摘要:

AbstractSince exposure to blood products occurs on a daily basis during hemapheresis, the acquired immunodeficiency syndrome (AIDS) epidemic has a serious impact both for patients undergoing apheresis procedures as well as for health professionals working in the field. We studied serum samples from 110 patients who underwent therapeutic plasmapheresis for a variety of diseases not related to AIDS for the presence of antibodies to human immunodeficiency virus (HIV). Exchange fluids used in the majority of the patients were plasma protein fraction and 5% human albumin. Four patients received only fresh‐frozen plasma. Fifty‐five patients also received IV gammaglobulin. The follow‐up period exceeded 24 months. All patients who did not belong to any known high‐risk group for AIDS were negative for HIV antibodies prior to treatment and remained negative at last follow‐up. Seven patients were homosexual men. All seven were seropositive prior to plasmapheresis and remained so throughout the treatment period.Seven health professional working in a busy haemapheresis unit were followed for 2 1/2 years. All remain HIV seronegative with normal immune function.These data indicate that transmission of HIV is unlikely through haemapheresis p

ISSN:0733-2459    

DOI:10.1002/jca.2920030302

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractPlasma exchange is currently being used to treat a variety of disorders including immune complex and hematologic disorders. It has been shown that the removal of plasma removes drugs bound to plasma proteins. This case documents the removal of phenytoin during plasma exchange therapy. Total and free phenytoin serum concentrations were obtained before and after each exchange. Aliquots were obtained from each pass, and total phenytoin concentrations were determined. The total phenytoin serum concentration increased during the first exchange, while the total concentration decreased as a result of the second exchange. It was determined that approximately 27.7 mg and 30.4 mg of phenytoin were removed by the first and second plasma exchanges, respectively.

ISSN:0733-2459    

DOI:10.1002/jca.2920030303

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractIn 50 individuals, intensive harvesting of relatively pure mononuclear cell fractions from the peripheral circulation was carried out in 195 procedures. Serial collections from bone marrow donors (group 1: n = 35) or isolated procedures from volunteers (group 2: n = 15) were without morbidity. A median yield of 4.0 × 109mononuclear cells were recovered in a final volume of 104 ml of cell‐rich plasma, for which 4,300 ml of venous blood was processed in 107 minutes. In neither group were changes documented in donor white cell count or lymphocyte numbers. In group I, a statistically significant but clinically unimportant and transient fall occurred in the platelet count at the end of the 5‐day intensive schedule. It is concluded that mononuclear fractions can efficiently be collected from normal donors without the development of relevant cell deple

ISSN:0733-2459    

DOI:10.1002/jca.2920030304

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA semiclosed counterflow centrifugal elutriation system that minimizes the risks of contamination and cell loss is presented. A detailed description of the configuration of the system and its sterilization and assembly is provided along with examples of its application to large‐scale separation of leukapheresis buffy coat and cadaveric bone marrow. We are currently using this system to deplete lymphocytes from human bone marrow prior to use in allogeneic bone marrow transplantation. The implementation of a semiclosed system increases the safety, ease of operation, and reproduciblity of a technique that has the potential for a wide range of clinical application

ISSN:0733-2459    

DOI:10.1002/jca.2920030305

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractGraphite furnace atomic absorption spectroscopy was used to demonstrate a fivefold increase in the median plasma aluminium levels of four patients undergoing therapeutic plasmapheresis. This plasma aluminium loading resulted from contamination of albumin incorporated in the replacement fluids and took place during its preparation, with albumin aluminium levels of 646, 669, and 715 μg/liter present in three representative samples. Aluminium overload may result in the development of encephalopathy and osteomalacia in patients with renal impairment, indicating the need to monitor aluminium levels in the albumin‐containing replacement fluids to avoid this potential haza

ISSN:0733-2459    

DOI:10.1002/jca.2920030306

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractTo determine whether any lymphocyte subset is preferentially harvested and transfused as a consequence of plateletapheresis with the Fenwal CS‐3000 Blood Cell Separator, the proportions of lymphocyte subpopulations in platelet concentrates were compared to their proportions in the donors' peripheral venous blood immediately prior to platelet collection. There was no difference in the proportion of B cells (surface immunoglobulin positive), T cells (OKT3 positive), helper/inducer T cells (OKT4 positive), suppressor/cytotoxic T cells (OKT8 positive), and natural killer cells (Leu 7 positive) in the donors' peripheral venous blood and the plateletapheresis product. Thus, although previous studies have demonstrated the ability to separate lymphocyte subpopulations by density centrifugation and velocity sedimentation, plateletapheresis with the CS‐3000 harvests the lymphocyte subpopulations studied in the same proportions in which they circulate in donors' peripheral venous bl

ISSN:0733-2459    

DOI:10.1002/jca.2920030307

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA patient with inclusion body myositis was treated with a course of 22 leukocytaphereses combined with prednisone and azathioprine therapy. He improved clinically during an induction phase of frequent cytapheresis, which reduced the circulating levels of T lymphocytes and monocytes and decreased the ratio of the T4+to T8+lymphocyte subsets. During subsequent maintenance cytapheresis there was partial recovery of the T4+population without recovery of T8+lymphocytes, and the patient lost most of his clinical improvement. In contrast to T lymphocytes and monocytes, there was no persistent reduction in circulating Blymphocyte levels during the course of therapy. T8+lymphocyte populations may regenerate more slowly than T4+lymphocytes following depletion with leukocyatpheresis combined with prednisone and azathioprine therapy. A loss of of T8+suppressor relative to T4+helper‐cell function could lead to an intensification of autoimmune condition

ISSN:0733-2459    

DOI:10.1002/jca.2920030308

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractBetween June 1982 and April 1984, 67 adult granulocyte donors were randomized to receive external arteriovenous shunts or modified right atrial catheters as vascular access for daily granulocyte collections using blood cell separators. Six of 32 donors with shunts and 2 of 35 donors with right atrial catheters experienced failure of the access method. Local infection occurred in one donor with a shunt and one donor with a right atrial catheter. Bacteremia occurred in one donor with a right atrial catheter. Specified whole blood flow rates of 50‐65 ml/minute were achieved with 28 of 32 shunts and 29 of 35 right atrial catheters (P = NS). The majority of the donors in each group tolerated the vascular access without significant problems. This study demonstrates that modified right atrial catheters can be successfully used as method of vascular access for single donor granulocyte collection with blood cell separator

ISSN:0733-2459    

DOI:10.1002/jca.2920030309

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractPlasma exchange (PE) is performed only rarely to remove a specific, well defined antibody. ABO incompatibility in marrow transplantation has allowed us a unique opportunity to compare the effectiveness of three apheresis procedures for removing anti‐red cell antibodies. We performed 140 marrow transplants in which a major ABO incompatibility between donor and recipient existed. To avoid a hemolytic transfusion reaction at the time of marrow infusion PE, plasma immunoadsorption (PIA) or whole‐blood immunoadsorption (WBIA) was performed a total of 243 times. PE removed a mean of 87% of intravascular IgM and 86% of intravascular IgG directed against red cell antigens. PIA removed 75% and 73% of IgM and IgG, respectively (P<.001 when compared to PE). Results for WBIA were 66% and 65%, respectively. Thus, PIA and WBIA were less efficient at removing antibody than PE. Furthermore, there were a few specific instances in which PIA or WBIA removed little or no antibody owing to differences in antibody specificity. PIA and WBIA resulted in less platelet consumption than PE. Although somewhat less effective that PE, PIA and WBIA have other advantages that can make them more desira

ISSN:0733-2459    

DOI:10.1002/jca.2920030310

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractTo assess the functional viability of platelets collected by standard apheresis techniques using the Fenwal CS‐3000 “closed system” and stored in Fenwal PL 732 plastic bags for 5 days at room temperature with agitation, a number of in vitro parameters (pH, morphology, platelet volume distribution, osmotic recovery, aggregation, and platelet‐associated IgG) were examined as a function of storage time. During the first 24 hours of storage, minimal changes were observed in the test parameters with the exception of ADP‐induced aggregation (75% decrease [10 uM], 84% decrease [5 μM]). Significant differences were observed between fresh (day 0) and 5‐day‐old platelet concentrates in all parameters except median platelet volume. These observed changes in in vitro test parameters with storage time are similar to those previously observed for comparably stored random single‐donor platelet concentrates. Thus, the “closed‐system” PL 732 apheresis platelet concentrates would be expected to be as effective in vivo as random single‐donor platelet concentrates, while minimizing recipient exposure to transmissible agen

ISSN:0733-2459    

DOI:10.1002/jca.2920030311

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY