ISSN:0041-1132    

DOI:10.1046/j.1537-2995.31.8s.1.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb03192.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Little information is available regarding the risk of human immunodeficiency virus type 1 (HIV‐1) infection for patients transfused before routine anti‐HIV‐1 screening of blood donors was instituted in March 1985. A model was developed for estimating both the proportion and the number of transfusion recipients in the San Francisco Bay area who were infected by HIV‐1 during each of the 7 years preceding routine donor screening for anti‐HIV‐1. The model is based on analysis of 1) donation histories of HIV‐1‐infected donors identified at the regional blood center; 2) HIV‐1 seroprevalence estimates for homosexual and bisexual men in San Francisco; and 3) HIV‐1 infection and survival rates for recipients traced by the Transfusion Safety Study and Irwin Memorial Blood Centers’ Look Back Program. The incidence of transfusion‐ associated HIV‐1 infection is estimated to have risen rapidly from the first occurrence in 1978 to a peak in late 1982 of approximately 1.1 percent per transfused unit. The decrease after 1982 coincided with the implementation of high‐risk donor deferral measures. It is estimated that, overall, approximately 2135 transfusion recipients were infected with HIV‐1 in the San Francisco region alone. This number suggests a higher prevalence of transfusion‐associated HIV‐1 infection than has been generally recognized and indicates the need for continued tracing of potentially exposed recipients. The data also strongly support the effectiveness of early donor education and self‐exclusion measures and emphasize the importance of continued re

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096183.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The transfusion of red cells (RBCs) was analyzed over a 4‐year period (1984–1987), during which 9596 cesarean deliveries were performed. A total of 336 patients were identified as receiving RBC transfusions during or after cesarean delivery; 747 units of RBCs were administered. The overall incidence of transfusion in this patient population declined from 6.2 to 3.2 percent during the study period (p less than 0.001). Slightly more than one‐half (54.4%) of all transfusions were given in the operating room or recovery room. The majority of patients (68.4%) received 2 units of RBCs, 11.6 percent received a 1‐unit transfusion, and 8.3 percent received 5 units or more. The most common obstetric diagnoses associated with RBC transfusion were disorders of placental implantation, preeclampsia, premature labor with tocolytic therapy, fetal distress, and augmentation of dysfunctional labor. In patients without risk factors for bleeding, there was no trend indicating increased transfusion requirements when general anesthesia was employed. In conclusion, this study documents a decline in the transfusion rate during cesarean d

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096177.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The goal of these studies was to develop a cost‐effective medium for the storage at 22 +/− 2 degrees C of platelets for transfusion. Platelet concentrates were prepared from platelet‐rich plasma in a standard fashion and resuspended in 55 mL of medium. Residual plasma was 14.4 +/− 4.3 percent of the final suspending solution. The use of a simple solution containing electrolytes and citrate, but no glucose or bicarbonate, was associated with a drop in pH to the range of 6.0 to 6.6, as a result of the production of lactic acid from the platelet glycogen and glucose present in residual plasma. When 25 mM (25 mmol/L) sodium phosphate was included as a buffer, the drop in pH was retarded, but the range throughout storage was still 6.5 to 6.8. Nonetheless, platelets stored for 5 days in this phosphate‐containing medium showed satisfactory maintenance of many in vitro variables. However, there was a 10 to 35 percent reduction of in vivo recovery after isotopic labeling. There was no significant reduction in subsequent mean cell life. Because of the in vivo abnormalities, these media are not recommended for use at the present time. However, the results are encouraging and suggest that further research may lead to a satisfactory, cost‐effec

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096178.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

ISSN:0041-1132    

DOI:10.1111/j.1537-2995.1991.tb03196.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

When a commercially available intravenous solution, plasmalyte‐A, was added to platelet pellets as a platelet storage medium (PSM) after more than 85 percent of the plasma had been expressed, the platelets functioned equally well, after 5 days of storage, in platelet aggregation, release reaction, and serotonin uptake as did platelets stored in plasma. The level of fibrinopeptide A was significantly different in the PSM. Similarly, lower levels of kallikrein and complement components in the PSM‐stored platelets indicated reduced activation of plasma enzyme systems. Morphology scores showed better shape maintenance in PSM, with values of 255 versus values of 185 in plasma (time zero, 280); electron microscopy also showed somewhat better structural maintenance in PSM. Glucose consumption, lactate and ammonia production, and fatty acid oxidation were also reduced in PSM. No significant differences in pH, white cell count, pO2, pCO2, or lactic dehydrogenase were observed after 5 days of storage in plasma or PSM; however, platelet counts were reduced after 5 days in plasma but remained constant in PSM. The beta‐thromboglobulin release was significantly lower in the PSM‐stored platelets after 5 days. The volume of platelet membrane glycoprotein lb (which is responsible for platelet adhesion) decreased 15 percent in plasma following storage, whereas a decrease of only 5 percent was noted in PSM. There was less leaching of plasticizers in PSM than in plasma. Survival and recovery using 51Cr‐labeled autologous platelets showed that, after 5 days of storage, the recovery of PSM‐stored platelets was 63 percent and the survival was 7.7 +/− 0.8 days (multiple hit model) The data support the hypothesis that plasma is not necessary for the storage of platelet concentrates and that removal of the plasma may benefit by removing enzymes systems that effect the biochemical alterations that occur d

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096179.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

Blood collection and component preparation have been performed in integrally connected multiple plastic containers made with a new plastic. This polyvinylchloride (PVC) container plasticized with butyryl‐n‐trihexyl‐citrate (BTHC) is a new material for blood storage; it contains no di(2‐ethylhexyl)phthalate (DEHP). After removal of plasma and buffy coat, the red cells were suspended in saline‐adenine‐ glucose‐mannitol (SAGM) medium. After 42‐day refrigerator storage, the total adenine nucleotide concentration remained the same as the initial concentration in the red cells, whereas ATP levels had decreased to 61 percent of the initial value. The 2,3 DPG concentration was 62 percent of normal on Day 7 and 21 percent on Day 14. Glucose consumption, lactate production, potassium leakage from red cells, and pH levels were similar to those found after storage in DEHP‐plasticized containers under the same conditions. After 42 days, hemolysis levels were 0.56 ± 0.21 percent and 0.42 ± 0.17 percent in two series of units mixed weekly and 0.70 ± 0.27 percent in units stored unmixed. Although even higher levels of hemolysis were observed in the units stored unmixed and used for 24‐hour posttransfusion survival, the autologous red cell recovery results were excellent (83.2 ± 5.1%, n = 8). BTHC‐plasticized PVC is found to be a suitable material for 42‐day storage of

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096180.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The fibrinogen activity in thawed cryoprecipitate stored between 1 and 6 degrees C is maintained essentially unchanged in most bags for a month. Occasionally, a bag will have a reduction in fibrinogen. If pooling has not occurred, thawed cryoprecipitate should be useful as a source of fibrinogen for a period of time considerably in excess of the 6 hours allowed for its use as a source of factor VIII or von Willebrand factor.

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096181.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY

摘要:

The inactivation of HIV by gamma‐radiation was studied in frozen and liquid plasma; a reduction of the virus titer of 5 to 6 logs was achieved at doses of 5 to 10 Mrad at ‐80 degrees C and 2.5 Mrad at 15 degrees C. The effect of irradiation on the biologic activity of a number of coagulation factors in plasma and in lyophilized concentrates of factor VIII (FVIII) and prothrombin complex was examined. A recovery of 85 percent of the biologic activity of therapeutic components present in frozen plasma and in lyophilized coagulation factor concentrates was reached at radiation doses as low as 1.5 and 0.5 Mrad, respectively. As derived from the first‐order radiation inactivation curves, the radiosensitive target size of HIV was estimated to be 1 to 3 MDa; the target size of FVIII was estimated to be 130 to 160 kDa. Gamma radiation must be disregarded as a method for the sterilization of plasma and plasma‐derived products, because of the low reduction of virus infectivity at radiation doses that still give acceptable recovery of biologic activity of plasma com

ISSN:0041-1132    

DOI:10.1046/j.1537-2995.1991.31191096182.x

出版商:Blackwell Science Ltd    

年代:1991

数据来源: WILEY