摘要:

Abstract.The Transfusion Safety Study monitored susceptible persons for human immunodeficiency virus type 1 (HIV‐1) infections transmitted by plasma products and blood components. Through December, 1988, 6 subjects without antibody to HIV‐1 (anti‐HIV‐1) became seropositive after receiving dry‐heated factor VIII concentrate. The preparations implicated in 3 cases were derived entirely from anti‐HIV‐1‐screened donors. In all instances, HIV‐1 infection could be explained by concentrates heated at 60 °C for 24–30 h. Limiting consideration to concentrates and components administered after study entry showed that 4 of the seroconversions occurred among 122 subjects given 10 million units of factor VIII concentrates. No seroconversions occurred among 84 subjects given 5 million units of factor IX concentrates, or 83 who received components from over 26,000 unpaid donations. Serologic surveillance of anti‐HIV‐1‐negative subjects provides important information, and should be routine in the management of persons receiving cl

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00846.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Previous studies with CPDA‐1 and Nutricel preserving solutions indicated that red cell properties were affected by small differences in storage temperature. The influence of a 3°C differential on the preservation of the in vitro properties of ADSOL‐preserved (AS‐1) red blood cells was investigated in a paired study. AS‐1 red blood cells were stored at 2.5 and 5.5°C for 42 days. Extent of hemolysis, glucose consumption and pH levels were comparable at the two storage temperatures. Lactate levels were slightly, but significantly higher at 5.5°C. ATP levels were slightly but significantly higher at 2.5°C, only during the later part of the storage period. 2.3‐DPG levels were slightly better retained at 2.5°C after 7 days of storage. Holding units of whole blood for either 1 or 8h at ambient temperature after phlebotomy prior to processing did not influence the types of temperature‐dependent changes. The differences as a function of storage temperature were small and appear to be of no practical importance in connection with the storage of AS

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00847.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A new method for the preparation of platelet concentrates (PCs) is described. The source material is buffy coat (BC), prepared after keeping standard CPD whole‐blood units at room temperature for 6–12 h, followed by centrifugation at 3,500 rpm for 10 min (first series) or 4,000 rpm for 12.5 min (second series). BC, separated from plasma and red cells, was kept at room temperature for a further 8–12 h without agitation. Pools of 6 (first series) and 4 (second series) BCs were prepared using a sterile docking device and suspended in a platelet‐additive solution (PAS) containing sodium/potassium chloride, citrate, phosphate, and mannitol. After gentle centrifugation, the platelet‐rich supernatant was expressed to and stored in one (first series) or two (second series) 1‐liter polyolefine (PL‐732) containers. In the first series, the total number of platelets was 316 ± 59 times 109per PC (yield 65%). However, when the method was applied at a routine scale, the yield varied considerably and was shown to be strongly dependent on the hematocrit of the BCs. A number of steps were taken to standardize the technique which resulted in an improved yield (77.3 ± 8.7%) with 316 ± 52 times 109platelets (mean ±SD, range 203–490, n = 134), obtained from 4 BC pools and lower leukocyte contamination than before, 18 ±17 times 106per preparation (range 1–73, microscopic counting, n = 38). The storage medium consisted of a mixture of plasma and PAS. Standardization of the hematocrit and volume of the BCs is essential, both for improvement of the yield and for providing a sufficient amount of glucose and bicarbonate to the platelets throughout storage. The method is particularly suitable in combination with automated techniques for blood component preparation which include BC removal. Blood gases, pH and adenosine triphosphate were maintained at satisfactory levels; the release of platelet factor 4 and lactate dehydrogenase was not different from traditional PC preparation and storage. However, the content of glucose was exhausted in many PC units towards the end of a storage of 6 days. When whole blood and BC are stored for such a long period, and when the gas permeability of their containers is poor, it is important, in order to avoid early loss of swirling, that the surface‐to‐volume ratio and the gas permeability of the PC containers is sufficiently large

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00848.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.We have studied the metabolism of plateletsin vitrousing washed platelets. Oxygen uptake and fuel utilization were measured. It was found that glucose is never oxidized to any significant extent and is always converted to lactate, regardless of oxygen availability. Oxidative metabolism fuels 70–100% of the ATP turnover, and oxygen uptake is the same whether the platelet is consuming glucose, acetate or only an unidentified endogenous fuel. When acetate is the added fuel, no endogenous fuel is oxidized, whereas the addition of glucose results in sparing of only 8% of endogenous fuel. Preliminary storage experiments using plasma‐free media show that an acetate‐containing buffered salt solution provided excellent storage conditions and that a medium without any exogenous fuel is better than one containing glucose. Thus we conclude that a successful storage medium should contain minimal amounts of glucose, and an oxidizable fuel such as acetate, in order to supplement the endogenou

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00849.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.We provide a detailed description of a new method for counting very low numbers of leukocytes present in platelet products. The method uses fluorescent staining of leukocyte DNA using propidium iodide and flow cytometry. The assay is accurate over a range of leukocyte concentrations from 0.1 to 10 WBC/μl. We validated the method using specially designed dilution studies and applied it to the measurement of leukocyte content in leukocyte‐depleted platelet products prepared by apheresis or filtration. This method should prove useful in studies which address the clinical impact of leukocyte‐depleted platelet prod

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00850.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In a 2‐year study of false‐positive anti‐HIV‐1 tests in blood donors at Manchester and Lancaster Blood Banks, the reactions associated with a HIV‐infected cell lysate antigen were compared with those using recombinant‐antigen‐based tests. In year 1 (cell lysate test) at Manchester BTS 0.21% of 119,178 donations were repeatedly reactive, compared with 0.53% of 119,004 donations in year 2 (recombinant antigen). Reactive sera were tested at Manchester PHL by three different immunoassays. Referred specimens were classified as anti‐HIV positive (95–100% reactive in all the assays), equivocal or negative (negative results in all three immunoassays). Two donors were confirmed to be anti‐HIV positive over the 2‐year period. Most sera were negative by confirmatory immunoassays in years 1 and 2. In year 1, a study of 60 referred sera with sex‐ and age‐matched controls showed high correlation between a reactive anti‐HIV‐1 screening test and indeterminate anti‐HIV‐1 patterns on Western blot showing reactions with HIV gag‐coded proteins. In year 2, less than 10% of referred sera were reactive by Western blot, and there was no correlation between a reactive screening anti‐HIV test, the strength of signal in the test or a reactive Western blot. Follow‐up showed that donors whose sera were reactive in years 1 and 2 by the anti‐HIV‐1 screening test formed almost two different populations. Four donors with equivocal anti‐HIV‐1 confirmatory tests had anti‐HIV ‘envelope’ reactions. The follow‐up of donors with equivocal confirmatory immunoassays on Western blot failed to show an increase in the strength of immunoassay reaction or Western blot reaction, with the possible exception of 1 donor with an anti‐HIV‐p24 reaction by Western blot. Most confirmatory testing can be done using immunoassays. The significanc

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00851.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A stringent procedure for the diagnosis of human T‐lymphotropic virus (HTLV) infection was applied to 1,732 volunteer blood donors, 401 patients with various hematological disorders and 78 individuals at high risk for HIV infection. It consisted of a viral lysate‐based screening assay (Abbott Laboratories, North Chicago, Ill., USA), and two confirmatory assays (Western blot and radioimmunoprecipitation assay). A confirmed positive sample had to react with at least two different HTLV gene products. Evidence of HTLV infection was not found in either blood donors or patients with hematological disorders. In fact, HTLV infection was only observed in 10 intravenous drug abusers or their sexual partners. Contrary to previous reports that claimed HTLV seroprevalences of between 0.3 and 8% in blood donors from Apulia (Italy), our data suggest that infection with this virus is principally restricted to intravenous drug abus

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00852.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.A group B recipient of a group 0 kidney developed severe intravascular haemolysis due to the formation of anti‐B. Immunoglobulin allotyping of donor serum, recipient serum and ‘unexpected’ anti‐B antibody showed the antibody to be of donor origin. The patient and donor genotypes were Gm 3;5/3;5 and Gm 1,2;21/1;21, respectively, and the anti‐B antibody allotype was Gm 1;21. The group B recipient of the other donor kidney showed no evidence of haemolysis. Possible factors influencing the occurrence and severity of post‐transplantation haemolysis are discussed. The production of anti‐A or anti‐B antibodies in non‐group 0 patients who receive group 0 organ transplants is well described [1–8]. We report a case of severe intravascular haemolysis in a group B patient who received a group 0 kidney, together with immunoglobulin allotyping studies which show conclusively that the antibody responsible for the haemolysis

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00853.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The influence of anti‐Rh(D) IgG subclasses on the severity of hemolytic disease of the newborn was examined in 98 pregnancies. Disease was severe in 19 of 32 cases in which only IgG1 was detected, 40 of 63 cases in which IgG1 and IgG3 were found and 0 of 3 cases in which only IgG3 was detected. When both IgG1 and IgG3 anti‐D were present, hemolytic disease was more severe than when IgG1 alone was detected. The earliest onset of hydrops was at 20 weeks gestation in the IgG1+IgG3 anti‐Rh group, and at 27 weeks gestation in the IgG1

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00854.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Between January 1987 and March 1989, 22 fetuses with severe hemolytic disease were treated with 64 ultrasound‐guided intrauterine intravascular transfusions. Eighteen infants survived and are doing well. In 12 fetuses, hydropic changes were present at the first transfusion; 9 of these survived. In 8 of the 10 fetuses with a gestational age<26 weeks, intrauterine treatment was successfu

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb00855.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY