摘要:

Abstract.Neonatal and antenatal alloimmune thrombocytopenia is induced by maternal antibodies against platelet‐specific fetal antigens. This disease is rare but potentially severe because of intracranial bleedings which may occur during pregnancy or around birth. In the last decade our knowledge of this disorder has markedly advanced. New techniques are used in platelet immunology. New platelet antigens involved in these perinatal thrombocytope‐nias have recently been discovered. A group of women likely to produce the responsible platelet antibodies has been genetically defined as regards the PLA1 antigen. The quality of the sonographies and the possibility of performing cord vein puncture in early pregnancy afford a new approach in the management of perinatal alloimmune thrombo‐cytopenias. But more must be done to prevent the complications of this di

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04697.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.A human solvent‐detergent (SD)‐treated factor IX concentrate has been produced from cryoprecipitate‐poor plasma using DEAE‐Sepharose CL‐6B and heparin‐Sepharose CL‐6B chromatography. The DEAE eluate was incubated with an SD mixture [0.3% tri(n‐butyl) phosphate‐1% Tween 80, 6‐h at 24°C] which was found to inactivate, in less than 1 h, more than 3.8 logio of vesicular stomatitis virus and more than 4.8 logio of Sindbis virus; the SD was removed by a subsequent heparin adsorption step. The specific activity of the concentrate was 10.9 ± 1.3 IU factor IX: c/mg protein (n= 15). The factor IX coagulant to antigen ratio was 0.7 ± 0.1. The concentrate was essentially free of factors II, VII and X, and protein C. The usual major contaminants of prothrombin complex concentrate (PCC) were absent: the concentrate contained about 94% alpha‐1 proteins, and only 4 major proteins were resolved by SDS‐PAGE (respective apparent molecular weight: 130, 86, 76 and 69 kilodaltons), and by crossed immunoelectro‐phoresis against an anti‐PCC serum. The nonactivated partial thromboplastin time was equivalent to that of PCC; the product was devoid of factor IXa, of other activated procoagulant factors and of coagulant‐active phospholipids (removed with SD in the heparin breakthrough fraction). Animal studies using the Wessler test and acute‐toxicity test in rabbits revealed no adverse side effects. SD treatment could thus be used to inactivate viruses in factor IX concentrate and improve the safety of r

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04698.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.A new, automated technique for the preparation of blood components is described. A system of 3 or 4 integrally connected plastic containers (Optipac®) is handled by a new type of extractor (Optipress®). The container in which the blood is collected has an outlet at the top and another at the bottom. After normal centrifugation to obtain separation of the blood components, these are squeezed out from the top and bottom simultaneously under control of a photocell. The primary separation step results in three components: a leukocyte‐poor red‐cell suspension in SAGM medium, CPD plasma, and a buffy‐coat preparation. The system has been tested in two laboratories (lab A and lab B). A ‘heavy‐spin’ centrifugation to obtain a maximum yield of cell‐poor plasma gave the best removal of leukocytes from the red cells; the remaining leukocyte content was 0.46 ± 0.25 (lab A) and 0.5 ± 0.4 (lab B)x 109/red‐cell unit. Platelet concentrates can be prepared either the normal way via platelet‐rich plasma or from buffy coat. Red‐cell 24‐hour autologous posttransfusion survival using labeling with51Cr was 87.5 ± 4.1% (lab A) after 35 days, and 84.2 ± 4.2% (lab A) and 77.5 ± 1.5% (lab B) after 42 days. Red‐cell morphology and fluidity compared favorably to previous studies using the same additive solution in traditional plastic‐bag systems. The total adenine nucleotide concentration was maintained normal for 42 days. Storage hemolysis after 6 weeks was slightly higher after a heavy spin, 0.52 ± 0.19% (lab A) and 0.23 ± 0.10% (lab B), than after a light spin, 0.31 ± 0.15 and 0.20 ± 0.09%, respectively. The formation of fibrinopeptide A was very low during the first 2 weeks and then increased to 15 ± 15 nmol/1 after a heavy spin and to 33 ± 11 nmol/1 after a light spin. Kallikrein and spontaneous proteolytic activity increased from day 14 on in the light‐spun units but not in the heavy‐spun ones. Clinical studies were made in two hospitals. A total of 1,492 transfused blood components prepared with the new system were compared with 1,169 components prepared with a traditional four‐container system for making buffy‐coat poor red‐cell suspensions. No unexpected transfusion reactions occurred. The frequency of febrile reactions was 3/516 (new method) and 2/466 (controls) in a group of patients with predominantly myeloproliferative diseases. The system appears to be a significant improvement for automa

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04699.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Platelet concentrates, irradiated with 15 Gy and stored for 5 days at room temperature under standardized conditions, were evaluated by in vitro tests and electron microscopy, in a paired study with nonirradiated platelets from the same concentrates, to investigate their usefulness for transfusion. The results showed no significant differences between the two groups in pH, pO2, PCO2, in vitro platelet aggregation, LDH, β‐thromboglobulin and thromboxane‐B2. Examination by electron microscopy showed a higher degree of degranulation in the 5‐day‐old platelets but no certain difference between irradiated versus nonirradiated platelets. On the basis of satisfactory in vitro storage properties, platelet concentrates can be stored for 5 days in PL‐1240 bags after irradiation. However, we recommend irradiation just before transfusion wheneve

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04700.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.Seventeen human monoclonal IgGl‐ or IgG3 anti‐D‐secreting clones have been examined for their ability to sensitise O+red cells for Fc‐receptor‐mediated rosette formation with U937 cells. IgG3 but not IgGl anti‐D antibodies were able to mediate stable rosette formation with unstimulated U937 cells via interaction with the FcRI receptor. Decreasing FcRI density by incubating U937 cells with di‐butyryl cAMP almost completely abolished rosette formation, whilst increasing FcRI density by incubating U937 cells with interferon‐γ increased the percentage of cells forming rosettes with IgG3‐ and IgGl‐sensitised red cells. These data suggest that rosette formation between IgG anti‐D‐sensitised red cells and FcRI‐expressing cells is dependent upon the density of IgG3 on the red cell surface, the density of FcRI on the effector cell, multiple FcRI/IgG interactions are required for stable rosette formation and that more FcRI/IgGl than FcRI/IgG3

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04701.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.For 18 months in this laboratory the manual polybrene technique (MP) has been used as the only crossmatching procedure preceded or accompanied by an antibody screen comprising two‐stage papain and LISS antiglobulin techniques. There were 17,161 requests representing 43,006 blood units crossmatched and 20,841 units transfused. Non‐specific reactivity with the MP required use of an antiglobulin crossmatch in approximately 0.2% of patient samples. Heparin in excess of 20 IU/ml reduced polybrene aggregation of red cells necessitating an antiglobulin crossmatch for 2 patients. Of 288 antibodies detected 20 reacted exclusively by MP compared with 18 by the papain procedure. The data supported the use of MP as an alternative to enzymes in antibody screening protocols. The polybrene technique was found to be a superior abbreviated crossmatch compared with the immediate spin technique and was applicable to all patients including those with known antibod

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04702.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.A 3‐year‐old female receiving Pediazole (erythromycin ethylsuccinate and sulfisoxazole) for tonsillitis and otitis media developed severe hemolytic anemia. No serum drug‐dependent antibodies could be demonstrated with an in vitro ‘immune‐complex’ method using Pediazole, pure erythromycin ethylsuccinate or pure sulfisoxazole. However, a method using red cells coated with erythromycin base showed in vitro lysis of the erythromycin‐coated red cells. This is only the second case of immune hemolytic anemia associated with erythromycin and the first where in vitro drug‐dependent hemolysis w

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04703.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.The fourth example of human anti‐LKE was identified in the serum of an antenatal patient. Study of the red cells of the proband and her family confirmed the recessive inheritance of the LKE‐ phenotype. The blood groups of the family confirmed that Pkexpression is greater on cells from LKE‐ members than on those from LKE+ members. In this family, the expression of LKE varied with the P1phenotype. LKE‐ individuals occurred with an incidence of 0.0017 in the donor population of the Glasgow and West of Scotland

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04704.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Abstract.BOW is a ‘new’ low‐frequency red‐cell antigen, detected in 2 unrelated English blood donors, that is sensitive to α‐chymotrypsin and pronase. Anti‐BOW is present in many polyspecific reagents used to define low‐frequency antigens. Red‐cell groups of the proposita, R.B., and her family show that the BOW blood group segregates independently from the ABO, Rh, MNSs, P1and Kell blo

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04705.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1988.tb04706.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY