ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00001.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Lane (1840) first noted the beneficial effect of blood transfusion in controlling haemophilic bleeding following ophthalmic surgery. The appreciation that haemophilia is due to a plasma defect, at first thought to be prothrombin, coincided with the discovery of blood groups. This led in due course to the discovery of citrate anti‐coagulant and the ability to store blood. The beneficial effect of citrated plasma in haemophilia led to the exploitation of stored blood, fresh frozen plasma, and the subsequent development of cryoprecipitate and factor concentrates. All this would not have been possible, however, without the selfless contribution of blood donors and the development of an organized blood transfusion service. In the United Kingdom, P. L. Oliver pioneered the development of blood donor panels, the London Blood Transfusion Service and the British Red Cross Society Blood Transfusion Service leading directly to the National Blood Transfusion Service; recognized as the World's senior service. The development of haemophilia therapy owes much, therefore, to Oliver's energetic and pioneering work and it is entirely appropriate that the first Oliver Memorial Lecture be directed to the evolution and future of haemophilia therapy. It is indeed an honour to be invited to deliver this Oliver Memorial Lecture at the combined meeting of the British Blood Transfusion Society and the British Society for Haematology here in Wemble

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00002.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.We investigated the infectivity of three hepatitis C virus antibody (anti‐HCV) positive blood donors with either hepatitis B core antibodies (anti‐HBc) (Nos 1 and 2) or raised alanine aminotransferase (ALT) (No. 3). The 57 recipients of blood products from these donors during the period 1971–1990 were identified and the living 23 were tested for anti‐HCV. Among these, 11 out of 14 (78%) recipients from Nos 1 and 2, and 1 out of 9 (11 %) recipients from No. 3 were anti‐HCV positive. The former donors had high titres of anti‐C 100‐3 and high rating scores in the HCV recombinant immunoblot assay (RIBA). They were evidently infective, chronic carriers of HCV but had no clinical signs or medical history of hepatitis. The latter donor had low titres of anti‐C100‐3 and a low RIBA rating score. She had clinical signs of chronic hepatitis and persistently elevated ALT, but only one of her recipients was

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00003.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Aqueous solutions of stroma‐free human haemoglobin are being evaluated as potential oxygen‐carrying resuscitation fluids. There are indications, however, that such solutions may produce toxic side‐effectsin vivo.Stroma‐free haemoglobin solution produced a 50% fall in mean arterial pressure when infused into a small animal model despite containing very low levels of non‐haem protein and phospholipid contaminants. This effect was not produced by haemoglobin solutions after extensive dialysis. Red cell‐derived adenine nucleotides were found to be present in concentrations high enough to cause such a response (80–85 μg/ml). We have developed a chromatographic assay capable of predicting hypotension in our animal model and consider that the complete absence of adenine nucleotides must be confirmed in all studies concerning the possible toxic side‐effects of stroma‐free hae

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00004.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Earlier studies have indicated that plasma from blood donations drawn into half‐strength citrate anticoagulant (0·5 CPD‐A2) may give improved yields of factor VIII:C after fractionation. It has also been shown previously that cellular components from blood donations drawn into 05 CPD‐A2 have satisfactory in‐vitro and in‐vivo properties. The present study examines the clinical use of red cell concentrate (RCC) from 0·5 CPD‐A2 blood donations.Forty‐nine patients who were undergoing elective orthopaedic surgery and who required blood transfusion received 0·5 CPD‐A2 RCC. A transfused control group of 107 patients received standard CPD‐A1 RCC for their transfusion requirements. Patients in the two transfused groups had similar haemoglobin responses to transfusion. All patients experienced a moderate pyrexia following the operation. Both study groups showed similar responses to serum lactate dehydrogenase levels in the 2 weeks following surgery, and in postoperative peripheral blood platelet counts. Serious postoperative complications arose in both groups. In the 0·5 CPD‐A2 group two patients had pulmonary emboli (one fatal) and one patient had a non‐fatal myocardial infarction. Three patients had pulmonary emboli in the CPD‐A1 transfused group.These incidences of major adverse events were within the expected range of these complications in patients who were undergoing major joint replacement surgery and did not differ significantly between the study groups. This study indicates that red cell concentrate prepared in half‐strength citrate anticoagulant is comparable to that prepared in CPD‐A1 for patients

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00005.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.The licenced balanced salt solution Plasma‐Lyte, buffered with a clinical solution of sodium bicarbonate, was evaluated as a suspending fluid for platelet concentrates. Platelets suspended in this medium showed better pH maintenance over 5 days of storage compared to platelets stored in plasma (7·0vs6·45,P<0·001). This was reflected in improvements in in‐vitro indicators of platelet viability hypotonic shock response (79vs48%,P<0·05), aggregation to paired agonists (86vs62%,P<0·05); and platelet size distribution (104vs119%,P<0·001). Dissolved bicarbonate measurement showed less depletion of bicarbonate in the synthetic medium compared to plasma, which suggests a lower rate of lactate formation. A synthetic medium containing dextrose showed inferior platelet storage characteristics when compared to the plasmalyte/bicarbonate medium in a paired study (Day 5, pH 6·53vs6·9,P<0·05). The results suggest that utilization of substrates other than dextrose allows platelets to metabolize without the accumulation of lactate that leads to pH drops during storage in plasma, and continue to support the feasibility of storing platelets in a non‐plas

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00006.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.A new private blood group antigen, SAT, was identified in an NFLD‐Japanese woman as a result of testing 10,480 blood donors with a serum containing anti‐NFLD and anti‐SAT. Three other sera were subsequently also shown to contain anti‐SAT. The donor's family showed that SAT is inherited as a dominant character and may be associated with a weak M antigen. Serological and immunochemical analysis revealed no other aberrations in the MNS system.Study of a second SAT+ Japanese blood donor and his family suggested that SAT is associated with an unusual MNS variant resulting from a hybrid glycophorin comprising the N‐terminus of glycophorin A and the C‐terminus of glycophorin B. The propositus appears to be homozygous for the gene that produces the putative hybrid, which differs from previously described glycophorin (A‐B) hybrids by expressing no S, s or U antigen. SAT antigen, therefore, may be associated with two different MNS variants in the only two families in which it has be

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00007.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.In this study we found that the frequencies of Sdaantigen on erythrocytes and urine of a large number of individuals from Emilia‐Romagna (a region of northern Italy) are 0·89 and 0·93, respectively. The hypothesis that the infection by pyelonephritogenicEscherichia colistrains with specific adhesions for the α2,3sialyl‐galactosyl structure might operate as selective agents for the high frequency of Sdaantigen in distal renal cells is dis

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00008.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Bacterial neuraminidase plays an important role in the pathogenesis of some haemolytic anaemias. It divides neuraminic acid from the red cell surface to expose a hidden antigen (Thomsen‐Friedenreich antigen, T). A physiologically circulating antibody can then react with the uncovered T and cause a rapid haemolysis. This study demonstrates the presence of T on human vascular endothelium. Similar to red cells it is exposed by the action of bacterial neuraminidase. The subsequent reaction with the physiological antibody could be involved in the pathogenesis of vascular damage observed in severe cases of bacterial septicaemi

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00009.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.Antibodies to the HPA‐la antigen can elicit a condition in the new‐born known as neonatal alloimmune thrombocytopenia (NAITP). Retrospective and prospective studies have shown that there is a strong correlation between the presence of HLA‐DR3, HLA‐DRw52 in the mother and the antibody response to HPA‐la. HLA Class II molecules play an important role in the initiation of the immune response and it has been postulated that HPA‐la antibody production could be determined by the presence of a specific HLA Class II molecule at the surface of the antigen‐presenting cell. Thirty‐one HPA‐la negative women with HPA‐la antibodies (responders) and nine HPA‐la negative women without HPA‐la antibodies (non‐responders) were recruited. They were studied using serological HLA Class I and Class II typing and RFLP analysis with a DRβ probe. We found that all responders had the HLA‐DRw52a sub‐specificity confirming recently published data. Moreover, two of the nine non‐responders were also found to be HLA‐DRw52a. These results suggest that the HLA‐DRw52a molecule is necessary for HPA‐la antibody responsiveness but not sufficient. The results also indicate that in HPA‐la negative women the absence of HLA‐DRw52a is associated with a very low risk of being antibody producers and hence, is associated with a

ISSN:0958-7578    

DOI:10.1111/j.1365-3148.1991.tb00010.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY