ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00209.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.Conventional treatment of beta thalassaemia major is based on regular blood transfusion from early childhood. Maximum effectiveness of transfusion therapy depends on the following. (1) Availability of safe blood. Donation programmes should aim at retaining repeat donors, who carry decreased risk of transmitting blood‐borne infections. Donors should be screened with laboratory tests performed to the highest possible standard of quality. Selection of safe donors can be improved by the adoption of questionnaires containing direct questions on risk factors for transfusion transmissible infections. (2) Use of good quality red blood cells, which should be leucodepleted, preferably by filtration, that can be carried out at the bedside. (3) Regular evaluation of blood transfusion indices, including mean level of haemoglobin maintained, annual blood requirement, daily haemoglobin fall, mean transfusion interval, transfusion reaction rate. This can be assisted by the use of a computerized patient record. (4) Maintenance of a permanent record of the patient's blood group genotype (including at least Rh, Kell, Kidd and Duffy systems) and any red cell antibodies that develop. This is mandatory to ensure optimal survival of transfused red cells. (5) Continuous monitoring of transfusion transmissible infections. (6) Vaccination against hepatitis B of all suitable patients. (7) Intensive iron chelation. This should be done by regular subcutaneous administration of desferoxamine B. Oral chelators, which are currently under laboratory and clinical evaluation, are not yet available for general us

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00210.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.Post‐transfusion hepatitis B remains a risk for recipients of hepatitis B surface antigen (HBsAg) screened blood. Anti‐hepatitis B core antibody (anti‐HBc) screening may help reduce this risk. To evaluate its usefulness, 9,238 East Anglian blood donors were screened for anti‐HBc. Those with isolated anti‐HBc were identified with two confirmatory anti‐HBc and anti‐HB surface antibody (anti‐HBs) assays. The prevalence of anti‐HBc reactions in screening and confirmatory assays was 1.29% and 0.35%, respectively. The level of reactivity was significantly higher when two anti‐HBc assays gave concordant results or, being concordant, were anti‐HBs positive. All isolated anti‐HBc‐positive units (0.04%) were negative for additional HBV markers including DNA tested with nested polymerase chain reaction (PCR).A 0.31% prevalence of past HBV infection was found in this population, all carrying both anti‐HBc and anti‐HBs antibody, most above the protective level (0.IU/ml).The proposed screening schemes would limit the number of deferred donors and discarded units and keep the testing time within the remit of routine blood banking practices for an additional cost of approximately £1 per unit. However, no evidence was found in this donor population to suggest that anti‐HBc screening would significantly reduce the incidence

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00211.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.Prevention of AIDS can only be achieved by a successful public awareness programme. This study was carried out to establish the level of awareness of AIDS and HIV infection through blood transfusion among Indian blood donors of various socioeconomic groups. A questionnaire consisting of 20 questions pertaining to various aspects of AIDS and HIV infection was circulated to 1012 voluntary blood donors. The responses were categorized as good, average and poor knowledge according to the number of correct responses. The majority of the donors were males (93.5%), married (69.7%) and belonged to the Hindu community. Of the donors, 44.4% were educated, 49.9% were highly educated and 5.8% were illiterate. Overall, only 205 (20.3%) showed good awareness of AIDS and the majority of these 168 (16.6%) were highly educated. Approximately 80% of our population did not have sufficient knowledge about AIDS or the danger of contracting as well as disseminating this disease in the community.One hundred and ninetyone (18.9%) donors were in the higher income group and only 13 of them showed good awareness. Most of the donors, 384 (38.0%), were government white collar workers and belonged to the middle income group. In this group 154 had good awareness.The majority of donors with good awareness (176 out of 205) preferred to receive HIVtested banked blood or blood from their own relatives during emergencies. None of the blood donors had any knowledge of autologous blood donations.This study showed that awareness of AIDS was not satisfactory in Indian society. More intensive public awareness campaigns by the Government with the help of Non‐Governmental Organizations is required in India to prevent an explosive AIDS situation in the near futur

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00212.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.A study was carried out on 1,028 voluntary blood donors to see how body mass index (BMI) correlated with the serum alanine amino transferase (ALT) activity. The mean ALT (U/1) values were 19.35, 27.63, 40.79 and 54.41 in the four BMI categories of ≤20, 20.1–25, 25.1–30 and>30, respectively. This study showed that the mean serum ALT level of obese subjects (BMI>30kg/m2), compared with the two categories of normal subjects (i.e. BMI ≤ 20 and BMI = 20.1–25 kg/m2), was increased by 2.8 and 1.96 times, respectively. Compared with the BMI group ≤ 20, there was a gradual per cent increase in the mean serum ALT in the three different BMI groups: 20.1–25 (+133%), 25.1–30 (+196%) and>30 kg/m2(+280%). This indicates the need to correct ALT values for BMI for blood donor screening, instead of using ac

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00213.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.Severe or life‐threatening anaphylactic reactions during blood transfusion to patients with anti‐IgA, though infrequent, can be avoided by transfusing blood products prepared from IgA deficient donors. This report describes the development and use a passive haemagglutination assay adapted for use on the Olympus PK7100 blood group analyser. Donor plasma samples identified as being presumptive IgA deficient were further screened by a manual passive haemagglutination inhibition technique and finally confirmed by means of a quantitative enzymelinked immunosorbent assay. Of 5723 donors tested simultaneously for IgA deficiency, blood grouping and red cell antibody screening, six (1 in 954) were confirmed as IgA deficient (i.e.<100ng/ml of IgA). The test is simple and cost effective and can be used to establish a database of IgA‐deficient d

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00214.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.The manual polybrene technique (MP) has been shown to be useful in pretransfusion testing as a rapid method capable of detecting a wide range of red cell antibodies. The clinical significance of alloantibodies reacting by the MP but not by an antiglobulin test (MP +/AGT‐) has not been determined.The monocyte monolayer assay (MMA) is an establishedin vitrotechnique for assessing the likely clinical significance of red cell antibodies. This was used to examine 21 MP +/AGT‐ alloantibodies and 41 alloantibodies reacting by a LISS antiglobulin method (LISS‐AGT).Two of the 21 MP +/AGT‐ antibodies (9.5%) produced positive results by the MMA compared with 26/41 (63.4%) of LISS‐AGT‐reactive antibodies. The incidence of positive reactivity of the latter antibodies in the MMA was similar between those that were reactive and nonreactive by the MP.These results suggest that antibodies reacting by MP and not by an antiglobulin test are less likely to be clinically

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00215.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.Allele‐specific PCR using sequence specific primers (PCR‐SSP) is a simple and reliable technique to detect point mutations in genes. We have developed a PCR‐SSP to enable the detection of a C‐T mutation at position 482 of the GPIb gene and a T‐G mutation at position 13962 in exon 26 of the GPIIb gene. These point mutations are at the basis of the HPA alloantigens 2a, 2b and 3a, 3b respectively. One primer of each primer set has a 3′ nucleotide complementary to the DNA sequence coding for one allele. PCR product is only produced when the corresponding DNA is present and thus the genotype is determined by the presence or absence of a band in agarose electrophoresis of PCR products. A second set of primers in the same reaction yields a product regardless of the HPA genotype to control the efficiency of the PCR amplification. The HPA‐2 and ‐3 genotypes determined in this way were in strict concordance with those established by conventional genotyping using PCR followed by restriction enzyme digestion (PCR‐ASRA). PCR‐SSP is a rapid and reliable technique that can be used for the determination of alleles which code for pl

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00216.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.An ion‐exchange chromatography purified factor VIII concentrate (Liberate) that had undergone a solvent—detergent viral inactivation treatment was compared with an intermediate‐purity concentrate (Z8), which was terminally heated at 80°C for 72 h, in 15 haemophilia A patients in a blinded crossover pharmacokinetic study. Both products achieved a peak level close to that predicted (100IU/dl for Liberate and 103IU/dl for Z8) and there were no significant differences in the recoveries achieved nor of any of the other pharmacokinetic parameters. We conclude that the pharmacokinetic properties of factor VIII: C, following solvent—detergent treatment and ion‐exchange chromatography, are equivalent to those of the lower purity terminally heat‐treated product (Z8), and it is therefore likely to be a clinically efficacious

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00217.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARY.The quality of platelet concentrates (PC) obtained with the blood cell separator OmnixTMwas investigated before and after in‐line filtration. PC were filtered 2h (protocol A) and 4h (protocol B) after the termination of apheresis. Platelet (PLT) yield after filtration was similar in both protocols (median 3.7 vs. 3.4 times 1011). Median white blood cell (WBC) contamination after leucocyte depletion was 0.07 times 106(range 0.02–3.27 times 106) in protocol A and 0.06 times 106(range 0.02–2.1 times 106) in protocol B. Glucose, lactate, lactate dehydrogenase, morphology score and pH value were not statistically different before and after filtration in both protocols. We conclude that in‐line filtration results in sufficient leucocyte depletion of the PC. The prefiltration storage time did not influence the studied parameters of product

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1995.tb00218.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY