bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous‐ and Semicontinuous‐Flow Blood Centrifugation Systems: Therapeutic Applications, with Plasma‐, Platelet‐, Lympha‐, and Eosinapheresis
Authors: Pineda A. A. , Brzica S. M. , Taswell H. F.
Published: December 2004

Blood centrifugation, with a continuous‐flow or semicontinuous‐flow system, was used in the treatment of 17 patients with various hematologic disorders. Total plasma exchange (TPE) controlled symptoms of hyperviscosity and arrested bleeding in three patients. In two patients, TPE made it possible to perform urgent surgical procedures. It was a very valuable adjuvant in the treatment of the one patient with a Factor VIII inhibitor. Eosinapheresis was not of significant value in the therapy of syndromes associated with eosinophilia. Lymphapheresis significantly reduced peripheral lymphocytosis, aiding in the chemotherapeutic control of chronic lymphosarcoma cell leukemia in one patient. It was of questionable value in the maintenance therapy of two patients with Sézary syndrome. Plateletapheresis significantly reduced peripheral platelet count in thrombocytosis, making it possible to minimize the chemotherapeutic dose and permitting urgent surgical procedures in two patients.
Evaluation of a Large‐Scale Frozen Blood Program
Authors: Szymanski I. O. , Carrington E. J.
Published: December 2004

The characteristics of previously frozen red blood cells, prepared in a large‐scale frozen blood program using the Red Cross method were evaluated. The use of the method as originally described resulted in approximately 91 per cent freeze‐thaw‐wash recovery of red blood cells. When the glycerolization step was modified by adding the partially glycerolized erythrocytes into 300 ml of 6.2M glycerol, freeze‐thaw‐wash recoveries were decreased. However, gradient addition of glycerol to the red blood cells without the use of stylet, resulted in acceptable in vitro recoveries. Thawing frozen units in waterbath, to which no antiseptic was added, could introduce bacteria into units of previously frozen red blood cells. Therefore, it seems advisable to use dry heat thawing procedures. Previously frozen red blood cells prepared in the large scale maintained normal levels of ATP and 2,3 DPG. Therapeutic transfusions had acceptable 24‐hour survival in vivo.
Military Blood Banking: Blood Transfusion Aboard a Naval Hospital Ship Receiving Multiple Casualties in a Combat Zone, a Controlled Medical Environment
Authors: Monaghan W. P. , Levan D. R. , Camp F. R.
Published: December 2004

The materials, methods, and policies used in the Blood Transfusion Service aboard the USS Sanctuary (AH‐17) during military operations off South Vietnam to transfuse multiple casualties are outlined. Materials and methods common to any blood bank were used with some modification to meet specific requirements. During the period 10 April 1967 to 1 May 1971, approximately 32,000 units of blood were received, and over 2,890 severely injured patients were transfused. The policies and techniques used enabled efficient and safe management of blood transfusion for these patients. These methods should be applicable in solving some of the problems which arise as a result of combat operations and civil disasters. A controlled medical environment is described.
Evaluation of Liquid Scintillation Counting Solutions for Radioimmunoassay of Hepatitis‐associated Antigen (HBsAg)
Authors: Hicks E. J. , Oei T. O. , Nordschow C. D. , Hughes B. J.
Published: December 2004

Liquid scintillation counting solutions for radioimmunoassay of hepatitis associated antigen (HBsAg) are evaluated and discussed. Data is also presented which indicates that liquid scintillation counting could be carried out by placing cut‐off Ausria‐125 test tubes in counting vials containing 10 ml of either Brays, Unogel, or Instagel solutions. The data suggest that Brays was the least effective and Unogel and Instagel were the most effective liquid scintillation counting solutions. This is a fundamental consideration if a laboratory is contemplating an initial investment in counting equipment. The acquisition of a liquid scintillation counter provides additional capabilities for the clinical laboratory interested in radioisotope measurements. In addition, if a laboratory already has a liquid scintillation counter (Beta counter), the director of the clinical laboratory may elect not to purchase additional counting equipment (gamma counter) since he already has the added advantage of measuring iodine‐125 with the Beta counter. The authors propose liquid scintillation (RIA) as an alternative counting system for HBsAg detection in hospital patients and donors.
Hemolytic Disease of the Newborn Due to Anti‐PPIPk (Anti‐Tja)
Authors: Levene C. , Sela R. , Rudolphson Y. , Nathan I. , Karplus M. , Dvilansky A.
Published: December 2004

A newborn infant of genotype P2p suffering from ABO‐like hemolytic disease was born to a mother of the very rare genotype pp. The disease was severe enough to require exchange transfusions with pp blood. The mother and other members of the family with the same rare pp blood provided compatible donor blood for transfusions of the mother herself and for replacement transfusion of her affected infant. The mother's serum contained IgM molecules and also IgG molecules capable of crossing the placenta to induce a hemolytic process on the infant's red blood cells. The genotype of the P1 negative father was very likely P2P2. so that the genotype of the affected infant had to be P1P2. A search of the literature revealed an earlier report from Japan in which the genotype of the P1 positive father was P1P2. As was to be expected the genotype of this affected infant was P2p.
Automated Donor‐Recipient Identification Systems as a Means of Reducing Human Error in Blood Transfusion
Authors: Sherer P. B. , Chambers R. W. , Taswell H. , Altshuler C. , Aster R. , Covino K. , Gordon S. , Gajewski M. , Smith A. , Horrigan S. , Pfaff K.
Published: December 2004

Clerical and administrative errors are the most common mistakes in blood banking, with errors of sample or patient identification accounting for the majority of mistakes. In an effort to reduce the incidence of human errors, three automated donor‐recipient identification systems were developed and were evaluated under clinical conditions. After two years of development and bench testing, each set of equipment was tested, along with established procedures, at a large clinical center, a medium‐sized community hospital and a regional donor center. Although none of the systems, as tested, proved acceptable under clinical conditions, a great deal was learned about prototype equipment testing in the clinical setting. Future development of identification systems for clinical use should respond to carefully defined problems, apply in all areas of the hospital or donor center, and be convenient and reliable. The development of the equipment should involve established manufacturers and be subject to exacting preclinical testing.
Effect of Hydroxyethyl Starch on Platelet Function Following Granulocyte Collection Using the Continuous Flow Cell Separator
Authors: Farrales F. B. , Belcher C. , Summers T. , Bayer W. L.
Published: December 2004

Hydroxyethyl starch (HES) was used as sedimenting agent in the course of granulocyte collection on seventeen normal donors using the continuous flow cell separator (CFCS). No clinical bleeding was noted in any of the donors. In spite of a 21 per cent mean reduction in postcollection platelet count, all donors had platelet counts within normal limits precollection and postcollection. Postcollection platelet adhesiveness increased in five donors, remained the same in one donor and declined in ten donors. Except in one donor there was no change in previously' normal platelet aggregation to adenosine diphosphate or collagen. In the dose used, 500 ml, the infusion of 6% hydroxyethyl starch as an adjunct to granulocyte separation using the continuous flow cell separator does not appear to adversely affect platelet number and function.
Management of Chronic Myelocytic Leukemia in Pregnancy by Cell Pheresis
Authors: Caplan S. N. , Coco F. V. , Berkman E. M.
Published: December 2004

Cell pheresis was employed in the initial management of a pregnant patient with chronic myelocytic leukemia (CML). Reduction in circulating leukocyte and platelet counts was evident after two weeks of therapy. This technique is an effective mode of management of the pregnant patient with CIVIL and may play an important therapeutic role in the treatment of other myeloproliferative diseases characterized by dangerously high levels of circulating platelets or myeloblasts.
Hemolytic Anti‐hr” (e) Detectable Solely by an Automated Polybrene Technique
Authors: Snyder E. L. , Spivack M. , Novodoff D. , Kling G.
Published: December 2004

An example of a hemolytic anti‐hr” (e) detectable solely by an AutoAnalyzer‐Polybrene (AAP) system is reported. The antibody was undetectable by routine indirect antiglobulin and enzyme tests, and produced a delayed intravascular hemolytic transfusion reaction. The anti‐hr” (e) was no longer AAP detectable five months after the transfusion reaction. This paper points out the potential usefulness of the AAP technique in detecting alloantibodies in cases of transfusion reactions where no antibody specificity can be demonstrated by standard manual techniques.
Community‐based Computerized Donor Record Systems
Authors: Moll J. D. , Drummond C. , Bloomfield L. , Chen T. T. , Williams B. T.
Published: December 2004

Computer programs for management of donor information have been developed for the Champaign County Blood Bank, a division of the Regional Health Resource Center, Urbana, Illinois. The system provides the blood bank with reports from the donor files, incorporating the donors' last donation dates, ABO group and Rh factors, memberships in assurance programs, and rare donor information to generate lists to meet either daily or emergency inventory needs. The system was designed to decrease time requirements for donor recruitment, improve donor base sampling, aid in support of special recruitment programs, and provide statistical profiles of the community donor base. Experiences in the development and use of the system indicate requirements for effective development of such systems include careful design, strict monitoring of performance, use of a versatile programming language, and incorporation of program modifications via staff‐programmer interaction throughout implementation.
Studies on 4 C Stored Frozen‐Reconstituted Red Blood Cells
Authors: Myhre B. A. , Nakasako Y. Y. , Schott R.
Published: December 2004

Units of frozen red blood cells were thawed, stored at 4 C for varying amounts of time up to five days, and then subsequently refrozen. This procedure was repeated for two or three cycles. Chemical and cytological studies showed that only a moderate number of red blood cells were lost and that the red blood cells would be transfusable with minimal danger to the patient. The units retained their sterility despite all of the manipulations. The ability to refreeze a unit of blood would extend the value of frozen blood greatly by preventing the loss of very rare units.
The Effect of Refreezing Previously Frozen‐Deglycerolized Red Blood Cells
Authors: Kahn R. A. , Auster M. , Miller W. V.
Published: December 2004

Frozen red blood cells, once thawed and washed, must be used within 24 hours or discarded. In this study, three units of blood underwent two freeze‐thaw cycles. It was shown that red blood cell survival, ATP, and 2,3‐DPG were not adversely effected. The data suggest that previously frozen red blood cells should be refrozen, rather than discarded, if not used within 24 hours of deglycerolization.
Computer Simulation as a Method for Evaluating the Copper Sulfate Test for Hemoglobin in Diverse Populations
Authors: Buckle G. C. , Webb G. L.
Published: December 2004

The copper sulfate hemoglobin screening method was separately evaluated for three local population groups which do not conform to accepted normal standards of hemoglobin and/or plasma specific gravity (SG). This was carried out by a computer which simulated the distribution of plasma specific gravity and hemoglobin levels in random samples of blood donors. Simulations of 1,000 were carried out for males and for females in each of the three main population groups in Natal (Caucasians, Negroes and Asians). These were compared with a simulation of hypothetical normal subjects whose hemoglobin and plasma SG conformed to accepted standards. Variations in accuracy, relating to differences in plasma specific gravity and in hemoglobin, were demonstrated. Acceptances of donors who should be rejected (Type II errors) were most common in Negroes, but did not occur in the normal group. Type II errors did not occur in males with hemoglobin levels below 12.5 gm/dl or in females under 11.5 gm/dl. Erroneous rejections of prospective donors who, in fact, satisfied the criterion of acceptance (Type I errors) occurred in all groups, but were fewest in the normal group.
Autoagglutination Dispersal Utilizing Sulphydryl Compounds
Authors: Reid M. E.
Published: December 2004

Autoagglutination caused by powerful IgM cold autoagglutinins can be dispersed by sulphydryl compounds to provide an unagglutinated red blood cell suspension suitable for immunohematologic testing. For this 0.1 M 2‐mercaptoethanol is added to twice washed red blood cells. Following agitation for 10 minutes at 37 C an unagglutinated red blood cell suspension is obtained without adverse effect to red blood cell antigens and without removal of in vivo bound IgG or complement. Dithiothreital may be substituted for 2‐mercaptoethanol if the incubation time is increased to 15 minutes.
Radioactive Antiglobulin Testing with 125I Anti‐C4 and Anti‐C3
Authors: Jenkins D. E. , Johnson R. M. , Moore W. H.
Published: December 2004

The report describes methods for quantitating C4 and C3 coating of red blood cells using 125I anti‐C4 and anti‐C3. Two methods of preparing antisera were used; one involving absorption and elution from complement coated cells, and the other employing IgG fractions of antisera prepared on DEAE cellulose. White‐cell‐free red blood cells were used in the test procedure. Both the labeled antisera and the test cells were diluted in cold carrier proteins, initially bovine serum albumin, but more recently normal rabbit serum. We have found that normal rabbit serum is particularly effective in reducing the high uptake of nonspecific counts on normal cells, which had previously been a major technical problem for the radioactive antiglobulin technique. These methods are highly reproducible and relatively easy to perform once the labeled antisera are prepared. Furthermore, the use of labeled antisera permits analysis of specificity by the highly sensitive technique of radioimmunoelectrophoresis. One problem with the technique is that results indicate uptake of labeled antisera, rather than amounts of coating substances. Nonetheless, the ease of performance and the reproducibility of the method, make the procedure very useful in comparative studies of uptake of C4 and C3 by red blood cells.
Reorganization of Blood Ordering Practices
Authors: Rouault C. , Gruenhagen J.
Published: December 2004

Physicians order blood crossmatched on the basis of habit. The resulting unnecessary crossmatching for elective surgical procedures is costly and wasteful. By realigning crossmatching orders with actual expected needs, substantial savings can be realized in terms of personnel time, reagents, and outdating of units of blood.
Transfusion Reactions Reported after Transfusions of Red Blood Cells and of Whole Blood
Authors: Milner L. V. , Butcher K.
Published: December 2004

Reactions reported after transfusion of 19,126 units of whole blood and of 42,678 units of red blood cells were analysed. The reaction rate with whole blood was about two and one‐half times as great as with red blood cells.
Antigenic Determinants of C3 and C4 Complement Components on Washed Erythrocytes from Normal Persons
Authors: Rosenfield R. E. , Jagathambal
Published: December 2004

Well‐washed erythrocytes from normal persons were agglutinated by antisera to C3, C3d, and C4, and this agglutination was specifically inhibited by the corresponding C3 or C4 protein. C3 and C4 antigenic determinants were present on the red blood cells of freshly shed blood promptly anticoagulated with EDTA, heparin, ACD, or CPD, and no significant changes in degree of agglutination were observed on storage of EDTA or CPD blood for two weeks at 4 C. Marked differences in degree of agglutination by anti‐C3, anti‐C3d, and anti‐C4 were observed when erythrocytes of 16 normal persons were assayed, and significant correlations were obtained when the quantitative results with any two anti‐sera were compared. Anti‐C3c did not agglutinate erythrocytes from normal persons, suggesting that the C3 antigens detected on normal cells are carried by the C3d fragment. To avoid significant agglutination of the erythrocytes from some normal persons, very dilute preparations of anti‐C3, ‐C3d, and ‐C4 had to be used for instrumented diagnostic direct antiglobulin tests. Stronger reagents could be used for indirect antiglobulin tests when the result of a suitable control could be subtracted.
An Aseptic Fluid Transfer System for Blood and Blood Components
Authors: Myhre B. A. , Nakasako Y. Y. , Schott R. , Johnson D. , Berkman R. M. , Cleland E. L.
Published: December 2004

A device is described which can be attached to all blood bags. Two of these devices are heat‐sealed together aseptically at any time during the storage life of the blood unit, and an opening connecting the two is created. In vitro and in vivo studies show that ten passes of a unit of blood through these devices produces no cytological changes and does not alter the in vivo survival of the unit when transfused. Further, if the unit is frozen, then thawed, and even stored at 4 C for five days after thawing, the in vivo survival is still unaffected.
A New Antigen, McCa(McCoy), and Its Relationship to Kna(Knops)
Authors: Molthan L. , Moulds J.
Published: December 2004

The antigen McCa is detected in 98.5 and 96.7 per cent of the American Caucasian and Negro populations respectively. In population studies with anti‐McCa and anti‐Kna, a strong association was demonstrated between the two antigens, with 53 per cent of McC(a–) samples being Kn(a–) compared with a reported frequency for Kn(a–) of only 0.19 per cent.
Filtration Characteristics of the Dual‐Mode (Johnson and Johnson) Micropore Blood Transfusion Filter
Authors: Hurley M. J. , Miller E. , DeJongh D. S. , Litwin M. S.
Published: December 2004

Stored human whole blood and red blood cells of varying age were passed through dual mode micropore blood transfusion filters. Passage through the filters resulted in markedly decreased screen filtration pressure (SFP) of the blood and increased filter weights. Numerous microaggregates were removed and SFP returned to normal. Filtration resulted in reduced platelet and white cell counts but other blood components were not adversely affected. On the basis of this research, we conclude that this micropore blood transfusion filter is effective in removing microaggregates from stored whole blood and red blood cells. It has a high capacity and rapid flow rate and is reliable during pressure transfusion.
Nonhemolytic IgG Anti‐IT
Authors: Hafleigh E. B. , Wells R. F. , Grumet F. C.
Published: December 2004

Nonhemolytic, IgG, anti‐IT autoantibodies were found in the sera of three Caucasian patients, none of whom had Hodgkin's disease. Each antibody reacted by indirect antiglobulin test. Two of the three also reacted in albumin at 37 C, and one of these was moderately enhanced by papain. As judged by transfusion responses, reticulocyte counts, hematocrit stability, and one hour 51Cr red blood cell survivals, none of the antibodies were considered to be hemolytic. When tested with anti‐IgG serum, cells from all three had a positive direct antiglobulin test. Anti‐IT antibody was eluted from their cells. Ii status of the patients' cells differed from normal in each case. These data suggest greater variation in the disease association, serologic reactivity, and clinical significance of anti‐IT than has been evident from previous studies.
Rapid Testing of Ficinized Cells in Capillary Tubes
Authors: Crawford M. N.
Published: December 2004

A technique is described for capillary tube testing using small amounts of serum with cells rapidly treated with a 4% ficin solution. This test aids antibody identification and cell screening.
Coexistent Tk and VA Polyagglutinability
Authors: Beck M. L. , Myers M. A. , Moulds J. , Pierce S. R. , Hardman J. , Wingham J. , Bird G. W. G.
Published: December 2004

Serologic investigations of the red blood cells of two patients indicated polyagglutination as the cause of compatibility problems. Lectin studies to classify the variety of polyagglutination demonstrated the simultaneous exposure of two latent membrane receptors, Tk and VA. It is proposed that different bacterial enzymes were responsible.
A Study of Soluble Lewis and P1 Substances Produced for Use in Immunohematology
Authors: Marsh W. L. , Øyen R.
Published: December 2004

We have investigated a new source of commercial Lewis and P1 soluble blood group substances produced for use in immunohematology. Our tests show them to be potent, specific, stable and suitable for use in antibody inhibition procedures. They should make a useful contribution to antibody identification studies in hospital blood bank laboratories.
Antibodies that Define NANA‐Independent MN‐System Antigens
Authors: Judd W. J. , Issitt P. D. , Pavone B. G. , Anderson J. , Aminoff D.
Published: December 2004

The hemagglutinating properties of a large proportion of anti‐M and anti‐N reagents, and sera containing antibodies to MN‐related antigens, have been shown to be unaffected by treatment of red blood cells with neuraminidase. These antibodies, which define NANA‐independent MN‐ system structures, provide further evidence that MN blood group specificity may also be determined by moieties other than N‐ acetylneuraminic acid.
The Can Serum: Demonstrating Further Polymorphism of M and N Blood Group Antigens
Authors: Judd W. J. , Issitt P. D. , Pavone B. G.
Published: December 2004

An antibody defining an antigen that is very similar in structure to M is described. The reactions of this antibody are considered in the light of what is now known of the biochemical structure of the M and N blood group antigens.
Platelet Behavior in Extracorporeal Circulation (ECC)
Authors: Jong J. C. F. de , Sibinga C. Th. Smit , Wildevuur Ch. R. H.
Published: December 2004

Compatibility of blood with nonphysiologic materials is of increasing importance. The basis of estimating such compatibility has shifted from the determination of hemolysis to the estimation of the clotting capacity. This can be specified in terms of number and function of circulating thrombocytes and the resulting bleeding time. In this study components of commonly used standard equipment for open heart surgery have been compared to alternatives. The parameters studied yield more relevant information for ranking materials in relation to their blood compatibility than does estimation of hemolysis alone. The behavior of the thrombocytes showed an initial dip (acute aggregation phenomenon), a plateau (equilibrium between aggregation and desaggregation) and a secondary dip (elimination of irreversibly damaged cells). Correlated to criteria of major hematological differences as observed between membrane‐oxygenators and bubble‐oxygenators, the percentage of circulating thrombocytes at the moment of the secondary dip gives the best overall information about hemocompatibility.
Phenotype i Associated with Congenital Cataract in Japanese
Authors: Ogata H. , Okubo Y. , Akabane T.
Published: December 2004

A Japanese family with two siblings of phenotype i is presented. Both had a past history of surgical treatment for congenita] cataract. In Japan, 18 individuals of phenotype i, including our case, have been found in ten unrelated families. Seventeen of them had congenital cataract. Cataract was not found in any of the 45 phenotype I members in these families. It is briefly discussed why these two linked and quite rare genes were found in combination only in Japanese persons.
A Rapid Tube Technique for Fetal Cell Typing
Authors: Bryant N. J. , Shanahan L. S. , Sutton D. M. C.
Published: December 2004

A modification of the Greendyke technique for fetal cell typing is described in which incubation time and quantities of antisera are reduced without affecting the sensitivity of the test.
Sodium and Potassium Changes in Blood Bank Stored Human Erythrocytes
Authors: Wallas C. H.
Published: December 2004

Storage of red cells for three weeks at 4 C under blood bank conditions resulted in a rise in intracellular Na+ and a fall in intracellular K+ with concomitant opposite changes in Na+ and K+ levels in the suspending plasma. A decline in red blood cell ATP during the storage period did not appear to be contributing to the changes. Increasing red blood cell ATP to levels 2 to 3 times normal did not prevent the cation changes from occurring. When assayed at 37 C in the presence of added Mg++, ouabain‐sensitive membrane ATPase activity and kinetics of activation by Na+ were unaffected by the three week period of cold storage. However, when assayed at 4 C without added Mg++, simulating the conditions of storage, ATPase activity was negligible. Sodium and potassium did not change when red blood cells with normal ATP content were stored at 20 to 24 C even in the absence of added Mg++. Thus, a major cause for the development of cation changes in the red blood cell during blood bank storage is the temperature which inhibits membrane ATPase, allowing cations to leak unopposed into and out of the red blood cells.
Allo‐Anti‐C in a Patient Who Had Previously Made an Autoantibody Mimicking Anti‐C
Authors: Weber J. , Caceres V. W. , Pavone B. G. , Issitt P. D.
Published: December 2004

A patient, previously studied by us,3 who had produced a benign autoantibody with a specificity that mimicked anti‐C, has now produced allo‐anti‐C that is not of the mimicking type. She is no longer producing any serologically demonstrable autoantibody. It is highly probable that conversion from auto to alloantibody production in this patient was prompted by the introduction of additional foreign immunogen on fetal red blood cells during her third pregnancy.
Liquid and Freeze‐Preservation of Dog Red Blood Cells
Authors: Contreras T. J. , Lindberg J. R. , Lowrie G. B. , Pivacek L. E. , Austin R. M. , Vecchione J. J. , Valeri C. R.
Published: December 2004

After storage in the liquid state at 4 C for up to three weeks, washing with sodium chloride solutions, and storage in a sodium chloride‐glucose‐phosphate solution for 24 hours at 4 C, dog red blood cells had excellent post‐transfusion survival. After freeze‐preser‐vation with 40% W/V glycerol at ‐80 C or with 20% W/V glycerol at ‐150 C, thawing, washing with sodium chloride solutions, and storage in a sodium chloride‐glucose‐phosphate solution for 24 hours at 4 C, dog red blood cells had satisfactory recovery values in vitro, acceptable 24‐hour post‐transfusion survival and long‐term survival values, and normal oxygen transport function. Controlled addition and removal of the cryo‐protectant, glycerol, helped reduce the amount of osmotic damage to the red blood cells and enhanced freeze‐preservation. Osmotic damage can also be prevented by warming the dog blood to a temperature of 22 ± 2 C prior to centrifugation to concentrate the red blood cells and remove the plasma. This step enhances removal of the cold agglutinins. Another processing step used by the authors was to add a sodium chloride solution to the dog red blood cells before adding the glycerol solution in order to eliminate rouleaux formation.
Autoimmune Hemolytic Anemia Associated Exclusively with IgA of Rh Specificity
Authors: Sturgeon P. , Smith L. E. , Chun H. M. T. , Hurvitz C. H. , Garratty G. , Goldfinger D.
Published: December 2004

A nine‐year‐old boy had typical clinical, hematologic and blood group serologic findings of autoimmune hemolytic anemia except for one important exception; with most commercially available broad spectrum anti‐human sera the direct antiglobulin tests were negative. With reagents prepared in the laboratory which were found to be relatively less potent in anti‐IgG and IgM activity but which utilize a short period of incubation after mixing with the washed cells, the tests were all clearly positive. If incubation were employed with the commercial reagents, the tests were positive. Further studies showed that the patient's cells were coated exclusively with IgA and that a commercial reagent, although potent in anti‐IgG and anti‐IgM, was relatively deficient in anti‐IgA. It is proposed that incubation compensates for the latter and is cautioned that incubation, with reagents potent in anti‐IgG, could lead to false negative reactions with weakly IgG sensitized cells due to antibody surplus prozones of inhibition. This case illustrates that the rare instances of “Coombs negative immune hemolytic anemias” may be based on mechanisms such as those reported here and, that to be ideal, a broad spectrum anti‐human serum should have balanced anti‐immunoglobulin activities in relation to its incubation time.
Anti‐Rh39—A “New” Specificity Rh System Antibody
Authors: Issitt P. D. , Pavone B. G. , Shapiro M.
Published: December 2004

Two examples of an autoantibody that defines a hitherto unrecognized Rh system antigen are described. Both were produced by C‐negative individuals and ostensibly resembled anti‐C in specificity. However, adsorption studies showed that the antigen that the autoantibodies define is present on all red blood cells with a “normal” Rh phenotype and on D—/D— and Dc‐/Dc‐ samples. The antigen detected is not present on Rhnull red blood cells. Serologic studies have shown that the new antibody, that has been named anti‐Rh39, has a different specificity from those that define the antigens C, Ce(rh1), G, Hro, Hr, CG, LW, Rh:29, Rh:34 and U. A possible relationship between auto‐anti‐Rh39 and alio‐anti‐C, in terms of the immune response, is discussed.
Augmentation of Hemagglutination by Low Ionic Conditions
Authors: Rosenfield R. E. , Shaikh S. H. , Innella F. , Kaczera Z. , Kochwa S.
Published: December 2004

Short incubation at 37 C, 80 per cent reduction in ionic concentration and removal of liquid phases after each reaction step, provided the basis for the construction of four new serologic tests for alloantibodies to human erythrocytes. In the first, the incubation fluid was replaced with protamine sulfate to aggregate intensely the evaluated red blood cells. After dispersal by phosphate buffer, residual antibody mediated agglutination could be discerned. As a second method, this low ionic polycation (LIP) test was followed by a normal ionic IgG antiglobulin test (LIP‐AGT). A third method employed low ionic washing of erythrocytes and low ionic antiglobulin serum (LIAGT). Finally, a modified LIP test was conducted entirely under low ionic conditions and followed by a low ionic antiglobulin test (modified LIP‐AGT). LIP, LIP‐AGT and LIAGT were successfully employed for all routine blood bank serology tests. Their sensitivity and impact on blood bank performance are described.
A Study of Blood Utilization by Diagnosis, Month of Transfusion, and Geographic Region of the United States
Authors: Friedman B. A. , Burns T. L. , Schork M. A.
Published: December 2004

The purpose of this study was to analyze blood utilization by 92,815 transfused patients treated in 300 United States hospitals during 1974. In order to achieve this end, transfused patients were first divided into 349 diagnosis groups. Blood transfusion data for the highest ranking 50 groups in terms of total units administered to patients in the group are presented and discussed, as well as the blood needs of patients in 19 major disease categories such as malignant neoplasm. Blood transfusion is then correlated with the month of the year by presenting the mean number and the total number of units transfused per month for the country as a whole and for each of four geographic regions. Individual diagnosis groups with significant variation in the mean number of units transfused among the months are also listed and discussed. To aid in the interpretation of mean monthly transfusion rates for the various diagnosis groups, a list of operative procedures with significant variation in the quarterly frequency is offered. Diagnosis groups with significant variation in the mean transfusion rate among the four geographic regions are presented with interpretation of the data.
Granulocyte Progenitor Cells (CFU‐C) in Peripheral Blood of Normal Volunteers following Cell Collection by Continuous Flow Centrifugation
Authors: Mayer S. , Schmitt M. , Noss P.
Published: December 2004

During leukapheresis, the donor undergoes cellular depletion which must be compensated. Moreover, the cellular suspensions obtained contain a certain proportion of granulocyte progenitors that form colonies in agar (CFU‐C). These findings prompted us to investigate the effect of a donation by cytapheresis on the number of circulating CFU‐C present in the donor. Our investigations were carried out on the day the donation was made, and at further fixed dates for a period of six months. Our study covers 25 cases, corticoid premedication was only given to granulocyte donors and not to platelet donors. In the majority of cases, there were no postdonation effects. A few donors had a less stable circulating CFU‐C count than is generally considered normal for a healthy subject. In some, quite wide variations were observed but immature cells never appeared in the circulating blood.
Heterophile Antibodies. Part I. The Specificity of Agglutinating and Hemolytic Sheep Red Blood Cell Antibodies in Human Sera
Authors: Vos G. H. , Vos D.
Published: December 2004

Absorption and agglutination inhibition studies carried out on human sera with intact red blood cells, secretory substances and soluble red blood cell membrane extracts show that antibodies against sheep red blood cells possess at least two types of specificities. The agglutinating type has specificities in common with human anti‐A and anti‐B, while the hemolytic antibody does not. Comparative titration studies clearly demonstrate that there is no correlation in the distribution of these two varieties of sheep red blood cell antibodies. Guinea pig and rat erythrocytes share human A‐ and B‐like determinants with sheep red blood cells. Rabbit, horse and goose red blood cells do not possess these blood group factors.
Preparation of Factor VIII Concentrates by Cryoprecipitate Sedimentation
Authors: Boudart D. J. , Naud M. F.
Published: December 2004

A new method for factor VIII concentrate preparation is proposed. The method is the collection of cryoprecipitate after sedimentation at 4 C in a jacketed glass vessel. The final product is standardized (4.0 ± 0.3 factor VIII units per ml) and can be infused in hemophilic patients regardless of their ABO blood type. Factor VIII recovery (52.2 ± 6.4%) is comparable to other processes.
Aggregation Response of Human Platelets Stored at 22 C as Platelet‐Rich Plasma
Authors: Moroff G. , Chang C. H.
Published: December 2004

The aggregating response of human platelets stored at 22 C for 72 hours has been studied. Platelets were stored as platelet‐rich plasma in order to maintain the plasma pH essentially constant. The response to ADP and collagen decreased with time, but the decrease was less with relatively high concentrations of the aggregating agents. The response to the lonophore A23187 was essentially unaltered during the storage period. Synergistic aggregation with combinations of ADP, collagen and ionophore A23187 was observed with platelets stored for 72 hours under conditions where singly each of the stimuli caused little or no effect. Stored platelets underwent reversible aggregation over a wide range of ADP concentrations but irreversible aggregation was observed in the presence of nonaggregating concentrations of collagen or ionophore A23187. The inhibition of aggregation by PGE1 or cyclic AMP was facilitated as a result of storage. It is suggested that the decreased response toward ADP and collagen reflects a reduced ability on the part of the platelets to mobilize calcium.
Stability of Solutions of Human Granulocyte Lactate Dehydrogenase Stored at Different Temperatures
Authors: Glasser L. , Finley P. R.
Published: December 2004

Granulocyte suspensions from eight healthy individuals were lysed ultrasonically in 0.15 M NaCI or serum. The leukolysates were tested for lactate dehydrogenase after being stored at 22 C, 5 C, ‐20 C and ‐196 C for one, two, three, four and seven days. The LDH content of granulocytes was 291 IU/1010 cells (mean) and the enzyme had a characteristic isoenzyme pattern rich in LDH‐5 with stepwise increases in each fraction from LDH‐1 to LDH‐5. The enzyme was unstable in saline solutions. This was marked at ‐20 C and related to the duration of storage. All the isoenzyme fractions showed significant inactivation. A mean 10 per cent loss of activity occurred at ‐196 C. This loss was independent of the duration of storage and related to the process of freezing and thawing. Moderate inactivation occurred at room temperature while refrigerated samples were stable for four days. Serum protected the enzyme from denaturation and samples stored at ‐20, ‐196 and 22 C were stable for the seven days of the experiment.
An Enzyme Linked Immunosorbent Assay (ELISA) for Detecting IgG Sensitized Erythrocytes
Authors: Bruner K. W. , Kissling C. W.
Published: December 2004

This paper describes an Enzyme Linked Immunosorbent Assay (ELISA) for detecting IgG sensitized erythrocytes utilizing a commercially available anti‐human IgG conjugated with alkaline phosphatase. Erythrocyte hemolysis in the assay was minimized by dissolving the p‐nitrophenyl phosphate substrate in a carbonate‐bicarbonate buffer. Nonspecific absorption of the enzyme conjugate to erythrocytes and glassware was reduced by adding 1% bovine serum albumin to wash solutions. Assay sensitivity was increased with greater concentrations of enzyme conjugate and erythrocytes in the incubation stage. The sensitivity of the described ELISA procedure is approximately equal to that of the standard antiglobulin test. Some possible future applications of ELISA in the blood bank are discussed.
A Comparison of Six Procedures for Compatibility Testing
Authors: Greendyke R. M. , Banzhaf J. C. , Inglis J.
Published: December 2004

Six procedures for compatibility testing were compared, using red blood cells sensitized in normal saline, albumin or low‐ionic strength saline (LISS) combined with either broad spectrum or anti‐IgG antiglobulin testing (AGT). Despite shortened incubation times, tests employing LISS were as sensitive as those with albumin and broad spectrum AGT and more sensitive than the other four combinations. No false positive results were found. LISS technique with broad spectrum AGT appears to be suitable and superior for routine antibody detection and compatibility tests.
Liquid Preservation of Granulocytes
Authors: McCullough J.
Published: December 2004

Granulocytes can be expected to have a life span of up to four days after collection. The number of morphologically normal cells declines by 10 to 15 per cent per day during the first two days. Phagocytosis, bacterial killing and metabolic activities related to the hexose monophosphate shunt remain essentially unchanged during the first day of storage, but chemotaxis ATP levels and the ability of the granulocytes to circulate are reduced after storage. Preliminary information suggests that chemotaxis and ATP may be better maintained at room temperature, although studies in rabbits suggest that in vivo function may be better maintained by refrigerator storage. Granulocytes collected by ordinary phlebotomy, CFCL and IFCL behave in general, similarly during storage. However, in our experience, FL granulocytes have a greater loss of bactericidal capacity and chemo‐tactic responsiveness during storage. Although others have been able to better maintain in vitro function of FL granulocytes, these cells may be more susceptible to damage during storage unless scrupulous collection technique is used. The influence of many other storage variables including: pH, composition of container, agitation, surface to volume ratio, cell concentration, nutrient requirements, presence of other cells such as red cells or platelets is not yet established. Agitation during storage at room temperature causes reduced chemotactic response. Granulocyte chemiluminescence is maintained when the storage pH is 6.5 to 8.0, however a narrower range may be needed for maintenance of chemotactic response. Other studies indicate that storage in polyvinyl chloride containers may be preferable to polyolefin or ethylenevinyl acetate. Although storage of granulocytes should be possible, the conditions are not yet sufficiently well defined to justify this practice. Granulocytes should be transfused as soon as possible after collection.
Enzyme‐Linked Antiglobulin Test: An Accurate and Simple Method to Quantify Red Cell Antibodies
Authors: Leikola J. , Perkins H.A.
Published: December 2004

An enzyme‐linked antiglobulin test was used to quantify the amount of IgG antibodies on red blood cells. Erythrocytes were sensitized with various blood group antibodies, washed, incubated with antiglobulin conjugated with alkaline phosphatase, washed, substrate was added and the optical density of the product was measured. This optical density was linearly proportional to the concentration of red blood cell antibodies incubated with the cells. The assay was easy to perform, had a standard deviation of 7 per cent on replicated assays, and was more sensitive than the manual antiglobulin test.
Administration of Microaggregate Filtered Blood Using a Manual Infusion Pump
Authors: Snyder E. , Underwood P. , Spivack M.
Published: December 2004

Administration sets containing in‐line plastic blood pumps are commonly used to transfuse blood. Flow rates were measured while six units of whole blood and red blood cells were infused through a blood pump administration set coupled to either a large pore 260‐micron filter or a 20‐micron microaggregate blood filter. Using the same type of blood pump administration system and three units of whole blood, the flow rates achieved by the currently available microaggregate blood filters were compared. Results showed that despite a smaller pore size the 20‐micron microaggregate blood filter achieved flow rates that were faster than or equal to those recorded for the larger pore (260‐micron) filter. This was attributed to the larger filtration surface area possessed by the smaller pore filter, 140 cm2 versus only 30 cm2 for the 260‐micron filter. All of the microaggregate filters studied were able to filter three units of whole blood at flow rates in excess of 80 ml/minute. There was no evidence of blood pump induced hemolysis. We concluded that a manual infusion pump can be used to transfuse microaggregate filtered blood rapidly enough to be acceptable for routine clinical or intraoperative use.
Extended Storage of Human Platelets at 22 C: Changes in Glycogen and Adenine Nucleotide Metabolism
Authors: Orengo A. , Lichtiger B. , Harper J. R.
Published: December 2004

The energy metabolism of human platelets stored at 22 C with continuous agitation has been studied. Freshly prepared platelets contain 9.7 mg of glycogen, 9.1 μ moles of ATP, 3.7 μ moles of ADP, 0.9μ moles of AMP per 1011 platelets and have an adenylate charge of 0.8. In the first 72 hours of storage there is no appreciable change in the glycogen content, adenylate charge and rate of ATP pool labeling. Therefore, on the basis of these results, the early impairment of function reported by others cannot be ascribed to alterations in the platelet energy metabolism. Upon further storage, however, there is a progressive loss of adenylate and glycogen while hypoxanthine accumulates extracellularly.
Use of Plasmapheresis and Partial Plasma Exchange in the Management of Patients with Cryoglobulinemia
Authors: Berkman E. M. , Orlin J. B.
Published: December 2004

The management of patients with cryoglobulins often meets with limited success. Reported here is the use of plasmapheresis and/or partial plasma exchange in the management of five patients with cryoglobulinemia. The procedure was carried out at room temperature with reinfusion through a blood warmer. Circulating levels of mixed cryoglobulins and monoclonal IgM cryoglobulins were more easily reduced than were IgG cryoproteins. Improvement in symptoms was associated with removal of the cryoprotein. Pheresis can be used as primary therapy for reduction of cryoglobulin levels in cases of symptomatic essential cryoglobulinemia. Where an etiology for cryoglobulinemia is known and specific treatment exists, pheresis can be used as effective adjunct therapy.
Frequent Multiunit Plateletpheresis from Single Donors: Effects on Donors' Blood and the Platelet Yield
Authors: Glowitz R. J. , Slichter S. J.
Published: December 2004

Two thousand plateletpheresis procedures performed on 335 donors by either semicontinuous flow centrifu‐gation (Haemonetics Model 30) or a multiple bag technique were analyzed for effects on donors and the yield of platelets. The platelet yield was independent of collection method, number of prior donations and donor's hematocrit. It varied directly with the donors' platelet count and was significantly higher for women donating by semi‐continuous flow centrifugation. Even at the lowest platelet harvest, the number of platelets obtained was sufficient to meet federal standards for platelet collection procedures. Donor platelet counts decreased following the first multiunit plateletpheresis procedure. After the equivalent of continued alternate day platelet collections the count reached a mean low of 70 per cent as compared to the precollection count, occurring after six to eight donations. The yield was comparably reduced to a mean of 64 per cent. By the tenth donation platelet counts had returned to baseline values, apparently as a result of increased production by the marrow. Similarly, platelet yields returned to higher (i.e. normal) levels. Further donations did not cause platelet counts or yields to vary from normal values. Repeated daily plateletpheresis resulted in more variability in donor platelet counts. Since none of the donors was subjected to this procedure for more than nine consecutive days, marrow response could not be assessed. Comparing number of donations, donor platelet counts and subsequent yields, there was no difference between daily pheresis and an alternate day schedule. Donor hematocrits were not changed by these frequent collections and other side effects were not observed. This study indicates that repeated multiunit plateletpheresis can continuously provide adequate platelet yields without adversely affecting donors.
Blood preservation. XLIII. Studies on the ascorbate mechanisms of maintaining red cell 2,3‐DPG
Authors: Dawson RB , Dabezies M , Hershey RT , Myers CS , Miller RM
Published: December 2004

Our previous experiments on the mechanisms of ascorbate's effect on the red blood cell failed to show an effect of iodoacetate (IA), a sulfydryl inhibitor. In this study, in contrast to the previous, iodoacetate (85 micromolar) was seen to prevent continued red blood cell metabolism. During the first weeks there was an absence of a continual fall in pH; ATP levels were depressed below half normal; and 2,3‐DPG levels fell to very low values within the first week. ATP was best maintained in the control preservative and next best maintained, at adequate levels, with ascorbate, 5 mM, with and without glutathione, 5 mM. 2,3‐DPG levels were well maintained with ascorbate and ascorbate with glutathione. Poor ATP maintenance and rapid decreases in 2,3‐DPG were observed with iodoacetate, IA plus ascorbate, and IA plus ascorbate and glutathione.