bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet Transfusion‐Induced Serratia Marcescens Sepsis due to Vacuum Tube Contamination
Authors: Blajchman M. A. , Thornley J. H. , Richardson H. , Elder D. , Spiak C. , Racher J.
Published: December 2004

Three instances of Serratia marcescens septicemia in two patients following infusion of platelet concentrates stored at 22 C, and the isolation of the organism from one unit of a platelet concentrate, led to a study to determine the possible sources of such contamination. Cultures of the available blood products, derived from the same blood donations used to prepare the suspect platelet concentrates, yielded Serratia marcescens from two units of cryoprecipitate and from one unit of red blood cells. All other available blood products were sterile. Serratia marcescens was isolated in considerable numbers from 82 per cent of the vacuum tubes from one manufacturer's lot in use in the transfusion center at the time of the septic episodes. Six other lots of vacuum tubes prepared by the same manufacturer in use at the same time were sterile. The organism was not found in samples from other equipment, materials or personnel involved in the preparation of the blood products. Simulation of the blood collection technique using vacuum tubes from the contaminated lot, when filled from an in‐line needle as used following the blood collection procedure, gave contamination of the primary pack with Serratia marcescens in five of the six experiments attempted. The contaminated vacuum tubes were thus considered the most likely source of contamination of the platelet concentrates.
Ultrasonic Purification of Bridge Anticoagulant Neutralizing Agent (BANA) and a Study on Its Effect on Factor VIII Inhibitor
Authors: Nour‐Eldin F.
Published: December 2004

Ether precipitation of globulins from the supernatant fraction of prothrombin complex concentrate, followed by adsorption on tricalcium phosphate and elution gives a beta2 fraction termed Bridge anticoagulant neutralizing agent (BANA). Although this is completely free of all known blood clotting factors, it improves recalcification time, PTT and thromboplastin generation of hemophilic plasma. It also counteracts the effect of factor VIII inhibitor. Ultrasonic elution produced more activity per mg N than did citrate elution. The possibility is discussed of incorporating BANA preparation in the routine fractionation of plasma without reduction in the yield of factor VIII or prothrombin complex concentrate.
The Effect of an Educational Program on Transfusion Practices in a Regional Blood Program
Authors: Hillman R. S. , Helbig S. , Howes S. , Hayes J. , Meyer D. M. , McArthur J. R.
Published: December 2004

With the increased complexity of blood component therapy, it is important to be able to modify physician behavior with reliable educational programs. A standardized educational program on the use of red blood cells and whole blood was tested in 22 hospitals in a regional blood program using medical audit and computer monitoring to evaluate effectiveness. Most hospitals were eager to take advantage of the education program but were unwilling to use the audit‐education cycle. At the same time, computer monitoring of individual hospital ordering and transfusion practices demonstrated an increased utilization of red blood cells in 64 per cent of hospitals with an overall improvement of 8 per cent. The improved use of red blood cells was appreciated within the month of the program and then sustained for six to twelve months at the new level.
Coagulation Factor Activity in Platelet Concentrates
Authors: Simon T. L. , Henderson R.
Published: December 2004

Coagulation factor activity in platelet concentrates stored under different conditions was investigated. At both 22 C and 4 C, coagulation factors II, VII, IX, X, XI, and XII and fibrinogen were well maintained up to 72 hours. Factor V activity declined slightly in platelet concentrates stored at 4 C (to 78% at 72 hours), but fell to 47 per cent activity in platelets stored at 22 C. Factor VIII activity declined to approximately 68 per cent of normal activity by 72 hours at both 22 C and 4 C. Agitation did not make a difference in levels of coagulation factors. While the decline in Factor V was clearly more pronounced in platelet concentrates than in platelet‐poor plasma from the same units, the decline in Factor VIII was decreased by the presence of platelets. Platelet concentrates are a source of coagulation factor activity which should be considered in a component program.
Properties of Neutrophils Collected by Discontinuous‐Flow Centrifugation Leukapheresis Employing Hydroxyethyl Starch
Authors: Strauss R. G. , Maguire L. C. , Koepke J. A. , Thompson J. S.
Published: December 2004

The properties of neutrophils, collected by discontinuous‐flow centrifugation leukapheresis in the presence of hydroxyethyl starch and citrate were studied in an attempt to insure that cells harvested in this fashion are suitable for transfusion. Neutrophils obtained from leukocyte units prepared for transfusion by leukapheresis were found to perform similarly to those isolated from the venous blood of corresponding donors prior to the pheresis procedures when assessed by morphology, viability, hexose monophosphate shunt activity, superoxide anion generation, nitroblue tetrazolium dye reduction, chemiluminescence, adherence to nylon libers, random mobility, chemotaxis and staphylococcal killing. The results compared favorably with values previously established for healthy control subjects. Neutrophils prepared in this manner should serve as a satisfactory blood component.
Ultrastructural Alterations and Phagocytic Function of Cryopreserved Platelets
Authors: Spector J. I. , Flor W. J. , Valeri C. R.
Published: December 2004

Fresh human platelets and platelets cryopreserved in 4% dimethylsulfoxide were examined ultrastruc‐turally before and after incubation in a suspension of latex particles. Cryopreserved platelets had fewer discoid forms than fresh platelets. The cryopreserved platelets had many sphered platelets containing an increased number of vacuoles; the sphered platelets were more electron‐lucent with margination and pallor of organelles. Phagocytosis of latex into vacuoles was markedly impaired in the cryopreserved platelets. The morphologic alterations suggested that the freezing, thawing, and washing procedures reduced the functional activity of platelets.
Engraftment with Chronic Granulocytic Leukemia Cells in Acute Myeloid Leukemia
Authors: Buskard N. A. , Kaur J. , Goldman J. M. , Spiers A. S. D. , Galton D. A. G.
Published: December 2004

A deliberate engraftment with nonirradiated chronic granulocytic leukemia (CGL) cells was performed in a patient with acute myeloid leukemia (AML) at a time when he was resistant to cytotoxic drug chemotherapy, pancytopenic and developed an infection. The CGL engraftment was confirmed by the presence of a Ph1‐positive donor clone in the recipient's bone marrow and by the pattern of colony growth of the recipient's bone‐marrow cells cultured in vitro. Bone marrow engraftment in the host helped in the resolution of infection and permitted the administration of further cytotoxic drugs, as a result of which a remission of AML occurred.
The Evaluation of Hemorrhage in Cardiac Patients Who have Undergone Extracorporeal Circulation
Authors: Marengo‐Rowe A. J. , Lambert C. J. , Leveson J. E. , Thiele J. P. , Geisler G. F. , Adam M. , Mitchel B. F.
Published: December 2004

The present study defines excessive bleeding in patients who undergo cardiopulmonary bypass, and evaluates the use of coagulation testing to predict those patients that bleed excessively. Evaluation of 774 consecutive patients undergoing aortocoronary bypass surgery was carried out. Cardiopulmonary bypass consisted of a bloodless prime and a Harvey bubble oxygenator. In the postoperative period, excessive hemorrhage was denned as that exceeding 600 ml chest tube drainage in the first eight hours. One hundred and sixty‐three patients (21%) were noted to be in this category. Excessive bleeding postoperatively was best predicted by a PTT greater than 45 seconds, a PT greater than 19 seconds, a fibrinogen level less than 225 mg/dl and a TFT equal to or less than 1:32. These laboratory findings occur singly or in combination. The assessment of platelet, numbers or function and fibrin(ogen) split products were of no prognostic value. Using these criteria, the re‐exploration rate for excessive hemorrhage and/or tamponade was 0.6 per cent (5 out of 774 patients). No preoperative laboratory test of hemostatic function was useful in predicting coagulopathies resulting from cardiopulmonary bypass.
Target Inventory Levels for a Hospital Blood Bank or a Decentralized Regional Blood Banking System
Authors: Cohen M. A. , Pierskalla W. P.
Published: December 2004

For any blood type, there is a complex interaction among the optimal inventory level, daily demand level, the transfusion to crossmatch ratio, the crossmatch release period and the age of arriving units that determine the shortage and outdate rate. The blood bank administrator should establish optimal target inventory levels based on a simple equation (decision rule) relating these factors. Evaluation of this rule indicates that its implementation can lead to a very low shortage rate and a reasonable low outdate rate if the blood bank administrator makes efforts to control the crossmatch release period and the average transfusion to crossmatch ratio.
A Regional Blood Management System with Prescheduled Deliveries
Authors: Brodheim E. , Prastacos G. P.
Published: December 2004

The prescheduling of blood deliveries from regional blood centers can improve blood availability at all transfusion services while reducing outdating, delivery costs and inventories maintained at region blood centers. A procedure for determining optimal distribution policies that maintain the highest possible blood availability at transfusion services while holding the achievable outdating level to a small percentage of the total usage is described. The manner in which this plan is being implemented in Long Island, New York, is presented, as well as a discussion of some preliminary results.
Blood Donorship and Psychological Reactance
Authors: Clee M. A. , Henion K. E.
Published: December 2004

Research in social psychology suggests that expressing urgent need in requests for blood donation may result in less volunteering to help, not more. In addition, there is evidence that requests for several donations over a period of time are more likely to meet with refusal than requests for only one donation. These issues were investigated within the framework of a social psychological theory known as reactance theory.
Priapism During Filtration Leukapheresis
Authors: Dahlke M. B. , Shah S. L. , Sherwood W. C. , Shafer A. W. , Brownstein P. K.
Published: December 2004

Priapism has been observed during two out of 3,680 filtration leukapheresis procedures in male donors and has been reported during hemodialysis. Both procedures are associated with enhanced granulocyte adhesion and aggregation presumably due to C5a. During both procedures, heparin is administered and this drug has been shown to cause heparin‐dependent anti‐platelet antibodies. It is suggested that complement mediated venous leukostasis or immune‐induced platelet aggregates might impair the normal blood flow from the penis and result in a state of priapism.
The Priming of Extracorporeal Circuits: The Effect on Canine Blood Elements
Authors: Woltjes J. , Jong J. C. F. de , Duis H. J. ten , Wildevuur Ch. R. H.
Published: December 2004

Improving hemocompatibility is of major interest in extracorporeal circulation (ECC). Changes in numbers and functions of the blood cells during ECC have been ascribed to the nonphysiologk materials of the circuit. In this study, commonly used priming fluids (banked blood, Ringer's lactated solution, gelatin solution and dextran 70 solution) have been investigated for their influence on numbers and functions of canine thrombocytes, leukocytes and erythrocytes. Infusion of banked blood and Ringer's lactated solution did not affect number and function of the thrombocytes, whereas the plasma expanders caused dramatic, but reversible decreases. Leukocyte numbers were also affected, but only gelatin resulted in a decrease of leukocyte function. No effect on erythrocyte numbers was observed. It is concluded that under these experimental circumstances some priming solutions cause acute intravascular aggregation. To obtain the optimal condition for studying the hemocompatibility of ECC, preferably Ringer's lactated solution should be used.
Anti‐Ytb in Pregnancy
Authors: Ferguson S. J. , Boyce F. , Blajchman M. A.
Published: December 2004

Anti‐Ytb was readily eluted from the cord red blood cells of the second child of a mother with both anti‐Ytb and anti‐Kelt in her serum. The baby was Yt (a+b+) and Kell negative. The cord red blood cells were found to have a weakly positive direct antiglobulin test. Clinically evident hemolytic disease of the newborn was not detected.
Use of Dextran 150 as a Macromolecular Agent to Improve Granulocyte Yields on the Intermittent Flow Blood Cell Separator (Haemonetics Model 30)
Authors: Isbister J. P. , Scurr R. D. , Clouten V. C. , Blggs J. C.
Published: December 2004

Leukaphereses were performed on the intermittent flow cell separator (Haemonetics Model 30) using citrated dextran 150 as a macromolecular agent to improve separation of granulocytes. A mean of 1.77 times 1010 granulocytes and 7.73 times 1011 platelets were obtained without steroid stimulation and 2.65 times 1010 granulocytes and 8.91 times 1011 platelets were obtained with steroid stimulation of donors. There were no significant adverse reactions to dextran.
Plasma Protein Fraction: The Disappearance of Kinin from the Solution on Storage
Authors: Combridge B. S. , Wesley E. D.
Published: December 2004

The kinin produced when plasma protein fraction was heated at 60 C for 10 hours in order to inactivate the agent of hepatitis was shown to lose its activity during storage. There was an 80 per cent loss after three months and negligible activity was detectable after six months of storage. Synthetic bradykinin treated and stored under the same conditions showed no loss in activity.
Platelet Glycolysis in Platelet Storage
Authors: Tegos C. , Beutler E.
Published: December 2004

The metabolism of exogenous citrate by freshly collected human platelets has been investigated by measuring the disappearance of citrate from platelet suspensions and by measuring the formation of C02 and glycogen from purified radioactive citrate. These studies indicate that platelets do not have the capacity to metabolize exogenous citrate.
The Use of Ion‐Exchange Resins as a Blood Preservation System
Authors: Harmening D. M. , Dawson R. B. , Masters J. M.
Published: December 2004

A system using ion‐exchange resins for the storage of whole blood was investigated. Blood was collected into CPD, thoroughly mixed and then divided into equal amounts. To one half of the split units, four grams of phosphate charged Amberlite IR‐45 resin were added, while no additions were made to the other split units. Both aliquots were stored at 4 C, adhering to routine blood banking, standards. The blood stored with the resin for up to 28 days maintained high levels of 2,3‐DPG and adequate levels of ATP. This new resin system has several advantages over the present blood preservation technology. There is initial increase in pH that promotes greater glucose utilization. Inorganic phosphate is provided to maintain both ATP and 2,3‐DPG levels. The resin buffers the blood and maintains a narrower pH range for red blood cell enzyme activity. The resin is totally inert, completely filterable and has the ability to adsorb bacteria from the suspending solution.
Pretransfusion Blood Group Serology
Authors: Heistø H.
Published: December 2004

The limited value of the antiglobulin phase of the crossmatch when a careful antibody screening is performed was demonstrated by analyzing 73,407 compatibility tests for 23,857 patients. By the blood grouping and screening of these patients, 178 cases were detected with unexpected blood group antibodies that had not been previously observed. Unexpected antibodies were detected in an additional 13 patients by the saline phase of the crossmatch. In addition, the antiglobulin phase disclosed only one patient with a very weak anti‐Lea and two patients whose sera gave doubtful reactions, possibly representing antibodies, but too weak to be identified.
Blood Preservation XXIX. Pyruvate Maintains Normal Red Cell 2,3‐DPG for Six Weeks of Storage in CPD‐Adenine
Authors: Dawson R. B. , Hershey R. T. , Myers C. S.
Published: December 2004

Pyruvate was placed in experimental CPD‐adenine (0.25 mM) blood preservative mixtures in four concentrations ranging from 40 to 320 mM. In the 320 mM pyruvate preservative, 2,3‐DPG levels were elevated above normal for six weeks of whole blood storage at 4 C. The lower pyruvate concentrations maintained elevated or normal 2,3‐DPG levels for less time: four weeks with 160 mM, two weeks with 80 mM, and one week or less with 40 mM or the control. ATP values were best maintained in the control. The higher pyruvate concentrations resulted in the most rapid decreases at ATP. However, even the 320 mM pyruvate did not cause ATP to fall below 2 μM/gm of Hb. The higher pyruvate concentrations produced and maintained a higher pH during storage. On the other hand, 2,3‐DPG levels increased with pyruvate during the first week of storage when the pH was decreasing rapidly. This could be the result of its oxidation of NADH to NAD. The high pyruvate concentration which maintained elevated 2,3‐DPG levels throughout the six weeks might be simulating the effect reported in pyruvate kinase‐deficient red blood cells, in which blockage of glycolysis at that step is preventing 23‐DPG catabolism.
The preparation of leukocyte‐poor red cells from liquid stored blood: an evaluation of the Haemonetics 102 cell washing system
Authors: Wenz B , Apuzzo JH , Ahuja KK
Published: December 2004

An evaluation of the Haemonetics 102, an automated cell washing system, is presented. Although the system removes 68.4 +/− 14 per cent of the white blood cells from liquid stored blood, the percentage wash out is an unreliable mode of evaluation. The residual number of white blood cells per unit is 6.5 +/− 2.8 × 10(8), which is independent of the unit's size, age, and initial leukocyte count. The residual number of white blood cells is also not influenced by any of the modifications used in the study. Red blood cell loss averaged 16.3 per cent. A direct correlation exists between the initial red blood cell mass and the amount of cell lost. It is recommended that packed cell units which have a volume of less than 300 ml with hematocrits of 75 per cent or less be used to minimize excessive red blood cell loss. Recommendation as to the selection of units by an ideal age or the preparation of units prior to washing are not supported by these data.
Treatment of renal allograft rejection by exchange plasma‐ lymphocytapheresis
Authors: Kurland J , Franklin S , Goldfinger D
Published: December 2004

Therapy for acute renal allograft rejection generally consists of administration of high doses of corticosteroids along with cytotoxic drugs. Failure of this treatment usually dictates removal of the graft. We describe a patient who was rejecting a renal transplant from his HLA‐ identical, mixed lymphocyte culture‐compatible brother. This acute rejection episode was unresponsive to three days of therapy with high doses of steroids, azathioprine and coumadin. The patient rapidly improved following intensive exchange plasmapheresis and lymphocytapheresis. This therapy produced depletion of immunoglobulins, complement components, coagulation factors and circulating lymphocytes, and resulted in dramatic improvement in renal function and reversal of the rejection crisis. We suggest that intensive pheresis may represent an important adjunct to currently available therapy for the treatment of acute renal allograft rejection.
An In Vitro Evaluation of a New Plasticizer for Polyvinylchloride Medical Devices
Authors: Jacobson M. S. , Kevy S. V. , Parkman R. , Wesolowski J. S.
Published: December 2004

The rate of Hatcol‐200 (H‐200) leaching from polyvinylchloride (PVC) by serum is one‐hundredth that of di‐2‐ethylhexyl phthalate (DEHP) as determined by radioassay. There is a proportional decrease in leach‐ability of DEHP but not of H‐200 as the plasma proteins are diluted. Saline extracts of DEHP demonstrated a low but progressive rate of leaching with an accumulation of 11 μg/ml after seven weeks whereas H‐200 showed only a constant residue of 0.35 μ/ml. Normal human serum incubated for three weeks at 37 C with PVC strips plasticized with DEHP produced significant growth‐inhibition of human diploid fibroblasts. Human serum incubated in an identical manner with PVC plasticized with H‐200 for up to four weeks demonstrated no effect on tissue culture. These studies indicate that H‐200 deserves further evaluation as a replacement for DEHP in PVC biomedical devices.
Viral Hepatitis Markers in Soviet and American Blood Donors
Authors: Holland P. , Golosova T. , Szmuness W. , Ketiladze E. , Purcell R. , Budnitskaya P. , Gerety R. , Vorozhbieva T. , Harley E. , Burlev V. , Alter H. , Margolina A. , Lubashevskaya E.
Published: December 2004

A cooperative study was undertaken to compare the frequency of hepatitis viral antigens and antibodies among blood donors in the Soviet Union and the United States. Age‐ and sex‐stratified blood donors were identified and their sera tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti‐HBs), antibody to the hepatitis B core antigen (anti‐HBc), and antibody to the hepatitis A virus (anti‐HAV). A total of 994 Soviet blood donor sera from five different regions and 1,178 American donor sera from six different regions were tested in the USA. Among the Soviet donors, 450 (45%) had some marker of exposure to the hepatitis B virus; while among the American donors, 94 (8%) did. Of the Soviet donors 848 (85%) were positive for anti‐HAV, compared with 403 (34%) of the American donors. For 1,977 serum samples that were evaluated in both countries for HBsAg, techniques in the USSR identified 36 HBsAg‐positive samples, while the technique in the USA found 38 HBsAg‐positive samples; however, only 24 were judged to be HBsAg‐positive by assays in both countries. Testing of these same 1,977 sera for anti‐HBs revealed that the radioimmunoassay used in the USA identified many more antibody‐positive donors than the immuno‐autoradiography technique used in the Soviet Union. When a portion of the sera were tested by similar radioimmunoassay techniques in each country, there was comparability of results for anti‐HBs, as well as for anti‐HAV, and anti‐HBc. The results permit calculation of age and sex prevalence of hepatitis B and hepatitis A serologic markers for blood donors within and between each country. They also allow comparison, on the same sera, of test methodologies in use in the Soviet Union and in the United States.
Response to Granulocyte Transfusions in the Alloimmunized Patient
Authors: Dahlke M. B. , Keashen M. A. , Alavi J. B. , Koch P. A. , Okpara R. A.
Published: December 2004

The effect of alloimmunization to white blood cells upon patients receiving granulocyte transfusions was studied. Eighteen episodes of sepsis associated with neutropenia were treated with 149 granulocyte transfusions. All products were crossmatched using a recent patient serum. Each serum was tested for granulocyte‐specific antibody using the granulocyte indirect immunofluorescence test (GIIFT), and for HLA antibody, using the standard NIH lymphocytotoxicity assay. In 14 episodes of sepsis treated with 114 granulocyte transfusions, the transfusions were discontinued because there was evidence of control of infection, with and without bone marrow recovery. In this group, four per cent of all transfusions were incompatible by the GIIFT and six per cent by lymphocytotoxicity. During four episodes of sepsis treated with 35 granulocyte transfusions, blood cultures remained positive and the product was discontinued because of death. In this group, 31 per cent of all transfusions were incompatible by the GIIFT and 6 per cent by lymphocytotoxicity. The unfavorable outcome in patients with granulocyte antibodies suggests that these antibodies have an adverse effect upon the function of the transfused granulocyte.
A Model for the Study of Granulocyte Concentrate Preservation
Authors: Lane T. A. , Windle B. E.
Published: December 2004

An inexpensive model system for the study of granulocyte concentrate preservation has been evaluated. Concentrates were collected from the same donors within one hour by manual and automated pheresis techniques. In both types of concentrates, phagocytosis, respiratory burst, microbial killing and cell migration were normal within four hours of collection. Granulocyte function defects induced by 24‐ to 48‐hour storage were similar in both types of concentrates; consequently, granulocyte concentrates collected as described here should serve as a useful model for the investigation of granulocyte concentrate preservation.
Size Distribution Measurements of Microaggregates in Stored Blood
Authors: Reynolds L. O. , Simon T. L.
Published: December 2004

Microaggregates in various blood preparations were studied, before and after filtration, using an optical scattering (laser) technique which measures number density and size of aggregates in flowing blood. These measurements were comparable to screen filtration pressures. In all blood units, storage increased aggregates in the 20 to 170‐μm range. Whole blood and red blood cells were comparable, while removal of leukocytes and platelets by an inverted spin technique essentially prevented formation of aggregates in all size ranges. Platelet‐depleted units of whole blood also reduced aggregates. Removal of cryoprecipitate did not significantly affect aggregate size distribution; however, blood modified by both platelet and cryoprecipitate removal reduced aggregates. Commercially available microfilters reduced aggregates initially, but some increase ("shedding") occurred with continued use. The optical scattering technique did not require the dilution or red blood cell lysis needed in other techniques. Therefore, this method has potential for aggregate detection in in vivo flowing blood.
Use of the Refractive Index to Measure the Adequacy of Glycerol Removal from Previously Frozen Erythrocytes
Authors: Umlas J. , O'Neill T. P.
Published: December 2004

A common method for measuring deglycerolization of previously frozen erythrocytes is to determine the osmolality of the supernatant fluid after completion of the wash cycle. We attempted to compare this type of examination with the simpler, faster, and cheaper determination of refractive index (RI) using the Goldberg refractometer. One hundred twenty units of degly‐cerolized red blood cells, some with glycerol added so as to exceed an acceptable 1% glycerol content, had measurements made of the post‐wash supernatant fluid by refractive index and osmometry. The responsiveness of refractive index to residual glycerol was essentially the same as osmolality. Although there is more interference from supernatant hemoglobin, this did not preclude the use of RI to measure glycerol removal. Readings up to 28 had glycerol levels of less than 1%. Readings between 29 and 31 should be checked by osmometry, and readings over 31 should cause the unit of blood to be rejected.
Acetylation of erythrocytic membrane peptides by aspirin
Authors: Green F.A. , Jung C.Y.
Published: December 2004

Acetylation of erythrocytic membranes by aspirin has not been reported. When erythrocytes or erythrocytic membranes are incubated with [acetyl‐14C]aspirin, there is good evidence of very tight binding to membrane peptides in concentrations known to occur in vivo, 20 to 200 µM. No such evidence is observed with [carboxy‐14C] aspirin. This indicates acetylation of membrane peptides. Although pronounced selectivity is not observed among the different peptides by gel filtration on Bio‐Gel A‐5M and sodium dodecyl sulfate polyacrylamide gel electrophoresis, there is overall saturation with a half‐maximum at about 10 mM. The clinical significance of acetylation of membrane peptides of erythrocytes is unclear.
Maternal Jka sensitization following amniocentesis and intrauterine transfusion
Authors: Harrison K.L. , Popper E.I.
Published: December 2004

Two cases of Jka sensitization following amniocentesis and intrauterine transfusion for Rh hemolytic disease are presented. In one case, previously reported, amniocentesis and intrauterine transfusion stimulated production of a second antibody. The apparent association of Jka sensitization with pregnancy is discussed.
An Unusual Inhibition of an Anti‐P1
Authors: Vengelen‐Tyler V. , Nason S. G. , Dugan M. , Stefansson M.
Published: December 2004

Tests for unexpected antibodies using commercially prepared red blood cells demonstrated no agglutination even though crossmatching and testing with saline washed commercially prepared reagent red blood cells identified an anti‐P1. This antibody was inhibited when tested with red blood cells suspended in a modified Alsever's solution and several commercially prepared reagent red blood cell diluents. The inhibitory substance was identified as inosine. Hypoxanthine, adenine, and thymine also inhibited the anti‐P1. Partial inhibition was produced by uracil, 5‐methylcytosine, and xanthine. No other example of anti‐P1 has been found to exhibit this unusual inhibiting characteristic.
Platelet Transfusion: Automated Selection of Donors
Authors: Muller J. Y. , Cartron J. P. , Trillot P. , Halle L. , Roquin H.
Published: December 2004

The selection of platelet donors, according to HLA antigens, has been computerized using a method based on the calculation of incompatibilities and risk of immunization between donors and recipients. Since the risk that an antigen present in a donor will immunize an incompatible recipient of known HLA phenotype, an incompatibility score is established and a donor file printed out, ranked according to the degree of incompatibility. The principle of this method is valuable for any other compatibility system and can be easily extended according to the computer potency. The method allows a rapid selection of the most appropriate plateletpheresis donors to avoid immunizing unsensitized patients or to achieve the best degree of compatibility in previously sensitized patients.
Blood Preservation 42: Improvement of Ascorbate's Ability to Maintain 2,3‐DPG with Inosine
Authors: Dawson R. B. , Meyer D. R. , Hershey R. T. , Meyers‐Hilbert C. , Miller R. M.
Published: December 2004

Inosine and ascorbate have been shown to maintain normal 2,3‐DPG levels during three to four weeks of blood storage. With the introduction of CPD‐adenine, which allows five weeks of storage, the desire for 2,3‐DPG maintenance may receive new emphasis. Red blood cell 2,3‐DPG remained at normal or higher levels for six weeks whenever 10 or 15 mM inosine and 10 mM vitamin C (L‐ascorbate) or D‐ascorbate were present in the CPD‐adenine preservative. Provision by inosine of a five‐carbon sugar for 2,3‐DPG synthesis, bypassing the rate‐limiting phosphofructokinase reaction, may allow NADH oxidation by ascorbate to provide an increased supply of substrate for the Rappoport‐Luebering shunt, thus affecting the net increase and maintenance of 2,3‐DPG.
One‐Year Follow‐Up of Plasma Exchange Therapy in 14 Patients with Idiopathic Thrombocytopenic Purpura
Authors: Marder V. J. , Nusbacher J. , Anderson F. W.
Published: December 2004

Fourteen patients with idiopathic thrombocytopenic purpura (ITP) have been followed for one year after plasma exchange therapy. Exchange was performed prior to splenectomy in eight of nine patients with acute ITP and following splenectomy in five patients with chronic ITP. None with chronic ITP showed a response in platelet count as a result of exchange therapy. Four of the nine with acute ITP had poor responses and required splenectomy because of persistent severe thrombocytopenia. Three of these have responded completely and are in remission. One patient with acute ITP had an equivocal response, with a most recent platelet count of 93,000/μl. The remaining four patients with acute ITP had prompt and complete responses and now have platelet counts above 100,000/μl without steroid treatment. Although the good responses were temporally associated with the use of plasma but not albumin, the data are not sufficient to conclude that a plasma factor must be infused to obtain a satisfactory result. The overall response after one year was about that expected for acute ITP patients treated with prednisone and early splenectomy. Exchange plasmapheresis may be of value in decreasing the number of patients who require splenectomy, but a randomized, prospective study is needed to adequately assess this possibility.
A Modified Capillary Test Using 4% Ficin
Authors: Hardman J. T. , Pierce S. R. , Crawford M. N. , Beck M. L.
Published: December 2004

A capillary technique is described for economical Rh‐phenotyping of large numbers of blood samples using diluted antisera and 4% ficin solution. This system is no more time consuming that conventional tube techniques, since enzyme premodification of the cells is not required.
Human platelets frozen with glycerol in liquid nitrogen: biological and clinical aspects
Authors: Herve P. , Potron G. , Droule C. , Beduchaud M.P. , Masse M. , Coffe C. , Bosset J.F. , Peters A.
Published: December 2004

Platelets were frozen using glycerol (3% in plasma) as a cryoprotective agent, a rapid cooling rate, and liquid nitrogen for storage. The cryopreserved platelets were thawed at 42 C and infused without washing. The results indicate that the quality of the thawed platelets is equivalent to platelets stored for 24 to 48 hours at room temperature. The availability of HLA phenotyped leukocyte poor platelets can reduce the frequency of sensitization to strong antigens and provide clinically effective platelets for alloimmunized patients.
Freezing red blood cells prepared for quality control of antiglobulin sera
Authors: Szymanski I.O. , Harper J.M. , Odgren P.R. , Valeri C.R.
Published: December 2004

A small‐aliquot freezing technique was employed to store at −80 C red blood cells (RBC) prepared for quality control of antiglobulin sera. These RBC were used to test the specificity and potency of both polyspecific and monospecific antiglobulin sera on the day of use. Following deglycerolization, about 83 per cent of test RBC were recovered. They were then stored as 5 per cent suspensions in 0.9% NaCl at 4 C for up to two weeks and tested for specific agglutination. EIg (RBC sensitized with immunoglobulins) and EC4 (RBC sensitized with the fourth component of human complement) remained reactive for the two‐ week period. EC43 (RBC sensitized with both the fourth and third components of human complement) tended to lose reactivity only with anti‐C3c antibodies following deglycerolization and storage. EC3d (RBC sensitized with the C3d fragment of the third component of human complement), produced in vivo as a result of Mycoplasma pneumoniae infection, remained reactive for the two‐week period, whereas EC3d prepared by the alternative pathway of complement activation was useful only for one week. Use of deglycerolized test RBC improved quality‐ control procedures by saving materials and technician time as well as by providing a constant supply of uniformly prepared test RBC.
Filtration plasmapheresis in vivo
Authors: Wiltbank T.B. , Castino F. , Grapka B.H. , Daniels J.R. , Solomon B.A. , Friedman L.I.
Published: December 2004

A continuous‐flow filtration plasmapheresis system has been developed as an alternative to conventional techniques for conducting plasmapheresis from blood donors. The system was tested in two stages, nonreinfusion and continuous reinfusion. Donor safety, separation efficiency, and plasma quality were examined. These studies indicate that membrane plasmapheresis is feasible, safe to the donor, and yields sufficient plasma for either therapeutic or component therapy use.
Enumeration of previously frozen platelets using the Coulter Counter, phase microscopy, and the technicon optical system
Authors: Vecchione J.J. , Chomicz S.M. , Emerson C.P. , Valeri C.R.
Published: December 2004

The Coulter Counter®, phase microscopy, and the Technicon® optical system were used to enumerate platelets in samples of whole blood, platelet‐ rich plasma, platelet concentrates before and after addition of DMSO, and on platelet concentrates that had been frozen, thawed, and washed. We observed agreement among the three counting methods when platelet counts were determined in whole blood, platelet‐rich plasma, and platelet concentrate before and after DMSO addition. Enumeration after the cryopreservation process, however, showed highly significant differences among the counting systems. Platelet counts on platelet concentrates after freezing the thawing performed with the Coulter Counter were 25 per cent greater than with phase microscopy and 55 per cent greater than with Technicon. Counts with phase microscopy were 30 per cent greater than Technicon values. These data indicate that the method used to enumerate previously frozen platelets affects the apparent platelet count.
Improved red blood cell storage using optional additive systems (OAS) containing adenine, glucose and ascorbate‐2‐phosphate
Authors: Moore G.L. , Ledford M.E. , Brummell M.R.
Published: December 2004

Red blood cells were treated with optional additive system (OAS) solutions to provide component‐specific metabolic enhancement for improved storage. Red blood cell viability, as monitored by ATP concentrations, was maintained by use of adenine and extra glucose. Red blood cell oxygen offloading characteristics were improved by maintenance of red blood cell 2,3‐DPG concentrations with ascorbate‐2‐ phosphate (AsP). The use of CPD‐collected red blood cells with an OAS containing adenine, glucose, and AsP, or CPD‐adenine collected red blood cells with an OAS containing AsP demonstrates the potential to store red blood cells at least 42 days and to maintain red blood cell 2,3‐DPG.
Preparation of varicella‐herpes zoster immunoglobulin
Authors: Janot C. , Stoltz JF. , Avenard G. , Perrier P. , Schooneman F. , Streiff F.
Published: December 2004

The efficacy of zoster immunoglobulin in prophylaxis of varicella and herpes zoster is reported by many authors. The screening for zoster's antibodies is performed in the blood donor population and in persons convalescing from herpes zoster. The results show that 25 per cent of blood donors and 83.5 per cent of convalescents, respectively, have CF antibody titer of 16. Varicella zoster immunoglobulin prepared by alcohol fractionation has a fluorescent antibody titer of 1,024 and a CF antibody titer of 512. These results are discussed and compared with those of the literature.
Does transfusion using a syringe infusion pump and small‐gauge needle cause hemolysis?
Authors: Wilcox G.J. , Barnes A. , Modanlou H.
Published: December 2004

Hemolysis of two‐ and nine‐day‐stored sedimented red blood cells (hematocrit 65%), infused by a constant‐rate syringe delivery pump through a 25‐gauge needle was investigated. Fifteen‐ml aliquots of blood were pumped through the system at flow rates of 10.6, 20.5, and 70 ml/hour. Plasma‐free hemoglobin and potassium were measured and compared to controls. Significant red blood cell hemolysis occurred during passage through this infusion system, and the amount of hemolysis was greater with nine‐day‐stored cells. These cells showed more hemolysis with slower flow rates, but the two‐day‐stored cells were not affected by rate of flow.
Viscosity of human blood hemodiluted with crystalline hemoglobin solution
Authors: de Venuto F. , Busse K.R. , Zegna A.I.
Published: December 2004

Hemoglobin solution has been proposed as a blood substitute and, when administered intravenously, causes hemodilution that affects the viscosity of the circulation fluid. To quantitate the changes in viscosity, hemodilutions were made by mixing freshly drawn human blood with a 7‐g/dl hemoglobin solution in different proportions. Viscosity measurements were made with a micro‐cone plate viscosimeter at various shear rates. The results demonstrate that even at low or moderate hemodilutions with hemoglobin solution, the viscosity of blood decrease considerably at each shear rate investigated. The decrease of viscosity is greater with increasing hemodilution. A shear thinning effect is observed with whole blood and with each hemodiluted sample. The viscosity‐hematocrit relationship, which could be demonstrated not only by cone‐plate but also by the Ostwald viscosimeters at a fixed shear rate, shows that the concentration of red blood cells significantly affects the viscosity of blood. Hemodilution of blood with hemoglobin solution not only reduces the viscosity but also may improve the blood flow.
Utilization of a cell separation technique to evaluate patients with a positive direct antiglobulin test
Authors: Wallas C. H. , Tanley P. C. , Gorrell L. P.
Published: December 2004

Density distribution curves of red blood cells (RBC) from patients with a positive direct antiglobulin test (DAT) were compared to a standardized curve constructed from cell column measurements of centrifuged microcapillary tubes filled with RBC and phthalate ester mixtures encompassing a specific gravity range of 1.078 to 1.114. Shortened survival resulted in a loss of older RBC and a shift of the curve to the right over the high specific gravity ester range. Reticulocytosis resulted in a downward shift of the curve over the low specific gravity range. In patients with a positive DAT due to an autoantibody or drug, the density distribution curve was either normal or demonstrated evidence of shortened RBC survival. In patients with a positive DAT due to an alloantibody, however, evidence of shortened survival was not seen. The distribution of antibody on young and old RBC harvested from the appropriate microcapillary tubes depended upon the etiology of that antibody. In patients with a positive DAT due to to an alloantibody or drug, both the young and old RBC gave an equally reactive DAT, while in patients with a positive DAT due to an alloantibody the young cells were weakly reactive or nonreactive and the older cells were more strongly reactive. When used together, the position of the density distribution curve and the pattern of distribution of antibody coating on young and old RBC provide important diagnostic information about the etiology and clinical status in a patient with a positive DAT and allow for the recognition of an alloantibody and autoantibody when both are present in the same patient.
Transfusion experience with platelet concentrates stored for 24 to 72 hours at 22° C
Authors: Lazarus H. M. , Herzig R. H. , Warm S. E. , Fishman D. J.
Published: December 2004

We studied the transfusion response from random donor platelet concentrates in 15 stable multitransfused, thrombocytopenic patients by comparing the platelet counts measured before and 20 hours after transfusion. The observed platelet increments were corrected (corrected increment, C.I.) for the number of units of platelet concentrate transfused and the patient's body surface area in square meters (platelets/microliter per unit/m2). Using platelet concentrates stored for less than 24 hours, the patients achieved a median C.I. of 9500 (range: 5000–18,000). When platelet concentrates stored for 24 to 48 hours or 48 to 72 hours were given, the median C.I. markedly decreased to 1000 (range: 0–4800) and 0 (range: 0–5100), respectively (p less than 0.001). These differences could not be explained by further recipient alloimmunization. Transfusion with platelet concentrates less than 24 hours old on a second occasion, bracketing the transfusions of older platelet concentrates, resulted in a median C.I. of 7200 (range: 5400–14,500). Similar results were obtained in three patients when HLA‐ identical sibling platelet concentrates were employed. In vitro tests, including pH, morphology, and aggregation, demonstrated no statistically significant differences among the platelet concentrates stored for less than 24 hours, 24 to 48 hours, and 48 to 72 hours. These studies suggest that, although platelet concentrates can be stored for 72 hours without loss of in vitro function, the in vivo recovery is significantly diminished after 24 hours of storage, and preferably patients should not be transfused prophylactically with platelet concentrates greater than 24 hours old.
Changes in coagulation factors, complement, immunoglobulins, and immune complex concentrations with plasma exchange
Authors: Volkin R. L. , Starz T. W. , Winkelstein A. , Shadduck R. K. , Lewis J. H. , Hasiba U. , Spero J. A.
Published: December 2004

Seventeen patients with a spectrum of immunologically‐related disorders were studied before and immediately after plasma exchange (PE) for changes in coagulation factors, complement, immunoglobulins, and immune complex levels. Each PE replaced 50 per cent of the plasma volume with 5% albumin and saline. With PE, coagulation profiles indicated a decrease of 23 to 55 per cent in the levels of fibrinogen, Factors II, V, VII, VIII, IX, X, XI, XII, and Fletcher factor. Only minimal changes were noted in the prothrombin time and activated partial thromboplastin time. Most coagulation factors, except fibrinogen, returned to baseline by 48 hours. Following three PE/week, fibrinogen was reduced by 51 per cent; other factors were not significantly altered. C3 and C4 fell by 35 to 40 per cent with each PE; these approached baseline by 24 hours. Immunoglobulins (G,A,M) were reduced by 34 ± 3,37 ± 3 and 34 ± 3 per cent, respectively. After three PE, the total immunoglobulins were decreased by 50 to 55 per cent. Five of eight patients who had three or more PE developed hypogammaglobulinemia (IgG less than 450 mg/dl). Immune complexes were reduced by 50 ± 4 per cent with each PE. Multiple exchanges in five patients led to a greater reduction (80 ± 6%). Thus PE was an effective means of reducing immune complexes but led to hypogammaglobulinemia and hypofibrinogenemia.
An antibody that recognizes a determinant common to S and s‐bearing sialoglycoproteins
Authors: Issitt P. D. , Wilkinson S. L. , Tregellas W. M. , Lee C.
Published: December 2004

We describe an antibody, made by an individual of the phenotype M+, N+, S+, s+, U+, that reacted only with ficin or papain‐treated red blood cells, and that initially appeared to have anti‐S specificity. However, further studies revealed that the antibody, which did not have anti‐U specificity, recognized a determinant present on S+, s‐, U+, and S‐, s+, U+, but missing from S‐, s‐, U‐, and S‐, s‐, U+, red blood cells. The specificity of this antibody is discussed in terms of current knowledge of the structure of the Ss sialoglycoprotein.
The effect of adenine on platelet storage
Authors: Wong S. C. , Rock G.
Published: December 2004

Adenine is an approved additive to citrate‐phosphate‐dextrose anticoagulant for whole blood collection and extends the storage life of red blood cells. We used in vitro methods to investigate the effects of adenine on platelet function and viability during 72 hours of storage at 22 degrees C. Although the hypotonic shock response and aggregation were decreased, these effects were reversed following separation and resuspension in fresh adenine‐free plasma. Serotonin uptake and release were not affected by adenine, however malonaldehyde formation was slightly enhanced. Glucose, pH and pO2 levels were lower, while lactate levels were slightly higher than in platelets stored without adenine. These results indicate little in vitro effect of adenine on platelets stored as platelet‐rich plasma or platelet concentrate.