bluuebunny/crossref_metadata_2025 huggingface dataset:
Evans' Syndrome: Possible Benefit from Plasma Exchange
Authors: Patten E. , Reuter F. P.
Published: December 2004

Because of previous reports of benefit of plasma exchange in immunologic disorders, we plasmapheresed a 45‐year‐old woman with immune thrombocytopenia and autoimmune hemolytic anemia (Evans' syndrome) who appeared to be dying despite splenectomy, prednisone, immunosuppressives and transfusions. Nine liters of plasma were removed over a 12‐day period. Prior to plasma exchange, the patient's hematocrit remained below 16 per cent despite six units of red blood cells over a three‐day period. Following plasma exchange, the hematocrit rose to 29 per cent; the platelet count gradually rose from 14,500/μl to 272,000//μl; and the transfusion requirements declined to only two units of red blood cells over the next 37 days. We conclude that plasmapheresis should be considered in the management of patients with refractory immune thrombocytopenia and autoimmune hemolytic anemia.
Viability and Function of Stored Sickle Erythrocytes
Authors: Castro O.
Published: December 2004

Functional and metabolic characteristics of fresh and three‐week stored erythrocytes from patients with sickle cell anemia were compared. The storage‐related changes in ATP, 2,3‐DPG, and P50 in sickle erythrocytes were similar to those in control (HbA) red blood cells. After storage in CPD, sickle erythrocytes maintained significantly higher levels of 2,3‐DPG (mean 2.20 ± 0.73 mm/ml RBC) than did control cells (mean 0.36 ± 0.13 mm/ml RBC). The posttransfusion recovery and survival of stored SS erythrocytes in autologous recipients and in an animal test system were at least as good as those before storage. Tolerance of the storage lesion by sickle erythrocytes is probably related to their young mean cell age. These results also suggest that the option of autotransfusion should be explored for selected patients with sickle cell disease in special clinical settings.
A Second Case of Hemolytic Disease of the Newborn Due to Anti‐Jsa
Authors: Levene C. , Rudolphson Y. , Shechter Y.
Published: December 2004

A second case of hemolytic disease of the newborn caused by Jsa sensitization is reported. The child was mildly affected and transfusions were not required. The mother and father are Arabs. Jsawas present in the father, the baby in question, and a sibling. In addition, the Fy gene was present in both mother and father, and in two of their three children.
Red Cell Membrane Protein Changes Caused by Freezing and the Mechanism of Cryoprotection by Glycerol
Authors: Ballas S. K.
Published: December 2004

Membranes isolated from frozen‐thawed erythrocytes and analyzed by polyacrylamide gel electrophoresis in sodium dodecyl sulfate have significantly decreased band six, which is the glycolytic enzyme, glyceraldehyde 3‐phosphate dehydrogenase. The total membrane protein and sialic acid contents of these membranes are also significantly decreased. The red blood cell membrane protein abnormality is reproduced by suspending membranes in NaCl solutions of increasing molarity. Glycerol prevents the elution of band six in NaCl solutions less than 0.2 M and ameliorates it in solutions of higher ionic strength. When intact cells are suspended in hypertonic salt solution, there is no elution of band six, indicating that exposure of the inner surface of the membrane to toxic concentrations of solutes results in this elution. The data indicate that freezing with its associated hypertonicity induces a specific membrane change which is ameliorated by the addition of glycerol.
Donor Platelet Response and Product Quality Assurance in Plateletpheresis
Authors: Lasky L. C. , Lin A. , Kahn R. A. , McCullough J.
Published: December 2004

Retrospective analysis of 352 donors who underwent plateletpheresis at least four times, each using the Haemonetics Model 30 Blood Processor, indicated that a postpheresis platelet count of less than 100,000/μl occurred in only 2.7 per cent of phereses. Restricting pheresis to those with a prepheresis platelet count of >150,000/μl would have lowered this to 1.3 per cent and eliminated only 3.7 per cent of donations. The donors' platelet counts returned to baseline approximately four days and rebounded above baseline eight to eleven days after pheresis. To minimize the chance of a donor having a postpheresis platelet count less than 100,000/μl, the prepheresis platelet count should be greater than 150,000/μl. A platelet count greater than 150,000/μl immediately following the previous pheresis can be used instead of the prepheresis platelet count. The yield was related to the prepheresis platelet count, number of cycles, sex, type of procedure (platelet or platelet‐leukapheresis), and the yield recorded during an individual's previous procedures. Seventy‐five per cent of plateletpheresis products contained more than 3.3 × 1011 platelets. This might be a satisfactory standard for quality assurance.
Pheresis with the IBM 2997
Authors: Kalmin N. D. , Grindon A. J.
Published: December 2004

We have used the NCI‐IBM 2997 cell separator in 85 leukapheresis and 34 plateletpheresis procedures. Using hydroxyethyl starch (HES)and steroid pretreatment, our mean granulocyte yield was 19.3 billion cells in a mean product volume of 270.5 ml, containing 10.6 ml of red blood cells. The mean platelet yield during leukapheresis was 18.5 × 1010, as compared with 37.2 × 1010 when plateletpheresis alone was performed. There was a strong correlation between the mean level of granulocytes in the blood before leukapheresis and the granulocyte yield in the product. Other variables well‐correlated with granulocyte yield were the red blood cells in the product, the total blood volume processed, and the product volume. Platelets obtained during plateletpheresis were significantly correlated with the total blood volume processed and with the volume of red blood cells in the product. Donor reactions were no more frequent with the IBM 2997 than with other pheresis systems. This appears to be the system that can provide the best granulocyte yields at the present time.
Cytapheresis in a Patient with Sezary Syndrome
Authors: Bongiovanni M. B. , Katz R. S. , Tomaszewski J. E. , Ziselman E. M. , Goldwein M. I. , Wurzel H. A.
Published: December 2004

A patient with Sezary syndrome underwent cytapheresis on the IBM 2997 cell separator. Four procedures were performed over a 12‐day period. A total of 8.3 × 1010 Sezary cells were removed. The patient's skin lesions and lymphadenopathy regressed. Transient thrombocytopenia occurred, requiring platelet transfusion. Although a significant number of platelets were removed by pheresis, this was not sufficient to explain the thrombocytopenia. The patient subsequently died of causes unrelated to the cytapheresis.
The Elimination of Hydroxyethyl Starch from the Blood of Donors Experiencing Single or Multiple Intermittent‐Flow Centrifugation Leukapheresis
Authors: Maguire L. C. , Strauss R. G. , Koepke J. A. , Bowman R. J. , Zelenski K. R. , Lambert R. M. , Hulse J. D. , Atnip A. K.
Published: December 2004

The elimination of hydroxyethyl starch (HES) from donor blood was studied following either single or multiple intermittent‐flow centrifugation leukapheresis. Immediately following pheresis, serum HES concentrations fell rapidly. The rate of elimination then slowed with trace amounts of HES persisting for weeks. Pharmaco‐kinetic analysis using a two‐compartment open model revealed an average distribution half‐life and terminal half‐life of 3.84 and 48 days, respectively. After multiple phereses, HES accumulated in serum. Although the pattern of elimination was similar, the persistence of HES was more protracted, with the serum level predicted to reach the baseline at 72 weeks pastpheresis versus 38 weeks after a single pheresis. The importance in regards to toxicity, if any, of the persistence of trace amounts of HES in donor blood is presently unknown.
Regeneration of 2,3‐bisphosphoglycerate and ATP in stored erythrocytes by phosphoenolpyruvate: a new preservative for blood storage
Authors: Hamasaki N. , Ideguchi H. , Ikehara Y.
Published: December 2004

Phosphoenolpyruvate is transported through erythrocyte membrane in acid citrate or sucrose solution and metabolized to 2,3‐bisphosphoglycerate and pyruvate. The levels of ATP and 2,3‐bisphosphoglycerate of depleted, stored erythrocytes were increased effectively by incubating the cells in acid‐citrate‐dextrose‐sucrose solution with phosphoenolpyruvate. The concentration of 2,3‐bisphosphoglycerate exceeded by three times its physlological level under suitable conditions. When fresh blood was stored at 4 C in acid‐citrate‐dextrose‐sucrose solution with phosphoenolpyruvate, the levels of ATP and 2,3‐bisphosphoglycerate of erythrocytes decreased during storage in essentially the same extent as those of erythrocytes preserved in acid‐citrate‐dextrose solution. However, the levels of ATP and 2,3‐bisphosphoglycerate of the cells increased when preserved erythrocytes with phosphoenolpyruvate were incubated at 37 C for 30 minutes. Especially noteworthy was the ATP concentration of erythrocytes preserved with phosphoenolpyruvate at 4 C for 14 days. It was kept at the same level as in fresh blood by the short incubation time.
Purine metabolism of erythrocytes preserved in adenine, adenine‐ inosine, and adenine‐guanosine supplemented media
Authors: de Verdier C.H , Strauss D. , Ericson Å. , Åkerblom O. , Högman C.F.
Published: December 2004

Four different media for erythrocyte preservation have been compared by studying 16 variables mainly describing the purine metabolism and glycolysis of the erythrocyte. The concentrations of the additives in the erythrocyte suspensions were as follows: adenine, 0.25 mmol/l; adenine, 0.75 mmol/l; adenine, 0.25 and inosine, 0.50 mmol/l; and adenine, 0.25 and guanosine, 0.50 mmol/l. Evaluated from the concentrations of glycerate 2,3‐bisphosphate and purine nucleoside triphosphates, the medium with adenine‐guanosine was superior to the others. In this medium with adenine‐guanosine was superior to the others. In this medium the guanosine was rapidly split to guanine, which was slowly used for nucleotide synthesis or deaminated to xanthine. Differences between ATP and GTP in their reactivity with the two enzymes phosphofructose kinase seems to explain the beneficial effect of guanosine on preservation of erythrocytes.
Plasma exchange in the treatment of hemolytic disease of the newborn
Authors: Rock G. , Lafreniere I. , Chan L. , McCombie N.
Published: December 2004

Plasma exchange has become a widely used therapeutic tool in the treatment of immune‐mediated disease. This technique has been applied to the treatment of gravid women whose high antibody titers and past history of stillbirths indicate a significant possibility of fetal loss due to HDN. The procedure was effective in decreasing both antibody titer and the quantity of antibody in four of five patients. In one other case, the antibody titer rose toward the end of the pregnancy; however, the quantity of anti‐D remained low. The IgG:IgM ratio and the subclass specificity of IgG did not significantly change with treatment. Hematologic monitoring also indicated no adverse effects, and three of the five women delivered viable fetuses. Two of the other women produced infants only moderately affected by HDN but stillborn within days of intrauterine transfusion. The results indicate that plasma exchange is a useful therapeutic consideration in the sensitized gravid women.
Hyperviscosity syndrome in paraproteinemia
Authors: Beck J. R. , Quinn B. M. , Meier F. A. , Rawnsley H. M.
Published: December 2004

Clinical and laboratory indices of hyperviscosity were studied in three patients presenting with this complication of paraproteinemia. Serum viscosity correctly predicted the presence of clinical hyperviscosity syndrome in patients with stable hemoglobin and albumin concentrations. Serum viscosity also correlated with total protein and paraprotein levels. A simple exponential model proved not only to describe the kinetics of blood viscosity during plasma exchange but also to predict protein concentration at symptomatic recovery. Construction of such a protein‐viscosity curve helps manage by plasma exchange patients with paraproteinemia who develop hyperviscosity syndrome.
Autoagglutinins with apparent anti‐P specificity reactive only by low‐ ionic‐strength salt techniques
Authors: Judd W. J. , Steiner E. A. , Capps R. D.
Published: December 2004

Two blood samples containing autoagglutinins reactive in room temperature tests using low‐ionic strength salt (LISS) reagents, but not by conventional saline‐albumin or enzyme tests, are reported. The anti‐P specificity of both sera, when tested near or diluted in group AB serum, was evident by their failure to agglutinate LISS‐suspended Tj(a‐),(p), and P1 red blood cells. However, one of the two samples displayed no anti‐P specificity when diluted in LISS solution as opposed to group AB serum. Some urine samples inhibited this latter serum. Inhibition did not correlate with urinary Sda antigen content, nor with pH, Na+, K+, C1‐, or osmolality levels. However, there was some correlation between inhibition and urinary conductivity levels. Moreover, partial inhibition was observed in tests with globoside. While there are no data to indicate that these LISS‐dependent autoagglutinins are of clinical consequence in vivo, it is likely that they represent low‐affinity autoantibodies reacting only in a low‐ionic environment. They establish a further cause of anomalous serologic reactions associated with LISS techniques.
Transport of 5‐hydroxytryptamine by human platelets incubated in glycerol
Authors: Armitage W. J.
Published: December 2004

The active transport of 5‐hydroxytryptamine was used to assess the effect of glycerol on human platelets. The amine is transported by a membrane‐based process that requires energy. The initial rate of uptake was measured using low concentrations of tritium‐labeled 5‐ hydroxytryptamine (0.25 to 2.0 mumol/l) and a short incubation time following exposure of platelets to 0.05 or 1.0 mol/l glycerol at 37 degrees C for 2, 15, or 30 minutes. Control values for Km and Vmax were 0.7 ± 0.05 mumol/l and 24.0 ± 1.2 pmol/10(8) cells/10 seconds, respectively. The kinetics of 5‐hydroxytryptamine uptake were not affected by incubation of platelets in 0.5 mol/l glycerol. However, 1.0 mol/l glycerol had a time‐dependent effect on the uptake process. Initially, 5‐hydroxytryptamine transport was noncompetitively inhibited, but this effect was reversed after 15‐minute incubation in 1.0 mol/l glycerol. Continued exposure to 1.0 mol/l glycerol, however, increased Km. It was concluded that concentrations of glycerol above 0.5 mol/l might not be suitable as a cryoprotectant for platelet cryopreservation.
Factor VIII concentrate prepared from blood donors stimulated by intranasal administration of a vasopressin analogue
Authors: Mikaelsson M. , Nilsson I. M. , Vilhardt H. , Wiechel B.
Published: December 2004

With an interval of eight weeks between collections, blood was drawn twice from 120 blood donors. At one of the donations, 0.25 ml of synthetic vasopressin, (DDAVP, 1300 micrograms/ml), was administered intranasally 60 minutes prior to collection of the blood. No drug was given at the other donation. The yield of factor VIII clotting activity (VIII:C) and factor VIII antigen (VIIIR:Ag) was compared in blood drawn from the treated and untreated donors. To prevent degradation of VIII:C by fibrinolysis, tranexamic acid was added to the plasma from treated donors immediately after separation from the red blood cells. Plasma from treated donors and the derived Cohn fraction I‐O contained approximately twice as much VIII:C as plasma and fraction I‐O from untreated control donors. The concentration of VIIIR: Ag was also increased in fraction I‐O made from plasma from treated donors, however to a lesser degree. The in vivo properties of factor VIII concentrates made from each group of donors were studied. Half‐life in plasma and recovery of VIII:C were identical. Thus, intranasal synthetic vasopressin may be used to increase the yield of VIII:C in production of factor VIII concentrates.
Computer simulation analysis of blood donor queueing problems
Authors: Pratt M. L. , Grindon A. J.
Published: December 2004

A computer simulation model was used to study work flow and queueing problems in blood collection. Donor scheduling strategies, such as stream and block arrivals, were compared with random arrival at a constant hourly rate. Controlling donor queueing required keeping donor arrivals from exceeding the system capacity, rather than using any one type of scheduling strategy. However, widely uneven arrivals compared to even arrivals at the same input level caused protracted queueing. Because men have a shorter average phlebotomy processing time, time can be saved in some situations by scheduling mostly men at the beginning of a drive. Nursing utilization appears optimal at donor arrival rates at or near system capacity. Techniques may be available to modify the collection system to ameliorate or prevent queueing when donor arrivals appear to be excessive.
A simplified method for quality control of deglycerolized erythrocytes
Authors: Silver Herbert , Umlas Joel , Kenney Peter , Anderson Janice , Pina Brenda , Cross Debra
Published: December 2004

Quality control to detect inadequately deglycerolized red blood cells can be easily and inexpensively accomplished by suspending the deglycerolized cells in either recipient serum or normal saline in the same way in which the routine crossmatch is performed. In vitro hemolysis is readily and consistently apparent when the residual glycerol exceeds either 2.4% (in saline) or 2.5% (in serum). In contrast to generally held beliefs, the in vivo 24‐hour survival of red blood cells with a residual glycerol concentration of up to 2.7% was demonstrated to be 76% of greater, a level which is well above what is usually accepted as adequate.
Platelet adenine nucleotide levels during room‐temperature storage of platelet concentrates
Authors: Savage B.
Published: December 2004

Platelet adenine nucleotide levels were measured in freshly prepared platelet concentrates and daily during storage at room temperature. Marked depletions in platelet adenosine triphosphate (ATP) and adenosine diphosphate (ADP) levels were associated with decrease in both plasma glucose levels and poststorage pH. In those concentrates with only moderate glucose consumption, platelet ATP and ADP levels were well preserved and the plasma pH remained above 6.0. The rate of glucose utilization and poststorage pH were greatly influenced by the concentration of contaminating leukocytes. These studies indicate that the rate of exogenous glucose consumption is an important factor affecting platelet adenine nucleotide levels during room temperature storage of platelet concentrates.
Immune system changes in cytapheresis donors
Authors: Senhauser D. A. , Bohman J. E. , Westphal R. G. , Neff J. C.
Published: December 2004

In vitro measurements of several variables of the immune system were made in 21 healthy donors who had been subjected to frequent cytapheresis an a group of whole blood donor controls matched for age and sex. Significant changes noted in the apheresis donors compared to controls included a 23 percent lower mean absolute lymphocyte count (p less than .01), a 25 percent lower mean T cell count (p less than .01), and a 46 percent lower mean B cell count (p less than .001). Serum protein changes included a 27 percent lower mean gamma globulin level (p less than .01), and 14 percent lower mean IgG level (p less than .05) in the apheresis donors when compared to the control group. The possible implications of these findings are discussed, and we suggest that donors undergoing multiple cytapheresis procedures be closely monitored to determine the safe donation frequency.
A study of granulocyte cytotoxins and detection of granulocyte allospecific antigens
Authors: Kořínková P. , Vorlíček J. , Májský A.
Published: December 2004

Granulocytes were isolated b overlaying leukocyte‐rich plasma discontinuous density gradients. The cell suspensions were 95 percent granulocytes. Sera of 383 polytransfused patients and 521 multiparous women were examined for lymphocytotoxins, granulocytotoxins, and granulocytoagglutinins. On the basis of these tests, sera were identified which contained only granulocytotoxins. These were further identified with more precision as to their titers and antibody absorption; reactivity with granulocytes, B, and T lymphocytes; and K 562 cell line. On the basis of calculated correlation coefficients, nine sera were selected which determined three granulocyte specificities having genotype frequencies consistent with the Hardy‐Weinberg equilibrium.
Collection of erythroid progenitor cells by cytapheresis of peripheral blood of normal donors
Authors: Barr R.D. , Stevens C.A. , Koekebakker M. , McBride J.A.
Published: December 2004

Human peripheral blood may be an alternative to bone marrow as a source of cells for hemopoietic engraftment. The ability to collect large numbers of circulating granulocyte‐macrophage progenitors provides support for this contention. In the present study of cells from normal granulocyte donors, the cell concentrates obtained by cytapheresis were shown to contain even greater numbers of primitive erythroid precursors (153–956 [median 647] per 106 mononuclear cells) than would be predicted from the peripheral blood mononuclear cell counts. Moreover, the number of primitive erythroid precursors harvested correlated significantly with the number of granulocyte‐macrophage progenitors obtained and with the total lymphocyte collection. These observations further substantiate the validity of transplanting peripheral blood as hemopoietic tissue.
Yersinia enterocolitica
Authors: Stenhouse M.A.E. , Milner L.V.
Published: December 2004

Yersinia enterocolitica multiplies rapidly in whole blood or red blood cells stored at 4 to 8° C. Gross contamination is not visible in a pack. Two incidents in which red blood cells grossly contaminated with Yersinia enterocolitica were transfused are described. One patientdied; the other survived.
Serologic comparison of a monoclonal anti‐C3d with commercial antiglobulin reagents
Authors: Barker J.M.
Published: December 2004

The serologic reactivity of a monoclonal anti‐C3d and commercial “monospecific” anti‐C3 and polyspecific antiglobulin reagents was compared. The testing consisted of a direct antiglobulin test performed on donor and patient cells and on in vivo and in vitro complement‐ coated cells; an indirect antiglobulin test was performed with low‐ ionic‐strength solution crossmatches. The monoclonal anti‐C3d demonstrated reactivity very similar to that of the commercial heterogeneous rabbit anti‐C3d; it gave relatively few weak “false positive” reactions with normal donor and patient red blood cells, and comparably strong reactions with in vitro and in vivo C3d‐coated red blood cells. The results suggest a promising future for monoclonal antiglobulin reagents.
Effect of microaggregate blood filtration on granulocyte concentrates in vitro
Authors: Snyder E. L. , Root R. K. , Hezzey A. , Metcalf J. , Palermo G.
Published: December 2004

To determine the effect of transfusing granulocyte concentrates through microaggregate blood filters, granulocytes prepared with a cell processor were passed through screen and depth microaggregate filters. Pre‐ and postfiltration evaluations were made of total granulocyte count, levels of muramidase, granulocyte viability, motility, phagocytosis, bactericidal activity, and hydrogen peroxide‐forming capacity. Compared to prefiltration levels, a significant (p<0.05) decrease in postfiltration granulocyte counts was seen for all the depth filters studied but not for the standard 170 μm (control) or the40 μm screen filter. For the various tests of granulocyte function evaluated prefiltration, no significant postfiltration differences (p > 0.05) were seen for any of the filters studied. Screen microaggregate filters retained only 1 to 3 percent of granulocytes contained in the concentrates, and thus appear satisfactory for use in clinical transfusions. The large percentage of neutrophils retained by the depth filters (20—62%), however, precludes their use for transfusion of granulocyte concentrates
Successful management of a patient with an acquired factor VIII inhibitor
Authors: Sultan Y. , Maisonneuve P. , Bismuth A. , Steg A.
Published: December 2004

An otherwise healthy 42‐year‐old man had hematuria and hematomas in both legs associated with a spontaneous inhibitor to factor VIII. The patient was treated with repeated plasma exchange, factor VIII concentrates, and steroids. Rapid clinical improvement with rapid recovery of circulating factor VIII occurred. Disappearance of the inhibitor was observed within 1 month. The patient remains well with no evidence of an inhibitor. It is unlikely that steroids were responsible for the disappearance of the inhibitor. Therefore, plasma exchange associated with factor VIII concentrate administration may be considered an effective tool for the management of patients with spontaneous idiopathic inhibitor to factor VIII
Fetal Rh blood group determination in pregnancy termination by dilatation and evacuation
Authors: La Ferla J. J. , Butch S.
Published: December 2004

Feasibility of Rh blood group determination from fetal samples at the time of second trimester abortion by dilatation and evacuation method was investigated. Fetal cord blood was found to be obtained easily, especially when gestational age was more than fifteen weeks. Fetal blood typing was performed easily and accurately. Selective prophylactic immunization of Rh negative patients undergoing dilatation and evacuation procedures is suggested
An unusual antibody related to the MN blood group system
Authors: Wright J. , Lim F. C. , Freeman J. , Giles C. M.
Published: December 2004

The serum of an untransfused white man agglutinated the red cells from black donor samples. An association with N, Tm and Hu determinants was observed.
Plasmapheresis in a child with the hemolytic‐uremic syndrome
Authors: Kalmin N. D. , Himot E. D.
Published: December 2004

Plasmapheresis, using fresh‐frozen plasma for replacement, has been reported to be of benefit in the treatment of hemolytic‐uremic syndrome and in thrombotic thrombocytopenic purpura. Both diseases have the same pathological characteristics and, possibly, the same pathogenesis. The mechanism by which plasma exchange results in clinical improvement is not clearly established, although recent reports indicate that it may be based on prostacyclin replacement rather than the removal of humoral factors toxic for platelets or vascular walls.

Exchange plasmapheresis using an intermittent‐flow cell processor with a disposable 100‐ml pediatric centrifuge bowl is described in a 5‐year‐old girl with hemolytic‐uremic syndrome.
Comparison of two continuous‐flow cell separators
Authors: Kalmin N. D. , Grindon A. J.
Published: December 2004

Two blood processors (IBM 2997 and Fenwal CS‐3000) were evaluated under similar conditions. Fifty‐four leukapheresis procedures with the 2997 resulted in a mean granulocyte yield of 19.4 × 109 (42.5% efficiency), with a mean of 2.1 × 1011 platelets (10.9% efficiency) per product. The CS 3000, at a whole blood flow rate of 50 ml/min, yielded a mean of 13.3 × 109 granulocytes (39.2% efficiency) and 4.0 × 1011 platelets (28.5% efficiency) during 63 leukapheresis procedures. At a flow rate of 60 ml/min, the mean yields of 20 leukapheresis procedures with the CS 3000 were 14.2 × 109 granulocytes (30.5% efficiency) and 4.3 × 1011 platelets (27.8% efficiency). Thirty‐four plateletpheresis procedures with the 2997 yielded a mean of 3.62 × 1011 platelets (53.12% efficiency), and 2.70 × 109 white cells. The mean CS‐3000 yield for 88 plateletpheresis procedures was 3.15 × 1011 platelets (49.13% efficiency) with a mean white cell content of 0.67 × 109. Granulocyte yields with the 2997 were greater than those obtained with the CS‐3000.
Extension of platelet concentrate storage
Authors: Simon T. L. , Nelson E. J. , Carmen R. , Murphy S.
Published: December 2004

Extension of the storage time of platelet concentrates in a satellite bag which is part of a new blood bag system was studied by reinfusing autologous 51Cr‐labeled platelets into normal volunteers, and measuring postinfusion platelet counts and bleeding times in patients requiring platelet transfusions. This satellite bag, made of polyvinylchloride plasticized with a new agent, was found to protect platelet concentrates against fall of pH better than other containers studied. This protection was felt to be due to the greater gas permeability of the new plastic. Mean in vivo recovery and half‐life (greater than 31% and 3.3 days, respectively) of autologous reinf used platelets were satisfactory following 5 days of storage. Following 7 days of storage, mean recovery was 41 percent and half‐life was 2.8 days. Peripheral platelet count increments in patients following platelet transfusions with concentrates stored 4 to 7 days in the new plastic were comparable to increments following transfusion of platelets stored 2 to 3 days in the other plastics studied. Bleeding times shortened in three of four patients receiving platelet concentrates stored from 4 to 6 days in the new plastic. Platelet concentrates stored in the new bag at 20 to 24 ° C with flat‐bed or elliptical agitation could be transfused for up to 5 days following phlebotomy with acceptable clinical results. The new plastic container is promising for storage of platelet concentrates for up to 7 days. Due to the higher pH of 50‐ml platelet concentrates stored in bags made with the new plastic, the concentrates were superior at any storage interval to those stored in bags made of the other plastics studied.
Standardization of blood product preparation by means of a “centrifugation index”
Authors: Boudart D. J. , Tardivel R. H. , Gauvin D. S. , Rochon D. M.
Published: December 2004

A centrifugation index for blood product preparation is proposed. This index, calculated from the domain of ultracentrifugation, is most applicable to describe the effects of centrifugation of large volumes than the relative centrifugal force and centrifugation time commonly used. The value of such an index is illustrated by the calculation of the minimum centrifugation time required for the preparation of platelet‐poor plasma with seven different centrifuges.
The effect of obstruction of bag surface on platelet concentrate pH
Authors: Simon T. L.
Published: December 2004

ABSTRACT Platelet concentrates stored in bags (made of a plastic film incorporating a new plasticizer) on flatbed agitators for up to 5 days were found to have accelerated pH decline when the surface of the bag was obstructed with added labels and an invoice on the non‐labeled side. Without the over‐labeling and invoice, only one of 20 concentrates had a pH below 6.0, even at very high concentrations of platelets. Blood banks experi encing problems with pH decline in the platelet concentrates being stored up to 5 days should consider eliminating surface obstruction on the bag.
Hemotherapy in patients undergoing blood group incompatible bone marrow transplantation
Authors: Lasky L. C. , Warkentin P. I. , Kersey J. H. , Ramsay N. K. C. , McGlave P. B. , McCullough J.
Published: December 2004

The management of hemotherapy in 31 cases of ABO‐ or Rh‐incompatible bone marrow transplantation is described. Our experience confirms that ABO or Rh incompatibility does not adversely affect engraftment, patient survival, or incidence of graft‐versus‐host disease. Eighteen recipients with ABO antibodies against the donors' red cells (major incompatibility) were managed by different combinations of plasma exchange, transfusion of incompatible donor type red cells, and removal of donor‐type red cells from the bone marrow before transplant. The only serious complication was delayed hemolysis in seven of nine patients who received incompatible red cell transfusions before transplant. Thirteen patients received bone marrow containing ABO antibodies against their red cells (minor incompatibility). Five were managed by centrifuging the bone marrow to remove plasma and reduce the amount of antibody. This did not cause substantial loss of stem cell activity (60–100% of original marrow), and no patients had complications related to the marrow transfusion. In contrast, two of seven patients who received uncentrifuged bone marrow experienced hemolysis. Two of four Rh positive recipients who received marrow from an Rh negative donor developed anti‐D, possibly due to Rh positive blood components transfused after transplantation. None of eight Rh negative patients who received an Rh positive transplant has developed anti‐D. Blood components should be selected to avoid transfusion of incompatible red cells and to avoid transfusion of a large amount of incompatible plasma. This may necessitate use of plasma components of a different ABO type than the red cell components.
Observations on the removal of microaggregates from stored blood by centrifugation and filtration through a standard 170 μm transfusion filter
Authors: Linko K.
Published: December 2004

The effect of centrifugation (5 minutes, 6900 ×g) on the amount and particle size of blood microaggregates was studied in order to assess whether centrifugation and filtration by a standard (170 μm) transfusion set filter could be used for aggregate removal instead of microfiltration. Aggregates were quantitated using a method based on nylon screens with graded pore sizes. At the beginning of storage, centrifugation increased the particle size of aggregates only slightly. In 7‐day‐old blood, aggregates capable of passing a 160 μm screen amounted to 308 ± 107 (SD) mg of debris protein per liter of blood before and 55 ± 26 (SD) mg of protein (n = 10) after centrifugation. In 14‐day‐old blood centrifugation increased the size of aggregates even more effectively: 311 ±81 (SD) before and 29 ± 14 (SD) mg of protein following centrifugation. Microaggregates can thus be removed effectively by the centrifugation and filtration method from blood stored for more than 1 week. A standard transfusion set filter can be used instead of a micropore filter.
Collection and preservation of human placental blood
Authors: Brandes J. M. , Roth E. F. , Berk P. D. , Bottone E. , Milano C. T. , Sarkozi L. , Zaroulis C. G.
Published: December 2004

High‐risk premature infants require red cell transfusions for anemia. Placental blood for autologous transfusions can be collected sterilely into citrate‐phosphate‐dextrose and stored at 4°C. During storage for 8 days, the placental red cell content of adenosine triphosphate remained normal. The 2,3,‐diphosphoglycerate concentration of cells stored 8 days declined sharply; however, the P50 value of the oxyhemoglobin dissociation curve declined to 24.4 ± 2.40 torr. During storage, placental blood underwent an exchange of extracellular Na+ and K+, but no change in glutathione content. Hemolysis was less than 1 percent. Bacteriologic and fungal cultures remained sterile. These in vitro studies suggest that human placental blood can be collected safely and preserved effectively for autologous red cell transfusion therapy.
Plasma volume nomograms for use in therapeutic plasma exchange
Authors: BUFFALOE GEORGE W. , HEINEKEN FRED G.
Published: December 2004

ABSTRACT: Nomograms have been developed for the convenient estimation of the plasma volumes of patients undergoing therapeutic plasma exchange (TPE), based on equations employing height, body weight, and hematocrit. These nomograms are offered as an aid to prescribing continuous‐flow TPE procedure exchange volumes.
A LISS spin enzyme method for the detection of red cell antibodies and its use in routine antibody screen procedures
Authors: Odell W. R. , Roxby D. J. , Ryall R. G. , Seshadri R. S.
Published: December 2004

A technique for performing the enzyme phase of the antibody screen on red cells suspended in low‐ionic‐strength‐salt solution (LISS) is described. The reliability of this LISS spin‐enzyme (LSE) technique was compared with the two‐stage papain‐tile method, in the detection of 62 previously identified enzyme reacting antibodies. All 62 antibodies examined were detected by the LSE method, and no false‐positive reactions were found. Using LSE and papain‐tile methods in parallel, further assessment was obtained by screening 2000 sequential blood samples under routine service conditions. Fifty‐six blood samples contained alloantibodies, of which 43 reacted by both methods, eight by the LSE method only, and five by the papain‐tile method only. It was concluded that the LSE method was comparable to the papain‐tile method.
Positive direct antiglobulin test due to anti‐Fra in a newborn infant
Authors: Harris P. A. , De la Vega M. S. , Cunton B. A. , Miller W. V.
Published: December 2004

A positive direct antiglobulin test due to anti‐Fra was found in a newborn infant whose mother previously had borne two other Fr(a+) children; all three were clinically unaffected. Family studies showed no evidence for close linkage between the Fr and HLA loci.
Red cell sensitization due to anti‐D in anti‐lymphocyte globulin
Authors: Shirey R.S. , Smith B. , Sensenbrenner L. , Bauer T.W. , Ness P.M. , Kickler T.S. , Gibble J.W.
Published: December 2004

ABSTRACT: Four Rh‐positive patients with severe aplastic anemia received equine anti‐lymphocyte globulin. Each developed a positive direct antiglobulin test. Anti‐D was identified in eluates prepared from the patients' sensitized red cells. The administered lot of anti‐lymphocyte globulin was found to contain anti‐D. Red cell sensitization due to passively acquired Rh antibodies can result from the administration of anti‐lymphocyte globulin.
Prolonged cryopreservation of human granulocytes
Authors: Richman C. M.
Published: December 2004

Normal human granulocytes prepared by dextran sedimentation were cryopreserved in 10 percent dimethyl sulfoxide and 25 percent autologous plasma using controlled‐rate freezing at −1°C per minute. Twenty‐four samples were stored from 0 to 8 months in the vapor or liquid phase of liquid nitrogen. The mean cell recovery was 58 pM 4 percent and the mean bactericidal activity using Staphylococcus aureus was 72 ± 4 percent. Cells stored for approximately 5 months examined with transmission electron microscopy had intact cell membranes and granules although some nuclear changes were observed. No decline in cell recovery or bactericidal activity was observed with prolonged storage and there was no advantage of liquid over vapor phase. Samples stored for over 8 months showed a 73 percent cell recovery and a 77 percent bactericidal activity. Maintenance of granulocyte function after prolonged cryopreservation in these studies suggests the feasibility of cryopreserved granulocyte transfusion therapy.
Effects of perfluorochemical on phagocytic function of leukocytes
Authors: Virmani R. , Warren D. , Rees R. , Fink L.M. , English D.
Published: December 2004

Oxygen‐carrying perfluorochemical emulsions may become useful for transfusions when red cells cannot be used. Since accumulation of perfluorochemicals in reticuloendothelial cells has been demonstrated, we tested the phagocytic function of monocytes and neutrophils in rabbit and human blood exposed in vivo and in vitro, respectively, to perfluorotributylamine (Oxypherol) a perfluorochemical blood substitute. Neutrophil and monocyte phagocytosis was assessed by determining the uptake of serum‐coated fluorescent beads by monocytes and neutrophils in whole blood. Morphologic changes were assessed by electron microscopy. The phagocytic activity of monocytes and neutrophils in the blood of four rabbits injected 4 hours earlier with 70 to 85 ml of Oxypherol (28ml/kg) was depressed by 87 ± 1.0 percent. Neutrophils in this blood showed morphological alterations characterized by swelling and extensive vacuole formation. Similar changes were found in neutrophils and monocytes of human blood incubated with Oxypherol (10–50%,V/V) at 37°C for 1 hour. The phagocytic activity of human neutrophils and monocytes exposed to 20 percent, V/V Oxypherol was depressed by 35 ± 9.9 percent. We conclude that caution should be exercised when administering perfluorochemical blood substitutes in patients exposed or at risk of infection.
Does hydroxyethyl starch cause lichen planus? Lichen planus in a long‐time routine blood donor never exposed to hydroxyethyl starch
Authors: Newman R.S. , Barr R.J. , Ocariz J.A. , Kaplan H.S.
Published: December 2004

A case of lichen planus attributed to exposure to hydroxyethyl starch has been reported previously. In this report, a case of lichen planus in a healthy blood donor never exposed to hydroxyethyl starch is presented, the statistical incidence of lichen planus in healthy leukapheresis donors is approximated, and a description of the Koebner phenomenon, which could falsely lead to incorrect conclusions regarding cause and effect in this disease, is discussed.
Physical and thermal properties of blood storage bags: implications for shipping frozen components on dry ice
Authors: Hmel Peter J. , Kennedy Anthony , Quiles John G. , Gorogias Martha , Seelbaugh Joseph P. , Morrissette Craig R. , Van Ness Kenneth , Reid T.J.
Published: December 2004

BACKGROUND: Frozen blood components are shipped on dry ice. The lower temperature (–70°C in contrast to usual storage at –30°C) and shipping conditions may cause a rent in the storage bag, breaking sterility and rendering the unit useless. The rate of loss can reach 50 to 80 percent. To identify those bags with lower probability of breaking during shipment, the thermal and physical properties of blood storage bags were examined.

STUDY DESIGN AND METHODS: Blood storage bags were obtained from several manufacturers and were of the following compositions: PVC with citrate, di‐2‐ethylhexylphthalate (DEHP), or tri‐2‐ethylhexyl‐tri‐mellitate (TEHTM) plasticizer; polyolefin (PO); poly(ethylene‐co‐ vinyl acetate) (EVA); or fluorinated polyethylene propylene (FEP). The glass transition temperature (Tg) of each storage bag was determined. Bag thickness and measures of material strength (tensile modulus [MT] and time to achieve 0.5 percent strain [T0.5%]) were evaluated. MT and T0.5% measurements were made at 25 and –70°C. Response to applied force at –70°C was measured using an impact testing device and a drop test.

RESULTS: The Tg of the bags fell into two groups: 70 to 105°C (PO, FEP) and –50 to –17°C (PVC with plasticizer, EVA). Bag thickness ranged from 0.14 to 0.41 mm. Compared to other materials, the ratios of MT and T0.5% for PVC bags were increased (p ≤ 0.001) indicating that structural changes for PVC were more pronounced upon cooling from 25 to −70°C. Bags containing EVA were more shock resistant, resulting in the lowest rate of breakage (10% breakage) when compared with PO (60% breakage, p = 0.0573) or PVC (100% breakage, p = 0.0001).

CONCLUSIONS: Blood storage bags made of EVA appear better suited for shipping frozen blood components on dry ice and are cost‐effective replacements for PVC bags. For the identification of blood storage bags meeting specific storage requirements, physical and thermal analyses of blood storage bags may be useful and remove empiricism from the process.
Statistical analysis of inappropriate results from current Hb screening methods for blood donors
Authors: James Virge , Jones Keith F. , Turner Elizabeth M. , Sokol Robert J.
Published: December 2004

BACKGROUND : The objective was to apply statistical analysis to the false passes and fails that occur with the primary and secondary Hb‐screening methods used at blood‐donor sessions.

STUDY DESIGN AND METHODS
: Venous samples from 1513 potential donors who had undergone primary CuSO
4 screening using capillary blood (Hb cut‐offs: women, 125 g/L; men, 135 g/L) were tested at the session by a secondary method (HemoCue; cut‐offs: women, 120 g/L; men, 130 g/L) and again at the base laboratory using another system (Beckman Coulter General S system), which generated the “true” Hb value.

RESULTS
: False‐pass and ‐fail rates for women and men, respectively, were 11.2 and 6.3 percent (women) and 5.2 and 1.8 percent (men) for CuSO
4
; 1.9 and 3.7 percent (women) and 1.5 and 0.4 percent (men) for HemoCue; and 2.7 and 2.4 percent (women) and 1.8 and 0.2 percent (men) for a combined procedure that mimicked current practice of only testing CuSO
4 fails by HemoCue.

CONCLUSION
: CuSO
4 Hb screening gives large numbers of false passes, particularly in women. Using venous samples, the majority correctly pass at the lower HemoCue cut‐offs. The current dual‐testing policy appears convenient for donor sessions, but because small percentages of false passes and fails represent large numbers of donors, every effort should be made to improve the accuracy of Hb screening.
Transmission of hepatitis A via WBC‐reduced RBCs and FFP from a single donation
Authors: Diwan A. Hafeez , Stubbs James R. , Carnahan Gary E.
Published: December 2004

BACKGROUND: Currently, individuals donating whole blood and cellular components are not screened for hepatitis A (HA). However, transfusion‐transmitted HA can occur, albeit very rarely. Although infection is typically mild and self‐limited, it may be catastrophic in a small percentage of cases. Two cases of HA transmission from a single donation to two patients with subsequent variable morbidity are reported.

CASE REPORTS: A 50‐year‐old, asymptomatic, volunteer blood donor made a whole‐blood donation. He was found to have HA 18 days later. When notified, the donor center initiated a recall of the components produced from the donated unit. However, the RBCs and FFP had already been transfused. Subsequently, both recipients developed HA as documented by IgM anti‐HA serology. The RBC recipient was a 49‐year‐old woman, transfused after a hysterectomy, who was found to have HA at the time of unit recall (20 days after transfusion). Her condition required the use of medical disability leave. The FFP was infused to a 52‐year‐old female cardiac surgical patient. Her course was marked by multiple complications, including postoperative development of mild hepatic dysfunction. After testing negative for HA, hepatitis B, and hepatitis C (24 days after transfusion), she suffered a second bout of more severe hepatic dysfunction and was documented to have HA at Day 55 after transfusion. Evaluation of both recipients' close contacts revealed no evidence for exposure to HA by any route other than transfusion.

CONCLUSION: HA can be transmitted by transfusion of units obtained from asymptomatic, infectious donors. Two patients contracted HA from components obtained from a single whole‐blood donation. The RBC recipient had a typical self‐limited course of HA. The FFP recipient developed HA of relatively delayed onset. Both recovered from HA.
Factor concentrate usage in persons with hemophilia in New York State
Authors: Linden Jeanne V. , Kolakoski Marcia H. , Lima Jennifer E. , Du Ping , Lipton Richard A.
Published: December 2004

BACKGROUND: Persons with a congenital deficiency of FVIII or F IX (hemophilia A and hemophilia B, respectively) receive factor concentrate to treat or prevent bleeding.

STUDY DESIGN AND METHODS: A population‐based study of all persons with hemophilia residing in New York State at any time during 1993 through 1998 was conducted. All available medical records for each patient were reviewed to determine type of therapy.

RESULTS: Case finding yielded 1160 cases, for a prevalence of 63.9 per 1 million population in 1998. Recombinant factor concentrates were used by 56 percent of patients. Patients with severe disease used more (158,234 IU/patient) factor concentrate than did patients with moderate disease (46,315 IU) or mild disease (5794 IU). Over half (57%) of all factor concentrate was prescribed for patients with severe disease on prophylactic therapy. Patients undergoing immune tolerance therapy used the most per person—455,116 IU each. Hemophilia treatment centers provided factor concentrate for 62 percent of all patients who used factor and 73 percent of patients with severe disease.

CONCLUSION: Hemophilia patients, especially patients with severe disease, use large amounts of expensive factor concentrates to prevent and to treat bleeding episodes. Specialized hemophilia treatment centers play a key role in the care of these patients.