摘要:

AbstractAn improved method for intermittent‐flow erythrocytapheresis in patients with sickle cell disease is reported. the method, a modification of the standard red cell exchange procedure for the haemonetics 30s unit, dilutes with physiologic saline the patient's blood as it flows from the draw line and before it reaches the centrifugation bowl. the blood dilution (approximately 1.6 parts saline to 1 part blood) is used only during the first two passes, when the proportion of sickle erythrocytes in the patient's blood is still high. only that amount of bowl supernatant (saline‐diluted plasma) necessary to maintain extracorporeal volume below 500 ml is returned to the patient. the method described largely prevents the clumping of sickle erythrocytes in the centrifugation bowl, a complication frequently encountered with the haemonetics 30s unit. thus, changing the bowl between passes is avoided. furthermore, the sickle red cells can be collected with the first pass and cryopreserved for possible future uses including the option of autotransfus

ISSN:0733-2459    

DOI:10.1002/jca.2920030203

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThe present study reports on the effects of plasmapheresis on both cellular (E‐rosette receptor‐ and Fc receptor‐bearing lymphocytes) and humoral (antilymphocyte antibodies) immunity in patients with active SLE. Ten untreated patients were studied before and after two plasma exchanges. The E‐rosette receptor‐positive cells were studied by OKT11 monoclonal antibody and Fc receptor‐bearing cells by Leu 15 monoclonal antibody. Antilymphocyte antibodies were studied before and after plasma exchange by an indirect immunofluorescence technique on autologous and normal lymphocytes. A reduction in OKT11+and Leu 15+lymphocytes was observed in all patients before plasmapheresis. Antilymphocyte antibodies were detected in five patients. After plasma exchange, an increase in E‐rosette receptor‐ and Fc receptor‐bearing lymphocytes was observed along with a reduction in the amount of antilymp

ISSN:0733-2459    

DOI:10.1002/jca.2920030204

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractAutomated apheresis techniques afford the opportunity of tailoring collection parameters for each donor's hemato‐logic profile. This study investigated the effect of various settings of the volume offset parameter as utilized in the Haemonetics Model V50 instrumentation during platelet‐ and lymphocytapheresis to optimize product yield, purity, and collection efficiency. In both types of procedures, increased product yield could be obtained by using an increased volume offset for donors having lower hematocrits. This improvement was related to an increase in collection efficiency. Platelet products also contained fewer contaminating lymphocytes with this approach. Adjustment of the volume offset parameter can be utilized to make the most efficient use of donors and provide higher‐quality pro

ISSN:0733-2459    

DOI:10.1002/jca.2920030205

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920030206

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractCentrifugal elutriation was used further to isolate human peripheral blood monocytes (HPBM) from mononuclear‐enriched cells harvested as a secondary component following platelet concentration collection samples. HPBM were recovered in either one or two populations consisting of either total HPBM or small (SM) and large monocytes (LM). The elutriation was carried out at 3,500 ± 5 rpm for the separation of lymphocytes and HPBM in Ca++−and Mg++‐free PBS without EDTA. An average of 5.05 ± 1.50 × 108HPBM were recovered in the total HPBM with a purity of 95% ± 3%. The SM and LM were obtained by splitting the total HPBM into two equal populations with an HPBM purity of 92% ± 3% and 93% ± 3%, respectively, by nonspecific esterase staining. The elutriation media were shown to have no effect on viability by trypan blue exclusion. All three HPBM populations were shown to be histochemically (lack of reactivity to leu‐1 and leu‐7) and functionally (depletion of NK cell activity) purified from the lymphocyte population. The HPBM populations were enriched in HLA‐Dr, OKM‐1, OKM‐5, MY‐8, and leu M‐3 monoclonal antibody marker staining. There were no differences in percent positive cells between SM and LM populations for any of the monocyte‐specific monoclonal antibodies. All three monocyte populations mediated antibody‐dependent cell‐mediated cytotoxicity to human red blood cells, with LM mediating more lysis (27.0% ± 5%) than SM (7% ± 3%). The HPBM produced H2O2and were activatable by bacterial lipopolysaccharide (LPS) and recombinant interferon gamma. HPBM did not have any spontaneous cytostasis to K562; HPBM, could be activated by 24‐hour exposure to 1.0 μg/ml of LPS (28.0%). The data obtained shows that mononuclear cell enriched plateletpheresis samples can be used to obtain large numbers of funct

ISSN:0733-2459    

DOI:10.1002/jca.2920030207

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractA woman with hyperthyroidism and myasthenia gravis developed respiratory failure in association with radiation‐induced thyroiditis. Treatment with steroids, propylthiouracil, propranolol, iodine, and plasmapheresis was associated with dramatic reduction in serum triiodothyronine (T3), serum thyroxine (T4), and thyroglobulin levels and prompt recovery of the patient. The medications that this patient received have been shown to cause an abrupt decline in serum T3 levels with little or no effect on the serum T4 concentration. The 56% decline in serum T4 observed in this patient during the first 24 hours of therapy suggests that plasmapheresis may be a useful adjunct to medical therapy in selected patients with severe hyperthyroidis

ISSN:0733-2459    

DOI:10.1002/jca.2920030208

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractOne hundred therapeutic phasmaphereses were carried out at biweekly intervals in seven patients, without morbidity or mortality, using the IBM 2997 blood fraction separator. In standardised procedures, 1.5 times the calculated plasma volume was replaced with an electrolyte solution containing 4% salt‐free human albumin. Anticoagulation was achieved using a whole venous blood to acid‐citrate dextrose ratio of 11 to 1. Median flow rates, plasma collection, and procedure times were respectively 40 ml/minute, 20 ml/minute, and 3 hours. Haemoglobin and total white cell counts were not significantly affected by the procedures. In contrast, platelet count, fibrinogen, immunoglobulin levels, total haemolytic complement, as well as C3 and C4 fractions fell, and the prothrombin and partial thromboplastin times were lengthened by the exchanges. All these measurements had returned to normal within 24 hours, apart from the fibrinogen, which took between 48 and 72 hours, and the immunoglobulin level, which required 35 days to return to baseline. In a further patient, more detailed studies (n = 13) were carried out to characterise the behaviour of antithrombin III and factor VIII. Both levels were markedly reduced immediately following the procedure and, like fibrinogen, had returned to normal within 48 hours. These data indicate that in an isovolaemic plasmapheresis there was a transient but rapidly reversible effect on all the factors studied, with fibrinogen level, antithrombin III, and factor VIII returning more slowly to normal than the others, and immunoglobulin levels responding the slowest. None of these changes was associated with clinically significant haemostatic abnormalities. It is concluded that there is no need to use fresh frozen plasma as replacement fluid, thereby avoiding the risk of hepatitis, and, secondly, that although transient decrease is demonstrable in coagulation and associated factors, patients can nevertheless be safely treated once every 48 hours using an albumin and electrolyte solution unless there is a pre‐existing abnormality in the haemostatic mech

ISSN:0733-2459    

DOI:10.1002/jca.2920030209

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractSix different protocols were employed in 710 plateletpheresis employing Haemonetics 30, Fenwal CS‐3000, IBM 2997 dual stage channel, IBM 2997 single‐stage channel, and Haemonetics V‐50 „surge pump”︁ method. When Haemonetics 30 and IBM 2997 single‐stage channel procedures were used, 5.4 to 5.9 × 1011platelets were collected with significant leukocyte contamination (10.8 to 11.6 × 109). With Fenwal CS‐3000, dual‐stage channel of IBM 2997 and Haemonetics V‐50 „surge pump”︁ there was less leukocyte contamination in concentrates (0.3 to 0.9 × 109) as well as a lower platelet yield (3.4 to 4.3 × 1011). No difference in yield was observed when plateletpheresis was performed with ACD‐A or ACD‐B employing the single‐stage channel of IBM 2997. Paraesthesias was the most frequently seen side effect in donors, with a higher inci

ISSN:0733-2459    

DOI:10.1002/jca.2920030210

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractCirculating immune complexes, autoantibodies, and suppressor factors to normal lymphoproliferation may play an important role in the induction and maintenance of the cellular immunodeficiency characteristic for the acquired immunodeficiency syndrome (AIDS) and its related conditions. In order to explore the possiblity that the removal of circulating humoral factors may have an immunomodulatory effect in patients with AIDS and AIDS‐related conditions (ARC), we used apheresis procedures to treat patients with different clinical presentations of AIDS and ARC. Five patients with AIDS and opportunistic infections were treated with plasmapheresis. Four patients with AIDS and Kaposi's sarcoma without opportunistic infections were treated with staph protein‐A immunoadsorption and two patients with ARC and peripheral neuropathy were treated with lymphoplasmapheresis. The treatments were tolerated well by all patients. Effective removal of circulating humoral immune factors was observed in all three groups. No significant clinical benefit was seen in the patients with AIDS and opportunistic infections treated with plasmapheresis. Partial tumor responses were observed in three of the four patients with AIDS related Kaposi's sarcoma treated with staph protein‐A plasma perfusion, and resolution of neurologic symptoms was seen in both patients with ARC and peripheral neuropathy treated with lymphoplasmapheresis. Our preliminary results suggest that lymphoplasmapheresis may be an effective treatment modality for patients with ARC related peripheral neuropathy, that protein‐A immunoadsorption is well tolerated by patients with AIDS‐related Kaposi's sarcoma, and that this treatment has antitumor and immunomodulatory effects in these

ISSN:0733-2459    

DOI:10.1002/jca.2920030211

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractPlasma exchange was performed on a patient with hemophilia A and inhibitor to factor VIIIC prior to bilateral cataract removal. Koate was used as replacement fluid with effective reduction of the inhibitor level. From the technical standpoint we found out that factor VIII is best reconstituted in water and directly infused through the venous line and not the centrifuge bowl.

ISSN:0733-2459    

DOI:10.1002/jca.2920030212

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY