ISSN:1660-3796    

DOI:10.1159/000222630

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

ISSN:1660-3796    

DOI:10.1159/000222631

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

Elektrolyt-Analysatoren verschiedener Hersteller mit ionenselektiven Elektroden (ISE) wurden daraufhin überprüft, ob die Konzentrationen an Natrium, Kalium und Kalzium in wäßrigen Lösungen dann mit ausreichender Genauigkeit bestimmt werden, wenn ein- oder mehrwertige anorganische und organische Anionen in physiologischer Konzentration vorliegen. Die Meßergebnisse zeigen übereinstimmend für alle Geräte mit ISE, daß Anionen wie Acetat, Citrat, Malat, Lactat, Phosphat und Sulfat in physiologischen oder therapeutischen Konzentrationen zu erheblichen Fehlern bei der Konzentrationsbestimmung von Natrium und Kalzium führen können. Es wird empfohlen, den Einsatz von ISE in Medien wie Infusionslösungen, Blutderivaten, Dialyseflüssigkeiten und Urin neu

ISSN:1660-3796    

DOI:10.1159/000222632

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

We report on the direct comparison of gel centrifugation technique and tube testing for antibody screening (ABS) under controlled routine conditions. 3,000 blood samples were screened for antibodies (AB) by gel centrifugation (ID-System®, bromelin 37 °C and room temperature, indirect antiglobulin test with LISS) and a sensitive tube test (TT; bromelin two-phase test, 37 °C and room temperature, and indirect antiglobulin test with 22 % bovine albumin) in parallel. By ID significantly more relevant and potentially hemolytic AB (51 vs. 35 AB 11.7 vs. 1.2 %) could be detected: anti-E 4, -C 1, -D 4, -Cw 2, -c 2, -Jk(a) 2, -Jk(b) 1. Eleven of these even remained negative in TT when retested with increased sensitivity and taking additional (homozygous) test cells. In addition, naturally occurring but rarely hemolytic AB (35 vs. 23 AB &slash; 1.2 vs. 0.8 %) were more frequently detectable by ID: anti-Le(a) 6, -Le(b) 2, -P1 6. In contrast, only two AB were only positive in TT: anti-Le(a) 1, -Le(a, b) 1. The main disadvantage of the ID was its frequent positivity (7.7 vs. 4.3 %) due to irrelevant cold AB (anti-I, -HI, -H) and unspecific factors. This can be partly reduced by omission of the bromelin test at room temperature (ID 3.0 %, TT 1.5 %) as the detection of relevant AB is not affected. The frequency of naturally occurring AB was still the same as in TT (0.7 %) when bromelin at room temperature was omitted in both techniques. Further advantages of the ID are simplicity, small volumes of sera and reagents, and easy evaluati

ISSN:1660-3796    

DOI:10.1159/000222633

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

In den letzten Jahren ist das Thema «lmmunsuppression nach Bluttransfusionen» immer häufiger Gegenstand von klinischen Studien gewesen. Die Ergebnisse dieser retrospektiven Untersuchungen erhärten die Vermutung, daß die Prognose einiger Tumorerkrankungen wie z.B. des Kolonkarzinoms von transfundiertem Blut negativ beeinflußt wird. Besonders Plasma steht im Verdacht, immunsuppressiv zu wirken. Wir untersuchten deshalb in vitro die Wirkung von Frischplasma (FP), gefrorenem Frischplasma (GFP) und Heparin-Plasma (HP) sowie von verschiedenen i.v.-Immunglobulinen (IVIG) auf die Mitogen(PHA, ConA, PWM)-induzierte Lymphozytentransformation sowie auf die Reaktivität in der gemischten Lymphozytenkultur. Des weiteren wurde die Beeinflussung der Phagozytoseaktivität von Monozyten durch Plasma und IVIG im Monozyten-Monolayer-Assay (MMA) untersucht. Zusammengefaßt erhielten wir folgende Ergebnisse: 1) FP und GFP hemmen hauptsächlich die T-Zellen sowohl nach PHA- als auch nach ConA-Induktion (p < 0,025). 2) HP stimuliert dagegen die PHA-induzierten T-Zellen. 3) Autologes und homologes FP oder GFP hemmen die Lymphozytentransformation in gleicher Weise, nur PHA-induzierte Lymphozyten werden durch autologes Plasma weniger stark supprimiert als durch homologes. 4) IVIG hemmt dosisabhängig die T-Zellen starker als die B-Zellen, wobei Unterschiede zwischen den verschiedenen Präparaten beobachtet wurden. 5) IVIG und FP wirken in den ersten 24 h nach Aktivierung der T-Zellen durch PHA. 6) FP, GFP, HP und IVIG verursachen eine starke Hemmung der monozytären Phagozytose (76-87%). Neben unspezifischen Mechanismen, teilweise verursacht durch Stabilisator bzw. Antikoagulanz (CPDA-1, CPD), die per se schon zu deutlicher Suppression der Lymphozytentransformation führten, ist in der Immunglobulin-Fraktion ein Plasmafaktor, der in vivo immunmodulieren-de Aktivität besitzt. Inwieweit als Immunmodulatoren dabei anti-idiotypische Anti-körper oder lösliches HLA-Antigen eine Rolle spielen, ist zur

ISSN:1660-3796    

DOI:10.1159/000222634

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

During LDL apheresis, various combinations of heparin and citrate are used for anticoagulation. With an in vitro batch system we examined whether heparin/citrate combinations can be optimized in terms of complement activation inhibition without the loss of anticoagulant potency. Plasma anticoagulated by using six clinically applicable regimens was incubated with anti-apo-B antibody-coupled Sepharose 4B CL, and the anaphylatoxin content of the supernatant was investigated. A significant dose-dependent reduction of complement activation was achieved by anticoagulating whole blood with 10 U/ml heparin (p < 0.05) if compared with serum, whereas citrate inhibited more effectively the generation of C5a (desarg) even at a low concentration (ACD-B 1:20) (p < 0.01). The lowest anaphylatoxin level was generated when heparin (10 U/ml) plus citrate (ACD-B 1:10) were applied, although such an approach may be of limited clinical interest. The empirically chosen heparin plus citrate ratio (2 U/ml, 1:20, respectively) provides for an optimal and almost ideal inhibition of complement activation and contributes considerably to the good tolerability of the immunadsorbent.

ISSN:1660-3796    

DOI:10.1159/000222635

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

As reported earlier, factors of the complement cascade get activated in CPD-A1-stabilized whole blood. As early as after 10 days of storage under normal blood bank conditions the elevations of the concentrations of C3a-desArg and C4a-des-Arg were highly significant. By contrast, the concentration of the C3 activator complex C4b2b remained unchanged even after 3 weeks of storage. Leukocyte depletion partially inhibited the activation of C4 but had no effect on C3a concentrations. Therefore, cleavage of C4 during storage of whole blood seems to be partially leukocyte-dependent, whereas the activation of C3 is possibly due to the activation of the alternate pathway of the complement system by contact of blood to plastic surfaces. Even though the radioimmunologically measured C3a might be inactive as an anaphylatoxin, these observations are of clinical importance since the inactivated C3a-desArg still possesses biological activities such as activation of platelets which may lead to hypercoagulability and thrombosis.

ISSN:1660-3796    

DOI:10.1159/000222636

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

The extent of anti-apo-B IgG-Sepharose-induced complement activation in serum and plasma (heparin 2 U/ml and ACD-B 1:20) was investigated using an in vitro model of LDL apheresis. The total volume of serum or plasma loaded to the chromatography column was collected in defined aliquots. The washing, desorption and regeneration fluids were processed in the same way. From the obtained values of generated complement split products C3a (desarg), C4a (desarg), C5a (desarg) and complement proteins C3, C4, C5, the conversion rates of the precursor were calculated. In the experiments with serum, 19% of C3, 8% of C4 and 2.3% of C5 were converted by the immunoadsorbent, whereas with plasma 7,6, and 0.6% respectively, were found. Furthermore, only 60-74% of total anaphylatoxins were found in the effluent during the loading process. The residual 26-40% was removed from the column with the subsequent washing fluids. Therefore, in the clinical routine, only a reduced part of generated anaphylatoxins will be retransfused to the patient. The fact that C5 is converted to the most limited extent to its biologically active fragment additionally contributes to the understanding of the good clinical tolerability of the LDL apheresis.

ISSN:1660-3796    

DOI:10.1159/000222637

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

Different platelet apheresis techniques were used for preparing platelet concentrates: the continuous flow method with Vivacell BT 798 DEA, the discontinuous flow method with V-50 of Haemonetics, and their plasmapheresis device PCS-Plus. 20 of our donors underwent all three procedures. All platelet separations led to suitable platelet concentrates of 3 × 1011 platelets within less than 90 min. However, the contaminating leukocytes reached 2 × 108. Due to less intense citrate reactions and a shorter donation time the donor acceptance of the continuous flow method was higher as compared with the discontinuous flow metho

ISSN:1660-3796    

DOI:10.1159/000222638

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger

摘要:

196 plateletapheresis procedures using the cell separator Haemonetics V 50 were performed applying 8 cycles under varying conditions. The anticoagulant ACD-A was used in a whole-blood to anticoagulant ratio of 8:1. The flow rate was selected for a range of 40-70 ml/min and the centrifuge speed was established at 4,800 and 4,400 rpm. The PWC factor was chosen between 0 and 4. 162 procedures could be statistically evaluated. 34 aphereses were accompanied with technical complications. The mean yield was (4.3 ± 1.05) × 1011 platelets, and the average of extraction efficiency (EE) was 53.9 ± 8.2 %. An analysis of variance confirmed that a higher flow rate decreased the EE (p < 0.002) and also the leukocyte counts (p < 0.0005). Increasing the PWC factor led to a higher EE; however, the leukocyte counts of the platelet concentrate were also increased (p < 0.0005). The g force has an essential effect. A high g force of the centrifuge permits to obtain a large quantity of platelets which is combined with a higher leukocyte contamination, Decreasing the centrifuge speed to 4,400 rpm by using PWC factors of 0 and 4 with different flow rates (50 and 60 ml/min) decreased the EE and the leukocyte counts in the produ

ISSN:1660-3796    

DOI:10.1159/000222639

出版商:S. Karger GmbH    

年代:1992

数据来源: Karger