bluuebunny/crossref_metadata_2025 huggingface dataset:
Decrease and rapid recovery of protein C after plasma exchange
Authors: Mannucci P. M. , D'Angelo A. , Viganò S. , Lewis J. H. , Spero J. A. , Baicchi U. , Gremignai G. , Rao A. K. , Walsh P. N.
Published: March 2003

The anticoagulant protein, protein C (PC), was measured after 40 plasma exchanges (PEs) in 26 patients treated for a variety of disorders, most of which were immunological in nature. After 27 PEs involving exchange of 50 percent of the plasma volume with albumin and saline, mean PC activity and antigen decreased in parallel to about one‐half normal levels, with good correlation between the two assays. Antithrombin III and prothrombin decreased to about the same levels as PC, with no significant differences between the percentage changes for either protein. After five PEs, during which exchange of larger plasma volumes was performed (86%), the percentage change of PC was greater than after the 50 percent exchange (38 ± 22 vs. 55 ± 24). To study postexchange recovery, PC was also measured serially for up to 24 hours after eight PEs (50% exchange). At 24 hours postexchange, PC levels did not differ significantly from pre‐exchange levels. This study demonstrates that decreases in PC are in proportion to the volume of plasma exchanged during PE. However, PC levels returned to normal within 24 hours after PE, so that any hemostatic imbalance induced by low PC should be transient.
A comparison of four commercial test kits for detection of cytomegalovirus antibodies in blood donors
Authors: Feng C. S. , Williams I. B. , Gohd R. S. , Causey A. P.
Published: March 2003

Four commercial test kits for detecting cytomegalovirus (CMV) antibodies (indirect hemagglutination assay, indirect fluorescent antibody technique, enzyme immunoassay, and passive latex agglutination technique) were compared according to their technical demand, hands‐on time, turnaround time, concordance with other techniques, reagent cost per test, and objectivity. The indirect hemagglutination assay, the enzyme immunoassay, and the passive latex agglutination technique produced identical results in 85 donors, detecting 63 positive and 22 negative samples. The indirect fluorescent antibody technique showed discrepant results in four samples. The passive latex agglutination technique rated best overall since it was technically the easiest and required the least hands‐on and turnaround times; the short turnaround time (10 minutes) rendered the latex technique a more flexible test for blood bank use because both scheduled and emergency CMV screening of donors could be accommodated. The comparatively high reagent cost of the latex test kit could be offset by savings on technologist time.
Relative specificity of enzyme‐linked immunosorbent assays for antibodies to human T‐cell lymphotrophic virus, type III, and their relationship to Western blotting
Authors: FANG C.T. , DARR F. , KLEINMAN S. , WEHLING R.H. , DODD R.Y.
Published: March 2003

Abstract: A population of 73 donor samples was assembled on the basis of reactive results in routine screening with three different licensed human T‐lymphotrophic virus type III (HTLV‐III) antibody enzyme‐linked immunosorbent assay (ELISA) procedures. The samples were retested by a number of licensed and developmental tests and by Western blot analysis. Our data indicate that nonspecific results are generated by ELISA tests and that many of these reactions appear to be directed against the cell substrate used to grow the virus. These findings suggest that combinations of currently licensed ELISA tests, based upon HTLV‐III grown in H‐9 cells, cannot be used to confirm the specificity of reactive samples.
HLA antigens on red cells. Implications for achieving low HLA antigen content in blood transfusions
Authors: Rivera R. , Scornik J. C.
Published: March 2003

HLA antigens on red cells were measured using the W6/32 monoclonal antibody as well as with other monoclonal antibodies directed to monomorphic determinants of HLA Class I molecules. Antibody binding was quantitated indirectly by either radioimmunoassay or flow cytometry. Red cells from approximately 50 percent of blood donors bound HLA‐A,B, and C antibodies but not antibodies to HLA‐DR or those directed to other leukocyte‐specific antigens. Persons with HLA‐B7‐positive lymphocytes consistently expressed measurable red cell HLA antigens. However, 35 percent of donors with HLA‐B7‐negative lymphtocytes also expressed HLA on red cells, and this expression did not correlate with any other HLA antigen. Storage did not affect expression of HLA antigens in red cells stored at 4°C for 21 days or in red cells that had been cryopreserved. Contrary to previous reports, red cells expressing HLA antigens also had beta‐2‐microglobulin detected, suggesting that the HLA molecules in red cells are similar to those in lymphocytes and other cells, and consequently, that they have the potential to be immunogenic. These results demonstrate that patients requiring multiple transfusions will be exposed to HLA antigens even if they receive blood units depleted of leukocytes and platelets.
A prospective study of the effect of dextran administration on compatibility testing
Authors: Bartholomew J. R. , Bell W. R. , Kickler T. , Williams G. M.
Published: March 2003

The effects of dextran therapy on pretransf usion compatibility testing were evaluated in 24 patients with a variety of vascular disorders. Specimens were drawn before, during, and after the administration of low‐molecular‐weight dextran (average molecular weight, 40 kd). Forty‐three specimens were studied extensively with several immunohematologic techniques. Dextran levels were measured to determine whether the concentration influenced the results of serologic tests. In no instance could we demonstrate any interference by dextran with pretransfusion tests, even at high serum levels of dextran.
Use of a control serum containing a low level of HBsAg for monitoring proficiency in screening for HBsAg
Authors: Nath N. , Wilkinson S. , Dodd R. Y.
Published: March 2003

Aliquots of a serum preparation called “run control” containing low levels (1.4 ng/ml) of hepatitis B surface antigen (HBsAg) were tested by four American Red Cross Blood Services regions using a commercial test based on enzyme‐linked immunosorbent assay (EIA). The run control was tested a total of 424 and 892 times by procedures A and C, respectively, as recommended by the manufacturer (Abbott Laboratories, North Chicago, IL) of the EIA test kit. Results of all the tests were analyzed and showed that the run control was stable and reliable under field conditions. Illustrative examples of different approaches for the use of the run control in monitoring quality control of HBsAg testing are discussed.
Status of the MNSs antigens on human platelets
Authors: Simpson M.B. , Dunstan R.A. , Rosse W.F. , Munro A.C. , Fraser R. , Nichols M.E.
Published: March 2003

A sensitive and specific radioimmunoassay was used to determine whether human platelets possess antigens of the MNSs blood group. Mouse monoclonal IgG anti‐M and anti‐N were purified by Staphylococcus protein A chromatography, labeled with 125I, and incubated with platelet pellets from donors of various MN phenotypes. Human IgG anti‐ M, ‐S, and ‐s were purified by absorption‐elution, incubated with platelet pellets from donors of different MNSs phenotypes, washed, and incubated with 125I‐labeled mouse monoclonal anti‐human IgG. In both assays, the platelet pellets were centrifuged through phthalate ester oils and the radioactivity in the pellets was counted. Dose‐response curves and ligand bound per cell indicated no significant difference in the binding of mouse or human anti‐M and anti‐N to platelets from donors of the MM, MN, or NN phenotype or of human anti‐S and anti‐s to platelets from donors of the Ss or ss phenotype. Contrary to many previous studies, our data indicate that the MNSs antigens are not expressed on the circulating human platelet. Therefore, antibodies to these antigens probably do not play a role in refractoriness to platelet transfusion.
A second Dr(a−) proposita with anti‐Dra and a family with the Dr(a−) phenotype in two generations
Authors: Levene C. , Harel N. , Kende G. , Papo S. , Bradford M.F. , Daniels G.L.
Published: March 2003

An Israeli Jewish woman who originated from the Uzbekskaya SSR in the south of the Soviet Union, had anti‐Dra in her serum and her red cells were Dr(a‐) as were those of three of her four children. All Dr(a‐) red cells had weakened expression of their Cra, Tca, Esa, IFC, and other Cromer‐related antigens. It is suggested that the Dr(a‐) phenotype may result from inheritance of a dominant inhibitor gene, although a relatively common recessive allele of Dra was not excluded. Anti‐Dra was inhibited by serums from the Dr(a+), but not the Dr(a‐), members of the family.
Studies of the sensitivity and reproducibility of commercial kits to detect antibodies to the human immunodeficiency virus
Authors: UJHELYI E. , FÜST G. , MIHALECZKY G. , KRÁLL G. , ZIMONYI I. , NAGY K. , MAYER V. , HOLLÁN AND S.R.
Published: March 2003

Nine serial three‐fold dilutions (1:1 to 1:6561) were prepared from 18 sera obtained from hemophiliacs confirmed to have antibodies to the human immunodeficiency virus. The dilutions were tested with five different commercial enzyme immunoassay kits and twelve sera were retested 5 to 7 months later by different lots of three kits. The dilution that gave an absorbance (OD) equal to the cut‐off OD was considered as the titer of antibody. Sensitivities of the kits were compared by statistical and regression analysis; the same approach was used for studying reproducibility from the results of retesting. The highest titers were found with the Wellcome kit, the lowest with Organon and Pasteur kits, whereas intermediate values were found with the Sorin/Biomedica and Electronucleonics kits. With the Organon and Wellcome kits, excellent reproducibility was observed on later retesting; however, a significant change in titers was seen on retesting the Sorin kit.
Effect of pentoxifylline on Wrb antigen
Authors: Tweedy Carol J. , Kalish Robert I. , Cummings Elizabeth A. , Snyder Edward L. , Tweedy Charles R.
Published: March 2003

Pentoxifylline, a hemorrheologic agent that lowers whole blood viscosity by increasing red cell membrane deformability, recently was approved by the Food and Drug Administration for the treatment of intermittent claudication. The effect of this drug on the phenotypic expression of red cell blood group antigens was studied with cells collected from six patients with intermittent claudication. After in vivo treatment with pentoxifylline, the serologic expression of the Wrb antigen increased. Comparative studies, using hemagglutination titration techniques, with red cells collected before treatment and 1 month after treatment, showed an increase in titer of at least two tubes and an increase in score of greater than 10 in all six patient samples drawn after treatment. No in vivo serologic changes were observed in any of the other antigens studied (A, B, D, C, E, c, e, M, N, S, s, U, P1, Leb, K, k, Fya, Fyb, Jka, Jkb, Yta). Protein analysis (sodium‐dodecylsulfate polyacrylamide gel electrophoresis, silver stain) of red cell membranes prepared from blood collected before treatment and 1 month after treatment showed an increase in band density in the 24,000 and 14,000 dalton regions in the samples drawn after treatment. In vitro treatment of red cells with pentoxifylline and one of its major metabolites did not affect the phenotypic expression of any of the antigens studied, including Wrb.
Unusual reactivity of several anti‐U serums with red cells RN‐ from EN persons
Authors: South S. F. , Tregellas W. M.
Published: March 2003

Several examples of anti‐U were diluted serially and tested with RN red cells and red cells of various Rh phenotypes from both blacks and whites. The agglutination scores were reduced for U+ red cells from people with RN compared with U+ red cells from whites. U+ red cells from blacks yielded score values greater than red cells from people who inherited RN, but definitely less than U+ red cells from whites. The rank‐correlation coefficient (0.92) indicated a p value of 0.0005.
‘Spin, cool, and filter’ red cells prepared in a regional blood center
Authors: Callicoat Patricia A. , Hicks Mary W. , Smith Dennis M. , Clark Douglas A.
Published: March 2003

Red cells depleted of leukocytes by the “spin, cool, and filter” (SCF) method are effective in preventing most febrile, nonhemolytic transfusion reactions (FNHTR). To determine whether red cell concentrates may be centrifuged in a blood center and filtered subsequently at an outlying facility, the authors examined how leukocyte removal was affected by the transport and storage of centrifuged red cells before microaggregate filtration (MAF). One hundred fourteen red cell units were each divided into two aliquots. After centrifugation, one aliquot from each unit was retained in the blood center, and the other was transported on a truck for 2 to 12 hours. Aliquots were stored for variable periods, after which the residual leukocytes were counted. Neither transportation nor storage significantly affected leukocyte removal by MAF. However, an unacceptable proportion of all SCF units failed to meet American Red Cross standards for leukocyte‐poor blood and studies of factors influencing leukocyte depletion were undertaken. A relative centrifugal force of 6700 × g was needed to produce consistently acceptable units when blood was 8 to 15 days old. These results show that making SCF red cells is a practical, inexpensive way for blood centers to provide hospitals with products that prevent most FNHTR; however, each facility that prepares these products must perform quality control carefully.
Morning admission to the hospital for surgery the same day
Authors: Moore S.B. , Reisner R.K. , Losasso T.J. , Brockman S.K.
Published: March 2003

Morning admissions for surgery the same day are increasing because of economic incentives. These admissions permit less time for red cell serologic preparation before surgery than do the more conventional methods of patient admission. During a 4‐month period, serologic problems arose in 70 of 2859 cases. In 36 of the 70 cases, the sample arrived at the blood bank about the time of the beginning of the operation; in 19 of these 36 cases, the operation had begun before serologic resolution, and in 7 of these 19, the antibody was found to be of hemolytic potential. It was concluded that administrative and logistic changes need to be made to ensure sufficient time for the serologic testing necessary for safe transfusion support for same‐day surgical admissions.
Characteristics of a donor population in western Venezuela
Authors: Medina J.W , DeEscobar D.M , DeVizcaino M.A , Sanchez O.G , Ballas S.K
Published: March 2003

To determine the characteristics of blood donors in western Venezuela, we collected data from 1983 to 1985 on 31,320 volunteer donors at the Blood Bank of the State of Zulia in Maracaibo. Fifty‐nine percent of the donors were blood group O, 30 percent were group A, 9 percent were group B, and 2 percent were group AB. Most of the donors (93%) were Rh positive. One percent of donors had positive reactions to hepatitis B surface antigen, 3.15 percent for syphilis, 1.43 percent for antibodies to Trypanosoma cruzi, and 0.32 percent to human immunodeficiency virus antibodies. About one‐half of the donors were between 18 and 30 years old, and only 10 percent were women. To determine if iron deficiency anemia was a cause for the small size of the female donor pool, we measured serum ferritin in 50 first‐time female donors. Ten of these (20%) had serum ferritin values below normal, and the distribution of serum ferritin levels of all 50 was very similar to that reported for frequent donors in Europe and the United States, with a clustering of ferritin values between 10 and 70 ng per ml. The data indicate that blood donors in western Venezuela are markedly different from those in the United States and that iron supplementation may be indicated for female Venezuelan donors.
Evaluation of factor VIII‐rich cryoprecipitate and the plasma fibronectin‐rich, heparin‐precipitable fraction prepared from single‐ donor plasma units
Authors: Menitove J.E , Amrani D.L , Meh D. , Frenzke M. , Mosesson M.W
Published: March 2003

A plasma fibronectin‐rich component was prepared by heparin‐induced 4 degrees C precipitation of fresh or stored (21 days at 4 degrees C), single‐donor plasma. The recovery of plasma fibronectin was 45 percent at a concentration of 0.05 mg heparin per ml (7.5 units/ml) and 75 percent at 0.1 mg per ml (15 units/ml). The biologic activity of plasma fibronectin, as assessed by the spreading of Chinese hamster ovary cells or attachment of monocytes to gelatin‐coated surfaces, was similar to that of plasma fibronectin concentrates made from fresh or stored plasma. Only 20 to 30 percent of the factor VIII activity in fresh plasma was recovered in cryoprecipitate produced after the heparin‐induced precipitate containing fibronectin was removed. Cryoprecipitate prepared from the supernatant plasma that remains after heparin‐induced cold precipitation in the presence of CaCl2 (5 mM) contained approximately 50 percent less factor VIII. The relatively low recovery of factor VIII in cryoprecipitate prepared from fibronectin‐ depleted plasma makes cryoprecipitation an unsuitable method of producing fibronectin‐rich and factor VIII‐rich components effectively from a single unit of fresh plasma. However, heparin‐induced cold precipitation provides an efficient method for preparing plasma fibronectin concentrates from small plasma pools or single units of stored or fresh plasma.
Xanthone additives for blood storage that maintain its potential for oxygen delivery
Authors: Paterson R.A. , Dawson J. , Hyde R.M. , Livingstone D.J. , Parry E.S. , Nash S. , Boyce I.M.
Published: March 2003

Two xanthones, 2‐hydroxyethoxy‐6‐(5‐tetrazoyl) (BW A440C) and 2‐ethoxy‐ 6‐(5‐tetraozyl) (BW A827C), are members of a chemical series tested in vitro as potential additives to citrate‐phosphate‐dextrose‐adenine (CPDA‐1) medium for blood storage. P50 was maintained in the presence of these compounds during 42 days' storage by a partial maintenance of 2,3 diphosphoglycerate (2,3 DPG) and by a direct effect on hemoglobin previously reported for BW A827C. Red cell 2,3 DPG levels for BW A440C (n = 5), BW A827C (n = 5), and control (n = 6), respectively, were 3.38 ± 0.47, 3.44 ± 0.25, and 1.20 ± 0.10 mM ± SEM on day 7; 1.16 ± 0.13, 1.52 ± 0.37, and 0.16 ± 0.02 mM on day 21; and 0.67 ± 0.09, 0.61 ± 0.08, and 0.06 ± 0.006 mM on day 42. Red cell adenine triphosphate levels at the same time intervals were 1.84 ± 0.09, 1.46 ± 0.18, and 2.11 ± 0.04 mM; 2.10 ± 0.05, 2.07 ± 0.17, and 2.13 ± 0.05 mM; and 1.42 ± 0.13, 1.37 ± 0.13, and 1.38 ± 0.06 mM, respectively. The degree of hemolysis was less with the addition of the compounds, and the methemoglobin formation, plasma Na+ and K+, and lactate production were unaffected by the compounds.
Density gradient isolation of peripheral blood mononuclear cells using a blood cell processor
Authors: Law P. , Dooley D.C. , Alsop P. , Smith D.M. , Landmark J.D. , Meryman H.T.
Published: March 2003

Large numbers of mononuclear cells (MNC) are needed for hematologic reconstitution using peripheral blood stem cells. The possibility of isolating those cells by discontinuous Ficoll‐diatrizoate density gradient centrifugation in two blood cell processors (the Haemonetics V50 [V50] and the Cobe 2991 [2991]) were examined. Buffy coats from peripheral blood containing 6.23 × 10(8) MNC were separated in the V50, resulting in a recovery of 75 percent. The purity of the cells, defined as the percentage of lymphocytes and monocytes among all leukocytes, was 95 percent. With larger cell loads (3 to 7 × 10(9) MNC), the yield was higher in the V50 than in the Cobe 2991 (92 versus 75%). After separation in the V50 or the 2991, the cloning efficiencies of hematopoietic progenitor cells (CFU‐GM and BFUe) were not different from those of cells isolated on 5 ml Ficoll‐diatrizoate gradients in centrifuge tubes. Both leukapheresis and MNC separation can be carried out with the same bowl and tubing set in the V50. With that approach, an average of 6 × 10(9) MNC were processed in 16 experiments. An average recovery of 82 percent with 95 percent purity was achieved. The authors conclude that, in terms of simplicity of operation, cost effectiveness, and maintenance of sterility, the V50 may be better suited than the 2991 for the purification of MNC from peripheral blood.
A one‐step Du test in microplates
Authors: Epley K. M. , Severns M. L. , Kline L. M.
Published: March 2003

A one‐step Du test, developed for use in automated microplate systems, uses anti‐D with 0.6 percent dextran to potentiate the reaction. Because the washing and reagent‐adding steps of the antiglobulin test are not required, the Du test can be performed in the same microplate as the ABO/Rh test. A set of reactions prepared with this technique was visually interpreted and also classified by an automated microplate ABO/Rh system. Visual interpretation of reactions resulted in a sensitivity and specificity close to those of the antiglobulin test, although the sensitivity of the test was reagent‐dependent. When the automated microplate blood grouping system was used, the test was not as sensitive or as specific as the antiglobulin test, although it may be sufficient for many applications.
Abnormal electrocardiographic findings in apheresis donors
Authors: Komatsu F. , Shikata M.
Published: March 2003

Electrocardiographic (ECG) monitoring was performed on 291 donors during apheresis. Twenty‐one donors (7.2%) had clinical symptoms such as discomfort, nausea, chill, numbness, and paresthesia, and 13 of this group exhibited ECG abnormalities, such as tachycardia, bradycardia, and other abnormal wave patterns. The donors with tachycardia and slight bradycardia had no symptoms. Ten donors had moderate to severe bradycardia with pulse rates less than 50 beats per minute; four of them had severe bradycardia (less than 45 beats per minute), and three of the four exhibited severe hypotension, vomiting, fainting, or convulsion. Other abnormal ECG changes, such as supraventricular and ventricular premature contractions, right bundle branch block, ST segment elevation or ST segment depression, and tall, flattened, or inverted T waves were observed in 29 donors (10%). These changes were not associated with symptoms. Only three of these donors complained of discomfort or chest heaviness. The abnormal waves appeared more often in granulocytapheresis donors than in plateletapheresis donors.
Studies on the blood of a Dc(e) homozygote and her family
Authors: Issitt P. D. , Smith D. L. , McCollister L. S. , Wren M. R. , Ballas S. K.
Published: March 2003

It has been reported previously that genes that have been called Dc‐ represent a heterogeneous group and that some of them would better be described as Dc[e] and Dc(e). We have studied the blood of a black proposita and some of her family members and have concluded that she is homozygous for Dc(e). The form of Dc(e) present in this family makes all the Rh antigens of common occurrence for which we were able to test. In this respect, it differs markedly from another form of Dc(e), which is seen in individuals whose red cells lack a very common Rh antigen and who become immunized against that antigen. We suggest the term Dc(e)R17 for the gene present in the family studied; our results indicate that its products are: normal amounts of D, c, G, Hr0, and Rh29; reduced amounts of e and f; and markedly reduced amounts of hrS and hrB. The expression of some antigens encoded by Dc(e)R17 are quantitatively but not qualitatively different from the products of R0.
Resident education in transfusion medicine: a multi‐institutional needs assessment
Authors: Eisenstaedt R. S. , Glanz K. , Polansky M.
Published: March 2003

A survey was conducted among resident physicians at nine academic medical centers to assess their perceptions of their knowledge of transfusion medicine (TM), their confidence in using various blood bank resources, and their ratings of the contribution of various learning resources to their knowledge of TM. A total of 320 residents completed the survey; nearly 90 percent were in an internal medicine, surgery, or anesthesiology residency. Respondents placed a high value on the relevance of TM to patient care, although they rated their knowledge and learning opportunities as only moderate. They rated senior residents as the most useful educational resource, with undergraduate medical school education, formal conferences, and journals and library resources being the three next most useful. Residents had the greatest confidence in using packed red cells, platelets, and fresh‐frozen plasma. Surgery and anesthesiology residents generally had greater confidence in using blood bank resources than internal medicine residents. The findings of the survey can be used, along with the results of medical care evaluations of transfusion practice and opinions of education experts, to create an optimally relevant and effective curriculum for resident education in transfusion medicine.
Detection of cytomegalovirus antibody in stored blood products using latex agglutination
Authors: Klinedinst A. F. , Baldwin M. L. , Ness P. M.
Published: March 2003

The detection of antibody to cytomegalovirus (CMV) in donor sera is one effective method for the prevention of posttransfusion CMV infection in seronegative recipients. A passive latex agglutination test (CMV Scan, Hynson, Wescott & Dunning, Baltimore, MD) has been shown to be an acceptable method of screening sera from the blood donor population. The procedure for this test, however, does not permit the testing of stored donor blood products. To evaluate the feasibility of testing blood components at various times during storage, the authors examined 25 CMV‐positive and 25‐CMV negative samples of CPDA‐1 plasma from 50 units each of platelets and red cells. Plasma samples from platelets stored at 22°C were tested on each of the 5 days of storage. Samples from red cell units stored at 2 to 6°C were tested on storage Days 1, 2, 4, 6, 8, 10, 12, and 14. Of 250 tests done on plasma from platelet units, there were 123 true‐positive and 123 true‐negative results (sensitivity and specificity, 98.4%). Of 400 tests on plasma from red cell units, there were 200 true‐positive and 198 true‐negative results (sensitivity, 100%; specificity, 99.5%). These data show that the CMV Scan test can be used reliably to test segments of CPDA‐1 plasma from platelets stored for up to 5 days and from red cells stored for up to 14 days.
An automated screening test for antibodies to human immunodeficiency virus‐1
Authors: Sekiguchi S. , Ikeda H. , Kato T. , Maeda R. , Fukai K.
Published: March 2003

An automated pretransfusion testing system was applied to HIV antibody screening by a gelatin particle agglutination (HIV‐PA) test. The test conditions for the test, such as diluent, plate shape, and incubation time, were applicable not only for the HIV‐PA test but also for other routine tests, including those for hepatitis B surface antigen and HTLV‐ 1 antibodies. After a 60‐minute incubation, the plates were read automatically and then were assessed visually. Tests with seropositive samples obtained from hemophiliacs and an HIV enzyme immunoassay (EIA) familiarization panel showed that the automated HIV‐PA test was more sensitive than the EIA and did not show a false‐negative result. Of 11,300 blood donors, 44 were positive by the automated test, and 51 were positive by the EIA. None of the blood donors was confirmed to be seropositive. Using the automated test, a large number of samples could be screened in a relatively short time without a significant increase of nonspecific reactions.
Interface dynamics in a centrifugal cell separator
Authors: Oxford R. J. , Petersen J. N. , Van Wie B. J. , Wooten S. L. , Schneider G. W.
Published: March 2003

Experiments were performed with bovine blood to study the response of the plasma/cell interface position to pumping rate adjustments in two single‐stage (SS I and SS II) cell separation chambers. Standard clinical instrumentation and equipment and on‐line computer interfacing were used to monitor and control the interface position. The data provided a quantitative description of its dynamics in the SS I and the SS II chambers. In the SS I chamber, adjustments in the flow rate caused the interface to move very slowly and in a complex manner from one steady‐state operation position to another. Such behavior made both manual and computer‐controlled operation very difficult. By contrast, the SS II chamber was inherently unstable for most operating conditions. We demonstrated, however, that a feedback controller could be used easily to adjust or maintain the interface position, and this system moved from one steady‐state operating condition to another 10 times as fast as the system using the SS I chamber. Also, the manner in which the controller allowed the system to respond to operator requests was much simplier than that for the SS I system.
Heat inactivation of human immunodeficiency virus in solutions of antithrombin III
Authors: Einarsson M. , Perenius L. , McDougal J. S. , Cort S.
Published: March 2003

Human immunodeficiency virus (HIV), isolated from cultures of infected peripheral blood lymphocytes, was added to solutions of highly purified antithrombin III (AT‐III), which was stabilized with 1 M citrate and 17 percent sucrose. The efficiency of heat inactivation of HIV in AT‐III at 60°C was compared with that of HIV in culture medium and followed for periods from 0 to at least 10 hours. The virus added, titer 105 by ID50, was inactivated as rapidly (less than 30 minutes) and efficiently (completely) in the stabilized AT‐III as in the culture medium. Virus was determined both by direct measurement of the HIV‐related reverse transcriptase activity and by quantitation of virus infectivity by ID50 assay.
Simultaneous collection of platelets and cryoprecipitate by plasma‐exchange donation
Authors: McLeod B. C. , Sassetti R. J. , Owens E. A. , Scott J. P.
Published: March 2003

To increase cost efficiency, the simultaneous collection of platelets during plasma‐exchange donation of cryoprecipitate was investigated. Sixteen desmopressin (DDAVP)‐stimulated donors underwent 90 simultaneous donations. Permanent donor plasma loss for each donation averaged 150 ml in cryoprecipitate and 151 ml in platelet concentrates. Mean factor VIII (FVIII) yield was 4699 ± 2754 IU per donation. The mean yield in the platelet products was 4.63 × 1011 platelets; aggregation properties and posttransfusion increments were satisfactory. White cell contamination averaged 4.05 × 109 but could be lowered by a secondary centrifugation. The direct cost for a single‐donor platelet transfusion produced in this way is estimated at $102.19 and that for FVIII at $0.055 per IU. Simultaneous donation is technically feasible and safe for donors, and it provides functional products that are more cost‐effective than apheresis platelets or cryoprecipitate donated separately.
The detection of an antibody against IgA allotype A2M 2 and a study of the Am genetic marker among the Han Chinese population
Authors: Wu G. , Liu D. , Fang G. , Hu W. , Jia H. , Zhang Q. , Fukada K. , Yoshimura K. , Saji H. , Lee T. D.
Published: March 2003

The serum of a woman was found by the Ouchterlony double‐diffusion and the hemagglutination inhibition (HAI) methods to have immunoglobulin A (IgA) deficiency. Further investigation using the hemagglutination (HA) test with red cells coated with IgA myeloma proteins of different specificities showed that the serum agglutinated only IgA2‐, A2M 1‐, and A2M 2‐coated cells. The patterns of the HAI test with a reference panel confirmed the presence of two specificities. One was anti‐IgA2 and the other was a rare antibody against the allotype A2M 2. The anti‐A2M 2 was used for population studies. Testing of the Han Chinese population, including family studies, confirms that A2M.1 and A2M.2 have an autosomal dominant mode of inheritance and are controlled by a codominant allele. The distribution of the two Am genetic markers among the Han Chinese population demonstrated A2M.1 with a gene frequency of 0.553 and A2M.2 with a gene frequency of 0.447 (χ2= 0.145, 0.80>p>0.70).
Homozygous familial hypercholesterolemia. Selective removal of low‐density lipoproteins by secondary membrane filtration
Authors: Leitman S. F. , Smith J. W. , Gregg R. E.
Published: March 2003

Selective plasma filtration with a hollow‐fiber membrane device was compared prospectively to plasma exchange in the therapy of a patient with homozygous familial hypercholesterolemia. Four liters of patient plasma was removed biweekly during each of six consecutive plasma exchanges, after which 20 consecutive biweekly 4‐liter filtration procedures were conducted. The hollow‐fiber membrane retained 94 percent of the low‐density lipoprotein (LDL) cholesterol presented to it, and allowed passage of 83 percent of the albumin, 68 percent of the IgG, and 47 percent of the high‐density lipoprotein (HDL) cholesterol. Both plasma exchange and plasma filtration decreased the patient's total and LDL cholesterol levels by 80 percent. However, filtration removed significantly less HDL than did exchange (54 versus 71% reduction in HDL levels, respectively); preserved significantly higher levels of IgG, clotting factors, and complement components; and avoided the need for expensive albumin replacement solutions. In addition, the patient tolerated the filtration procedures significantly better than the exchanges. Newer apheresis techniques that selectively deplete plasma of LDL cholesterol, such as secondary membrane filtration, are likely to replace plasma exchange as the therapy of choice in patients with homozygous hypercholesterolemia.
ABO compatibility can influence the results of platelet transfusion
Authors: Lee E. J. , Schiffer C. A.
Published: March 2003

Sixty consecutive patients with untreated acute leukemia alternately received either ABO‐matched or ABO‐mismatched random‐donor platelet transfusions prepared from pooled platelet concentrate stored for 1 to 3 days. Patients were assigned randomly to receive matched or mismatched platelets as their first transfusion, and the first four transfusions were analyzed. In 40 evaluable patients, there was no significant difference (paired t test) between the 10‐minute posttransfusion corrected count increments (CCI) of the initial transfusions of matched and mismatched platelets. In contrast, the second matched transfusion was significantly better than the second mismatched transfusion. This effect of ABO compatibility was particularly pronounced in a subset of patients. Six patients in whom mismatched transfusions were consistently inferior to matched transfusions had either a significant increase in anti‐A or ‐B isoagglutinin titers following the first transfusion or elevated titers before or at the conclusion of the study. Conversely, in five patients in whom there was no apparent effect of ABO mismatching, only one had an increase in isoagglutinin titer. Platelet survival was not altered as the ratio of 18‐hour to 10‐minute posttransfusion CCI was 0.6 for both matched and mismatched platelet transfusions. These data demonstrate that ABO compatibility can affect the results of random‐donor platelet transfusions and that patients who experience poor increments from ABO‐mismatched platelets may benefit from a trial of ABO‐compatible platelets before the initiation of HLA‐matched platelet transfusion.
Evaluation of platelet concentrates prepared from buffy coats and stored in a glucose‐free crystalloid medium
Authors: Bertolini F. , Rebulla P. , Riccardi D. , Cortellaro M. , Ranzi M. L. , Sirchia G.
Published: March 2003

Comparison was made between platelet concentrates prepared from pools of buffy coats removed from standard blood donations and stored in a glucose‐free, commercially available crystalloid solution (BC‐PCs) and standard platelet concentrates prepared from platelet‐rich plasma (PRP‐PCs). Platelet yield in BC‐PCs and PRP‐PCs was 59 and 75 percent of donated platelets, respectively. The number of total white cells in 1 BC‐PC unit, prepared from a pool of 7 buffy coats, was 21 × 106, i.e., 50 times lower than that of 7 units of PRP‐PCs. The in vitro values of adequate platelet quality were maintained for 10 days in BC‐PCs stored in 1000‐mL polyolefin bags. Prolonged bleeding times were reduced or corrected in three of three thrombocytopenic leukemic patients evaluated before and after transfusion of stored BC‐PCs. Pretransfusion and 1‐ and 24‐hour posttransfusion median platelet counts in 57 leukemic recipients during 4 months of routine transfusion of BC‐PCs (n = 93) were 14,35, and 27 × 109 per L, while those of PRP‐PCs (n = 246) were 13, 37, and 31 × 109 per L, respectively. No reactions to BC‐PCs were reported, but a 1.3 percent rate of reaction to PRP‐PC transfusions was reported. This study indicates that BC‐PCs are a good alternative to PRP‐PCs for platelet support of thrombocytopenic patients. TRANSFUSION 1989;29:605–609.
Studies with nonradioisotopic sodium chromate
Authors: Heaton W. A. L. , Hanbury C. M. , Keegan T. E. , Pleban P. , Holme S.
Published: March 2003

A nonradioisotopic method for measuring red cell volume that involves the use of 52Cr‐sodium chromate as the red cell label and of graphite furnace atomic absorption analysis of chromium is described. The technique allows the labeling of 20 mL of packed red cells with 40 to 50 μg of sodium chromate (Na2CrO4) in 30 minutes at 22° C with 94 ± 6 percent uptake. Approximately 40 μg of Na2CrO4 was injected for in vivo studies. This results in posttransfusion in vivo red cell chromium levels after sample processing in the range of 1 to 7 μg per L, which could be quantitated accurately (coefficient of variation = 4.7%) by Zeeman electrothermal atomic absorption spectrophotometry. The labeling concentration of chromium did not cause increased hemolysis, and the labeled cells exhibited an osmotic fragility curve similar to that of unlabeled, fresh ACD red cells. Red cell glutathione peroxidase was unaffected by labeling, although glutathione reductase was reduced by approximately 13 percent (p < 0.05). The 52Cr red cell volume‐measuring method was evaluated by concurrent in vivo studies with the standard 51Cr and 125I‐albumin methods for that procedure. Simultaneous measurement of red cell volumes in seven volunteers by the 51Cr, 52Cr, and 125I‐albumin techniques correlated highly with each other (r > 0.76), with mean values of 2294 ± 199, 2191 ± 180, and 2243 ± 291 mL, respectively. The standard deviations of the differences were small: 134 mL for 52Cr versus 51Cr and 183 mL for 52Cr versus 125I. These results indicate that the nonradioisotopic technique gives reliable and accurate red cell volume estimates that are similar to those obtained by the standard methods.
Prevention of primary cytomegalovirus infection in patients with hematologic malignancies by intensive white cell depletion of blood products
Authors: Graan‐Hentzen Y.C.E. de , Gratama J.W. , Mudde G.C. , Verdonck L.F. , Houbiers J.G.A. , Brand A. , Sebens F.W. , Loon A.M. van , The T.H. , Willemze R. , Gast G.C. de
Published: March 2003

The effect of white cell depletion of red cells and platelet concentrates on the transmission of cytomegalovirus (CMV) was studied retrospectively in 150 patients treated intensively for acute leukemia or non‐Hodgkin's lymphoma. CMV infection was diagnosed on the basis of IgM and IgG antibody responses to CMV late antigen (CMV‐LA). Before cytoreductive therapy for their underlying disease, 59 patients were CMV seronegative and 91 were CMV seropositive. None of the 59 CMV‐seronegative patients showed persistent seroconversion 2 months after the cytoreductive treatment. The comparison group, consisting of 312 cardiac surgery patients, showed a significantly higher incidence of primary CMV infections: 10 of 86 (11.6%, p = 0.004). Twenty‐five percent of the CMV‐seronegative patients and controls had transient IgG antibodies to CMV‐LA without IgM antibodies, which is indicative of antibodies passively acquired via blood products. These results indicate that white cell‐poor blood products carry a very low risk, if any, of CMV transmission. The policy of transfusing white cell‐poor blood products provides a useful alternative to the selection of CMV‐seronegative donors.
The 30‐minute rule for reissuing blood: are we needlessly discarding units?
Authors: Hamill Timothy R.
Published: March 2003

The standards of the American Association of Blood Banks require that blood for reissue must be maintained continuously between 1 and 10 degrees C. To comply with this standard, most transfusion services have set a 30‐minute limit on the time that a unit of blood can be out of a monitored refrigerator before it must be discarded. The primary reason for such a time limit is to reduce the risk that small numbers of contaminating bacteria could grow to lethal numbers before the blood is administered. An extensive review of the pertinent literature revealed that the organisms that may survive refrigeration (i.e., psychrophilic bacteria) are unable to begin logarithmic phase growth for several hours after returning to room temperature. This is due to alterations in bacterial enzyme systems and membrane lipids that occur during growth at refrigerator temperatures and that must be repaired before rapid growth may occur. On the basis of this information, it appears that the 30‐minute limit could be extended to 2 hours without any increased risk to the recipient. Such a policy change could save 18,000 units of blood per year in the United States.
Percutaneous umbilical blood sampling and umbilical vein transfusions
Authors: Steiner E.A. , Judd W.J. , Oberman H.A. , Hayashi R.H. , Nugent C.E.
Published: March 2003

Percutaneous umbilical blood samples (PUBS), obtained under ultrasound guidance, are used for prenatal diagnosis and management of hemolytic disease of the newborn (HDN) and other fetal disorders. Rapid testing at the time of sampling is vital to distinguish fetal from maternal blood. Blood typing was performed by slide technique in the treatment room during 38 procedures on 25 patients. Anti‐l was used to test 50 presumed PUBS; venous l‐positive maternal blood was tested in parallel. Because anti‐l cannot detect fetal blood after umbilical vein transfusion (UVT) of l‐positive donor blood, ABO and Rh blood typing reagents were used to test 29 samples when maternal and fetal or donor blood groups differed. Monoclonal reagents were used for optimal detection of weak AB antigens in fetal blood. Avid, chemically modified anti‐D was used for Rh typing. Blood typing showed 27 (34%) of 79 samples to be maternal blood. Fetal blood was obtained in 8 of 10 cases investigated for fetal disorder and in 16 cases of potential HDN (anti‐D, 5; ‐CD, 5; ‐cE, 2; ‐K, 2; ‐c; ‐E). The absence of HDN (antigen‐negative fetus) was determined in 4 cases. UVT afforded live birth of 9 of 10 infants with HDN and was not indicated in two cases
Microbial challenge of a blood cell separator outside‐seal bowl system
Authors: Jacobson M.S. , Kevy S.V. , Thorne G.M. , Goldmann D.A. , Blasetti L. , Smith J.W. , Schaefer H.
Published: March 2003

The ability to store platelets beyond 24 hours requires a functionally closed system. This study tested the ability of a cell separator bowl seal system to resist penetration of microbial contamination under normal running conditions and under extreme environmental stress. Three test organisms, Micrococcus luteus, Serratia marcescens, and Staphylococcus epidermidis, were applied directly to the bowl at the edge of the seal or aerosolized and passed through the centrifuge chamber while the cell separator was run through a simulated platelet collection. A sterile, bacteriologic nutrient medium was perfused through the tubing set, thus simulating the flow of blood fractions. Following the procedure, the medium was examined for microbial growth. The concentration of aerosolized bacteria ranged from 5.2 times 101 to 3.9 times 103 colony‐forming units (CFU) per mL, and the concentration of bacteria applied to the edge of the seal ranged from 1.9 times 105 to 2.8 times 109 CFU per mL. The positive control, direct inoculation of S. marcescens into the circulating medium (50 CFU/500 mL), resulted in recovery of the identical organism after 24 hours' incubation. No contamination of the system was detected in 40 experiments with aerosolized bacteria or in 32 experiments in which bacteria were applied directly to the seal. This study demonstrates that this sealed‐bowl system resists microbial contamination.
Lack of success with a combination of alanine and phosphoenolpyruvate as an additive for liquid storage of red cells at 4° C
Authors: Matsuyama H. , Ericson Å. , Högman C.F. , Niklasson F. , de Verdier C.H.
Published: March 2003

Red cells were stored at 4° C in a storage solution containing alanine or alanine plus phosphoenolpyruvate (PEP). The intention was to investigate whether alanine and PEP might act synergistically to maintain a normal level of both red cell ATP and 2,3 diphosphoglycerate (2,3 DPG) under normal liquid storage conditions. Storage in the presence of alanine kept the red cell concentration of 2,3 DPG higher than the reference solution for an extended period of time, provided the initial pH was about 7.0 (37° C). When the pH of the storage solution containing alanine plus PEP was lowered to facilitate the transport of PEP into the red cells, the concentration of 2,3 DPG was lowered to a rate equal to that in the reference solution. The level of ATP was also about the same as in the reference solution. The majority of the added PEP was continuously converted to 2 phosphoglycerate and 3 phosphoglycerate in the extracellular fluid. A small amount of unconverted PEP penetrated the red cell membrane when the pH went below 6.5; this occurred after 3 weeks of storage. The intracellularly located PEP, however, was not metabolized to 2,3 DPG to any significant extent within the first 6 weeks of storage. These findings indicate that PEP is not suitable as an additive for liquid storage of red cells at 4° C. The combination of alanine and PEP that theoretically could be a suitable additive for liquid storage of red cells was not satisfactory in practice.