer and fibrin‐ fibrinogen degradation products remained unchanged. Thrombin and reptilase clotting times were shortened to indicate rapid detection (and presumably accelerated formation) of fibrin clots. Urokinase‐ activated clot lysis times were shortened to suggest rapid fibrinolysis. Results of in vitro studies were similar. Shortened thrombin, reptilase, and urokinase‐activated clot lysis times were reproduced in vitro by mixing HES, but not albumin or NaCl, with normal plasma. Although these findings qualitatively are similar to those reported previously for dextran, the molecular mechanisms involved and the clinical importance, if any, of the hemostatic effects remain to be defined. Thus, it would be premature to conclude either that HES or dextran exert identical biological effects on hemostasis or that the two agents possess similar clinical properties. HES has an excellent safety record when it has been used during leukocytapheresis and for plasma volume expansion in recommended doses. Its effects when given in larger doses remain to be

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219903.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

A healthy man with previously undiagnosed, mild von Willebrand's disease received one 1 of 6 percent hydroxyethyl starch solution intravenously. Following infusion, the bleeding time lengthened, platelet adhesion decreased, and the partial thromboplastin time was prolonged in association with decreased plasma levels of factor VIII coagulant activity, factor VIII‐related antigen, and factor VIII ristocetin cofactor. Abnormalities persisted for days, but overt bleeding did not occur. Care should be taken to screen and possibly reject prospective granulocyte donors with positive personal or family bleeding histories. Caution should be used when administering hydroxyethyl starch as a colloidal plasma volume expanding agent to patients with underlying hemostatic defect

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219904.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

Modified fluid gelatin (MFG) is a possible alternative to hydroxyethyl starch (HES) for use as a red cell sedimenting agent in neutrophil collection procedures. Since the efficacy of neutrophil transfusion therapy depends upon the integrity of the infused cells, we examined the in vitro and in vivo function of neutrophils collecting using MFG. Neutrophils were collected from 17 normal subjects by continuous flow centrifugation using MFG in place of HES. In vitro measurement of neutrophil function included dye exclusion, phagocytosis, candidacidal activity, staphylococcal killing, chemotaxis, and random migration. For in vivo studies, neutrophils were labeled with3H‐ diisopropylfluorophosphate, reinfused into the donor, and blood kinetics and skin chamber accumulation of the labeled cells were measured. In vivo results were compared with results from previous studies using neutrophils collected with HES or by phlebotomy. MFG neutrophils were normal by all in vitro functional criteria and localized normally at an in vivo inflammatory site. Intravascular survival (T ½ = 3.3 ± 0.9 hours) was significantly shorter than normal (T ½ = 7.3 ± 2.3 hours) but was identical to that of cells collected using HES. Thus, on the basis of neutrophil functional capabilities, MFG appears to be an acceptable alternative to HES in collection of neutrophils for transf

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219905.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY

摘要:

The recent use of lymphocytapheresis to treat immune‐mediated diseases such as rheumatoid arthritis prompted a study of factors that influence the cell composition of lymphocytapheresis concentrates. Following single cytapheresis procedures, using protocols recommended by manufacturers, lymphocyte yields were significantly higher with the model 2997 (IBM) and CS‐3000 (Fenwal) cell separators as compared to the model 30 (Haemonetics) separator (9.8 ± 1.1 and 7.1 ± 1.2 × 109lymphocytes, respectively, versus 4.6 ± 1.1 × 109; p<0.01). The lymphocyte concentrate obtained with the CS‐3000 separator contained the smallest number of monocytes (0.6 ± 0.4 × 109versus 1.4 ± 1.6 and 1 ± 0.3 × 109for the model 2997 and 30 cell separators, respectively). Platelet contamination of the lymphocyte concentrate was highest with the CS‐3000 (6.5 ± 2.4 × 1011, and erythrocyte contamination was highest when the model 30 was used (21 ± 3.0%). Studies using the model 2997 indicated that lymphocyte yields were significantly influenced by donor pre‐apheresis absolute lymphocyte counts, and for this cell separator by specific operating variables, such as channel centrifugation speed and positioning of the red cell interface during lymphocyte collection. Maximal yields were obtained when the channel centrifugation speed was 800 to 1000 rpm (equivalent to 100–150 × g) and the red cell interface was adjusted to yield a cell concentrate with a hematocrit less than 4 percent. These results suggest that it will be necessary to standardize lymphocytapheresis collection protocols in future studies to assess the role of lymphocytapheresis in the management of immune‐mediated diseases s

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1985.25385219906.x

出版商:Blackwell Science Ltd    

年代:1985

数据来源: WILEY