ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01228.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractSevere anaphylactic or allergic reactions may occur during blood transfusion to patients who are IgA‐deficient and have anti‐IgA in their blood, particularly those with class‐specific antibodies. These patients are a particular challenge to the hospital transfusion service when large volumes of blood components are required for transfusion support, as in liver transplantation. We have successfully provided blood components for 3 such patients undergoing liver transplantation. Red cells were washed manually or by automated technique. Platelets were washed manually. All plasma was from IgA‐deficient donors. One patient's entire plasma requirements were supplied by autologous plasmapheresis. Serial determinations of IgA levels and anti‐IgA titers in 1 patient demonstrated an abrupt fall in anti‐IgA with the appearance of barely detectable amounts of IgA during the surgery. IgA‐containing plasma cells were demonstrated in the biopsies of liver homografts of 2 patients following transplantation. IgA deficiency with anti‐IgA can be successfully managed during liver transplantation with a

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01229.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractIn order to increase the safety of blood products, we have developed a procedure for the virus inactivation of fresh frozen plasma. Several batches have been prepared and with the first 10 batches, each of them composed of 60 litres of plasma, we have determined a set of biological parameters. Virus inactivation was realised using TnBP (1%) and Octoxynol 9 (1%). After their elimination with castor oil using chromatography on insolubilized C18 resin, glycine was added and the pH of the plasma was adjusted to 7.4. Plastic bags were aseptically filled with a mean volume of 200 ml of plasma. The mean levels of coagulation factors were all over 0.7 U/ml and their recovery from initial plasma was nearly the same as total protein except for factor VIII:C. The net loss in factor VIII:C was 16%, when including the dilution of plasma. In vivo and in vitro tests demonstrated that in the final product there were no activated factors. As in fresh frozen plasma, the protein concentration was over 50 g/l and the potassium level lower than 5 mmol/l. According to these results, virus‐inactivated plasma has the same qualities of fresh frozen plasma and could now replace i

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01230.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractIn a prospective study the incidence of allo‐immunization and platelet refractoriness was investigated using a consequently leucocyte‐poor blood product regime. Twenty‐five previously non‐transfused patients with acute leukaemia (11 men, 7 women) or autologous bone marrow transplantation for Hodgkin's or non‐Hodgkin's lymphoma (2 men, 5 women) received at least 80 donor units of filtered red cells (filtration within 24 h after donation, leucocyte content 8.5+3.9 times 106/U) and/or of platelet concentrate (produced by the buffy coat method, leucocyte content: 7.8+4.2 times 106/U). A 1‐hour recovery of 20% in three consecutive transfusions, in the absence of clinical factors known to impair increment, was defined as platelet refractoriness. HLA class I antibody screening with a panel of 60 cells was performed before the first transfusion and after 80 U of blood components. Of 25 patients who entered this study, 6 patients developed platelet refractoriness after a mean of 38 units of blood components (range 26–45 U); all 6 were female with a history of multiple pregnancies. In 19 patients regarded as non‐refractory, no HLA antibodies were demonstrated (13 men, 6 women). This study, though limited in size, suggests that the use of blood products containing less than 1 times 107leucocytes/donor unit prevents primary HLA class I immunization and platelet

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01231.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to develop an enzyme‐linked antiglobulin test (ELAT) for IgG on RBC without the hemolysis caused by the high pH of the alkaline phosphatase reaction. This was achieved by fixing the RBC with 0.05% glutaraldehydeafterattachment of the antibodies. Assays using anti‐D reference standards demonstrated the sensitivity to be 1–2 ng of antibody as compared to 7.5 ng for the manual indirect antiglobulin test. The coefficients of variation of these assays ranged from 10.4 to 20.1%. The mean background absorbance at 405 nm of 105 normal RBC samples was 0.08+0.03 SD. There was an increase in sensitivity of the test after the fixed RBC were stored. Dilute glutaraldehyde stabilizes the RBC membrane and the antigen‐antibody linkage resulting in a more sensiti

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01232.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA modified enzyme‐linked antiglobulin test (ELAT) for quantifying D‐posi‐tive red blood cells in the circulation of D‐negative pregnant women is described. The antibody‐antigen bond was stabilized and the problem of hemolysis eliminated by the use of 0.05% glutaraldehyde. The r value for the standardization curves for measuring cord RBC in mixtures was 0.98; coefficient of variation 5.8%. Reproducible quantitation of 0.125% D‐positive cord RBC mixed with D‐negative RBC was demonstrated. In comparative studies of artificial mixtures, Kleihauer‐Betke results for more than 1% cord RBC were 50–100% greater than the true values. In several examples of large fetomaternal hemorrhages, the ELAT results matched the clinical data more closely than the Kleihauer‐Betke based estimates. 2 ml of fetal RBC in a 1,600‐ml red cell mass can be quantified us

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01233.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA method is described in which polystyrene latex beads are used for constructing standard curves to estimate the number of protein molecules on cell surfaces by an enzyme‐liked immunoassay test (ELAT). A series of immune globulin (IgG) dilutions in pH 9.8 carbonate buffer were coated on 3‐μm microbeads by incubation overnight at 4°C and subjected to ELAT. The r value of the curve derived from four assays was 0.9991. This standard curve applied to previously recorded ELAT data resulted in estimating that normal RBC have 63+19 (SD) IgG molecules and that the lower level of sensitivity of the antiglobulin test is 155 IgG molecules per RBC. the method should be useful for more precise standardization of procedures for measuring proteins on cell sur

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01234.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA multiparous white woman developed severe thrombocytopenia following transfusion of red blood cells. Six ineffective platelet transfusions (a total of 42 random donor concentrates) were given from day 0 to day +6, high‐dose steroids from day +1, progressively tapered until day +30, and a total of 150 g of intravenous immunoglobulins from day +2 to day +6. As platelet count had not increased significantly by day +8, four plasma exchange procedures, each consisting of 2,000 ml of plasma exchanged with 5% albumin solution, were performed on days +8, +10, +14 and +18. Platelet count was 5, 50, 100 and 234 times 109/1 on days +8, +14, +26 and +32 (discharge), respectively. The patient's acute phase serum contained increased levels of platelet alloantibodies with anti‐HPA‐la (PlA1, Zwa) specificity and a titer of 3,200. IgG1, IgG2 and IgG3 subclasses of platelet‐reactive antibodies in the patient's serum were elevated, whereas IgG4, IgM and IgA were within the reference values. Levels of IgG1, IgG2 and IgG3 of antiplatelet antibodies showed a marked and parallel reduction during treatment, but were still above the reference values at the end of treatment and 1 year later, when the patient platelet count was normal. Although a failure of intravenous immunoglobulins cannot be proven in this case, plasma exchange seems to have contributed more than intravenous immunoglobulins to clinical re

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01235.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01236.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA total of 52 nonrelated Caucasian patients (21 male, 31 female, age at onset of the disease: 7–74 years, average: 31.6 years) suffering from intermediate uveitis were tissue typed for 56 different HLA‐A, ‐B, ‐C and ‐DR‐antigens.No significant association between any specific HLA‐antigen and the disease, both when comparing the total patient group with a large, healthy control population, or any of the different subgroups (male vs. female, early vs. late onset, mild vs. severe course) could be

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1992.tb01237.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY