摘要:

Abstract.Since 1982, when the World Federation of Hemophilia first published a document on the state of the art of hemophilia diagnosis and care, there have been lights and shadows in this field. Although the widespread infection of hemophiliacs with the human immunodeficiency virus (HIV) contaminating clotting factor concentrates is still a threatening and formidable shadow, the gloomy picture brought about by the AIDS epidemic is partially lightened by spectacular improvements in therapy and diagnosis. Carrier detection and first‐trimester prenatal diagnosis can now be performed accurately in most kindreds by analysis of DNA of the factor VIII or IX genes. An important step forward towards the elimination of the risk of blood‐borne infections transmitted by plasma products was recently made through the application of virucidal methods to clotting factor concentrates. Since HIV appears more vulnerable to such methods than the hepatitis viruses, currently available concentrates can be considered substantially free from the risk of transmitting HIV infection. Even though transmission of hepatitis is much reduced but not totally abolished, virucidal methods are continuously being improved, so that it can be foreseen that concentrates will become safer and safer. Finally, factor VIII produced by recombinant DNA technology is undergoing the first clinical trials in hemophiliacs. Hopefully, it will free from the risk of transmitting infections and will be available in sufficiently large amounts to meet the need of hemophiliacs worldwide.In 1982, the World Federation of Hemophilia published a message [1] on the status of diagnosis and treatment of hemophilia. Since then, hemophilia care has been complicated by widespread infection of hemophiliacs with human immunodeficiency virus (HIV). Improvements have been made since 1982 in (1) diagnosis, especially carrier detection and prenatal diagnosis, and (2) treatment, especially with the development of safer clotting factor concentra

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02016.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.The effect of rapid cooling to 20–24 °C of whole blood immediately after collection, using ‘cooling units' with butane‐1,4‐diol and prolonged storage up to 24 h at ambient temperature was investigated in the whole blood and the subsequently prepared plasma, buffy coat and buffy‐coat‐poor red cell concentrate (BC‐poor RCC) in saline‐adenine‐glucose‐mannitol (SAGM) solution. Factor VIII:C content of the plasma (n=10), after 24 h storage was 80± 3% of the initial value. In routine procedures factor VIII:C content in the plasma (n= 129 pools of 20 donor units plasma) was 0.77 ± 0.078 IU/ml, after storage of the whole blood for 16–20 h. In whole blood (n=10), the 2,3‐diphosphoglycerate (2,3‐DPG) content of the red cells decreased from 4.36 ± 0.55 to 1.47 ± 0.6 μmol/ml red cells after 24 h storage at 20–24°C. After storage of the BC‐poor RCC (n=10) at 2–6°C for 1 week, the 2,3‐DPG had dropped to 0.76 ± 0.46 μmol/ml red cells. During the first 24 h of storage of whole blood, the adenine triphosphate (ATP) levels of the red cells remained stable. A mean increase of 20% of the initial value was observed after addition of SAG M solution. In the BC‐poor RCC the ATP slowly decreased to 81 ± 5% after 5 weeks and to 68 ± 6.6% of the initial value after 6 weeks storage. In citrate‐phosphate‐dextrose blood the yield of platelets in the buffy coat was found to be 84 ± 6% (mean ± SD) of the original value when whole blood (n= 12) was stored for 16–20 h at 20–24 °C, as compared to 76 ± 18%, when buffy coats were prepared within 3 h after collection of whole blood without rapid cooling (n= 12). Rapid cooling of whole blood to 20–24 °C immediately after collection and subsequent storage of the whole blood up to 24 h contributes to the quality and standardization of the subsequently prepared bl

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02017.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.Intravenous immunoglobulin (IVIG) treatment was attempted as a novel therapeutic approach for unexplained recurrent spontaneous abortions (RSA) occurring in the first trimester of pregnancy. Twenty women with a history of RSA were treated with IVIG during pregnancy. Therapy was commenced at week 5 of gestation with 1 dose of 0.5–0.6 g IVIG/kg body weight. Infusions were repeated every 3 weeks (0.3–0.4 g/kg) and terminated by week 22 to 24. Of 20 women, 11 delivered healthy infants at term. 5 women are still pregnant, 3 in the third trimester. Only 3 patients suffered abortions and 1 presented with ectopic pregnancy. The overall success rate was 82–86%. Thus, the therapeutic effect of IVIG is comparable to that of the conventional transfusion/vaccination regimen with allogeneic leukocytes, but avoids the risk of transmission of infections and/or HLA immunization, has no major adverse effects and is applicable to ‘nonresp

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02018.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.A method for the heat treatment of human IgG solution at 60 °C for 10 h was established. Human immunodeficiency, mumps, vaccinia and 4 other viruses were added to the IgG solution in 33% sorbitol and heated at 60 °C. Those viruses were inactivated within 1 h. Heat‐treated intravenous IgG (IVIG‐H) was prepared by heat treatment and polyethylene glycol (PEG) fractionation. Conventional nonheated intravenous IgG (IVIG‐C) was prepared from the same source paste by the fractionation method. No physicochemical or biological difference was observed between the heated and control IVIG prepa

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02019.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.During a follow‐up period of 23–40 months, 7 regular blood donors had persistently, and 4 had intermittently indeterminate anti‐p24gagreactivity in human immunodeficiency virus (HIV)‐1 Western Blot. Serological testing and viral cultures revealed that these donors had no signs of infection for HIV‐1, HIV‐2, human T‐cell lymphotropic virus (HTLV)‐4, and HTLV‐1. Extensive interviewing and physical examination of these donors revealed neither risk factors, nor signs of HIV infection in the tested donors. Ten recipients, who were transfused with blood products from 6 of these 11 anti‐p24gag‐positive donors, were traced back. Six months after transfusion, no serological or clinical signs of HIV‐1, HIV‐2, or HTLV‐1 infection were observed in these patients. It is concluded that blood donors with persistent or intermittent anti‐p24gagreactivity in HIV‐1 Western Blot, without development of antibodies to other HIV‐encoded proteins in later blood samples, do not transmit the described re

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02020.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.Healthy blood donors, patients with adult T‐cell leukemia (ATL) and HTLV‐I‐associated myelopathy (HAM) and recipients of unscreened blood (SR) who had seroconverted and were followed‐up for more than 2 years were examined for HTLV‐1 antibodies of immunoglobulin G (IgG) and M(IgM) classes. The overall infection rate in donors was 4.9%, as determined by screening with a particle agglutination method (PA). The rate increased with increasing age. Positive sera with a low titer in the PA test (1/16, 1/32 and 1/64) contained IgM antibodies in 32.5% (titer 1/16) to 36.1% (titer 1/64) of the cases, but IgG antibodies were detected in only 5.6% of the sera with a titer of 1/16 and in 36.1% of the sera with a titer of 1/64. Conversely, in high titer sera (1/128 or higher) IgG antibodies were almost always detectable (99.0%) and IgM antibodies less frequently (25.5%). Sera from acute, chronic and pre‐ATL, HAM and SR patients contained IgG antibodies in high titer in all cases. The incidence of IgM antibodies was 7.7, 30.0, 53.3, 72.3, and 77.8%, respectively. IgM antibodies were demonstrated repeatedly in some cases who were followed up for a year. Only IgM antibodies from HAM patients occurred in high titers and had strong reactivity to the p24 antigens of HTLV‐I in Western blot testing. It is concluded that it is important to detect IgM antibodies not only in primary infections but also in persistent infecti

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02021.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.A non‐blow‐molded LE‐2 polyolefin (PO) container was developed to store single‐donor apheresis platelet concentrates (PCs) processed by the Haemonetics Plasma Collecting System (PCS) at 22°C for over 1 day. We molded PO containers with heat‐sealing of light‐weight polymer alloy films with a thickness of 0.25 mm. The film was made of polymer blends consisting of polypropylene, styrene ethylene butylene styrene‐block copolymer, and ehtylene ethylacrylate copolymer. The PO container with enough strength and flexibility in routine practice has 2 and 1.6 times higher oxygen and carbon dioxide gas transfer properties than standard polyvinyl chloride (PVC) plastic containers. PCs (1–1.9times1011platelets) processed from 450 ml platelet‐rich plasma were stored in 0.6‐liter PO containers at 22°C with flatbed agitation for up to 6 days. The pH of PCs was well maintained at the mean values of 7.0 in PO containers after 6 days in the well‐oxygenated condition. The energy metabolism of stored platelets was determined. Oxygen consumption rates of platelets stored in PO containers averaged 1.5 nmol/min/109platelets. The rates of glucose consumption and lactate production were 0.4 and 0.8 nmol/min/1011platelets, respectively. The rates of adenosine triphosphate (ATP) generation of platelets, 9.7 nmol/min/109platelets, in PO containers did not differ from those in the PVC containers. Aggregation responses to adenosine diphosphate and hypotonic shock response of platelets were better maintained in PO containers. The morphological changes into sphere forms with projections and the appearance of unclassified forms were more frequently observed in PO than in PVC containers. Single‐donor apheresis platelet products collected by the PCS system may be stored in a new 0.6‐liter PO container for over 5 days

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02022.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.IgG subclasses were determined in 138 A or B infants weighing over 2,500g, born to O mothers. Direct antiglobulin test (DAT) was positive in 43 infants and negative in 95 with anti‐A and/or anti‐B antibodies detected by heat elution test. In 59 out of 131 infants without ABO hemolytic disease (ABO‐HDN), no IgG subclass was detectable. In the 72 others, IgG1 was found in 29/72, IgG2 in 63/72, and IgG3 was not detected. In 7 infants with ABO‐HDN, DAT was positive in 4 and negative in 3. In conclusion, in DAT‐positive infants without HDN, IgG1 or IgG2 may be bound to erythrocytes, but the amount of IgG1 is too small to cause hemolysis. In DAT‐positive ABO‐HDN the amount of IgG1 is sufficient to cause hemolysis. In DAT‐negative ABO‐HDN, IgG3 is responsible for hemolysis, even though un

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02023.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.We report an instance of transfusion‐induced anti‐k so severe that three intrauterine intravascular fetal transfusions were required. The pretransfusion circulating hemoglobin level in the fetus was 60 g/l and hematocrit was 0.19. This, to our knowledge, is the first example of the rare alloantibody, anti‐k, producing erythroblastosis so severe that fetal transfusions were required in order to prevent hydrops fetalis from developing. Anti‐k alloimmunization, which in a period of 20 years and 8 months occurred only once in 3,246 alloimmunized pregnancies in Manitoba, can cause severe fetal disease. The k‐alloimmunized pregnant woman should be managed in the same manner as the D‐, c‐, or K‐alloimmunized

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02024.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract.Previous biochemical studies of HLA class I gene products were based on the use of radiolabelled lymphoblastoid cell lines and/or mitogen‐stimulated peripheral blood lymphocytes (PBL). We present here a nonradioactive methodology for defining HLA class I polymorphism on a small number of cells, such as 5times106lymphocytes, the vitality of which is not a requirement in contrast to radiolabelling techniques, where 1–2times106PBL are needed. We analyzed 54 serologically typed families with a total of 261 individuals and 214 haplotypes by one‐ dimensional isoelectric focusing and subsequent immunoblotting, using a polyclonal anti‐class I heavy chain serum. The banding patterns segregated within families and correlated with the serological results. A substantial number of HLA‐A and HLA‐B products appeared biochemically heterogeneous allowing the definition of subtypes and the calculation of their

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1989.tb02025.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY