摘要:

The management of hemotherapy in 31 cases of ABO‐ or Rh‐incompatible bone marrow transplantation is described. Our experience confirms that ABO or Rh incompatibility does not adversely affect engraftment, patient survival, or incidence of graft‐versus‐host disease. Eighteen recipients with ABO antibodies against the donors' red cells (major incompatibility) were managed by different combinations of plasma exchange, transfusion of incompatible donor type red cells, and removal of donor‐type red cells from the bone marrow before transplant. The only serious complication was delayed hemolysis in seven of nine patients who received incompatible red cell transfusions before transplant. Thirteen patients received bone marrow containing ABO antibodies against their red cells (minor incompatibility). Five were managed by centrifuging the bone marrow to remove plasma and reduce the amount of antibody. This did not cause substantial loss of stem cell activity (60–100% of original marrow), and no patients had complications related to the marrow transfusion. In contrast, two of seven patients who received uncentrifuged bone marrow experienced hemolysis. Two of four Rh positive recipients who received marrow from an Rh negative donor developed anti‐D, possibly due to Rh positive blood components transfused after transplantation. None of eight Rh negative patients who received an Rh positive transplant has developed anti‐D. Blood components should be selected to avoid transfusion of incompatible red cells and to avoid transfusion of a large amount of incompatible plasma. This may necessitate use of plasma components of a different ABO type than the red

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276858.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

An analysis of the computer searches for HLA‐matched donors was done for 100 alloimmunized patients requiring HLA‐matched platelet transfusion support. With a pool of 2470 donors, an average of only 1.3 (range 0–14) perfectly matched donors were potentially available per patient. Patients had an average of 9 donors with no mismatched antigens. Although the number of potential donors increased when cross reactive or single antigen mismatches were considered, our estimate of donor availability of this type is lower than reported previously. More donors were identified for the 39 patients with relatively common genotypes than for the remaining 61 patients. Of the latter group, 25 patients did not have any potential donors with “no mismatches” while in most of the others the only suitable donor was a family member. These data suggest that, given the limitations of platelet donor selection using current HLA typing technology, it may be difficult to provide long‐term platelet transfusion support for alloimmunized patients with unusual HLA types. This fact should be considered when planning intensive therapeutic regimens for alloimmunized patients wi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276859.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

Manual plasmapheresis is widely used to permit collection of fresh‐frozen plasma with return of the red cells to the donor. However, this method is time‐consuming and carries the inherent risk of returning the wrong cells to any individual donor. Automated plasmapheresis, using a specially designed discontinuous cell separator, permits the collection of 500 ml of plasma within 30 minutes without disconnecting the donor from the bag containing the donor's red cells. However, this plasma contains a small number of platelets which are not suitable for transfusion. We now report the modification of this machine to permit simultaneous collection of 3 units of platelet concentrate as well as 500 ml of plasma in less than 50 minutes. Reduction of the g force of the separator from 1200 to 650 g permits the simultaneous collection of plasma and a platelet concentrate with an averageyield of 2.21 × 1011platelets. Platelet size distribution, in‐vitro function.51Cr survival, posttransfusion increment, and bleeding time correction are all normal. This modification has increased the flexibility of the separator and provides an instrument which can be used with a random volunteer blood donor population to generate both plasma and cells in less than 50 minutes and with increased cost‐effectiveness over plasmapheres

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276860.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

Blood Group Antigens and Antibodies. Marjory Stroup and Margaret Treacy.

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1983.tb02554.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

Previous studies have shown that CL‐2399 (Cutter) and PL‐130 (Fenwal) polyvinyl chloride (PVC) plastic bags are unsatisfactory for storage of platelet concentrates (PC) at 22°C. In an effort to explain the effects of plastic bags, the chemical make‐up of CL‐2399 and PL‐130 PVC films was determined and compared with that of P1‐146 (Fenwal) PVC, which is satisfactory for PC storage at 22°C. The only significant difference between the three materials was the incorporation of tetrahydrofurfuryl oleate (THFO) as a secondary plasticizer in CL‐2399 and PL‐130. The response of platelets to aggregating agents, uptake of serotonin, recovery from hyptonic stress, and serotonin release during storage following storage in a modified CL‐2399 plastic prepared without THFO and designated CL‐3000 (Cutter) was equivalent to PL‐146 and far superior to CL‐2399. In vivo studies in two laboratories of platelets stored in CL‐3000 bags showed satisfactory recovery (56 ± 4.2% and 46.7 ± 2.7%) and survival (6.4 ± 0.4 days and 7.4 ± 0.6 days). From these studies we conclude that the THFO secondary plasticizer component of PL‐130 and CL‐2399 is the cause of the poor platelet viability of platelets stored in these plastic bags. The mechanism of impairment is not known. The causative agent(s) may be degradation products of THFO (formed during manufacture of the PVC film) that are leached from

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276861.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

The enzyme‐linked antiglobulin test was used to determine the percentage of antibody removed from sensitized red cells by five elution methods: Rubin ether, xylene, digitonin‐acid, glycine, and heat. Antibodies examined in the study included anti‐D, ‐c, ‐E, and ‐K. With two examples of anti‐D, more antibody was eluted by the Rubin ether method (45.5% average) than the xylene (38%) or the digitonin acid method (35%) (p<0.05); the glycine (8%) and heat method (15%) were less efficient. With one example of anti‐E and one example of anti‐c, more antibody was eluted by the ether method. The percentage of anti‐K recovery, however, was greater with the digitonin acid method (45%) than with the ether (30%). We found the enzyme‐linked antiglobulin test method useful in the quantitative evaluation of elution procedures. TRANS

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276862.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

Enzyme‐linked immunoabsorbent assays (EIA) permit quantitation and automation of reactions. Previous reports have also shown improved sensitivity for red cell antibodies. We have developed a microtiter technique for EIA, thus decreasing the amounts of reagents required. EDTA was used rather than NaOH to stop the enzyme reaction allowing more precise timing of reactions and improved quantitation of large batches of tests. As in prior reports, the sensitivity was slightly greater than the antiglobulin test, but occasional red cell antibodies failed to show specificity by EIA. The use of microtiter plates and EDTA decreased the steps and reagents required and has the potential for automation of at least the optical reading of such assays in the blood ban

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276863.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

The effect of centrifugation (5 minutes, 6900 ×g) on the amount and particle size of blood microaggregates was studied in order to assess whether centrifugation and filtration by a standard (170 μm) transfusion set filter could be used for aggregate removal instead of microfiltration. Aggregates were quantitated using a method based on nylon screens with graded pore sizes. At the beginning of storage, centrifugation increased the particle size of aggregates only slightly. In 7‐day‐old blood, aggregates capable of passing a 160 μm screen amounted to 308 ± 107 (SD) mg of debris protein per liter of blood before and 55 ± 26 (SD) mg of protein (n = 10) after centrifugation. In 14‐day‐old blood centrifugation increased the size of aggregates even more effectively: 311 ±81 (SD) before and 29 ± 14 (SD) mg of protein following centrifugation. Microaggregates can thus be removed effectively by the centrifugation and filtration method from blood stored for more than 1 week. A standard transfusion set filter can be used instead of a mi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276864.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

The glycerol concentration of frozen‐thawed red cells must be less than 2 percent to prevent hemolysis upon transfusion. Three methods were investigated for monitoring the glycerol concentration of frozen‐thawed red cells prepared by the agglomeration technique. The supernatant osmolality and glycerol concentration were determined on 47 units of frozen‐thawed red cells prepared by agglomeration, and were found to be linearly related (r = 0.83, p<0.001). The supernatant refractive index was determined on 29 of the same units. There also was a linear relationship between the refractive index and the glycerol concentration (r = 0.74, p<0.001). The relationships were different from those previously reported for red cells prepared by other methods. The simulated transfusion test was done on red cells from three units whose glycerol concentration had been artificially elevated. The simulated transfusion test was found to be sensitive to glycerol concentrations above 2 percent. All three of the methods evaluated can be used to estimate the glycerol concentration of frozen‐thawed red cells prepared by the agglomeration te

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276865.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY

摘要:

A computer system that enhances the efficiency of a hospital transfusion service is described. It reduces the possibility of clerical errors; shortens the time elapsed between the ordering and the delivery of blood products; decreases the outdating of these units; and provides easy access to medical, demographic, and statistical information.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1983.23483276866.x

出版商:Blackwell Science Ltd    

年代:1983

数据来源: WILEY