ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094662.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094663.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

To evaluate accurately the current performance of filtration, the French Produits Sanguins Labiles study group, composed of 21 transfusion teams, conducted a large‐scale 6‐month study involving over 1400 filtrations and 3000 controls. Some 745 standard red cell concentrates (RBC concentrates) and 690 concentrates previously white cell (WBC)‐reduced by removal of buffy coat (BC‐poor RBC concentrates) were filtered using six commercially available filters: at least 170 results were collected per filter, spread among a minimum of three teams. Prefiltration controls show that the removal (manual and automated) of the buffy coat results in an initial WBC reduction of approximately 63 percent, along with a hemoglobin loss of 4 g (7%). After filtration, residual WBCs were counted in the Nageotte manual counting chamber. The reliability of this counting method, which is simple and adapted to low WBC concentrations, was characterized in this study by a 25‐percent coefficient of variation (CV) for a concentration of 2.5 WBCs per microL (i.e, 0.6 × 10(6)WBCs/filtered unit). The analysis of the results shows that, for five of six filters (1 filter was excluded), the postfiltration median value of residual WBCs was 1.1 × 10(6)in filtered RBC concentrates (n = 590), whereas it was 0.34 × 10(6)in filtered BC‐poor RBC concentrates (n = 581). The difference is significant (p<10(−8), Wilcoxon test). Hemoglobin loss due to filtration varies according to the filter, from 5.7 ±/− 2.2 to 17.3 ±/− 2.5 g. The study data confirm that the combination of prefiltration BC removal plus filtration results in a reduced number of residual WBCs (99% of filtered BC‐poor RBC con‐ centrates contained<5 times 105WBCs, as compared to only 81% of filtered RBC concentrates). However, these combined methods result in a significantly higher overall hemoglobin loss than filtration alone (10 g overall hem lobin loss for filtration alone vs. 15 for combination of B

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094664.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

In the United States (US), travelers who have had malaria or who have taken antimalarial chemoprophylaxis are deferred as blood donors for 3 years to prevent transfusion‐transmitted malaria. To assess the impact of shortening this 3‐year exclusion period, national malaria surveillance data from 1972 to 1988 were reviewed. The average annual rate of transfusion‐transmitted malaria is 0.25 cases per million units of blood collected. Of 45 reported cases, 38 percent were caused by Plasmodium malariae, 29 percent by P. falciparum, 24 percent by P. vivax, and 9 percent by P. ovale. Thirty‐two donors were implicated in 34 cases of transfusion‐transmitted malaria. Of 30 implicated donors whose native country was identified, 23 (77%) were foreign nationals and 7 (23%) were from the US. In a review of all imported malaria cases by species and by interval between date of entry and onset of illness, 98 percent of P. falciparum, 86 percent of P. malariae, 76 percent of P. vivax, and 74 percent of P. ovale infections became symptomatic within 6 months of the patient's arrival in the US, regardless of the use of prophylaxis. Shortening to 6 months the donor exclusion period for US travelers to malarious areas would result in a minimum of 70,000 additional blood donors' being made available, with a maximum annual increase of 0.03 additional cases of transfusion‐transmitted malaria. The potential benefit of bringing healthy travelers back into the donor pool after a shorter period of exclusion merits consideration by the blood bank

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094665.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Red cells (RBCs) contain an abundance of protein methylase II, which catalyzes the transfer of methyl groups from S‐adenosylmethionine to carboxyl groups of aspartyl and glutamyl residues in proteins. Enzyme‐ catalyzed transfer of methyl groups, labeled with 14C or 3H, from S‐ adenosylmethionine to membrane proteins of McLeod, Ko, and control RBCs was assayed by determining the acceptance of labeled methyl groups under standardized conditions. Membranes of control cells and Ko cells showed about 50 percent greater uptake than did those of McLeod cells. However, when ovalbumin was used as a methyl‐accepting substrate, the levels of protein carboxymethyltransferase activity in all three types of cells were found not to differ significantly. In addition, no significant qualitative differences were apparent when methyl‐labeled polypeptides from control and McLeod cells were separated by slab gel electrophoresis. The mechanisms responsible for changes in membrane protein methylation of McLeod cells remain unclear. However, these observations provide further evidence of the pleiotropic biochemical lesion associated with the acanthocytic morphology that characterizes Mc

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094666.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Preoperative autologous blood donation is used by only a small percentage of surgery patients for whom crossmatched blood is ordered. To document the reasons the patients failed to donate, the medical records of surgical patients at three university and three community hospitals were studied. All procedures for which crossmatched blood was ordered, but for which autologous blood was not available, were included (n = 8121). Probable reasons for nondonation were found in 72 percent of university hospital patients and 65 percent of community hospital patients (n = 6064 and n = 2057, respectively). The most frequent reasons for nondonation among university hospital patients were emergency surgery (27%) and age<12 years (17%), and those among community hospital patients were emergency surgery (42%) and American Society of Anesthesiologists physical status ≥to 4 (20%). Surprisingly, anemia (hemoglobin<11 g/dL [<110 g/L]) as the only limitation to donation was rarely found: this was the sole reason in only 3.3 percent of university hospital and 4.5 percent of community hospital patients. Overall, of 8121 patients who failed to donate autologous blood, 5731 (71%) had legitimate medical reasons. The remaining 2390 (29%) had no identifiable reason for nondonation, and recruitment efforts should be focused on them and their surgeon

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094667.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Transfusion‐associated Chagas' disease is a serious public health problem in Central and South America. With the recent influx of immigrants from Chagas' disease‐endemic areas, concern about the risk of disease from blood transfusion has increased in the United States. To assess the prevalence of Trypanosoma cruzi infection in one area, 1024 consecutive blood donations from 988 voluntary blood donors at a medical center in Los Angeles County were screened serologically. The median age of donors screened was 32.5 years; 53.4 percent were male, and 38.4 percent were born in Chagas' disease‐endemic countries. All donor sera were tested by complement fixation (CF) and indirect immunofluorescence (IIF) tests. A radioimmunoprecipitation assay (RIPA) was also done on all sera from CF‐ or IIF‐reactive donors and an equal number of sera from nonreactive donors. A second serum specimen was obtained, and interviews were completed for 18 (67%) of 27 donors with an initial CF titer greater than or equal to 8 or an IIF titer greater than or equal to 64. The overall seroreactivity (by CF and IIF) was 1.1 percent (11/988). One donor (0.1%) had antibody specific to the 72‐ and 90‐kDa antigens of T. cruzi on RIPA. Seven recipients of blood components from the seroreactive donors were located and were seronegative at 3 to 6 months. Seroreactive donors were 3.6 times more likely to have been born or to have resided in Mexico or Central America, 8.7 times more likely to have donated blood in the past, and 11.8 times more likely to have a history of malaria prophylaxis

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094668.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Second bone marrow transplants have been used successfully to treat marrow graft failure or relapse following the original marrow transplantation. Hospital records of 16 related two‐time bone marrow donors were reviewed to determine what risks a person faces in making a second marrow donation. One donor suffered a minor complication following the first collection, but no donors suffered complications during the second donation. The volume of marrow collected for the first and second donations (1253 +/− 504 vs. 1261 +/− 471 mL) was similar. However, more marrow donors received transfusions of homologous red cells during the second collection than during the first collection (5/16 compared to 1/16; p = 0.06). To determine what factors might contribute to the high incidence of homologous red cell transfusion during second donations, the experiences of donors who received homologous blood during the second donation were compared to the experiences of donors who received only autologous blood. Persons receiving homologous blood during the second collection received more red cell units than persons receiving autologous blood (2.0 +/− 0.7 units compared to 0.9 +/− 0.5 units; p<0.01). Their precollection hemoglobin levels were lower (12.3 +/− 1.2 vs. 14.4 +/− 1.4 g/dL [123 +/− 12 vs. 144 +/− 14 g/L]; p<0.01), and the time between the first and second collections was significantly less (45 +/− 8 days vs. 342 +/− 432 days; p<0.05).(ABSTRACT TRUNCATED AT 250 WORDS)). Further analysis showehat five of eight persons who donated marrow a second time within 60 days of the first donation were transfused with homologous blood, while none of eight persons who donated bone marrow more than 60 days after their first donation were transfused with homologous blood (p<0.05). These results suggest that people can safely do‐ nate marrow a second time; however, if the second marrow collection occurs within 60 days of the first collection, precautions should be taken to reduce the chances of exposing the marrow do

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094669.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

In cases of disputed parentage, it is commonly thought that the probability of paternity (P) represents the probability that the tested man is the biologic father of the child whose parentage is in doubt and that the paternity index (PI) is the likelihood ratio that enters into this probability. Using the results of HLA typing in a sample of disputed parentage cases, the distribution of P was examined within two groups: actual mother‐alleged father‐child trios, and simulated mother‐ unrelated man‐child trios. These distributions were found to be roughly consistent with the usual understandi

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094670.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The residual white cell (WBC) content of donated units of red cell concentrate rendered WBC‐reduced by filtration through commercially available polyester filters was quantified and phenotypically analyzed. All studies were performed by flow cytometery. Quantification studies were performed with a DNA/RNA fluorophore, propidium iodide. WBC subset analyses were performed with fluorescence‐labeled monoclonal antibodies directed against various cluster differentiation (CD) loci. The results indicate that the filter removes in excess of 3 log10 total WBCs from the red cell components and depletes granulocytes to or beyond the specific assay's sensitivity of 3 log10. Total T and B cells, T4 and T8 lymphocytes, and monocytes are reduced by approximately 4 log10. These analyses provide plausible explanations for the clinical success of the filter and suggest other potential applicati

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31992094671.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY