摘要:

AbstractTransfusion medicine has become challenged by its own success. Within little more than two generations, diligent workers in this field have transformed blood conservation and transfusion techniques from a ‘cottage industry’ with unpredictable outcomes to a science that delivers components that are safe and efficacious and transfusion advice that is increasingly based on evidence rather than speculat

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110001.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIn recent years the development of recombinant DNA and sequencing techniques has led to a greatly increased understanding of the genetic complexity, structure and function of the human major histocompatibility complex. This system may be subdivided into the ‘classical' HLA (human leukocyte antigen) class I and II transplantation antigens and novel HLA and non‐HLA genes, involved in antigen processing and presentation to T cells. Parallel technological developments in HLA DNA typing in the clinical laboratory have resulted in a more precise awareness of the role of HLA matching for the classical HLA antigens in bone marrow and solid organ transplantation, while alternative strategies and techniques for donor selection are currently under evaluation. This review offers a current perspective on the genetics, structure and function of the HLA system, its relevance to clinical transplantation and future prospects for improvements in donor select

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110006.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe evaluated a new glucose‐free citrate‐acetate‐NaCl platelet additive solution (PAS 2). In series I, platelet concentrates (PC) were prepared by apheresis and subsequently stored either in plasma (n =16) or in PAS 2 (n =15). In series II, PCs were prepared from pools of four buffy coats (BC) and stored in plasma (n =12) or in PAS 2 (n =11). By means of ultrastructural morphometry, the volume fractions of α‐granules, the open canalicular system (OCS) and the fraction of storage granules secreted into the OCS were analyzed during storage for up to 8 days. Additionally, we determined pH, glucose, lactate, pCO2, HCO3–, lactate dehydrogenase and platelet factor 4. Apheresis platelets stored in plasma showed no changes in their contents of α‐granules and in the fractions of the OCS. In contrast, apheresis platelets stored in PAS 2 displayed a decrease of their relative volume fraction of α‐granules from 9.1±1% on day 1 to 3.7±0.9% on day 5. The fraction of the OCS increased from 7.4±0.8% on day 1 to 17.1±1.4% on day 3. On day 8, 93±9% of all platelets were lysed. Levels of glucose were significantly lower in these preparations and after day 3 glucose consumption decreased to zero. Among PC derived from pooled BC, differences between storage in PAS 2 or plasma were less striking. Only the fraction of α‐granules secreted into the OCS was significantly greater in BC derived PC stored in PAS 2 on all days. These PCs stored in PAS 2 had a higher plasma carryover (30%) in comparison to apheresis PC stored in PAS 2 (10%). We conclude that plasma is superior to PAS 2 for storage of both apheresis and buffy coat platelets. For preservation of the structural integrity of platelets, the use of PAS 2 requires a minimum

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110013.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe transmission of viral infections through the use of products derived from blood has emphasised the need for adequate validation of the production process, testing of materials used in production and quality control tests on the final product. Since the late 1980s, as part of its batch release procedures, NIBSC has tested for markers of viral infectivity plasma pools used in production of blood products used in the UK. As a result of testing over 9,000 pools, NIBSC has identified 9 pools contaminated with HBsAg and 2 pools containing antibodies to HIV‐1. Since routine screening of plasma pools for anti‐HCV was introduced in 1993, 8 pools out of the 4,000 tested have been found to contain antibodies to HCV. In addition, the release of 12 batches of blood products was withheld and it is known that further batches of material produced from the positive pools were not submitted for batch release. Studies involving assays of dilutions of known positive plasma samples indicated that there is considerable variation in the endpoint dilutions of antigen or antibody detected by test kits from different manufacturers. The selection and validation of the kits used in such testing is therefore important. The usefulness of standardised low‐level external controls in assays of plasma pools for markers of viral infection is disc

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110021.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe report herein the case of a 54‐year‐old woman with a moderate bleeding tendency, diagnosed as an EDTA‐dependent pseudothrombocytopenia associated with a congenital platelet release defect. The patient, at the age of 12, had a misleading diagnosis of idiopathic thrombocytopenic purpura and all the recurrent bleeding problems she had during her life were referred to that disease. The recent correct diagnosis of a false thrombocytopenia stimulated further laboratory investigation on the cause of the patient's bleeding tendency with the consequent identification of a congenital platelet deficiency of the arachidonic acid pathway. This finding is of relevant importance for the management of the patient in case of elective surgery or hemorrhagic emer

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110027.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe mechanism whereby passive Rh (D) immunoglobulins suppress the feto‐maternal alloimmunization is still unclear. New in vitro tests are needed to better characterize the functional properties of polyclonal anti‐Ds. The DAF assay was developped to monitor the antibody‐dependent cell‐mediated cytotoxicity (ADCC) and the phagocytosis of anti‐Rh (D)‐sensitized RBCs by effector cells. The principle of this test is based on the oxydization of the 2,7‐diaminofluorene (DAF) by the pseudoperoxidase activity of free hemoglobin. The reaction is proportional to the hemoglobin concentration. This test was performed to determine and emphasize the efficacy of different polyclonal anti‐D immunoglobulin preparations to mediate lysis and phagocytosis of sensitized RBCs by human peripheral mononuclear cells. The functional properties of different human RhD monoclonal antibodies were also analyzed and compared. The test was found to be convenient to perform and allowed the avoidance of radioactive labelling of RBCs for ADCC studies. It is mainly useful for the direct quantitation

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110030.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractSolid‐phase systems are very sensitive for detection of erythrocyte alloantibodies in serum and suitable for large scale donor screening. Serum samples of 10,008 blood donors were screened by three solid‐phase tests (Capture R Ready Screen, Solidscreen II, and Solidscreen II‐Donor) with pooled red cells derived from two donors. The prevalence of antierythrocyte IgG and IgM antibodies in donor sera was 0.56% (IgG antibodies: 0.42%). The test efficiency for IgG antibodies was 1.40 with Capture R Ready Screen (test sensitivity 97.6%, test specificity 99.39%), 1.78 with Solidscreen II (95.1, 99.88%), and 1.95 with Solidscreen II‐Donor (92.7, 99.98%). The IgG antibody titers differed significantly between all tests including a gel matrix test: Capture R>ID‐Gel>Solidscreen II>Solidscreen II‐Donor. Previously characterized antibodies that were not detected after long‐term follow‐up by any of the three solid‐phase tests had a prevalence of 0.10%. All three solid‐phase tests detected the alloantibodies, which were of higher titers and considered clinically relevant in blood components. The significant difference in antibody titers between the tests was not matched by a similar variance in the detection of donors with antibodies. Even with sensitive solid‐phase tests, many antibodies may not be detected afte

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110037.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA multilaboratory investigation has identified a new low‐incidence antigen ‘VLAN’ on the red cells of a blood donor. The VLAN antigen is destroyed by 2‐aminoethylisothiouronium bromide treatment of the donor's red cells suggesting an association with the Kell system. Monoclonal antibody‐specific immobilization of erythrocyte antigen analysis with anti‐VLAN and with several mouse monoclonal antibodies directed at epitopes on the Kell glycoprotein gave positive results, indicating that the VLAN antigen is located on the Kell glycoprotein. The VLAN red blood cells have the common Kell phenotype: KEL:–1,2,–3,4,5,–6,7,–10,11,12,13,14,–17,18,19,–21,22,–23,–24. Additional serologic data indicate that the VLAN antigen is not part of any other ISBT blood group system, collection or series. A family study showed that the VLAN antigen is inherited since the red cells of two sisters and one niece of the propositus are also VLAN+. The ISBT Working Party on Terminology for Red Cell Surface Antigens has assigned VLAN to the Kell blood group system as KEL25 (number fo

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110043.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe Cromer blood group system consists of 7 high incidence and 3 low incidence antigens that are carried on the complement regulatory glycoprotein called decay‐accelerating factor (DAF; CD55). Despite laboratory results that would predict clinical significance, antibodies with specificities in the Cromer blood group system have not been reported to cause hemolytic disease of the newborn. It is possible that strong expression of DAF on the apical surface of antigen‐positive fetally derived placental trophoblasts may absorb maternal antibodies that are directed to antigens in the Cromer blood group system. We studied two cases where strongly reactive anti‐Craand anti‐Drabecame undetectable during second and third trimesters of preg

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110048.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1046/j.1423-0410.1996.7110051.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY