bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Prior Whole Blood Transfusion on Subsequent Granulocyte Support in Leukopenic Dogs
Authors: Westrick M. A. , Debelak‐Fehir K. M. , Epstein R. B.
Published: December 2004

The present studies were undertaken to evaluate the effect of prior transfusions on the response to subsequent granulocyte support in leukopenic dogs. Ten separate experiments were carried out. Each study included three dogs. One dog served as an unrelated granulocyte donor for two recipients rendered leukopenic (average: 373/μd) by a single I.V. dose of 40 mg/kg of cyclophosphamide. One recipient was transfused with 100 ml whole blood from the donor fourteen and seven days prior to cyclophosphamide administration. Granulocytes obtained by filtration leukapheresis were given on days five and six following cyclophosphamide. Granulocyte increments, per cent recovery one hour posttransfusion, presence of preformed cytotoxic antibodies, and survival time of the dogs were measured. Granulocyte transfusions averaged 5.4 times 108 cells per kg recipient body weight. Three of ten previously transfused recipients had positive cytotoxic crossmatches. Mean one‐hour increments for previously transfused dogs averaged 106/μl with 2.4 per cent recovery, versus 624/μl with 8.7 per cent recovery for controls (p < .01). Duration of survival for control animals was significantly increased over dogs with prior transfusions (p < .05). Gram‐negative sepsis occurred in five previously transfused dogs and in one of the control animals. Two prior blood transfusions effectively sensitized recipients against subsequent granulocyte support. In most instances such sensitization was not detectable by cytotoxic crossmatching. Sensitization was associated with shortened survival and an increased incidence of sepsis.
Occurrence of Anti‐Wra in Blood Donors and in Selected Patient Groups, with a Note on the Incidence of the Wra Antigen
Authors: Greendyke R. M. , Banzhaf J. C.
Published: December 2004

The occurrence of the Wra antigen on the red blood cells of 5,000 primarily Caucasian New York State blood donors was shown to be 1:1,000. Anti‐Wra was detected in sera from random blood donors with a frequency of 1:56 and with progressively increasing frequency in postpartum women, patients undergoing open‐heart surgery, hemodialysis subjects, and random persons with other alloantibodies. Anti‐Wra was found in one fourth of sera from patients with positive direct antiglobulin tests, including 12 of 23 in whom the positive test was associated with alphamethyldopa treatment.
Fetal Cell Counting as an Evaluation of Rh Prophylaxis with Antenatally Administered Anti‐RhO (D) Gamma Globulin
Authors: Harrison K. L.
Published: December 2004

Fetal cell counts were performed on pregnant women at 34 weeks' gestation following an injection of Anti‐Rho (D) gamma globulin at 28 weeks' gestation. In cases where the fetus subsequently proved to be Rho (D) positive and ABO compatible, the fetal cell detection rate and the mean number detected were considerably less than those where the fetus was Rh negative. Postpartum fetal cell counts after one and two antenatal anti‐Rho (D) gamma globulin injections were also less when the baby was Rh positive than when the baby was Rh negative. These findings provide evidence that antigen clearance is definitely part of the mechanism involved in Rh prophylaxis by the use of anti‐Rho (D) gamma globulin.
Undetectable ABO Isoagglutinin in a Patient with Chronic Myelocytic Leukemia
Authors: Ogata H. , Hasegawa S.
Published: December 2004

An instance of undetectable anti(A + B) was described in a patient, group O, in acute crisis of chronic myelocytic leukemia. The finding was not parallel to the level of gamma globulin in the patient and a possibility of functional abnormality of the related antibody was discussed.
An Investigation of the Relationship between the V(hrv), VS, and hrH Antigens
Authors: Tregellas W. M. , Issitt P. D.
Published: December 2004

The data from this investigation show that the anti‐VS sera studied cannot be separated into anti‐hrv (anti‐V) and anti‐hrH specificities. The antibody specificity is singular and is directed against an antigenic determinant present on VS positive red blood cells. That some anti‐VS sera appear to have a separable specificity may be due to the incomplete absorption of those antisera.

It was shown that V–, VS+ red blood cells adsorb more anti‐VS than do those that are V+, VS+. Several absorption of anti‐VS serum with V +, VS + red blood cells may remove enough of the antibody that the absorbed serum will no longer (visibly) react with V +, VS+ red blood cells, though the same absorbed serum will react with V‐, VS+ red blood cells. That this is not a separable specificity can be demonstrated by subsequent absorption to exhaustion of the same serum with V +, VS+ red blood cells.

Testing of the original Hernandez serum confirmed that it defines the antigenic specificity, hrH. The relationship of hrH to VS may be similar to the relationship of the Rho (D) antigen to the antigens of the Rho (D) mosaic.
Studies on 4 C Stored Frozen‐Reconstituted Red Blood Cells
Authors: Myhre B. A. , Nakasako Y. Y. , Schott R.
Published: December 2004

In order to determine the feasibility of 4 C storage of frozen‐thawed red blood cells beyond the 24 hours now allowed by the Food and Drug Administration (BoB), chemical and cytological measurements were made of blood units processed by different methods. The only significant findings were a progressive increase in the plasma hemoglobin and plasma potassium. These were most pronounced when the storage medium was the 0.8% NaCl‐0.2% dextrose and storage was continued past five days. Storage in autologous plasma produced less pronounced changes, but the changes were still about twice that found in a unit of whole blood stored for the same amount of time. Storage in 5% albumin or Plasma Protein Fraction did not seem to provide conditions much superior to the dextrose‐saline solution. Contamination of the unit produced somewhat more hemolysis than in its sterile control but not enough to be readily detectable. From these studies it seems logical that the 4 C storage time could be extended to at least three, and in all probability five days, with no significant harm to the recipient, and with a great increase in the useable life of the blood unit, thus increasing the availability of a very precious commodity.
Naturally Occurring Anti‐Kell Stimulated by E. Coli Enterocolitis in a 20‐Day‐Old Child
Authors: Marsh W. L. , Nichols M. E. , Øyen R. , Thayer R. S. , Deere W. L. , Freed P. J. , Schmelter S. E.
Published: December 2004

Anti‐A and anti‐K have been found in the serum of a 20‐day‐old child who had not been transfused but who was acutely ill with E. coli enterocolitis. Both antibodies arc IgM proteins. The mother's serum does not contain either antibody and the anti‐A and anti‐K in the infant's serum are not of maternal origin. Both parents and the child are of the Kell pheno‐type K–k+. Stool cultures made from the child yielded E. coli O 125:B15, an uncommon B‐variant pathogenic coliform. Cell‐free preparations made from broth cultures of this organism have strong specific inhibitory activity against IgM anti‐A and anti‐K, and both antigens have been identified on the bacterial cells. At age 3 months the child had made a clinical recovery, stool cultures showed no pathogenic coliforms, and anti‐A and anti‐K were no longer detectable in her serum. These data indicate that absorption of metabolites with A‐like and K‐like activity produced by a pathogenic coliform in the intestinal tract were responsible for the appearance of apparent naturally occurring anti‐A and anti‐K in the child's serum.
Quantitative Studies of Specific and Nonspecific Second Antibody Uptake by Sensitized Erythrocytes
Authors: Greendyke R. M. , Banzhaf J. C.
Published: December 2004

Experiments were conducted using the technique of quantitative hemagglutination with an electronic particle counter to study the specific and nonspecific uptake of blood group antibodies by previously sensitized erythrocytes. Specific attachment of a second antibody was impaired by prior RBC sensitization. It was found possible to quantitate simultaneously the amount of both specific and nonspecific second antibody uptake.
Toxoplasmosis Transmitted by Blood Transfusions
Authors: Räisänen S.
Published: December 2004

Blood from humans collected into heparin or citrate was inoculated with toxoplasma organisms. After storage at 4 C up to 28 days, samples were injected into the ear veins of rabbits. The test rabbits developed toxoplasmosis. Similar results were obtained by transfusing rabbits with blood obtained from rabbits sub‐cutaneously injected with toxoplasma organisms.
Hemolysis Induced by Cefazolin and Cephalothin in a Patient with Penicillin Sensitivity
Authors: Moake J. L. , Butler C. F. , Hewell G. M. , Cheek J. , Spruell M. A.
Published: December 2004

A patient with penicillin sensitivity, who had never received a cephalosporin antibiotic previously, developed anemia and spherocytosis following the administration of cefazolin. Hemolysis abated when the drug was discontinued on the fourth day, and recurred on day six when cephalothin therapy was begun. IgG and complement components were present on the patient's erythrocytes, and IgG antibodies in her serum reacted with normal red blood cells which had been coated with benzylpenicillin, cefazolin or cephalothin. Antibodies to cephalothin‐coated red blood cells were removed partially by incubating her serum with either benzylpenicillin or cefazolin. Complement‐fixing IgG antibodies which reacted with red blood cells coated by cefazolin, cephalothin, and benzylpenicillin were considered to be responsible for hemolysis during the administration of cefazolin and, subsequently, cephalothin. The patient recovered completely following discontinuation of antibiotics, transfusion of red blood cells, and treatment with glucocorticoids. It is concluded that hemolysis may occur during therapy with cefazolin, as well as cephalothin, and may develop rapidly in a patient with penicillin sensitivity.
Severe Hemolytic Disease of the Newborn Associated with Anti‐Jsb
Authors: Lowe R. F. , Musengezi A. T. , Moores P.
Published: December 2004

The red blood cells of the group A infant of a group O central African Negro woman of the Zezuru tribe with anti‐Lea and anti‐Jsb in her serum were found to be strongly agglutinated by a commercial antiglobulin reagent six days after birth. The high concentration of bilirubin in the infant's serum gradually decreased but he became profoundly anemic and, in the absence of a suitable donor, was successfully transfused with blood from his mother. Subsequent tests using the maternal anti‐Jsb diluted one in ten to avoid agglutination by the anti‐Lea showed that the frequency of the Js (b–) pheno‐type in group O Zezuru is approximately one per cent.
The Natural History of Alloimmunization to Platelets
Authors: Howard J. E. , Perkins H. A.
Published: December 2004

Sixty‐three patients have provided evidence that platelets are highly immunogenic even in recipients of potentially immunosuppressive therapy for malignant diseases. Approximately 70 per cent of patients who receive repeated transfusions of platelets from random donors over a prolonged period can be expected to develop lymphocytotoxic antibodies. Antibodies became detectable in one patient ten days after his first exposure to HLA antigens in the form of platelet concentrates, and as early as four days in two patients with prior exposure to HLA antigens. In the most heavily immunized patients, the presence of antibody correlated with poor increments of platelets after transfusion. Patients with prior exposure to HLA antigens are more likely to have antibodies resulting in poor platelet survival. On the other hand, 30 per cent of recipients of repeated platelet transfusions show no tendency to form cytotoxic antibodies.
Preparation of Leukocyte‐Poor Red Blood Cells Using the IBM 2991 Blood Cell Processor
Authors: Buchholz D. H. , Charette J. R. , Bove J. R.
Published: December 2004

Leukocyte‐poor red blood cells (RBCs) were prepared from one‐to‐seven‐day‐old whole blood using the IBM 2991 Blood Cell Processor. Blood was centrifuged at 3,000 rpm for 5 minutes on the initial processing cycle and for 1.5 minutes each subsequent cycle. The red blood cell override (RCO) control was used to remove portions of the leukocyte‐rich red blood cell layer at the cell/liquid interface after separation. RBC loss was directly proportional to RCO time and averaged 5.4, 10.6, 15.6, 21.2, and 26.7 ml with RCO settings of 1.5, 2.5, 3.5, 4.5, and 5.5 seconds, respectively. A single RCO cycle removed 54.7, 66.0, 70.7, and 69.7 per cent of total leukocytes at RCO settings of 2.5, 3.5, 4.5, and 5.5 seconds, respectively. With double cycle processing at the same RCO times, 78.6, 88.9, 90.3, and 90.7 per cent of white blood cells were removed with loss of 12.4, 16.7, 22.4, and 25.4 per cent of RBCs respectively. Four‐cycle processing with an initial 2.5‐to‐5.5‐second RCO followed by three 1.5‐second RCO cycles removed the greatest number of leukocytes (86.9, 93.3, 93.3, and 91.7 per cent, respectively) with corresponding RBC losses of 11.9, 17.2, 20.2, and 23.1 per cent. Total leukocytes contaminating the processed RBCs averaged 0.37, 0.18, 0.18, and 0.22 × 109, respectively. The processing cycle with the 3.5‐second initial RCO provided maximal leukocyte removal and minimal erythrocyte loss.
Relationship of Physical Symptoms, ECG, Free Calcium, and Other Blood Chemistries in Reinfusion with Citrated Blood
Authors: Ladenson J. H. , Miller W. V. , Sherman L. A.
Published: December 2004

Changes in ECG, free calcium (CaF), and other biochemical parameters were measured during reinfusion of citrate anticoagulated blood in 12 subjects undergoing plateletpheresis. Physical symptoms during the procedure were also monitored. The CaF was found to correlate best with the Q‐oTc interval as compared to the Q‐oT, Q‐Tc, or Q‐T interval. While the correlation was significant (r = 0.592, p < .001), the Q‐oTc could not predict the CaF. A number of other blood constituents were found to change during plateletpheresis, with most directly related to either citrate administration or hemodilution. Severe physical symptoms were found in one subject and no symptoms in three. In the subjects without symptoms the changes in Q‐oTc, P1, alkaline phosphatase, and glucose through the plateletpheresis procedure were different from changes in all subjects. The decrease in glucose level was the most striking single factor correlating with the lack of physical symptoms during the citrate‐induced hypocalcemia associated with plateletpheresis. It is concluded that monitoring of the ECG cannot substitute for direct measurement of free calcium in citrate‐induced hypocalcemia, that the physical symptoms associated with similar levels of hypocalcemia are variable, that glucose level may be a marker for the effects of citrate‐induced hypocalcemia, and that lowered citrate loads during plateletpheresis appear warranted.
Viral Serology (Hepatitis B Virus, Cytomegalovirus, Epstein‐Barr Virus) and Abnormal Liver Function Tests in Transfused Patients with Hereditary Hemorrhagic Diseases
Authors: Enck R. E. , Betts R. F. , Brown M. R. , Miller G.
Published: December 2004

Posttransfusion hepatitis and asymptomatic liver disease remain serious and unresolved problems in transfused patients with hereditary hemorrhagic diseases. We studied the occurrence of antibody and antigen to hepatitis B virus (anti‐Hbs and HBsAg) as well as antibody to cytomegalovirus (anti‐CMV) and Epstein‐Barr virus (anti‐EBV) in this population and correlated this with liver function tests. The study population was divided into two groups: Group I, consisting of 35 patients (moderate to mild disease) requiring less than 12 transfusions per year and Group II, consisting of 38 patients (severe disease) requiring more than 12 transfusions per year. Frequency of transfusion correlated with detectable anti‐HBs and anti‐CMV (48.6% and 25.7% in Group I, 94.7% and 47.4% in Group II). Three patients, all in Group I, were HBsAg positive while none in Group II had demonstrable antigen. Anti‐EBV occurred with similar frequency in both groups. The abnormal liver funtion tests present in 62.9 per cent of Group I and 89.5 per cent of Group II correlated poorly with the presence of anti‐HBs, anti‐CMV and anti‐EBV. Splenomegaly was not detected in any of the 73 patients. HBV and CMV appear to be transmissible by transfusion, and other viruses such as non‐A, non‐B may account for this liver dysfunction.
The Use of an Oxygen Dissociation Curve Analyzer in Transfusion Therapy
Authors: Festa R. S. , Asakura T.
Published: December 2004

Two automatic apparatuses utilizing a dual wavelength spectrophotometry method were developed to perform oxygen dissociation curves on microsamples of blood. This method provides a complete printout of an oxygen dissociation curve in 15 to 20 minutes and the P50 values obtained agree closely with those obtained by classical methods. This technique was used as part of a routine clinical evaluation in assessing oxygen delivery in anemic patients. These apparatuses allowed identification of patients with well‐compensated anemia, patients with no compensatory decrease in oxygen affinity, and several patients with a paradoxical increase in oxygen affinity. Knowledge of the oxygen‐releasing capacity of the blood permits a more thorough evaluation of oxygen transport in anemic patients than the hemoglobin level and a more precise assessment of the need for transfusion therapy. The ready availability of an oxygen dissociation curve by this method is feasible for routine clinical evaluation and permits more judicious use of blood products.
The Effects of Combined Platelet and Leukapheresis on the Blood Coagulation System
Authors: Kisker C. T. , Strauss R. G. , Koepke J. A. , Maguire L. C. , Thompson J. S.
Published: December 2004

Analysis of blood coagulation was done on samples of blood collected from ten donors undergoing combined platelet and leukapheresis using the Haemonetics Model 30 Blood Processor. Blood samples were obtained from the donors prior to, during, and following pheresis. Blood was also obtained from the blood‐return line after the first collection of leukocytes and platelets, but before it was returned to the donor. Although the citrate anticoagulant was returned to the donor and there were some decreases in the concentrations of fibrinogen, platelets, and factors V and VIII, there were no changes of sufficient degree to suggest the development of a potential bleeding disorder. In addition there was no evidence to suggest that any activation of blood coagulation occurred during the pheresis or that thrombogenic substances were returned to the donors. Combined platelet and leukapheresis using the Haemonetics Model 30 Blood Processor, therefore, do not appear to subject the donor to risks for either bleeding or thrombotic complications.
Auto‐Anti‐Kpb Associated with Weakened Antigenicity in the Kell Blood Group System: A Second Example
Authors: Beck M. L. , Marsh W. L. , Pierce S. R. , DiNapoli J. , ØYen R. , Nichols M. E.
Published: December 2004

An 84‐year‐old woman with intestinal bleeding had marked reduction of red blood cell antigenicity in the Kell system, and a positive direct antiglobulin test caused by auto‐anti‐Kpb. Kx antigen activity of her cells was increased, an observation which supports the belief that Kx marks a precursor structure utilized in the normal Kell biosynthetic pathway. It is postulated that reduced Kell antigenicity was an acquired change that resulted from enzymatic degradation, possibly of bacterial origin.
Concomitant T‐ and Tk‐Activation Associated with Acquired‐B Antigens
Authors: Judd W. J. , McGuire‐Mallory D. , Anderson K. M. , Heath E. J. , Swanson J. , Gray J. M. , Oberman H. A.
Published: December 2004

Three patients with acquired‐B antigens are reported whose red blood cells also manifested T‐ and Tk‐activa‐tion. The results of tests using purified Arachis hypogaea and Bandeiraea simplicifolia (BS II) lectins, and red blood cells either T, Tk or both T and Tk‐activated by bacterial enzymes in vitro, suggest that the acquired‐B phenomenon, T‐activation and Tk‐activation result from the action of different bacterial enzymes.
Clinical and Serologic Management of Patients with Methyldopa‐Induced Positive Antiglobulin Tests
Authors: Snyder E. L. , Spivack M.
Published: December 2004

Methyldopa can produce both a positive direct antiglobulin test and less commonly a positive indirect antiglobulin test. When the drug‐induced antibody is present in the serum, it acts as a panagglutinin and reacts with all normal red blood cells; consequently crossmatch‐compatible blood cannot be prepared. Although the methyldopa‐induced antibody itself rarely produces hemolysis, difficulties can arise in previously unscreened patients in whom the panagglutinin may mask an unknown, pre‐existing, and potentially hemolytic alloantibody. We report on our clinical and serologic management of 14 such patients for whom transfusions were requested.
Systematic Survey of Monoclonal Gammapathies in the Sera from Blood Donors
Authors: Fine J. M. , Lambin P. , Derycke C. , Muller J. Y. , Marneux M.
Published: December 2004

Routine screening of monoclonal gammapathies (M.G.) was performed on the serum of 13,914 blood donors by cellulose acetate electrophoresis. Twenty‐six cases of M.G. were detected corresponding to a frequency of 0.19 per cent. The incidence of the M.G. progresses with increasing age comparatively to the age distribution of the blood donors under investigation. Most of the M.G. detected can be classified as “asymptomatic” M.G. (23 of the 26) and heavy chain classes are only IgG or IgM with a large predominance of IgG class (about 90%). It is suggested that donors in whom M.G. have been detected should not be eligible for blood donation. A yearly clinical, hematologic and immunoglobulin checkup is recommended for these patients in order to detect a possible malignant transformation.
Long‐Term Plateletpheresis in the Management of Primary Thrombocytosis
Authors: Goldfinger D. , Thompson R. , Lowe C. , Kurz L. , Belkin G.
Published: December 2004

We attempted to control the platelet count of a patient with primary thrombocytosis utilizing long‐term plateletpheresis therapy. The patient previously could not be controlled with chemotherapy, because of rapid development of leukopenia. Although intensive pheresis at the rate of four to five procedures per week produced rapid lowering of the patient's platelet count, continued therapy at the rate of two to three procedures a week failed to maintain these counts, and platelets gradually rose to pretreatment levels. We conclude that while plateletpheresis can produce acute lowering of elevated platelet counts, the rate of platelet production in primary thrombocytosis may be too rapid to allow for long‐term control by pheresis alone, utilizing an acceptable treatment schedule of one to three procedures per week.
Differentiation of Granulocyte Antigens Demonstrated by Granuloagglutinins and Granulocytotoxins
Authors: Májský A. , Kořínková P.
Published: December 2004

Twenty sera containing granuloagglutinins along with granulocytotoxins were typed with 27 to 54 samples of granulocytes from different donors. For the most part, positive results of the microgranuloagglutination test and microgranulocytotoxic test were not in agreement. The positivity of the agglutination test was more frequent (35.24%) than that of the cytotoxic test (18.9%). The statistical evaluation of the results for each serum in both tests made by calculating the correlation coefficient showed the two types of antibodies to be independent, and to determine different antigens.
The Immunoglobulin Structure of Human Anti‐M Agglutinins
Authors: Smith M. L. , Beck M. L.
Published: December 2004

Fifty examples of human anti‐M agglutinins were subjected to reductive cleavage using both 2‐mercapto‐ethanol (2‐ME) and dithiothreitol (DTT). Thirty‐nine (78%) were resistant to inactivation by sulphydryl compounds indicating IgG composition. This was confirmed by column chromatography. The remaining eleven sera were sensitive to reduction cleavage. There was no obvious association of immunoglobulin composition of the antibody with previous immune exposure to the M antigen. These results confirm observations in the literature that anti‐M agglutinins are an exception to the generally expected correlation of saline agglutinating activity with IgM structure.
An Overview of a Hierarchy of Planning Models for Regional Blood Bank Management
Authors: Cohen M. A. , Pierskalla W. P. , Sassetti R. J. , Consolo J.
Published: December 2004

Optimal regionalization of a blood banking system requires a hierarchical structure based on an analysis of preexisting elements in the region to determine at what level of activity economies of scale, cost effectiveness and efficiency will be greatest. We have applied operations research techniques to segments of the blood service complex. This paper is an overview of the general results of this research. From analysis of the data in each segment, a mathematical response function is developed for such managerial processes as demand forecasting, requirements computation, crossmatch and recycle control at each level of the hierarchy in a regional system. These processes in independent hospital blood banks are contrasted with those in hospital blood banks and transfusion services which are dependent on central blood banks for their supply. An example is presented of a model which is useful in the planning of a regional system. Implementation of these hierarchical models in hospital blood banks can reduce outdating, size of inventories and shortage. In central blood banks, these models can minimize shipment quantities, determine optimal transshipments and the most efficient routing.
A Strong Antibody Reacting with Enzyme Modified E Positive Red Blood Cells
Authors: Heistø H. , Fagerhol M. K.
Published: December 2004

A high titer antibody was discovered in a healthy young man of blood group A1 R2r. The antibody strongly agglutinated all E positive red blood cells including his own, which had been modified by papain, ficin and bromelin, but only very weakly when modified by trypsin. The antibody was shown to be an IgM antibody. It did not react with unmodified red blood cells.
Fatal Delayed Hemolytic Transfusion Reaction due to Anti‐c + E
Authors: Hillman N. M.
Published: December 2004

A 72‐year‐old man with a peptic ulcer received seven units of apparently compatible red blood cells. Six days after the last unit, he had a hemolytic transfusion reaction manifested by high fever, marked fall in hematocrit, hemoglobinemia, hemoglobinuria, severe bili‐rubinemia and oliguria. He went on to become uremic, hyperkalemic, anuric and died five days later. Serologic studies showed that the donor and recipient bloods were completely compatible prior to the transfusions and that unexpected antibodies were not detected. The anamnestic response from donor antigens was precipitous even after a latent period of six days.
Anti‐Kell (K1) in Idiopathic Thrombocytopenic Purpura
Authors: O'Brien M. , King G. , Dube V. E. , Siegel M. , Earlywine J.
Published: December 2004

A transiently occurring anti‐Kell antibody was observed in a 21/2‐year‐old child who had idiopathic thrombocytopenic purpura after recovery from an upper respiratory tract infection. The antibody was probably of the IgM class. There was no history of prior blood transfusion.
Potential Danger of Thrombosis after Plasma Exchange in the Treatment of Patients with Immune Disease
Authors: Sultan Y. , Bussel A. , Maisonneuve P. , Poupeney M. , Sitty X. , Gajdos P.
Published: December 2004

Coagulation studies were serially performed before and after repeated plasma exchange in seven patients with myasthenia gravis. The fall in platelets and coagulation factor activities after plasmapheresis using a replacement material devoid of clotting factors was not so low that bleeding episodes were to be feared and no hemorrhages were observed. In contrast, thrombotic phenomena were suspected in two patients. Antithrombin III fell to undetectable levels in some cases. This finding associated with elevated values of factor VIII related antigen, factor VIII coagulant activity and von Willebrand factor suggested a potential danger of thrombosis in such treated patients.
Anticomplement and the Indirect Antiglobulin Test
Authors: Wright M. S. , Issitt P. D.
Published: December 2004

We used 140 IgG complement‐fixing blood group alloantibodies of 17 different specificities in tests to determine whether anticomplement antibodies are still necessary in antiglobulin reagents to be used in indirect antiglobulin tests. Anti‐Rh and other IgG noncomple‐ment fixing antibodies were excluded from the study. A polyspecific antiglobulin reagent that contained anti‐IgG and anticomplement antibodies, and an anti‐IgG reagent containing the same level of anti‐IgG as the polyspecific one, were compared. Titrations with some of the antibodies were repeated with only the polyspecific reagent. With each antibody, studies were done with complement activation blocked, and compared with results in which it was allowed to proceed. We found that 42.9 per cent of the antibodies were detected at a higher dilution, and 64.3 per cent of them were detected with a higher titer score, when the polyspecific antiglobulin serum containing anticomplement antibodies was used. We conclude that anticomplement antibodies are indeed still essential for the correct performance of indirect antiglobulin tests.
An Analysis of Blood Transfusion of Surgical Patients by Sex: A Quest for the Transfusion Trigger
Authors: Friedman B. A. , Burns T. L. , Schork M. A.
Published: December 2004

The factor or constellation of factors which precipitates blood transfusion in hospitals can be termed the “transfusion trigger.” The blood transfusion experience of 535,031 male and female surgical patients was compared in order to evaluate the importance of the hematocrit as a component of this transfusion trigger. Transfusion data presented support the hypothesis that surgeons use the same support and ceiling hematocrit levels to regulate blood transfusion in men and women, despite the fact that women have lower hematocrits. The use of a lower hematocrit support level to govern the blood transfusion of female surgical patients should be considered. Data cited showing that women have a degree of physiologic adaptation to their lower hematocrits suggest that this change could be introduced without causing increased morbidity. A net saving of blood would most certainly result from it.
Hemolytic Disease of the Newborn Associated with Anti‐Jk3
Authors: Pierce S. R. , Hardman J. T. , Steele S. , Beck M. L.
Published: December 2004

This report documents a mild case of hemolytic disease of the newborn (HDN) associated with anti‐Jk3. The Filipino mother had previously had six children none of whom had been affected by HDN. She had been transfused at the time of her second pregnancy. Anti‐Jkb and anti‐Jk3 were detected in the maternal serum at the time of her seventh delivery. No prenatal serologic tests for blood group antibodies had been performed. The cord blood was found to have a positive direct antiglobulin test and anti‐Jkb plus anti‐Jk3 were eluted. The infant was treated with phototherapy.
The Manual Polybrene Test: A Simple and Rapid Procedure for Detection of Red Cell Antibodies
Authors: Lalezari P. , Jiang A. F.
Published: December 2004

A rapid manual Polybrene test for detection of red blood cell antibodies has been devised which uses standard laboratory equipment. Red blood cells are incubated with the test sera in a low ionic medium at room temperature for one minute. Polybrene, a quaternary ammonium polymer, is then introduced to cause nonspecific red blood cell aggregation. The test tubes are centrifuged, the cell free supernatant fluid decanted, and the Polybrene effect on the cells is neutralized by adding a dilute sodium citrate‐glucose solution. The hemagglutination results are evaluated macroscopically and microscopically. The entire procedure is completed in less than three minutes. In the Rh system, the test is 10–160‐fold more sensitive than the antiglobulin reaction. In other systems tested, except for the Kell, a high sensitivity is achieved. The sensitivity for the Kell system is markedly increased, however, by performing a supplementary antiglobulin reaction on the sensitized, Polybrene‐treated, red blood cells. The antiglobulin reagent used for this purpose should lack anti‐C4 and anti‐C3 activities. Sensitivity for cold reactive antibodies is augmented by cooling the cells for 30 seconds before citrate‐glucose reagent is added.
Acquisition of cytomegalovirus infection in infants following exchange transfusion: a prospective study
Authors: Kumar A , Nankervis GA , Cooper AR , Gold E , Kumar ML
Published: December 2004

A prospective study of newborn infants who required exchange transfusion was undertaken to evaluate the risk of transmission of cytomegalovirus (CMV). Buffy coat‐, urine‐ and saliva‐saturated throat swabs for viral cultures and serum specimens for CMV complement‐fixing (CF) antibody were obtained from 45 infant‐mother pairs. Buffy coat from the donor blood was cultured and CMV CF titers measured. Viral studies were repeated on infants and mothers at six and 12 weeks after exchange transfusion. Fifteen infants received CMV seropositive blood and 14 infants received CMV seronegative blood. Sixteen infants who did not receive blood or blood products served as controls. Three of 12 antibody‐positive newborns developed infection after getting seropositive blood. One of three antibody‐negative newborns developed infection after getting seropositive blood. The presence of transplacental antibody does not appear to protect the infants. None of the control infants developed CMV infection. None of the infected infants were symptomatic. Although CMV infection in infancy can be acquired by routes other than blood, exchange transfusion with seropositive blood enhances the likelihood of acquiring infection.
Recovery of autologous erythrocytes in transfused patients
Authors: Wallas CH , Tanley PC , Gorrell LP
Published: December 2004

A microcapillary method utilizing phthalate esters or an ultracentrifuge method are both capable of separating autologous from homologous erythrocytes in polytransfused patients. The microcapillary technique which is readily adaptable to blood bank laboratories provides a previously unavailable method for defining blood group antigen typings in transfused patients. Such typings are of vital importance in the laboratory evaluation of transfused patients with multiple or weak blood group antibodies.
Surgical hypothermia in a patient with a cold agglutinin. Management by plasma exchange
Authors: Klein HG , Faltz LL , McIntosh CL , Appelbaum FR , Deisseroth AB , Holland PV
Published: December 2004

Cold agglutinins are a potential danger to patients who must be subjected to hypothermia. A patient with a cold agglutinin of moderate titer but broad thermal amplitude was to undergo hypothermia during aortic valve replacement. He was managed preoperatively with an eight‐ liter plasma exchange by continuous‐flow centrifugation to remove the cold agglutinin. There were no adverse effects during or after hypothermia.
Human Blood Components I. Preparation and Characteristics of Leukocyte Concentrates from Single Units of Human Blood
Authors: Waldman A. A. , Shander C.
Published: December 2004

The distribution of white blood cells in the packed cells remaining after removal of platelet‐rich plasma has been examined. The top 50 ml, which includes the huffy coat, was expressed in 5 aliquots of 10 ml and analyzed. With ACD, the top SO ml contained 52 per cent of the total sedimented WBC but only 33 per cent of the available polymorphonuclear leukocytes (PMN). With CPD, the top 50 ml contained 65 per cent of the total sedimented WBC and 52 per cent of the available PMN. The PMN were relatively evenly distributed throughout the five aliquots, while the non‐PMN leukocytes were concentrated in the first three aliquots. The hematocrit of the top layer of packed cells was consistently lower for units collected in ACD than for units collected in CPD anticoagulant. Standard curves for the volume dependence of the differential and hematocrit were generated from these data. The characteristics of leukocyte concentrates routinely prepared as part of component production from the top 35 ml of the packed cells have been analyzed. Leukocyte concentrates prepared with ACD had, on the average, lower hematocrit, a lower percentage of PMN and fewer total white blood cells than leukocyte concentrates prepared from CPD‐anticoagu‐lant. Using CPD‐anticoagulant instead of ACD‐anti‐coagulant during source blood collection resulted in an increase of the mean PMN differential count of the leukocyte concentrates from 29.8 to 45.7 per cent and of the mean total number of PMN in the concentrates from 0.46 × 109 to 0.74 × 109. The application of these data to component preparation and use is discussed.
Adsorption of Lec and Led from Plasma onto Red Blood Cells
Authors: Hirsch H. F. , Graham H. A.
Published: December 2004

When red blood cells lacking a particular antigen (Lea Leb Lec or Led) were incubated with plasma from a donor whose red blood cells had that antigen, the red blood cells became agglutinable by the antiserum that agglutinated the red blood cells of the plasma donor. The presence of each of these antigens on an individual's red blood cells correlates with the presence of a soluble antigen in his plasma, presumably glycosphingolipid, which is capable of adsorbing onto red blood cells.
The Etiology of ABO Hemolytic Disease of the Newborn
Authors: Grundbacher F. J.
Published: December 2004

The etiology of ABO hemolytic disease of the newborn is complex because of the natural presence of anti‐A and/or anti‐B in individuals who do not possess the A and/or B antigen. Although only IgG anti‐A and anti‐B can cross the placenta, these antibodies are found in the circulation of most newborn infants born to blood group O mothers. The A and B antigens are much weaker on the red blood cells of newborn infants than of adults. This relatively weak reactivity constitutes a major protective factor against maternal antibodies which have crossed the placental barrier. However, much variation was found in the strength or the reactivity of the A antigen among infants born at term. This variation was large enough to account for the poor quantitative relationship between maternal antibody levels and the ensuing hemolytic process in the infant. Thus, the variation in antigen strength among newborns constitutes an unpredictable factor in the etiology of ABO hemolytic disease. Infants with a relatively weak A antigen can tolerate a moderately high level of circulatory anti‐A without any untoward effects, while in the presence of the same antibody level, infants with a relatively strong A antigen, a portion of the red blood cells will be destroyed.
Modifications of B, I, i, and Lewisb Antigens in a Patient with DiGuglielmo's Erythroleukemia
Authors: Kolins J. , Allgood J. W. , Burghardt D. C. , Klein H. G. , McGinniss M. H.
Published: December 2004

Loss of red blood cell antigens has been documented in patients with acute myelocytic leukemia and includes loss of A, B and H antigens in the ABO system as well as antigens of the Rh, MNSsU, Lewis and Ii systems. The following case represents partial loss of the B, I and Lewisb antigens in a patient with erythroleukemia. Also, the loss of the I antigen was associated with a concomitant increase in i antigen, a known but rare finding. These changes within the ABO, Ii, and Lewis systems do not appear to be coincidental, as these blood group systems share a common biochemical backbone.
Transfusion‐Associated Fatalities: Review of Bureau of Biologies Reports 1976–1978
Authors: HONIG C. L. , BOVE J. R.
Published: December 2004

Review of the 70 transfusion‐associated fatalities reported to the Bureau of Biologics (BOB) between 1976 and 1978 revealed 44 acute hemolytic reactions, two delayed hemolytic reactions, five fatalities associated with acute respiratory failure, two cases of bacterial contamination, one graft‐versus‐host reaction (GVHR), ten cases of hepatitis, and six fatalities not associated with transfusion. Thirty‐eight of 44 acute hemolytic reactions were due to ABO incompatibility. Clerical confusion was the cause of 33 of 37 cases in which error could be defined.
Vasovagal Reactions in Blood Donors
Authors: Ogata H. , Iinuma N. , Nagashima K. , Akabane T.
Published: December 2004

The donor records of a hospital blood bank, analyzed from a statistical standpoint, demonstrated a low incidence of vasovagal reactions: 119 in 10,547 donations (1.13%). Donors of younger age and of lower diastolic blood pressure were more prone to reaction. There was no significant sex difference. Higher reaction rates were also associated with first‐time donation, the time of year (spring), and a particular phlebotomist. The low reaction rate and the clearly demonstrated psychologic factors in the present study were attributed to a reflection of the small amount (200 ml) of blood withdrawn. The importance of the phlebotomist‐donor relationship was stressed.
Absence of Autoanti‐Jk3 as a Component of Anti‐dl
Authors: Issitt P. D. , Pavone B. G. , Frohlich J. A. , Mallory D. McGuire
Published: December 2004

Thirty‐five examples of anti‐dl, autoantibodies initially reacting with all red blood cells against which they were tested, were examined prior to, and following adsorption with Jk(a‐b‐) red blood cells. None of them was found to contain autoanti‐Jk3. One example of auto‐anti‐Jka was identified in an adsorbed eluate. The antibody had been produced by a pregnant Caucasian, in whom laboratory and clinical evaluation showed that the auto‐antibody was benign in vivo.
Measurement of anti‐IgA antibodies by a two‐site immunoradiometric assay
Authors: Homburger H.A. , Smith J.R. , Jacob G.L. , Laschinger C. , Naylor D.H. , Pineda A.A.
Published: December 2004

To enable the detection of IgG class, anti‐IgA antibodies (IgG‐aIgA) and to investigate the possible occurrence of IgE class, anti‐IgA antibodies (IgE‐aIgA), we developed a solid phase immunoradiometric assay (IRA), which uses purified IgA coupled covalently to microcrystalline cellulose as an immunosorbent. Radiolabeled, Fc specific anti‐IgG and anti‐IgE antibodies were used to detect specific aIgA after incubation of test sera or controls with the immunosorbent. IgG‐aIgA were detected by the IRA in 100 and 67 per cent of control sera with class specific and limited specificity aIgA. The IRA was sensitive to approximately two ng of class specific IgG‐aIgA. IgG‐aIgA also were detected by IRA in 7.9 per cent of sera from patients with urticarial transfusion reactions and 73 per cent of sera from patients with ataxia telangiectasia and IgA deficiency. Sera from 50 normal blood donors did not have detectable IgG‐aIgA. Tests for IgE‐aIgA were negative in all cases, including control sera with class specific IgG‐ aIgA. We conclude that the IRA is a sensitive and reproducible method for detection of class specific and limited specificity IgG‐aIgA, and that IgE‐aIgA do not mediate urticarial transfusion reactions.
Delayed hemolytic episodes due to anti‐M
Authors: Furlong M.B. , Monaghan W.P.
Published: December 2004

We observed three cases in which anti‐M, undetectable in pretransfusion serum, was responsible for accelerated hemolysis of crossmatch‐ compatible red blood cells 5 to 15 days after transfusion. In each case, the direct antiglobulin test, which had been negative on pretransfusion testing, was weakly positive on the posttransfusion sample. Anti‐M was identified in both the serum and eluate from the posttransfusion sample in two cases. In the third, anti‐M could be identified only in the posttransfusion serum. Hemolysis was mild, and was not clinically suspected in any of these three patients until blood was requested for further transfusion. In one of the cases, the antibody was undetectable within a few weeks after the hemolytic episode. Destruction of transfused red blood cells by newly synthesized alloantibodies, particularly those of the Kidd system, is a familiar phenomenon to blood bankers. It is apparent from these studies that anti‐M also can behave in this fashion.
Heparin removal in an autotransfusor device
Authors: Umlas J. , O'Neill T.P.
Published: December 2004

In order to determine the residual heparin in the supernatant fluid recovered from blood washed with increasing amounts of solution in the Haemonetics Cell Saver, various modifications of Grann's polybrene neutralization test applied. It is suggested that each 450 to 500 ml of recovered heparinized blood be washed with a minimum of 500 ml of saline, although 700 ml is advisable. The red color from hemolyzed erythrocytes may clear while unacceptably high levels of heparin remain.
Altered platelet function and circulation induced by amphotericin B in leukemic patients after platelet transfusion
Authors: Kulpa J. , Zaroulis C.G. , Good R.A. , Kutti J.
Published: December 2004

Four adults, recently diagnosed, acute leukemic patients received 40 separate platelet transfusion treatments before, during, and after intravenous administration of amphotericin B. Fourteen of these platelet transfusions were administered while the patients also received amphotericin B; 26 platelet transfusions were given before or after amphotericin B therapy. The mean platelet increment for platelet transfusions administered while the patients were untreated with amphotericin B was 58 ± 6 per cent. While the same patients were being treated with amphotericin B, the mean platelet increment was significantly decreased to 29 ± 8 per cent (t = 3.1; p < 0.005). In addition, when the patients were not being given amphotericin B, a highly significant negative relationship (r = ‐0.77; p < 0.001) between the values for bleeding time and venous platelet count was present. In contrast, during amphotericin B treatment there was no correlation between the patients' bleeding times and venous platelet counts. We propose that amphotericin B therapy has a direct toxic effect on the function and circulation of transfused platelets. These toxic effects are quickly corrected by discontinuing this antifungal antibiotic.
Delayed hemolytic transfusion reaction caused by anti‐P1 antibody
Authors: Chandeysson P.L. , Flye M.W. , Simpkins S.M. , Holland P.V.
Published: December 2004

A 67‐year‐old white woman received transfusions of a total of 87 units of whole blood and red blood cells during and within 48 hours following a pneumonectomy. Although she had previously received blood transfusions, unexpected antibodies were not detectable by routine screening. On the second postoperative day, she developed fever, hemoglobinemia, hemoglobinuria, and oliguria. However, the direct antiglobulin test and the antibody screen were negative. On the eighth postoperative day, an IgM anti‐P1 antibody was detected for the first time. This anti‐P1 antibody increased in thermal amplitude from 22 to 37 C, but remained IgM. The circulating transfused P1‐positive cells decreased progressively without evidence of bleeding. Testing of the patient's preoperative blood at 15 C found her serum to be weakly reactive with P1 cells, while her own cells were PM2. Thus, an anamnestic response to the P1 antigen is the most likely cause of her delayed hemolytic transfusion reaction.
Auto‐anti‐A1: another cause of ABO discrepancy
Authors: Rogers V.B. , Reid M.E. , Ellisor S.S. , Carrick S.
Published: December 2004

Anti‐A1 was found in the serum of a patient of blood group A1 who had never received a blood transfusion. The patient's serum caused agglutination of his own red blood cells. The anti‐A1 could be totally absorbed by red blood cells from the patient and from other A1 individuals. The anti‐A1 was inhibitable by soluble group A‐specific substance and was denatured by 2‐mercaptoethanol. The A and H serum transferases were normal. The presence of auto‐anti‐A1 in the serum of an A1 individual is yet another cause of ABO discrepancy.