摘要:

Summary.A retrospective study was carried out to ascertain the blood bank provision required to support a liver transplant programme and to assess the effect of intraoperative aprotinin on blood product requirements in liver transplant recipients with cirrhosis. Sixty patients with end‐stage liver disease underwent 62 consecutive orthotopic liver transplants between October 1988 and January 1991. The total and intraoperative requirements of red cells, platelets and fresh frozen plasma (FFP) were analysed for three groups of liver transplant recipients, those without cirrhosis (n= 15), those with cirrhosis (n= 25) and those with cirrhosis who received intraoperative aprotinin (n= 20). Fifteen without cirrhosis had mean total requirements of 15 units of red cells, 18 units of platelets and 16 units of FFP. Twenty patients with cirrhosis who received intraoperative aprotinin had broadly similar requirements. However, blood product requirements for 25 patients with cirrhosis were significantly greater (46 units of red cells, 41 units of platelets, 43 units of FFP, excluding the seven patients with primary biliary cirrhosis). We conclude that a liver transplant programme can be supported by a teaching hospital blood bank. The use of intraoperative aprotinin significantly reduces blood product requirement

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00046.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.The requirement of donor platelets for fuels, plasma and calcium were studied using platelets washed, filtered to remove leucocytes and resuspended in a new glucose‐free minimal platelet storage medium with low citrate (3 mmol/1), low buffer capacity and no calcium. This is the first study of platelets stored without plasma, glucose or calcium and it was shown that platelets continued to aggregate with collagen plus adrenaline for 48 h and showed only a 50% fall in ‘swirl index’, an objective morphology score, after 3 days, showing that by these criteria human platelets do not require glucose. Sodium acetate extended the storage time by between 2 and 4 days, depending on the index parameter. This is the first evidence showing that failure of platelets in these conditions is at least partly due to exhaustion of fuel, and the first evidence that acetate prolongsin vitrosurvival. As little as 10% low‐glucose plasma extended the storage time, but it was no better than acetate. New observations using this system included a very rapid fall in pH during resuspension of the washed platelet pellet, a rising pH in the absence of added fuel and an increased pH with added

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00047.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.The amount of membrane‐associated glycoprotein Ib in platelet concentrates (PCs) irradiated with a high dose of UVB light has been shown to be significantly reduced after 48 h storage. We recently corroborated this finding when we noted an increase in the supernatant levels of glycocalicin (GC, a major segment of glycoprotein Ib) in UVB‐treated PCs during storage. The aim of the present study was to determine whether GC release was related to both the UV dose and the rate of dose delivery. Plateletpheresis concentrates obtained from five donors were pooled and split into five equal parts. Four of these were treated with 7500 and 15000 mJ/cm2UVB using two prototype UV sources with differing rates of dose delivery; namely, Baxter (BAT) and British Aerospace (BAC) cabinets, with the latter having the slower rate of delivery. On days 1 and 5 of storage, GC levels in the supernatants of PCs were determined by ELISA. Moreover, the following parameters were also assessed: platelet and WBC count; hypotonic shock response (HSR) and platelet aggregation response to ADP, ADP +collagen, ADP + arachidonic acid and ristocetin; pH; supernatant levels of lactate, glucose, von Willebrand factor (vWf) and β‐thrornboglobulin (βTG). The results revealed an association of GC release with UVB dose using both UV sources, although this was more apparent in the BAC system, in which glycocalicin release at day 5 of storage was as follows (μg/ml, mean ± SD): 4·8±0·3 and 9·5±3·6 at 7500 and 15000 mJ/cm2respectively. Moreover, at 15000 mJ/cm2, PCs treated in the BAC system exhibited significantly higher levels of GC than those treated in the BAT system: 9·5±3·6 and 4·8± 3·6 respectively at day 5 of storage (P= 0·05). This differential GC increase in the BAC was coupled with a decrease in HSR and a significant increase in lactate and βTG levels compared with the BAT system. In contrast to the GC results, vWf supernatant levels in PCs treated with UVB were decreased relative to non‐treated PCs of the same origin. Moreover, GC release correlated significantly with various standard tests of platelet function indicating its importance as a quality indicator for the investigation of the platelet storage lesion. Our results show that UVB not only increases GC release in a dose/rate‐dependent manner but that it may also affect the quality of irradiat

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00048.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.Three antibody‐containing samples (anti‐Fyaanti‐S and anti‐Jka), each at two dilutions, were distributed to U.K. hospitals and transfusion centres together with an antibody screening panel comprising red cells homozygous for the corresponding antigens. Participants in the study subjected the samples to their routine antibody screening procedures using both their own antibody screening panels and the screening panel provided.A within‐group comparison of those participants using their own screening panels having a heterozygous expression of the antigens, with the same participants when using the screening panel provided, showed for five of the samples a greater detection rate in routine antibody screening procedures when using the panel provided, having homozygous expression of the corresponding antigens. The sixth sample, the most potent, was detected equally using both panels. The difference in overall detection rate is statistically significant (chi‐square test, 2p0.001).The study shows that the use of red cells presumptively homozygous for Fya, S and Jkaimproved the detection of the corresponding

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00049.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.A new low‐frequency red cell antigen, ERIK (MNS37), is associated with the Staantigen of the MNS system. Four ERIK + propositi have been identified: all are St(a+). Thirteen other St(a+) samples, including one of the Mztype, and over 200 St(a‐) samples were ERIK‐. In two of the propositi ERIK is associated with an abnormal trypsin‐resistant M antigen; in the others it is associated with N, which is shown to be expressed weakly in one family. Immunoblotting with an antibody to an epitope common to glycophorin A (GPA) and glycophorin B (GPB) gave identical results with St(a+) EiRIK + and St(a+) ERIK‐cells, revealing GPA, GPB, an abnormal structure GPStaaggregates of these components. In the propositi with trypsin‐resistant M, GPStacarries the unusual M antigen, whereas in the M ‐ N + ERIK+ individual analysed by immunoblotting GPStacarries N. Immunoblotting with anti‐Staanti‐ERIK showed that Stais located on GPStabut that ERIK is located on GPA, presumably the GPA molecule encoded bythe GYPAgene contiguous to the ge

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00050.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.Monoclonal antibodies BRIC 18, BRIC 68, BRIC 107 and BRIC 203 recognize high‐frequency epitopes absent from erythrocytes expressing the Kophenotype. BRIC 107 has anti‐k (K2)‐like specificity. BRIC 203 has a unique specificity denoted anti‐Kpbc. All four monoclonal antibodies identify anMr, 95 600 erythrocyte membrane protein by immunoprecipitation from radio‐iodinated erythrocytes. In quantitative binding studies using IgG it is estimated that there are from 2000 (BRIC 18) to 4000 (BRIC 68) copies of the Kell glycoprotein per erythrocyte. Using Fab fragments the estimates are in the range 4000 (BRIC 18) to 18 000 (BRIC 68) copies. In competitive binding assays the four epitopes defined by the BRIC monoclonal antibodies fall into two non‐overlapping groups. The first group comprises BRIC 18, BRIC 68, BRIC 203 and an antibody (6–22) with anti‐K14 specificity. The second group contains BRIC 107 and two further anti‐k‐like monoclonal antibodies (BS45 and OSK5). The results suggest that the polymorphisms encoded at theK/kandKpa/Kpb/Kpcloci may be located in two spatially distinct regions of the K

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00051.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.A batch of an anti‐D preparation, reference 91/608, has been prepared for the preparation of red cells weakly sensitized with IgG that can reveal inhibition of the antiglobulin test by one volume of human serum, diluted 1:1000. The preparation provides an objective assessment of red cell washer efficacy and the confidential, in‐house assessment of operator variability in detecting weak but definite macroscopic agglutination by blind, replicate tests.Red cell washer efficacy and poor operator reading procedures causing disruption of weak agglutination are two major causes of false‐negative antiglobulin tests; neither are adequately detected by the common quality‐control procedure of adding strongly IgG‐sensitized red cells (‘Coombs control cells’) to apparently negative antiglobulin tests. However, weakly IgG‐sensitized red cells do offer a valuable control function that can detect some degree of cell washer inefficiency and reading errors although such cells are not a substitute for the more sensitive replicate testing.Test protocols are provided to assess the efficacy of cell washing machines and operator skills in the detection of weak but definite macroscopi

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00052.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.We retrospectively examined the antibodies to p22, a hepatitis C virus (HCV) nucleocapsid protein, and to c100‐3, a HCV nonstructural protein, in donors whose blood was transfused to patients who later developed post‐transfusion non‐A, non‐B hepatitis. Of 13 such blood donors, three seroconverted and three seroreverted with the anti‐c100‐3 test. In contrast, 12 of the 13 blood donors showed the same results at transfusion and follow‐up, and one donor showed seroconversion with the anti‐p22assay. The follow‐up study shows that the anti‐p22antibody test provides consistent results and is far more suitable for screening blood than t

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00053.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.The agreement between human platelet antigen‐1 typing with polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) and typing with a serological ELISA method was evaluated. A total of 82 individuals were typed and an absolute correlation was found between the two typing methods. The PCR‐RFLP typing method could be clinically useful in a number of immunologically mediated platelet disorders, characterized by severe thrombocytopenia and in early prenatal diagnosis of neonatal alloimmune thrombocytopenia, in which serological methods are difficult to apply because of their dependency on access to platelets and access to well‐characterized anti‐HPA

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00054.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary.To detect human granulocyte‐reactive antibodies, a glycoprotein‐specific enzyme immunoassay for platelet antibodies was adapted for the use of granulocytes as target cells. Peripheral blood granulocytes were simultaneously incubated with a monoclonal antibody (mAb) and the serum to be investigated. After solubilization, aliquots of the cell lysate were transferred to plastic tubes coated with goat anti‐mouse antibodies. Following immobilization of the trimolecular (mAb‐glycoprotein‐human antibody) complex it was detected by addition of enzyme‐labelled goat anti‐human antibodies using a luminescence technique. This assay allowed identification of different granulocyte‐reactive antibodies present in the same sample without the need for complicated absorption studies. Alloantibodies against HLA and the granulocyte‐specific NA antigens as well as isoantibodies against the Fc‐gamma‐receptor III (FcRIII) were detectable using mAb‐specific immobilization of granulocyte antigens (MAIGA). Binding of autoantibodies to the FcRIII and to the CD 11b/CD 18

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1993.tb00055.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY