摘要:

AbstractThis review summarizes three aspects of current research on the immunomodulatory effect of allogeneic transfusion. Representatives of three laboratories ‐ each of which is actively engaged in research on transfusion‐induced immunomodulation ‐ summarize their current investigative approach. First, current animal models of transfusion‐induced immunomodulation are presented and research on the tumor growth‐promoting effect of allogeneic transfusion is described. Second, mechanisms underlying an immunomodulatory effect of transfusion are summarized and experiments on the induction of transplant tolerance by selective introduction of donor‐type MHC antigens is presented. Third, the potential clinical impact of increased infection and tumor recurrence resulting from transfusion‐induced immunomodulation is assessed. The potential role of donor‐derived hematopoietic stem cells is presented as an area of future investigation in the area of transfusion‐induced

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01324.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractControversy exists as to whether treatment of HIV‐1‐seropositive hemophiliacs with blood coagulation products of high purity might help prevent the decline of CD4‐positive lymphocytes and thus delay progression toward AIDS. As viral load has recently been shown to be associated with disease progression in HIV‐1 infection, we tested for a possible direct interference of high‐ or intermediate‐purity blood coagulation products with replication of HIV‐1. The data obtained revealed comparable replication of HIV‐1 in the presence and absence of all blood coagulation products tested (assessed by PCR‐based quantitation of proviral HIV‐1 DNA in infected cells after a 10‐day incubation period). These data suggest that coagulation factor concentrates per se will also have no direct effect on HIV

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01325.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHuman serum albumin solutions have been used as plasma replacement fluids for many years and adverse events associated with their use are rare. Albumex®5 is a new albumin solution manufactured by a combination of the Cohn fractionation process and a chromatographic technique. A multicentre, randomised study was conducted to compare the safety of Albumex®5 and 5% normal serum albumin (5% NSA) in patients undergoing large volume therapeutic plasmapheresis for a variety of disorders. Up to six exchanges were performed on each patient. A total of 208 evaluable exchanges were performed on 40 patients, 109 5% NSA and 99 Albumex®5. There were 9 adverse events (reaction rate of 8.3%) in 6 patients with 5% NSA and 12 events (reaction rate 12.1%) in 8 patients with Albumex®5. The difference is not statistically significant (p = 0.37, Fisher's exact test). None of the adverse events were considered serious. Only six reactions were thought to be possibly related to the product and three exchanges were modified as a result of an adverse event; one with Albumex®5 was interrupted and two with 5% NSA were slowed. Albumex®5 can be considered to be a safe product with a low adverse event

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01326.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIntravenous immunoglobulins (IVIg) purified by cold ethanol fractionation have a very good safety record with regard to the transmission of many viruses. However, a few cases of non‐A‐non‐B hepatitis have been described after intravenous injection of some immunoglobulin preparations. To ensure even higher safety for our IVIg, an additional virus inactivation step, based on pasteurization, was developed. The heating of aqueous IVIg was performed without stabilizer, and at a very low salt concentration (<1 mM) at acidic pH. No generation of polymer was detected after pasteurization and a significant decrease in the proportion of dimers was observed. Analysis of the secondary structure by circular dichroism showed a very slight change in the secondary structure. The biological properties of the Fc region as well as the Fab region were not affected by the pasteurization. Our method has several advantages: (1) improvement of viral safety; (2) there is no need to add stabilizer which may stabilize viral particles, and (3) the absence of any hypotensive effect and low anticomplementary activity indicates a good clinical tolerance of IgG prepar

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01327.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIn a prospective randomised trial 39 patients undergoing either arterial bypass surgery with a polytetrafluoroethylene (PTFE) bypass graft (n = 18) or aortic aneurysm repair with a woven Dacron graft (n = 21) were randomised either to receive fibrin sealant as a topical haemostatic agent at the arterial anastomosis or to act as control. The main outcome measure was the time taken to achieve haemostasis at the suture line. The median time to achieve haemostasis was 0.5 min (range 0–11 min) in the treatment group and 4 min (range 0–21 min) in the control group. This difference was statistically significant p<0.014 by the Mann‐Whitney test. Immediate haemostasis on release of the clamps was achieved in 13/21 patients in the treatment group and in 4/18 patients in the control group (p = 0.023 by Fisher's exact test). There was no difference in total operative time or operative blood loss. No patients in the treatment group suffered any perioperative thromboembolic event and 1 patient in the control group suffered an early graft occlusion. There was no evidence of transmission of hepatitis B or C, or parvovirus B19. In conclusion, fibrin sealant is an effective topical haemostatic agent for arterial suture lines involving PTFE or woven D

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01328.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe detection of antibody to the second envelope protein (E2) of the hepatitis C virus (HCV) has been hampered by the lack of suitable antigens. A previously described E2 recombinant antigen (CHO‐E2) expressed as a non‐fused, highly glycosylated protein in mammalian cells was used to detect specific antibody (anti‐E2) in samples from blood donors and viraemic patients showing positive or indeterminate results for anti‐HCV after a wide serological study. Anti‐E2 was detected in 50–75% of the donors positive for anti‐HCV, 80% of viraemic immunocompetent patients with anti‐NS3 alone and 28% of non‐viraemic donors with anticore alone. In donors with anti‐NS3 (15 samples) or anti‐NS4 (51 samples) alone, anti‐E2 was found occasionally (3 cases). Moreover, two anti‐E2‐positive samples from viraemic patients were misidentified by some commercial assays for screening anti‐HCV These results suggest that testing for anti‐E2 may be useful for improving the performance of the current assays for anti

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01329.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTransfusional iron overload leading to cardiopathy and other severe complications continues to be a major problem in chronically transfused homozygous β‐thalassaemia patients. It is well known that young red cells (neocytes) survive longer after transfusion and therefore may contribute to the extension of the intervals between transfusions. We evaluated the impact of neocytes in the total annual blood requirements and consequently the transfusional iron load in 18 thalassaemia patients. A two‐period study comparing transfusions of standard red cells versus neocytes in the same group of patients was performed. Neocytes were harvested by density separation using the Neocel®System. The method of preparation was simple with relatively low costs and required no special equipment. There was a significant difference (p<0.005) in PK and MCV values of the neocyte and older red cell (gerocyte) fractions indicating that a good separation of the two populations was achieved. All patients had a reduction in blood requirements during the neocyte period. The total annually transfused red blood cells and concomitant iron blood load were significantly reduced (p<0.001) by 20.2±9.1%. However, the response was variable. Seven of the 18 patients had a large reduction in blood consumption (24.8–34.8%), 9 others ranged between 10.7 and 21.6%, and in 2 the reduction was less than 10%. This reduction in blood requirements and in the transfused iron may change the chelation index resulting in more efficient iron chelation therapy and perhaps reduce the cost of the haemochromatosis therapy on a long‐term basis. We conclude that the use of neocyte therapy using this system can benefit the majority of chronically transfused patients by reducing transfusional iron overload and related complications and may lead to a much better quali

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01330.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTo determine whether autologous blood donation can be used safely and efficiently in children weighing 8–25 kg, we studied children whose perioperative blood losses were expected to exceed 25% of total blood volume. Blood donations were performed in pediatric units, under the direction of an anesthesiologist and a blood bank physician experienced in pediatric care. Twenty‐four children, median age 6 years (1–13), were included. They underwent surgery mainly for digestive or urological disorders, and for orthopedic defects. Forty blood collections were performed of the 46 prescribed. Phlebotomies could not be performed in 1 child because of the mother's apprehension, and in 5 cases because of venous access problems. All phlebotomies were hemodynamically well tolerated. Hemodilution was also performed in 17 children, and cell saver used in 2. Allogeneic blood transfusion was avoided in 21/24 chi

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01331.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01332.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1996.tb01333.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY