ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242631.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242632.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242633.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

In a retrospective study on samples from 10,000 recently transfused patients, 35 samples were found to contain an antibody that reacted with ficin‐treated red cells but was not demonstrable by low‐ionic‐ strength saline solution and indirect antiglobulin test (LISS‐IAT). In those 35 patients, the specificity of the antibody was such that each patient would have been transfused with antigen‐negative blood had the antibody reacted in LISS‐IAT. Tests on red cells from the units already transfused showed that 19 patients had among them received, by chance, 32 antigen‐positive and 74 antigen‐negative units. The remaining 16 patients had among them received 57 units that were, again by chance, all antigen negative. One patient given antigen‐positive blood suffered a delayed transfusion reaction; in two others the antibodies became LISS‐IAT active after transfusion. However, similar changes to the LISS‐ IAT‐active state were seen with two antibodies of patients given only antigen‐negative blood. Also found in the 10,000 patients were 28 clinically insignificant antibodies, 77 sera in which the antibody was too weak to identify, and 216 autoantibodies that reacted only with ficin‐treated red cells. These data support a belief, generally held in the United States but not necessarily elsewhere, that the use of protease‐treated red cells for routine pretransfusion tests creates far more work than

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242634.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The survival of transfused red cells (RBCs) diminishes with time of in vitro storage in blood banks, but the molecular mechanisms underlying the slow but incessant deterioration are incompletely understood. To investigate the possibility that impaired resistance to autologous complement attack could play a role in this phenomenon, packed RBCs stored for variable periods were assayed for decay‐accelerating factor (DAF) and CD59, two glycoinositol‐phospholipid (GPI)‐anchored, membrane‐ associated complement regulatory proteins that function physiologically to protect blood cells from autologous complement activation on their surfaces. Immunoradiometric and flow cytometric assays employing DAF and CD59 monoclonal antibodies showed that levels of both surface proteins gradually declined over 6 weeks. Digestion analyses with phosphatidylinositol‐specific phospholipase C, an enzyme that releases GPI‐anchored proteins from cell surfaces, showed that DAF and CD59 molecules with GPI anchors containing unacylated inositol were preferentially lost. These findings suggest: 1) that DAF and CD59 molecules with acylated GPI anchors are more stable in RBC membranes than are molecules with unacylated GPI anchors, and 2) that DAF and CD59 loss may participate with other membrane alterations that occur during in vitro storage in compromising the survival of trans

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242635.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The in vitro effects of storage of platelets prepared from 6 pooled buffy coat units and stored in a platelet storage medium consisting of CPD and plasma and different platelet additive solutions were evaluated. The total count of platelets per pooled unit included in the present investigation (n = 20) was 335 +/− 35 × 10(9) (mean +/− SD). Measurements of pH, pO2, pCO2, glucose, lactate, ATP, total adenine nucleotide content, and extracellular adenylate kinase activity were performed in a three‐part study. The observations were 1) During storage in saline and citrate (10 mmol/L of citrate), the consumption of glucose and the production of lactate were significantly increased over the values with storage in saline, which were used as a reference. The values for pH at Day 6 were significantly lower. 2) The effects of different concentrations (10, 20, and 30 mmol/L) of acetate in saline were studied. With the exception of significantly higher pH values in saline and acetate, no significant differences were seen in the effects with saline and those with saline and acetate. 3) The combined effect of citrate and acetate was evaluated. The consumption of glucose and the production of lactate, the values for pO2, and extracellular adenylate kinase activity were significantly lower with saline and citrate and acetate than with saline and citrate. Significantly higher values for pH were found at Day 5.The results of these studies indicate that an increase in the concentration of citrate in a platelet storage medium from approximately 8 mmol per L (saline) to 14 mmol per L or more (saline and citrate media) is associated with significantly increased consumption of glucose and production of lactate. This effect can be reversed by the addition of acetate and can be reduced to the same levels that were found with

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242636.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The development of a synthetic medium for platelet storage is an important goal in transfusion medicine. Its use would make large volumes of plasma available for fractionation and might improve the quality of platelets after storage. Several investigators have described successful storage in media containing acetate. The previous work of the authors showed that platelet concentrates (PCs) can be stored successfully for 5 days at 22 degrees C by using an additive solution (Seto sol) to replace 80 to 95 percent of the plasma usually employed as a suspending medium. Seto sol contains 23 mM (23 mmol/L) sodium acetate and 25 mM (25 mmol/L) sodium phosphate. The roles of acetate and phosphate in achieving successful platelet storage were studied in the work reported here. The concentration of acetate decreased linearly for 7 days at 0.61 +/− 0.11 mumol per day per 10(9) platelets in parallel with the disappearance of 1–14C or 2–14C acetate. There was no disappearance of tritiated acetate from PCs or of 1–14C acetate from platelet‐free mixtures of plasma and Seto sol, which suggests that the disappearance of 14C acetate from PCs reflected oxidation to CO2, which could leave PCs through the walls of the plastic container. Since O2 consumption was 1.47 mumol per day per 10(9) platelets, and the oxidation of a molecule of acetate requires 2 molecules of oxygen, acetate oxidation accounted for approximately 85 percent of oxygen consumption by platelets. The pH of PCs stored in Seto sol was nearly constant for 7 days, whereas, without acetate, it fell to 6.4 +/− 0.1 on Day 5.It is known that the oxidation of one molecule of acetate produces one molecule of CO, and one molecule of bicarbonate. Indeed, in PCs in Set0 sol, there was an elevation of bicarbonate concentration of 1.4 mEq per L by Day 3, which suggests bicarbonate production. Thus, acetate acts as both a substrate for oxidative meta‐ bolism and a source of buffer. However, in 5 of 11 PCs stored in Set0 sol without phosphate, the pH dropped to 6.2 within 3 days. PCs that showed a drop in pH were those in which the content of plasma carryover during PC preparation was less than 12.5 percent of the suspending medium. It appears that a buffer system in addition to that provided by acetate is necessary to the maintenance of platelet integrity during storage when plasma car

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242637.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

During the last decade, the trend toward intensifying chemotherapeutic regimens in patients with hematologic malignancies rapidly increased the demand for single‐donor platelet concentrates (PCs). The logistics of such supply, however, necessitated the storage of these blood components prior to transfusion. Today, most blood centers use di(2‐ ethylhexyl)phthalate‐free blood bags, which are assumed to allow a storage period of up to 5 days. This report describes biochemical and functional changes of stored single‐donor PCs, which may influence the expected quality of PCs. The acid‐base status is characterized by an initial respiratory alkalosis compensated by a metabolic acidosis. Changes in extracellular electrolyte, lactate dehydrogenase, glucose, lactate, elastase, and complement levels, as well as in the release of alpha granule content and the initial activation of plasma coagulation, are demonstrated. These changes result in a functional impairment of stored PCs as reflected by thromboxane and serotonin release reaction and by aggregation and in vitro bleeding time studies. In contrast, in vivo recovery and survival rates have been reported to be unaffected. Whether the good recovery and survival rates are caused by a rejuvenescence of stored PCs in vivo or are due to injured circulating platelets has not yet be

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242638.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

The recruitment of mononuclear cells (MNCs), colony‐forming units‐ granulocyte macrophage (CFU‐GM), lymphocyte subpopulations, and CD34+ progenitor cells was studied during large‐volume (15–25 L blood processed) peripheral blood stem cell (PBSC) harvests. Normal donors (n = 13) underwent a 4‐hour leukapheresis designed to maximize PBSC yield (blood flow rate, 85 mL/min). Mean (± SD) volume processed was 17.7 ± 0.4 L, and yield was 2.4 ± 0.7 × 10(10) white cells containing 99 percent MNCs and 1.3 mL red cells per L of blood processed. Postapheresis hematocrit, platelets, and MNCs were reduced from preapheresis values by 7, 35, and 23 percent, respectively (p<0.05). In nine donors, the component was collected as four 1‐hour samples, and culturing of CFU‐GM and flow cytometric analysis of lymphocyte subpopulations and CD34±;/HLA‐DR±; cells were done in individual samples. Total CFU‐GM were 2.4 ± 1.4 × 10(6) (3.0 ± 1.8 × 10(4) CFU‐GM/kg) and lymphocytes were 20.8 × 10(9), with 75 percent CD3±; T cells, 10 percent CD19/CD20±; B cells, and 17 percent natural killer cells. A more than twofold increase in CFU‐GM and CD34±; cells was noted over the course of the 4‐hour procedure (p<0.05). In four donors, the leukapheresis component underwent counterflow centrifugal elutriation (CCE), which separated it into four fractions in an attempt to concentrate CD34±; and CFU‐GM progenitors and to deplete T‐lymphocytes on a large scale. There was a 1.8‐, 4.6‐, 3.9‐, and 0.32‐fold increase in CFU‐GM in the four fractions relative to the unseparated component. CD34+cells represented 0.09,0.23, 0.66, and 0.41 percent of the fractions, respectively, while there was a relative de‐ pletion of CD3+T‐lymphocytes by 61.4, 78.7, 85.1, and 98.1 percent. Thus, MNCs, CFU‐GM, and CD34+cells are recruited during lar e‐volume leukapheresis, which ma generate adequate mean CFU‐GM er kg to afow PBSC bone marrow rescue in&wer procedures. CD34+and CFU‐eM rogenitors

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242639.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY

摘要:

Human red cells (RBCs) were collected in CPDA‐1 and then freeze‐dried in lyoprotective solution. The lyophilized RBCs were then stored at ‐20 degrees C for 7 days. At the end of the storage period, the lyophilized RBCs were rehydrated and washed in dextrose saline. The washed, reconstituted, lyophilized RBCs were resuspended in final wash solutions of ADSOL, CPDA‐1, or a special additive solution containing glucose, citrate, phosphate, adenine, and mannitol, and then they were stored at 4 degrees C for an additional 7 days. The main purpose of this study was to determine whether human RBCs can be lyophilized in such a manner that normal metabolic, rheologic, and cellular properties are maintained during rehydration and subsequent storage in standard blood bank preservative solutions. Our results show that reconstituted, lyophilized RBCs maintained levels of ATP, 2,3 DPG, lactate, and cellular properties that are equal to or better than those in control nonlyophilized RBCs stored for a comparable period in CPDA‐1. Reconstituted, lyophilized RBCs stored at 4 degrees C after rehydration also show better maintenance of ATP, 2,3 DPG, and lactate than do control RBCs stored in the same preservative solutions for comparabl

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1993.33493242640.x

出版商:Blackwell Science Ltd    

年代:1993

数据来源: WILEY