摘要:

AbstractTissue transplantation and banking are rapidly growing services throughout the world reflecting the widening availability of transplantable cadaver tissue and the mounting clinical indications particularly in orthopaedic, plastic and cardiovascular surgery. In the US tissue banking is more established, yet continues to show a rapid growth profile. In the UK it is currently organised in a variety of different ways and by a number of different organisations. The risks of disease transmission by tissue transplantation are similar to those for blood transfusion and the majority of tissues are grafted during procedures that are not life saving. The danger of disease transmission has resulted in the introduction of legislation in the US which allows the FDA to inspect tissue banks and to recall and destroy tissues. In the UK, there is currently no regulation or inspection of tissue banks to demonstrate that donor selection, tissue processing and tracking are conducted to acceptable standards. Blood transfusion services in the UK, US, New Zealand, Australia and possibly other countries have extended their roles to include organ and tissue donation to varying degrees, with the collection, processing and distribution of bone and tendon allografts most commonly undertaken. They have readily available special capabilities and experience with an established infrastructure, compliant with Good Manufacturing Practice, placing them in an ideal position to provide this service safely and cost‐effectivel

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120071.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe performance of a leukocyte reduction bedside filter with different types of RBC concentrates was analyzed. Three types of RBCs were prepared: buffy‐coat‐depleted RBCs suspended in saline‐adenine‐glucose‐mannitol (SAGM)‐additive solution (BC‐RBCs; n = 20), RBCs suspended in SAGM‐additive solution without buffy coat removal (SAGM‐RBCs; n = 20), and RBCs drawn in CPDA‐1 conservative solution and processed for component preparation by the platelet‐rich plasma method (CPDA‐RBCs; n = 20). The units were filtered within 8 h of collection. One filter was used for every 2 units. High numbers of residual WBCs were found even in the units filtered first. Filtration of CPDA‐RBCs resulted in a higher residual WBC content than SAGM‐RBCs or BC‐RBCs (p = 0.0032 and p = 0.0002, respectively). The filter performance strikingly decreased when the WBC load per filter exceeded 4 × 109or the platelet load was less than 100 × 109. We conclude that filter performance varies with the WBC and platelet content of the RBC concentrates. Under the experimental conditions assayed in this study CPDA‐RBCs are the least appropriate ones to be use

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120078.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe clinical effectiveness of platelet transfusion in refractory patients is still a subject of debate. We have evaluated the possible hemostatic effect of platelet transfusion in 16 alloimmunized thrombocytopenic patients whose platelet counts were less than 20,000/μl. Platelet concentrates were always obtained by apheresis procedures from incompatible donors. The posttransfusion platelet recovery was greater than 15% only in 3 cases. In the first 6 patients, measurements of bleeding time performed immediately before transfusion were in all cases longer than 30 min and did not change significantly 10 and 60 min after platelet transfusions. In all patients, ex vivo perfusion experiments with Baumgartner's platelet adhesion model, using native nonanticoagulated blood, were performed immediately before and 10 and 60 min after transfusion. No difference in platelet deposition onto the subendothelial surface was observed after platelet transfusion. Unexpectedly, the deposition of fibrin on the subendothelial surface was statistically augmented in the posttransfusion studies. Quantification of thrombin‐antithrombin complexes (TAT) in plasma showed statistically significant elevations (p<0.01) in the posttransfusion samples (31.9±12.6 vs. baseline 5.8±1.7 ng/ml), not justified by TAT levels in the transfused material (2.3±0.17 ng/ml). Transfusion of incompatible platelets to refractory patients may activate coagulation mechanisms in the absence of an increase in peripheral platelet

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120084.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTo assess whether measurement of CD34+ cells in the peripheral blood allows one to estimate the progenitor cell yields of subsequent leukapheresis procedures, 733 corresponding blood and leukapheresis samples were analyzed. Peripheral blood progenitor cells of cancer patients were mobilized with hematopoietic growth factors alone or postchemotherapy, and harvested processing 10 liters of blood for each leukapheresis product. The CD34+ cell count (CD34+ cells/μl blood) correlated most closely with the progenitor cell yield in the corresponding leukapheresis product (CD34+ cells/kg bodyweight, r = 0.80), while the proportion of circulating CD34+ cells to the white blood and mononuclear cells predicted the yield less reliably (r = 0.74 and r = 0.60). The CD34+ cell yield was independent of the white blood count (r = 0.04), whereas a weak correlation was found between the mononuclear cell count and the number of CD34+ cells/kg collected (r = 0.42). It was unlikely to obtain the threshold quantity of 2.5 × 106CD34+ cells/kg required for rapid engraftment when counts below 10 CD34+ cells/μl blood were detected. At levels between 10 and 30 CD34+ cells/μl sufficient autografts could be harvested, whereas 30–100 CD34+ cells/μl were required to achieve this by a single leukapheresis. A surplus of CD34+ cells was likely above 100 CD34+ cells/μl which could be useful for progenitor cell enrichment techniques. The correlation between the CD34+ cell count and progenitor cell yield was independent of the mobilizing regimen and whether leukaphereses had been performed previously. In conclusion, the number of CD34+ cells/μl blood allows a reliable prediction of the CD34+ progenitor cell yield in subsequent leukapheresis procedures. However, rare cases of unexpectedly sufficient progenitor cell yields may be observed even at CD34+ cell levels below detecti

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120090.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractDrawing of blood into a citrate‐phosphate‐dextrose (CPD) solution with a reduced citrate concentration has been shown to improve the maintenance of coagulation factor VIII (F VIII) in plasma and to give possibilities to improve erythrocyte preservation. We studied the quality of plasma obtained from whole blood drawn under continuous mixing into CPD in which the citrate concentration was reduced by 50% (0.5CPD). The blood was stored at room temperature for 8 h before component preparation. We confirmed improved stability of F VIII by 0.5CPD. We found no clinically significant changes in inhibitors to the coagulation and kallikrein systems, and no signs of activation of these systems, during the 8‐hour holding time. In control blood drawn into CPD, F VIII and coagulation factor IX decreased by 0.09 IU/ml (8%) and 0.07 U/ml (7%), respectively, otherwise we found no significant differences between 0.5CPD plasma and CPD p

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120097.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractPurpose:To determine the frequency of maternal‐fetal hemorrhage at or above 1 μl of maternal whole blood.Methods:Seventy‐three mothers whose red blood cells bore an Rh antigen (Rh D, Rh c, Rh E) that was absent on red blood cells of their newborns were identified and a new cytological method, the Kleihauer‐immunogold‐silver‐staining technique, was applied on the blood of their neonates to detect and quantify maternal red blood cells. Stringent precautions were taken to avoid contaminations of neonatal blood samples by adult red blood cells.Results:Maternal red blood cells were present in 3 newborns, a frequency of 4% (95% CI: 1–11%), and the estimated volumes of hemorrhage were 0.8, 1.5, and 101 μl of maternal whole blood. No obstetric factor was clearly associated in this limited study with the occurrence of maternal‐fetal hemorrhage.Conclusions:Mother‐to‐fetus microtransfusion greater than 1 μl is infrequent at or near delivery, and it may be observed after an uncomplicated pregnancy

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120103.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractMrs P. presented at 13 weeks of gestation with apparent anti‐C+D. At week 34, with antibody levels of 168 IU/ml, a D‐negative (r′r) baby was delivered with a strongly positive DAT and an Hb of 3.0 g/dl. Anti‐G in maternal serum was isolated by adsorption and elution from R2R2cells and shown, using flow‐cytometric and chemiluminescence assays, to sensitize r′r cells at levels of cell‐bound IgG consistent with fetal haemolysis. In an analysis of 28 sera from alloimmunized women with over 5 IU/ml anti‐C+D, 2 sera were shown to contain levels of anti‐G consistent with moderate or severe haemolytic disease of the newborn (HDN). Thus HDN due to anti‐G may not be rare. An analysis of 187,037 blood donors in the south‐west of England showed the r′ gene frequency to be 0.005897 suggesting that approximately 2.9% of matings of rr women with D‐negative fathers can produce an r′r baby. These findings highlight the need for the continuous non‐invasive monitoring of D‐negative fetuses

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120108.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractUsing a recently introduced multiplex polymerase chain reaction and restriction fragment length polymorphism ABO genotype screening method we have found an anomalous ABO genotype (A2O1 variant) not correlating with the serological phenotype (blood group O). The blood group was confirmed by absorption/elution and detection of blood group substances in saliva. Sequencing of exons 6 and 7 in the ABO genes of the propositus indicated anA2gene (C467T and C1060‐) apparently inactivated by the same single nucleotide insertion recently reported in individuals with the ABO subgroup Ael. Investigation of relatives confirmed the inheritance of this new inactive hybrid allel

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120113.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe Waldner blood group antigen (Wda) was first identified in members of a Hutterite kindred. Evidence that the gene governing the Waldner polymorphism is located on chromosome 17, and the observation that the antigen is inactivated by chymotrypsin prompted the investigation of a possible association between Wdaand band 3. Single Stranded Conformational Polymorphism (SSCP) analysis and DNA sequence analysis of theAE1gene, from subjects of known Waldner phenotypes, showed a heterozygous mutation leading to the substitution Val557→ Met in the presumptive Wd(a+) heterozygotes. Therefore the Wdablood group antigen is associated with the presence of Met557on band 3. The Waldner antigen has been assigned to the Diego blood group system with the International Society of Blood Transfusion number DI

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120118.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTyping for human platelet antigens (HPA) is useful in a variety of clinical situations. We developed a method for genotyping for HPA‐1, ‐2, ‐3 and ‐5 by means of the PCR amplification with sequence‐specific primers (PCR‐SSP) technique. Primer sets were designed to allow PCR amplification for all systems using the same assay conditions. Specificity and sensitivity of the method were assessed in a blind quality control study (n = 112). In 111 cases, results obtained by PCR‐SSP were identical as compared with PCR‐restriction fragment length polymorphism technique. One discrepancy was found to be due to a typing error in the data sheet. The results of the PCR‐SSP technique were available within 3 h. We conclude that genotyping based on PCR‐SSP enables rapid typing for HPA systems, which makes this technique feasible in most clinical settings where urgent HPA

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7120121.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY