bluuebunny/crossref_metadata_2025 huggingface dataset:
Preferential Decrease in Thymus Dependent Lymphocytes during Storage at 4 C in Anticoagulant
Authors: Grunow J. E. , Lubet R. A. , Ferguson M. J. , Gaulden M. E.
Published: December 2004

Human lymphocytes stored at 4 C either as leukocyte concentrates (LCs) in citrate‐phosphate‐dextrose (CPD) or as whole blood anticoagulated with CPD show a rapid and marked decrease in the relative and absolute numbers of thymus derived (T) lymphocytes. Determinations were made on cells recoverable on a Ficoll‐Hypaque (F‐H) gradient. In evacuated LCs, the relative percentage of T cells dropped to less than 10 per cent within 72 hours with a concomitant increase in the relative percentage of bone marrow derived (B) cells to 80 per cent or more. LCs opened to the air and subsequently stored at 4 C displayed an even more precipitous decline in the relative percentage of T cells, reaching a 10 per cent level within 72 hours. The relative percentage of T cells in CPD‐anticoagulated whole blood samples stored at 4 C displayed similar decreases, reaching 20 per cent levels within 24 hours. The change in the relative percentage of T cells at the Ficoll‐Hypaque interface was shown to reflect a decrease in the total numbers of T cells placed on the F‐H gradient with time, since determinations of T and B cell numbers in NH4CI‐treated whole blood showed a 65 to 80 per cent decrease in the numbers of T cells within 24 hours in anticoagulated whole blood held at 4 C. Thus, it may be inferred that the T cell decrease is mediated via some interaction of anticoagulant, storage time, and some component(s) present in both LCs and whole blood.
Freezing and Deglycerolizing Sickle‐Trait Red Blood Cells
Authors: Meryman H. T. , Hornblower M.
Published: December 2004

Sickle‐trait red blood cells respond to freezing and thawing like normal cells, but during deglycerolization by centrifugal methods, they pack and hemolyze. This appears to be the result of changes in surface characteristics with suspension in hyperosmotic saline and even modest increases in osmolality result in packing with centrifugation. Modifications to permit deglycerolization of sickle‐trait cells have been designed for use with both the Haemonetics and the IBM cell washing systems. Sickle‐trait cells do not agglomerate satisfactorily but we were unable to devise a modification of this deglycerolizing system that would accommodate sickle‐trait cells.
A Second Example of Anti‐Lu14
Authors: Marsh W. L. , ØYen R. , Rosso M. , Gruber D. , Cooper J.
Published: December 2004

Anti‐Lu 14 has been found in the serum of a gravida 2 pregnant woman who had not been given any blood transfusions. Her husband is Lu:14 but otherwise of common Lutheran blood type. Maternal immunization probably occurred during the first pregnancy. The second child did not inherit the father's Lu14 gene and was not affected by the maternal antibody.
A Simple Method for the Cryopreservation of Human Lymphocytes at −80C
Authors: Simon J. D. , Flinton L. J. , Albala M. M.
Published: December 2004

A simple and inexpensive method for the freezing of human blood lymphocytes at −80 C is described. Lymphocytes were frozen in either polystyrene tubes or polyolefin bags. Optimal recovery of cells was obtained when 5 per cent DM SO and 62 per cent plasma were used as cryoprotectants. Viable cell recovery, as assessed by response to phytohemagglutinin (PHA) and pokeweed mitogen (PWM), was greater than 80 per cent after 60 days of storage. In addition, percentages of T and B lymphocytes were essentially unchanged. The excellent viable cell recovery in polyolefin bags suggests that it is possible to cryopreserve large numbers of lymphocytes in a single container.
Clinical Value of Washed‐Platelet Concentrates in Patients with Non‐Hemolytic Transfusion Reactions
Authors: Silvergleid A. J. , Hafleigh E. B. , Harabin M. A. , Wolf R. M. , Grumet F. C.
Published: December 2004

In patients with severe allergic reactions to plasma proteins it is possible to observe such reactions to even the small quantity of plasma contained in platelet concentrates. A platelet washing solution was designed, and platelet concentrates for four such patients were washed before infusion. Transfusion reactions were completely eliminated by the washing procedure. Platelet recovery was equivalent to that of unwashed platelets, and hemostatic effectiveness of the infused platelet concentrates was evidenced by abrupt cessation of bleeding episodes, including purpura and hematuria. Platelet washing represents a valuable, rapid and simple approach to the problem patient with thrombocytopenia and severe reactions to plasma proteins.
The Uptake and Egress of Adenine from Human Red Blood Cells in Vitro
Authors: Moore G. L. , Ledford M. E.
Published: December 2004

The initial uptake of adenine from plasma by human red blood cells was measured at 0,10, and 20C. Initial uptake is completed in several minutes as distribution equilibrium is reached; however, total uptake requires several weeks at 4C. Adenine inside the red blood cell was shown to egress to the plasma if the equilibrium shifted due to plasma dilution or exchange.
Independence of Wright from Many Other Blood Group Systems
Authors: Pavone B. G. , Issitt P. D. , Wagstaff W.
Published: December 2004

The finding that En(a ‐) red blood cells are Wr(a‐b‐), and thus probably represent a “null” phenotype of the Wright system, has provided evidence of the independence of the Wright blood group system from many others. Detection of blood group antigens on “null” red blood cells almost certainly indicates that those antigens do not belong to the same blood group system as the “null” cells. In the case of Wright, lack of certainty that En(a ‐) is the “real,” or only, null type slightly reduces the weight of the evidence.
Experimental Induction of Caprylate‐Dependent Albumin Antibodies
Authors: Hossaini A. A. , Hazeghi K. , Amiri P.
Published: December 2004

To provide evidence for the immune nature of the albumin agglutination phenomenon or caprylate dependent albumin agglutinins (CDAA), rabbits were injected with native serum that had been incubated in a solution of sodium caprylate. Two of three rabbits responded with the production of CDAA, which in vitro behaved identical to human antisera. Human cells were agglutinated only when caprylate stabilized albumin was added to the cell/serum mixture or when caprylate free albumin plus sodium caprylate were used. The CDAA failed to agglutinate rabbit cells, although, both human adult and cord cells were agglutinated. These experiments indicate that the CDAA represent an immune response to native albumin that had been altered by caprylate.
Component Preparation Record
Authors: Frohman E. M.
Published: December 2004

A card form has been developed to record production and distribution data of non‐red cell blood components prepared. This form provides a concise, accurate, and permanent record of each unit of non‐red cell blood component produced. The form can be modified to meet local requirements.
Self‐Administered Blood Donor Medical History
Authors: Katz A. , Bray J. , Pelton T. , Caton C.
Published: December 2004

An experiment in self‐administered blood donor medical histories is described. This history, reviewed by a medical history nurse, was not associated with more rapid donor processing. Donors and medical history nurses reacted positively to self‐administration. The quality of the medical history did not appear to be affected by the procedure. The findings suggest that there is value in the self‐administration process, and that further trial is warranted.
A rapid method for the preparation of high potency auto and alloantibody eluates
Authors: Jenkins DE , Moore WH
Published: December 2004

The present report describes a modified, rapid acid‐stromal method for elution of erythrocyte antibodies. With this method, potent crystal clear auto and alloantibody eluates can be produced. The simplicity of the method makes it readily adaptable to the routine serological laboratory or blood bank. In semiquantitative and quantitative studies, we have found that this method compares favorably with other antibody elution methods. With alloantibodies, the rapid acid elution method and the ether method produced the strongest eluates with the ether eluates being slightly more potent than the rapid eluated. By contrast, with autoantibodies the rapid method was clearly superior, producing much stronger IgG erythrocyte coating as judged by the 125I antiglobulin test.
Changes in agglomeration of human red blood cells in liquid storage in CPD media
Authors: Meyerstein N. , Mazor D. , Dvilansky A.
Published: December 2004

A procedure which may distinguish between old and new CPD blood units in liquid state is described. It is based on the observation of increased tendency to reversible agglomeration in old erythrocytes in liquid preservation. Erythrocytes clump together when they are mixed with low ionic strength solutions in pH range of 5.2 to 6.5. We found that liquid‐stored erythrocytes show an augmented tendency to agglomerate in 0.24M sucrose, pH 7.2. The tendency increases with storage so that in the fourth week, more than 70% of the units show agglomeration under these conditions. The addition of minute amounts of sodium chloride may prevent agglomeration. As the cells age, higher salt concentration is required to prevent agglomeration. A short incubation of washed cells with adenosine may reverse the tendency of outdated erythrocytes to agglomerate, concomitantly with reestablishment of initial ATP level. However, depletion of the ATP of fresh cells with fluoride does not induce agglomeration. A 20 hour incubation of units at 37 C with CPD revealed an increased sensitivity of older units, with low ATP and positive agglomeration. This test may help in distinguishing between outdated and younger units in the blood bank.
In vitro function of granulocytes isolated from blood of normal volunteers using continuous‐flow centrifugation in the IBM‐aminco celltrifuge and adhesion‐filtration leukapheresis using nylon fiber
Authors: Wade PH , Skrabut EM , Vinciguerra L. , Valeri CR
Published: December 2004

Granulocytes were harvested from each of five healthy male volunteers once by continuous flow centrifugation with the IBM‐Aminco Celltrifuge, and once by adhesion filtration leukapheresis with nylon fiber. Granulocyte recovery and purity were significantly better with the filtration leukapheresis system than with continuous flow centrifugation. Measurements of trypan blue dye exclusion and muramidase activity were similar to those in control granulocytes regardless of the method of isolation. Granulocyte‐stimulated oxygen consumption was diminished in granulocytes prepared by the adhesion filtration method, but normal in those prepared by continuous flow centrifugation with the IBM‐Aminco Celltrifuge.
Hydroxyethyl starch and prednisone as adjuncts to granulocyte collection
Authors: Bearden JD , Coltman CA , Ratkin GA
Published: December 2004

A total of 232 leukaphereses were performed with a continuous flow (CFC) of 89 donors related to recipients to obtain granulocytes for infected granulocytopenic recipients. One hundred fifteen runs were done without pretreatment of the donors and were used as controls. Pharmacological pretreatment of the remaining one hundred seventeen donors included Prednisone, given in an oral dose (50 mg) the evening prior to the run, and/or 250ml of 6 per cent hydroxyethyl starch added to the input line of the CFC throughout the run. A median of 9.2 liters of donor blood was processed with each run. The pretreatment of the donors with Prednisone plus the addition of HES to the input line significantly increased the number of granulocytes collected. Donors tolerated the leukapheresis procedure well, and no significant side effects were associated with Prednisone or HES administration. Early and frequent use of such granulocytes was effective in the short‐term control of fever in the granulocytopenic recipients who failed to respond to 48 hours of broad spectrum antibiotic coverage.
A rapid method for determining the sterility of frozen‐reconstituted blood
Authors: Myhre Byron , Nakasako Y. Y. , Schott R.
Published: December 2004

A rapid, fast, and accurate method of determining bacterial contamination in blood units is needed to provide a safe unit of frozen‐ reconstituted blood which can be stored at 4 C after thawing for more than the 24 hours currently allowed by law. The Bactec instrument seems to provide this method. It detects most of the organisms which have been reported in contamineted blood, and does this in a short enough period of time that any organisms introduced into the blood unit during the sampling process will not grow sufficiently to contaminate the unit while the culturing process is going on.
A highly specialized and motivated volunteer population: platelet donors
Authors: Wendlandt Gay , Lichtiger Benjamin
Published: December 2004

The plateletpheresis program of the M.D. Anderson Hospital was established in 1963. Approximately 20,000 units of platelet concentrates are produced per year. Credit for the nonreplacement fee generates the greatest number of donors. No organized recruitment campaign exists. Each donor becomes a recruiter for the program. Also involved in donor recruitment are all laboratory personnel, as well as Donor Room exployees.
Platelet transfusion survey in a regional blood program
Authors: Silva Victor A. , Miller William V.
Published: December 2004

We studied the pattern of use of platelets stored at 4 C. About half of 2,168 platelet concentrates were transfused to achieve hemostasis in 360 transfusion episodes. More than half of the platelet concentrates were given during the second and third day after collection. Of 164 prophylactic transfusion episodes including 44 plateletpheresis packs, 74 percent were given to patients with leukemia. Reactions to platelet transfusion occurred in about 4 per cent of the transfusion episodes. Considering our survey findings, the generally accepted properties of cold stored platelets and the capabilities and limitations of this blood bank, we plan to continue to store platelets at 4 C.
Simplified quality assurance of floor model centrifuges
Authors: Tregellas >W. Michael , Bourland Donald L.
Published: December 2004

Present methods for calibration of the rotor speed of large floor model centrifuges used for blood component preparation can be cumbersome and/or dangerous. This report describes a safe and inexpensive method of modifying a centrifuge lid so that calibration of the machine with a photoelectric tachometer is a simple and safe procedure.
Metabolism by the Rabbit of Intravenously Administered Adenine
Authors: Bartlett G. R.
Published: December 2004

A study was made of the metabolism by the rabbit of adenine administered intravenously at a dose of 35 mg/kg with 100 μCi of 8‐14C‐adenine. The infused adenine was removed from the blood in two phases, first by diffusion into the tissues and second by metabolic reactions throughout the body. The adenine equilibrated within a few seconds equally between plasma and red blood cells and between them and kidney, liver, duodenum, lung and heart. Diffusion into skeletal muscle was much slower and into brain slowest. The more gradual disappearance of adenine from blood, and from the rest of the body, with a half‐life of about 20 minutes and with complete removal by two hours, was predominantly along three pathways, leading to, after four hours: 1) 74 per cent in adenine nucleotide (mostly AMP, ADP, and ATP); 2) 12 per cent as unchanged adenine in the urine; and 3) 11 per cent as a mixture in almost equal parts of 8‐oxyadenine and 2,8‐dioxyadenine in the urine. Conversion of adenine to adenine nucleotide, probably by initial reaction with phosphoribosyl pyrophosphate and adenine‐phosphoribosyl‐transferase, was at widely different rates in the organs with duodenum, kidney, liver, and lung high and heart, red blood cell, skeletal muscle and brain relatively low. Sites of formation of the two oxyadenines, probably by action of xanthine oxidase, were not determined.
The in Vivo Survival of Red Blood Cells Stored in Modified CPD with Adenine: Report of a Multi‐Institutional Cooperative Effort
Authors: Zuck T. F. , Bensinger T. A. , Peck C. C. , Chillar R. K. , Beutler E. , Button L. N. , McCurdy P. R. , Josephson A. M. , Greenwalt T. J.
Published: December 2004

In order to provide data in support of licensure applications for citrate‐phosphate‐dextrose (CPD) supplemented with adenine, a multi‐institutional cooperative effort was organized to determine survivability of red blood cells subjected to prolonged liquid storage. Two manufacturers supplied plastic multiple bag blood storage containers prefilled with modified CPD (glucose 25% greater than the normal concentration) supplemented with adenine (17.0 to 17.3 mg per 63 ml of anticoagulant; 0.25 millimolar approximate final concentration when diluted with 450 ml of whole blood). Red blood cells from 32 units stored as whole blood for 35 days showed a mean survival of 80.53 + 6.44 per cent (1 SD). Both red blood cell and supernatant plasma biochemical characteristics were comparable to those reported for whole blood stored for 21 days in either acid‐citrate‐dextrose (ACD) or CPD. Red blood cells from 19 units stored as concentrates for 35 days (Hct 75.03 + 3.74%) had a mean survival of 71.38 + 10.3 per cent with considerable interdonor variation in survival and interlaboratory variation in some biochemical characteristics. Red blood cells from eight units stored as concentrates (Hct 75.38 + 4.30%) for 28 days showed a mean survival of 83.97 + 6.10 per cent and biochemical characteristics comparable to those reported for red blood‐cell concentrates stored in CPD or ACD for 21 days. Modified CPD with adenine as formulated offers an improved anticoagulant for blood banking by extending the permissible red blood cell storage period.
Enhanced Solubility of 2,8 Dihydroxyadenine (DOA) in Human Urine
Authors: Peck C. C. , Bailey F. J. , Moore G. L.
Published: December 2004

Water solubility of the adenine catabolite 2,8 dihydroxyadenine (DOA) frequently forms the basis for predicting potential DOA crystal formation in human urine following infusion of adenine‐fortified blood. Measurements relevant to solubility, ionic dissociation, and supersaturability of DOA in aqueous buffers and human urine at 37 C establish striking quantitative differences in the physico‐chemical behavior of DOA in the two media. The basal solubility of DOA is 1.53 + 0.04 mg/1 (≅9 times 10‐6 M) in water (pH 6.5). DOA is an ampholyte characterized by aqueous thermodynamic macrodissociation constants of pKa1= 2.6, pKa2= 8.1, and pKa3= 11.52. This compound displays pH‐dependent solubility, although significant solubility increases beyond basal values do not occur within the physiologic pH range for human urine. Supersaturated aqueous solutions (three to sixteen times basal solubility) can be achieved but are unstable.

In contrast, human urine at 37 C exhibits enhanced capacity for solubilizing DOA. In vitro basal solubility is 2.68 + 0.84 mg/l at pH 5.0 and 4.97 + 1.49 mg/l at pH 7.8. The apparent pK2 for DOA in urine of 7.9 to 8.1 is dependent upon urine osmolality. Urine can be supersaturated with DOA in vitro to approximately ten times its basal solubility by adding DOA solubilized in weak base, or by evaporation of a urine‐DOA mixture. DOA remains supersaturated in urine for at least 16 hours despite gentle agitation. Little variation in in vitro DOA apparent supersaturation was found among urine samples from four normal individuals (40.38 + 3.33 mg/l). A patient receiving oral adenine exhibited urinary DOA solubility in considerable excess (96.0 mg/l) of that predicted from water and from in vitro urine solubility studies. Thus, water solubility of DOA is poorly predictive of in vitro and in vivo DOA solubility in human urine. On the basis of these data, estimates of the load of adenine‐fortified blood expected to result in urinary DOA crystal formation may be revised upward.
Relative Efficiency and Interchangeability of Huggins and American Red Cross Red Cell Freezing Procedures
Authors: Hornblower M. , Meryman H. T.
Published: December 2004

Cells glycerolized in a low salt medium (Huggins) and deglycerolized by agglomeration were compared to cells glycerolized in a high salt medium (ARC) and deglycerolized by a centrifugal procedure. Both agglomeration and centrifugal deglycerolization produce entirely acceptable products. The average total recovery by agglomeration is somewhat less (86 per cent) than by the centrifugal method (93 per cent). The osmolalities and hemoglobin concentrations are comparable. Cells glycerolized in a high salt preparation are very stable while unfrozen and are relatively unaffected by failures of refrigeration and can be refrozen. Cells glycerolized in low salt media may increase in volume with time and are variable in their stability to unfrozen storage and to refreezing. Sickle trait cells do not agglomerate satisfactorily and cannot be deglycerolized by agglomeration but can be deglycerolized by a modification of the centrifugal method. Container surfaces can adversely influence the freeze‐thaw hemolysis of high salt cells but appear to have no effect on the low salt preparation. Although cells glycerolized in high salt medium cannot be deglycerolized by agglomeration, the converse is possible. The standard 8.6M low salt glycerolizing solution did not permit optimal recovery by centrifugal wash. When cells were glycerolized in a Huggins low‐salt formula modified to contain 6.2M glycerol in 400 ml of solution, the frozen‐thawed cells could be deglycerolized by either agglomeration or centrifugation with good recovery.
Error Rate, Precision, and Accuracy in Immunohematology
Authors: Grindon A. J. , Eska P. L.
Published: December 2004

Quality control in the blood bank has traditionally been concentrated in the areas of reagents, equipment, and components. We have found that it can be extended to the measurement of error rate, accuracy, and reproducibility as well. We propose the use of a “correction rate” as a correlate of actual error rate, since numbers of errors in final ABO interpretations are infrequent and difficult to accumulate. We have measured accuracy as the frequency of false positive and false negative results, using weakly active antibodies both in the test situation and in actual practice. Finally, reproducibility can be measured with a series of coded duplicate samples covering the range of immunohematologic reactivity. By using these methods, a laboratory can regularly measure error rate, accuracy, and reproducibility as part of its quality control program.
Formaldehyde in the Pathogenesis of Hemodialysis‐related Anti‐N Antibodies
Authors: White W. L. , Miller G. E. , Kaehny W. D.
Published: December 2004

The role of formaldehyde (CH2O) in the pathogenesis of anti‐N‐like antibodies found in patients on chronic hemodialysis was investigated. In vitro studies were performed by incubating MM cells in varying concentrations of CH2 O for variable time periods, corresponding to conditions that occur in dialysis. These MM cells acquired reactivity to anti‐N antibody. The antigenic shift is felt to occur from the interaction of CH2 O) with the terminal N‐acetylneuraminic acid (sialic acid) groups of M substance, resulting in the exposure of an altered‐N antigen that is immunogenically active. Through a similar mechanism, CH2O may also directly modify N substance.
Ultrafiltrable Adenosine Triphosphate and 2,3‐Diphosphoglycerate Concentrations in Cold‐stored Human Erythrocytes
Authors: Marshall W. E. , Rassaian N. , Greenwald L. S. , Omachi A.
Published: December 2004

Free ATP and DPG concentrations in ACD‐preserved human erythrocytes (rbc) were estimated by measuring these organic phosphates in ultrafiltrates of cell lysates prepared at 0 to 2 C. The free ATP concentration in hypotonic hemolysates decreased from 0.59 to 0.08 μmol/ml rbc during four weeks of cold storage. In French Pressure Cell lysates, free ATP increased from 0.23 to 0.47 μmol/ml rbc in the first week and then declined to 0.12 μmol/rbc during the following three weeks. In two weeks, the free DPG level decreased from 0.64 to 0.41 μmol/ml rbc in hypotonic lysates and from 1.08 to 0.15 μmol/ml rbc in French Pressure Cell lysates. It is proposed that, as total DPG concentration decreases during cold storage, free ATP concentration also decreases due to increased ATP binding to hemoglobin sites vacated by DPG. It is suggested that it is the change in the free rather than the total ATP which may be more relevant to the metabolism of the cold‐stored erythrocyte.
An Empirical Approach to Projecting Regional Blood Need
Authors: Krowka M. J. , Schwartz J. P.
Published: December 2004

An empirical mathematical model was developed for projecting monthly and yearly regional blood utilization. Based upon 1974 data from eight Clark County, Nevada hospitals offering a total of 1,389 medical‐surgical, and pediatric beds, an unadjusted projection deviated minus 7.2 per cent from the actual 1975 regional blood utilization. Adjusted projections, modified by an averaging technique that utilized previous month's blood utilization along with historical utilization data, resulted in an annual projection that deviated minus 1.9 per cent from the actual blood use. The adjusted monthly mean projection did not differ significantly from the actual mean monthly blood use. This approach appears to be of value in regional planning for long‐ and short‐range blood needs.
Large Scale Preparation of Leukocyte Concentrates and Further Purification of Lymphocytes and Granulocytes with the IBM 2991 Cell Processor
Authors: de la Rivière A. Brutel , Verhoef‐Karssen P. R. , de Wit J. J. F. M. , Loos J. A. , Prins H. K.
Published: December 2004

A procedure is described for the large‐scale production of pure suspensions of human lymphocytes and granulocytes. Platelet‐poor buffy‐coats, obtained by centrifugation of six units of ABO‐compatible ACD blood, were pooled and centrifuged again, resulting in a crude leukocyte concentrate containing approximately 60 per cent of the original amount of leukocytes. Further fractionation of such crude leukocyte concentrates was achieved by scaling up Bøyum's Ficoll‐Isopaque density gradient technique with the aid of an IBM 2991 blood cell processor. In this way 2.9 + 0.3 times 109 mononuclear leukocytes, consisting of 90 + 0.7 per cent lymphocytes and 5.3 + 0.3 times 109 polymorphonuclear leukocytes of 92 + 0.7 per cent purity could be isolated in one run. The overall yield was 36 per cent of the original amount of leukocytes.
Autoantibodies Mimicking Alloantibodies
Authors: Issitt P. D. , Zellner D. C. , Rolih S. D. , Duckett J. B.
Published: December 2004

A patient with myelofibrosis, who has produced many red blood cell autoantibodies, is described. Although the patient is phenotypicaily R1R1 (CDe/CDe), eluates made from his red blood cells have consistently contained what appeared to be anti‐E, and more recently another antibody that appeared to be anti‐c. In in vitro experiments we have shown that the “anti‐E” and “anti‐c” can be totally adsorbed by E‐negative and c‐negative red blood cells, respectively. We conclude that the two antibodies have quite different specificities from those indicated by simple antibody identification studies, and that both are more closely related to the anti‐Hr series of antibodies than to anti‐E or anti‐c.
An Evaluation of Several Blood Transfusion Filters
Authors: Kennedy P. S. , Solis R. T. , Scott M. A. , Wilson R. K.
Published: December 2004

Several blood transfusion filters designed to remove microemboli were evaluated for filtration and flow characteristics, as well as for hemolysis and for release of participate debris from the filter. The Dacron wool filter, a depth filter, was superior at removing microemboli measured with an electronic particle size analyzer. A 25 μm pore mesh filter was least effective at removing microemboli from stored blood, but demonstrated the most favorable flow rates and induced no apparent red blood cell destruction during filtration. In general, filter efficiency and filter induced hemolysis correlated inversely with flow rates. No filter tested released significant quantities of particulate debris when compared with unfiltered isotonic saline.
Risk Factors in Transmission of Non‐A, Non‐B Posttransfusion Hepatitis: The Role of Hepatitis B Antibody in Donor Blood
Authors: Conrad M. E. , Knodell R. G. , Bradley E. L. , Flannery E. P. , Ginsberg A. L.
Published: December 2004

Risk of developing icteric hepatitis in a transfusion study involving cardiac surgery patients was 0.2 per cent per unit of blood transfused with the ratio of icteric to anicteric cases being 1:4. Risk of developing hepatitis was proportional to the number of units transfused: one to four units, 4 per cent; six to ten units, 8 per cent; 11 to 20 units, 19 per cent; > 21 units, 42 per cent. The prevalence of type B hepatitis was low (6 per cent), with the vast majority of patients being shown to have non‐A non‐B hepatitis. However, a greater incidence of hepatitis type B serologic events was observed among recipients of anti‐HBs positive blood than those transfused only with units not containing antibody (p = 0.04). A significantly greater incidence of non‐A, non‐B hepatitis was observed among patients transfused with blood containing anti‐HBs when compared with a group who received blood without antibody (p < 0.01). Caution should be exercised in interpretation of this difference because patients transfused with blood containing anti‐HBs received significantly more units of blood. However, utilization of stepwise regression analysis to unconfound the two dependent variables suggest that the use of blood containing anti‐HBs increases the hepatitis risk (p = 0.06) although the number of units transfused was the more significant factor (p < 0.001). Additional data from carefully designed studies are needed to determine if donor blood containing anti‐HBs significantly increases the risk of transmitting non‐A non‐B hepatitis.
Causes of Disqualification in a Volunteer Blood Donor Population
Authors: Farrales F. B. , Stevenson A. R. , Bayer W. L.
Published: December 2004

The causes of disqualification in a volunteer blood donor population for a period of two years were analyzed. Of 138,436 prospective volunteer blood donors, 24,327 (17.6%) donors were disqualified. Phlebotomy was unsuccessful in 721 (0.5%) donors and blood was drawn from 113,388 (81.9%) eligible donors. The majority of rejections were due to medical history findings (61.0% of all rejections). The ten leading causes of disqualification were: low hemoglobin/hematocrit, medication, allergies, signs and symptoms, high blood pressure, illness in last month, hepatitis and hepatitis exposure, malaria and travel overseas, atypical antibodies, and high serum bilirubin. Hepatitis B surface antigen was detected in 82 donors out of 114,746 donors tested (0.07%).
Changes of Pulmonary Function Following Transfusion of Stored Blood
Authors: Takaori M. , Nakajo N. , Ishii T.
Published: December 2004

Ventilatory volumes, blood gases and other aspects of pulmonary function were measured before and after intra‐operative transfusion in 16 patients who had undergone operation under general anesthesia. One group consisted of eight patients transfused with 1275 ml of stored blood passed through a standard nylon mesh filter (SF group) and the other consisted of eight patients transfused with stored blood passed through a dacron wool filter (DWF group).

Since respiration of the patients was depressed slightly due to preanesthetic sedation, lowered Ve, Vt, and elevated Paco2, respiratory dead space ratio Vd/Vt were observed either in the SF or DWF group before anesthesia and transfusion. Even after the recovery of patients from anesthesia Vd/Vt remained high and Feco2 decreased in the SF group. In contrast, Vd/Vt decreased almost to normal and Feco2 remained normal in the DWF group. Fraction of physiological shunt Qs/Qt tended to decrease after anesthesia and transfusion either in the SF or DWF group. The ventilation‐perfusion ratio increased relatively more markedly and pHa elevated definitely in the SF group after transfusion.

The above data indicate that microembolism occurs after transfusion of stored blood, even in an amount of 1,000 ml, with a standard nylon mesh filter and concealed pulmonary dysfunction is observable. Therefore, a fine filter, such as a dacron wool filter or a polyester mesh filter, is recommended to avoid the pulmonary microembolism and the consequent respiratory distress following the transfusion of stored blood.
Selection of Compatible Platelet Donors: A Prospective Evaluation of Three Cross‐Matching Techniques
Authors: Wu K. K. , Hoak J. C. , Koepke J. A. , Thompson J. S.
Published: December 2004

A prospective study was undertaken to assess the values of platelet aggregometry, lymphocytotoxicity, and mixed lymphocyte cultures in selecting compatible donors for patients refractory to random platelet transfusions. Donors were selected at random without regard to HLA types. Concurrent with each platelet transfusion, platelet aggregometry and lymphocytotoxicity were performed using patient serum and donor cells. The results were compared with HLA types, MLC, and increments in platelet counts. Forty‐one transfusions were given to 21 patients; 27 were from related and 14 from unrelated donors. Platelet aggregometry was used successfully in selecting compatible donors in 37 cases (90%) with three false negative and one false positive results. Lymphocytotoxicity was useful in 73 per cent of cases with eight false negative and three false positive results. The response to platelet transfusions correlated poorly with HLA matches or MLC reactions. These data suggest platelet aggregometry and lymphocytotoxicity are useful cross‐matching techniques in selection of compatible platelet donors.
Pyrogen Reactions Associated with the Infusion of Normal Serum Albumin (Human)
Authors: Steere A. C. , Rifaat M. K. , Seligmann E. B. , Hochstein H. D. , Friedland G. , Dasse P. , Wustrack K. O. , Axnick K. J. , Barker L. F.
Published: December 2004

In November, 1974, eight patients in three hospitals had pyrogen reactions associated with the infusion of 25% Normal Serum Albumin from the same lot. The reactions were recognized because the same physician or nurse observed several patients having recurrent reactions or because a single patient receiving several vials had consecutive reactions. The remaining albumin in three vials associated with reactions had apparent endotoxin concentrations of 4, 16, and 32 ng/ml and that in 22 vials from recalled supplies had a median concentration of 4 ng/ml (range: 2 to 64) as determined by the Limulus amebocyte lysate test, but the lot again passed the rabbit pyrogen test. In a prospective study to determine the efficacy of the Limulus test in quality control, patients had their temperatures taken hourly during albumin infusions and the remaining fluid was tested by the Limulus assay. The albumin in 443 of the 662 vials infused (65%) gave a positive test and 311 of these vials (45%) had apparent endotoxin concentrations of 4 to 64 ng/ml, but no patient had a reaction. Because of the limitations of both the rabbit pyrogen and Limulus tests, the detection of some pyrogenic lots continues to depend on hospital surveillance and reporting of suspect reactions.
Elevated Red Blood Cell 2,3‐Diphosphoglycerate Levels in Black Blood Donors
Authors: Wallas C. H.
Published: December 2004

Mean levels of 2,3‐diphosphoglycerate (DPG) were significantly increased in erythrocytes (RBC) from 43 nonanemic black blood donors (4.80 ± 0.06 μmoles/1 RBC) compared with 22 white donors 4.47 ± 0.08 μmoles/1 RBC) (p < 0.01). Additional studies were done on RBCs from eight of the 12 black donors with DPG levels > 5 μmoles/1 RBC. Although a potentially hemolytic disorder could be defined in four (AS hemoglobin, β‐Thalassemia minor, C6PD deficiency), reticulocyte counts were normal. However, when RBCs from the subgroup were compared to RBCs from an additional 25 unselected white donors, the following suggested an abnormally large population of young RBCs in the subgroup: 1) normal or elevated RBC‐ATP with normal serum phosphate level; 2) significantly increased activities of RBC age‐dependent enzymes hexokinase (p < 0.02), pyruvate kinase (p < 0.05), and glutamic‐oxaloacetic transaminase (p < 0.01), with normal activity of phosphoglycerate kinase, an age‐independent enzyme; 3) decreased dense (older) RBCs as determined by sedimentation in phthalate esters. Since DPG is increased in young RBCs and falls as the RBC ages, loss of older relatively DPG depleted RBCs due to shortened survival could account for the elevated DPG levels seen in the subgroup.
Effects of Fenwal 4C2423 Transfusion Microfilter on Microaggregates and Other Constituents of Stored Blood
Authors: Marshall B. E. , Wurzel H. A. , Neufeld G. R. , Aukburg S. J. , Ewing B. C. , Fried R. J. , Barnes C.
Published: December 2004

The effects of a new micropore transfusion filter (Fenwal 4C2423) on stored whole blood have been examined. Five filters were preloaded by passage of two units of outdated type specific bank blood, and the effects of filtration on a third unit, consisting of 21‐day‐old blood, flowing under 150 mmHg pressure, were measured. Filtration did not significantly alter red blood cell count, total hemoglobin, red blood cell fragility, plasma sodium, potassium, albumin, or globulin. Some platelets and white blood cells were removed and a small amount of hemolysis of erythrocytes (<0.1%) was observed. Removal of microaggregates, assessed by Coulter counting, screen filtration pressure, total screen proteins, wet and dry weights of material retained, and scanning electron microscopy, was shown to be excellent over the entire range of particle size. Comparison of the Bentley PFS‐127, Fenwal 4C2417, Johnson & Johnson Intersept®, Pall Ultipore®, and Swank IL200 filters led to the conclusion that the Fenwal 4C2423 was both a significant improvement over the previous Fenwal design and comparable to the most efficient of these filters for both the removal of microaggregates during massive blood transfusion and for the blood flow rates obtained.
Preservation of Human Granulocytes
Authors: Contreras T. J. , Hunt S. M. , Lionetti F. J. , Valeri C. R.
Published: December 2004

Human granulocytes were isolated from blood either by counterflow centrifugation in a Beckman JE‐6 rotor or by sedimentation of the red blood cells with dextran and centrifugation of the granulocyte‐rich plasma. The stability of the granulocytes was assessed during storage in the liquid state by measurements of granulocyte loss, volume distribution characteristics, and ability to produce fluorescein in their cytoplasm and to exclude ethidium bromide from their nuclei. After storage at 4 C for 2 days in phosphate‐buffered saline with a pH of 7.1 containing 5 g/dl human albumin + 0.46 g/dl dextrose or 1 g/dl Physiogel + 0.46 g/dl dextrose, the granulocytes were adequately preserved from the in vitro measurements.
A Study of the Conversion from Paid to Altruistic Blood Donors in New Mexico
Authors: Surgenor D. MacN. , Cerveny J. F.
Published: December 2004

We investigated the recent conversion of the New Mexico blood supply from a donor recruitment base which depended almost entirely upon paid, responsibility fee, and insured donors to 100 per cent reliance upon altruistic donors. Blood Services of New Mexico (BSNM) effected this change. The local Red Cross played a key role in interpreting the change to the community and in providing entree for BSNM recruiters to the right places in the community, resulting in the enlistment of an almost entirely new group of donors who had never been asked to give blood before. The sequence of decision making is identified in relation to the detailed results during the transition. Altruistically donated blood did not significantly alter the incidence of HBsAg in the New Mexico blood supply. The supply of blood was not interrupted or diminished, the range and quality of blood services improved and the cost of blood service to the patient was reduced. The New Mexico community responded magnificently, although focal responsibility for the success of this project rests with a small number of key individuals. New Mexico now has an altruistically donated blood supply.
The Effect of Agitation of Stored Human Blood on Microaggregate Formation
Authors: Gervin A. S. , Mason K. G. , Buckman R. F.
Published: December 2004

Microaggregates (MA) composed of platelets and white blood cells form during the storage of human blood. These particles are believed to be a cause of pulmonary insufficiency in patients receiving massive blood transfusions. The present controlled study determined the effect of constant gentle agitation of CPD‐anticoagulated blood, during storage at 4 C, on the formation of MA. Using a Model T Coulter Counter, it was found that agitated blood contained significantly lower volumes of MA at 7 and 14 days than did nonagitated controls. However, significant elevations, above control levels, of plasma free hemoglobin, lactic dehydrogenase, and potassium indicated significant injury to cellular components of agitated blood. This study raises serious doubts concerning the potential clinical usefulness of blood agitation during storage to prevent MA formation.
Compatibility Test Using 51Chromium‐Labeled Red Blood Cells in Crossmatch Positive Patients
Authors: Silvergleid A. J. , Wells R. F. , Hafleigh E. B. , Korn G. , Kellner J. J. , Grumet F. C.
Published: December 2004

For the past three years, we have routinely used the one‐hour in vivo survival of 51Cr‐labeled donor red blood cells to select units for transfusion to patients for whom crossmatch compatible blood was unavailable. This technique successfully evaluated in vivo compatibility, thus avoiding acute hemolytic transfusion reactions in 38 problem patients. New or confirmatory data regarding the hemolytic potential of several well defined antibodies was also obtained.

Antibodies which proved to be clinically insignificant included: anti‐IT (all IgG), anti‐Sda, anti‐Kir, Mil, Oca, anti‐Chido, anti‐Bg, 14 of 15 “nonspecific warm autoantibodies” (three of which were associated with the ingestion of alphamethyldopa), and four of five antibodies to high‐incidence antigens. Clinically significant antibodies included: anti‐Yta, anti‐Jkb, the antibody in PCH (with “P” specificity), one intensely hemolytic “nonspecific warm autoagglutinin,” and one of five incompletely characterized antibodies to high‐incidence antigens. An acceptable in vivo compatibility test in every instance was associated with an appropriate rise in hematocrit and no clinical symptoms of hemolytic transfusion reaction.
Massive Extracorporeal Blood Clotting during Discontinuous Flow Leukapheresis
Authors: Drescher W. P. , Shih N. , Hess K. , Tishkoff G. H.
Published: December 2004

A case is reported in which massive extracorporeal blood clotting necessitated the discontinuance of leukapheresis and loss of the product. An investigation of the cause of the massive clotting is reported along with suggested precautions to prevent similar occurrences in phoresis programs.
AO Incompatibility in a Small Group of Developmentally Disabled Children
Authors: Szymanski L. S. , Szymanski I. O. , Yessayan L. , Shea M.
Published: December 2004

Prevalence of fetal‐maternal AO incompatibility was studied in a group of 150 children having developmental delay in the neuropsychological sphere. In a given population the number of A children having O mothers (AO incompatibility) should equal the number of O children having A mothers (OA compatibility). However, in the study group we observed 26 children in the former and 14 children in the latter category. This difference was statistically significant (p = 0.04). The frequency of AO incompatibility in the developmentally disabled population was higher (17.3%) than that in 437 child‐mother pairs of the general population (10.1%). It was not possible to demonstrate association of any specific neurological defect with AO incompatibility, although the children born from AO incompatible pregnancies tended to start walking later than the other children of the study group.
Granulocyte Transfusions for Patients with Severe Thermal Burns
Authors: Workman R. D. , Faville R. J. , Strate R. G. , Quie P. G. , Jager R. M. , McCullough J.
Published: December 2004

Ten severely burned (>50% BSA) pediatric and young adult patients developed 19 episodes of clinical sepsis of four or more days duration. During eight of the 19 septic episodes the patients received granulocyte transfusions (median, four; range, two to seven). Risk variables, types and prevalence of infections, mainly Pseudomonas aeruginosa and antibiotic regimens were similar for all the septic episodes studied. All eight episodes (100 per cent) resolved in the transfused group while eight of 11 (72 per cent) episodes resolved in the nontransfused group. Patients survived four episodes of ecthyma gangrenosum when granulocyte transfusions were used and the single episode in which they were not used was fatal. Granulocyte transfusions may he helpful in severely burned patients with sepsis.
Coombs' Negative Immune Hemolytic Anemia with Anti‐E Occurring in the Red Blood Cell Eluate of an E‐Negative Patient
Authors: Rand B. P. , Olson J. D. , Garratty G. , Petz L. D.
Published: December 2004

A previously untransfused 20‐year‐old man presented with a seven day history of malaise, fatigue, jaundice, dark urine and splenomegaly. Hemolytic anemia was indicated by a hemoglobin of 8.7 mg/dl, reticulocyte count 8 per cent, Lactic dehydrogenase 389 iu/L, bilirubin 4.3 mg/dl (direct 0.1 mg/dl), and undetectable haptoglobins. Tests for nonimmunologic mediated hemolytic anemia were negative. The direct antiglobulin test (DAT) was repeatedly negative with polyspecific, anti‐IgG, ‐IgA, ‐IgM and anti‐C3 antisera. The patient's serum contained a weak anti‐I, anti‐E strongly reactive by indirect antiglobulin test (IAT) and an antibody reactive against all cells tested. The latter antibody reacted weakly by the IAT but strongly against enzyme‐treated cells (Titer 160). Eluates from the patient's red blood cells only reacted with E+ red blood cells. The patient typed E negative. He was treated for warm autoimmune hemolytic anemia (AIHA) with high doses of prednisone. By the twelfth day his response allowed the medication to be tapered and by one month from the onset of treatment laboratory studies had returned to normal. The DAT remained negative, however, following recovery, anti‐E could not be eluted from the red blood cells. Anti‐E remained in his serum and the titer of the enzyme reactive antibody had decreased to 16. It is suggested that the anti‐“E‐like” antibody may represent auto anti‐Hr preferentially reacting with E+ red blood cells. A unique feature in the case is the presence of a specific antibody eluted from cells that appear to lack that antigen in a DAT‐negative patient with AIHA.
Quinidine‐induced Hemolytic Anemia: Immunohematologic Characterization
Authors: Ballas S. K. , Caro J. F. , Miguel O.
Published: December 2004

A 40‐year‐old white male with quinidine induced hemolytic anemia but no thrombocytopenia is described. Hemolysis was extravascular in nature and via the immune‐complex mechanism. The quinidine antibody was an IgG immunoglobulin that did not activate complement.
Storage of Platelets Prepared by Discontinuous Flow Centrifugation
Authors: Katz A. , Houx J. , Ewald L.
Published: December 2004

Platelet concentrates were prepared by plateletpheresis using discontinuous flow centrifugation. Platelet units were stored in PL‐146 bags of 300 ml and 2,000 ml capacity, and in vitro measures helpful in predicting platelet viability were compared. Storage in bags of 300 ml capacity led to significant fall in pH, decreased recovery from osmotic stress, and deterioration of morphology in 24 hours. Storage lesions were significantly decreased by use of 2,000 ml capacity bags.