bluuebunny/crossref_metadata_2025 huggingface dataset:
Counting Microaggregate Particles in Blood
Authors: Suehiro A. , Leinberger H. , McNamara J. J.
Published: December 2004

A method is described for measuring microaggregates in stored blood with an electronic particle counter avoiding the usual use of a hemolytic agent. To overcome red blood cell coincidence at low dilutions of the samples two different sized apertures were used. The method reliably measures microaggregates from 12.7μ to 80.6μ diameter. Hemolytic agents added to fresh blood were shown to induce the formation of microaggregates. The present study demonstrated that a tenfold reduction in a commonly used saponin concentration produced satisfactory hemolysis without inducing significant microaggregate formation. Hemolytic agents added to stored blood decreased the population of microaggregates significantly from that of unhemolyzed blood. This phenomenon was minimized with reduced saponin concentrations.
“Naturally‐Occurring” Anti‐K1: Possible Association with Mycobacterium Infection
Authors: Kanel G. C. , Davis I. , Bowman J. E.
Published: December 2004

We report a case of “naturally‐occurring” (nonred blood cell stimulated) anti‐K1. The patient had never received a blood transfusion. Red blood cell antibody screening panels showed agglutination with KM red blood cells at room temperature and not in the anti‐globulin test. Testing with 2‐mercaptoethanol showed the antibody to be IgM. The antibody is “naturally‐occurring” and may be associated with pulmonary tuberculosis.
Weak B Antigen in a Family
Authors: Boose G. M. , Issitt C. H. , Issitt P. D.
Published: December 2004

A family is described in which six members were of a weak subgroup of B. Presence of the subgroup in each individual was first indicated by lack of anti‐B in that person's serum. Additional tests showed that the B subgroup red blood cells would adsorb anti‐B and yield that antibody on elution, and that the saliva of two B subgroup persons tested contained B and H substances. The blood of one of the family members with the weak B antigen was inadvertently transfused to a group O recipient but caused no ill effects.
Ionized Calcium During Plateletpheresis
Authors: Szymanski I. O.
Published: December 2004

The concentration of ionized calcium (Ca++) during platelepheresis was monitored when donors received 461 ± 95 (mean ± S.D.) ml of anticoagulant acid‐citrate‐dextrose (ACD), N.I.H. formula A. Most donors experienced mild subjective symptoms (perioral tingling) during reinfusion of autologous blood. The concentration of serum Ca++ before the procedure was 4.19 ± 0.203 (mean ± S.D.) mg/dl and it decreased to 3.27 ± 0.391 (mean ± S.D.) mg/dl after the procedure. Two of the 79 donors experienced more severe symptoms (nausea, lightheadedness) while ionized calcium was lower than 3 mg/dl. Mild hypocalcemic effects could be demonstrated by electrocardiography in most donors.

When donors received 414 ± 28 (mean ± S.D.) ml of ACD, N.I.H. formula B, only some of them experienced perioral tingling during reinfusion of the autologous blood. The concentration of Ca++ before the procedure was 4.18 ± 0.14 (mean ± S.D.) mg/dl and it decreased to 3.66 ± 0.14 (mean ± S.D.) mg/dl after the procedure. These data indicated that ACD N.I.H. formula B promotes greater donor comfort and safety than does ACD, formula A.

The data showed that hemodilution occurred immediately following the withdrawal of one unit of blood, prior to infusion of any intravenous fluids. The analysis of the data revealed also that both magnesium and calcium entered the intravascular compartment during plateletpheresis. Although the origin of the calcium ion entering the plasma could not be established, it appeared that at least part was derived from calcium‐citrate complexes.
An Analysis of Surgical Blood Use in United States Hospitals with Application to the Maximum Surgical Blood Order Schedule
Authors: Friedman B. A.
Published: December 2004

Excessive preoperative crossmatching can be limited with a maximum surgical blood order schedule (MSBOS) which is a list of the commonly performed elective surgical procedures performed in a hospital with the maximum number of units of blood which will be crossmatched preoperatively for each. The purpose of this study was to analyze the blood requirements of 535,031 surgical patients treated in 300 United States hospitals during 1974, and to suggest maximum preoperative blood orders including type and screen recommendations based on data derived from this large national patient sample. Such recommendations are offered for 63 common elective surgical procedures. Specific reference is made to blood utilization during hysterectomy, transurethral resection of the prostate, and cesarean section. A preoperative type and screen order is adequate for the vast majority of patients undergoing these latter procedures.
A Factor VIII Concentrate of Intermediate Purity and Higher Potency
Authors: Smith J. K. , Evans D. R. , Stone V. , Snape T. J.
Published: December 2004

A fractionation method has been modified to produce a factor VIII concentrate of intermediate purity and a potency of about 12 iu/ml, suitable for injection by syringe. The solubility, ease of filtration and purity of the concentrate have been improved by including a stage in which contaminants are precipitated at controlled temperature, pH and ionic strength. A summary of the first 50 production‐scale batches is presented. Plasma can be harvested from whole blood and frozen within eight hours of donation, or after overnight storage of whole blood, with no significant difference in overall yield.
Failure to Confirm Specificity of Samples Containing a Very High Titer of Hepatitis B Surface Antigen (HBsAg)
Authors: Nath N. , Armbruster A. , Ellis F. R.
Published: December 2004

Two samples repeatedly positive for HBsAg by the AusRIA II screening procedure failed to be confirmed by neutralization with anti‐HBs serum. Both samples could be effectively neutralized by the same anti‐HBs sera if diluted 1:10, 1:50 and 1:100 prior to testing. It is suggested that the inability to neutralize was due to a very high concentration of HBsAg in these samples.
Human Granulocyte Isolation by Continuous Flow Centrifugation Leukapheresis and Counterflow Centrifugation Elutriation (CFCL/CCE)
Authors: Contreras T. J. , Jemionek J. F. , French J. E. , Shields L. J.
Published: December 2004

Human granulocytes (PMNL) isolated by continuous flow centriftagatlon leukapheresis (CFCL) were further purified by counterflow centrifugation elutriation (CCE). Studies were conducted to determine the maximal granulocyte capacity of the 4.5‐ml elutriation chamber and to determine the efficiency of granulocyte recovery from CFCL concentrates. The maximal capacity of the elutriation chamber was determined to be 1.30 times 109 granulocytes with a 98.8 per cent granulocyte purity and a 51:1 PMNL/RBC ratio. The efficiency of recovery was 82.2 per cent with a 95.1 per cent granulocyte purity and a 68:1 PMNL/RBC ratio. The CCE flow system was designed to allow continuous elutriation runs without need of breakdown time between runs. In four to five hours, approximately 4 to 5 times 109 granulocytes can be isolated with purity in excess of 95 per cent. In vitro analysis of the viability and function of CFCL/CCE‐isolated granulocytes indicates that the morphologic integrity and physiologic function were not comprised as a result of the combined isolation procedure relative to granulocytes isolated by CCE from whole blood samples. Granulocytes were held at 4 to 6 C for 16 to 24 hours in granulocyte storage medium (GSM) plus 20 per cent autologous plasma at concentrations of about 6 times 106 PMNL/ml prior to in vitro analysis.
Clinical Results on the Use of Human Ceruloplasmin in Aplastic Anemia
Authors: Shimizu M.
Published: December 2004

Frequent blood transfusions are necessary in aplastic anemia because of decreased hematopoietic function. In order to maintain the hemoglobin level and to decrease the need for blood transfusion, human ceruloplasmin was used for the treatment of 73 patients with aplastic anemia. A marked beneficial effect was obtained in 16 cases. The treatment was moderately effective in 17 cases, slightly effective in eight cases, and ineffective in 32 cases. The usual dose of ceruloplasmin was 15 mg/day, but it was varied according to symptoms. Side effects were minimal when ceruloplasmin was administered by slow intravenous injection.
Antibody to Hepatitis B Surface Antigen: Immunochemical Purification from Standard Immune Serum Globulin
Authors: Dodd R. Y.
Published: December 2004

Hepatitis B surface antigen (HBsAg) may be insolu‐bilized onto a controlled pore glass (CPG) matrix by simple adsorption from acidified serum or plasma. The resultant complex has the properties of an HBsAg‐specific immunoadsorbent. In this study, CPG‐HBsAg complexes have been used to adsorb anti‐HBs from standard immune serum globulin. Specific antibodies were eluted with acidic or chaotropic buffers. Recoveries ranging from 29 to 46 per cent, with purifications of approximately 1000‐fold were obtained. Two procedures designed to inactivate hepatitis B virus had no effect upon the immunoadsorbent properties of the CPG‐HBsAg complex. The possibility of using this simple method to prepare hepatitis B immune globulin is discussed.
The preparation of leukocyte‐poor red blood cells: a comparative study
Authors: Meryman HT , Bross J , Lebovitz R
Published: December 2004

Thirteen methods of prepararing leukocyte‐poor red blood cells were compared for their effectiveness in removing leukocytes. When the starting material was six to ten days old, the residual leukocyte count was three to four times lower than when fresh material was used and no granulocytes could be found. The most effective manual procedure was a single upright sedimentation of six‐ to ten‐day‐old saline‐diluted red cells. Inverted sedimentation was no more effective in leukocyte depletion than upright sedimentation. Automated cell processors were no more effective than several of the better manual methods. Freezing and deglycerolizing resulted in a ten‐fold improvement in leukocyte removal with less red blood cell loss but at higher cost than the nonfreezing methods. The study indicates that unless the minimal leukocyte count of frozen red blood cells is essential, a single upright sedimentation of saline‐diluted, six‐ to ten‐day‐old red blood cells is currently the most effective procedure for preparing leukocyte‐poor red blood cells.
Polyagglutination due to combined T and Tk activation
Authors: Perkash A , Carlson A , Ellisor S
Published: December 2004

The development of polyagglutination in vivo in two patients with an unusual presentation of features of both T and Tk activation is described. The problems of laboratory diagnosis of these red blood cell anomalies and the impact of these anomalies in clinical management is discussed.
Blood preservation XLIV. 2,3‐DPG maintenance by dehydroascorbate better than D‐ascorbic acid
Authors: Dawson RB , Hershey RT , Myers CS , Eaton JW
Published: December 2004

A study was designed to compare the effects of D‐ascorbate and dehydroascorbate on red blood cell metabolism during blood storage. Dehydroascorbate increased red blood cell concentrations of 2,3‐DPG such that the levels are above normal for four weeks and normal at six weeks of storage. In contrast, there is a gradual decrease in 2,3‐DPG levels with D‐ascorbate such that the levels are approximately 80 per cent of normal after six weeks. ATP levels were adversely effected such that the worst levels were produced by 10 and 5 mM dehydroascorbate, with 10 mM having a more adversive effect than 5 mM. Intermediate levels of ATP were produced by D‐ascorbate, with the 10 mM concentration. The control CPD‐adenine preservative maintained near normal ATP levels for the entire six‐week storage period. pH values were initially slightly lower with dehydroascorbate compared to the other preservatives early in storage, the difference being slightly over 0.1 pH units.
Blood for Use in Exchange Transfusion in the Newborn
Authors: Barnard D. R. , Chapman R. G. , Simmons M. A. , Hathaway W. E.
Published: December 2004

Biochemical and coagulation parameters were studied in fresh whole citrate‐phosphate‐dextrose (CPD) blood, whole blood stored for four days, and blood reconstituted from four‐day‐old packed cells with fresh frozen plasma. Plasma potassium levels were significantly elevated (mean 9.5 mEq/1) in both stored whole blood and reconstituted blood. The mean factor VIII activity in stored blood was 41 per cent compared with a mean of 75 per cent in both fresh whole blood and reconstituted blood. Platelet microaggregates as measured by the Swank filtration technique were elevated in stored whole blood, but not in fresh whole blood or reconstituted blood. Both stored blood and reconstituted blood were deficient in platelets. Based on in vitro studies, reconstituted blood, supplemented by platelet transfusions if necessary, may be a suitable alternative to fresh whole blood for exchange transfusion in the neonate. Preliminary observations are reported of exchange transfusions performed on sick infants, four receiving whole blood, and three receiving reconstituted blood. Six out of seven infants had a postexchange fall in their factor VIII level. These studies do not show any significant differences in the infants' response to exchange transfusion whether whole blood or reconstituted blood was received. No detectable evidence of adverse effects was seen in the infants receiving reconstituted blood.
Recovery, Lifespan, and Function of CPD‐Adenine (CPDA‐1) Platelet Concentrates Stored for Up to 72 Hours at 4 C
Authors: Kahn R. A. , Staggs S. D. , Miller W. V. , Heaton W. A.
Published: December 2004

We studied the in vivo recovery, lifespan, and hemostatic effectiveness of CPDA‐1 platelet concentrates stored for up to 72 hours at 4 C. A total of 120 CPDA‐1 concentrates containing an average (± 1 S.D.) of 6.6 ± 2.0 × 1010 platelets were prepared. The pH of the units following storage at 4 C was 6.8 ± 0.2; no unit had a pH below 6.3. Autologous transfusion of six normal volunteers showed that platelets stored at 4 C for 72 hours had an in vivo recovery of 40 ± 18 per cent and a lifespan of 5.1 ± 1.5 days. The hemostatic effectiveness of CPDA‐1 platelets was determined by platelet counts and template bleeding time measurements in 10 thrombocytopenic patients. Patients receiving 48‐hour‐stored platelets had a four‐ to six‐hour posttransfusion corrected platelet increment averaging 15,300 ± 3,200/μl which was 67 ± 34 per cent of expected recovery. Four of the five patients transfused with this preparation showed an improved bleeding time. In contrast, three patients receiving 72‐hour‐stored platelets had a four‐ to six‐hour posttransfusion increment of 5,800 ± 2,400/μl that was only 26 ± 13 per cent of the expected recovery; furthermore, only one of these patients showed any correction of the bleeding time. These data indicate that CPDA‐1 platelets are hemostatically effective when stored at 4 C for up to 48 hours.
Some Properties of Blood Stored in Anticoagulant CPDA‐1 Solution. A Brief Summary
Authors: Moore G. L. , Peck C. C. , Sohmer P. R. , Zuck T. F.
Published: December 2004

Approval of the new anticoagulant preservative, CPDA‐1, was based in part on data from human clinical trials of CPDA‐1 performed by six cooperating laboratories and two blood bag manufacturers. Biochemical and red blood cell survival properties of 123 units of blood stored for 28 to 35 days in CPDA‐1 (as reported by cooperating laboratories) are briefly summarized.
Clinical and Laboratory Findings on Two Patients with Naturally Occurring Anti‐Kell Agglutinins
Authors: Judd W. J. , Walter W. J. , Steiner E. A.
Published: December 2004

Two patients with naturally occurring anti‐K agglutinins are reported. Both patients manifested clinical symptoms associated with septicemia. Transfusion of one patient with K‐positive blood did not result in hemolytic complications, further stimulation of the anti‐K agglutinin or any change in its immunoglobulin nature.
Quality Control for Deglycerolized Red Blood Cells
Authors: Meryman H. T. , Hornblower M.
Published: December 2004

A quality‐control procedure to detect inadequately deglycerolized red blood cells is feasible, although the cost‐effectiveness of routinely employing such a test needs to be considered by each individual blood bank. When the standard deglycerolizing protocol is meticulously followed by experienced personnel, the chances of an error that would result in inadequate deglycerolization are remote. The administration of cells with excess residual glycerol can result only in intravascular lysis of the infused cells. However, if a blood bank feels the need for a quality‐control test for deglycerolized red blood cells, resuspending cells in 0.7% NaCl and estimating the per cent hemolysis using a color comparator is a simple and effective test.
False‐Positive DAT Caused by Variables in Sample Procurement
Authors: Grindon A. J. , Wilson M. J.
Published: December 2004

A positive DAT may occur when blood samples are drawn from an intravenous line and are a function of 1) drawing the sample from a line containing 5% or 10% dextrose rather than dextrose with lactated Ringer's; 2) using a large bore rather than a small bore needle; 3) using a clot rather than anticoagulated sample for the DAT; and 4) drawing a smaller volume of blood (reactions strongest at a sample size of 0.5 ml).
Estimation of anti‐D IgG in red blood cell eluates using the specific radioactivity of 125I‐labeled IgG: effect of unlabeled, cytophilic IgG
Authors: Masouredis S.P. , Mahan L.C. , Sudora E.J. , Langley J.W. , Victoria E.J.
Published: December 2004

The specific radioactivity of conventionally prepared 125I IgG anti‐D eluates is significantly less (from 1/5 to 1/20) than that of the 125I IgG fraction used to prepare the eluate. This discrepancy is due to the release of unlabeled, cytophilic IgG from normal red blood cells during eluate preparation and does not represent an underestimation of the eluate anti‐D IgG content. Cytophilic IgG content of eluates plays an important role in reducing the nonimmunologic binding of labeled antibody IgG. The results justify the assumption used in numerous studies that the specific radioactivity of 125I IgG fractions can be used to provide a valid estimate of the anti‐D IgG content of eluates.
Cryopreserved red blood cells for pediatric transfusion
Authors: Valeri C.R. , Valeri D.A. , Gray A. , Melaragno A.J. , Vecchione J.J. , Dennis R.C. , Emerson C.P.
Published: December 2004

Human nonrejuvenated and rejuvenated red bood cells were prepared for cryopreservation and subsequent pediatric transfusion. Glycerol was added to the red blood cells in the primary polyvinyl chloride plastic collection bag to achieve a concentration of 40 per cent W/V. The red blood cells were concentrated by centrifugation, and the supernatant glycerol was discarded. Each glycerolized unit was divided into four equal aliquots in the individual 600‐ml bags of a dry quadruple polyvinyl chloride plastic system, and each aliquot was frozen and stored at −80 C. After thawing, sodium chloride solutions were used to wash the aliquots in the IBM Blood Processor 2991‐1 or 2991‐2 or the Haemonetics Blood Processor 115, and the washed aliquots were stored in a sodium chloride‐glucose‐phosphate solution at 4 C for 24 hours. Freeze‐thaw recovery of the red blood cells was about 97 per cent, and freeze‐thaw‐wash recovery was about 84 per cent. Twenty‐four‐hour posttransfusion survival values were about 92 per cent for both nonrejuvenated and indated‐rejuvenated red blood cells. Nonrejuvenated red blood cells, those frozen within three to five days of collection without biochemical modification, had normal oxygen transport function at the time of transfusion; rejuvenated red blood cells, those biochemically treated with PIGPA Solution A after three to five days of storage at 4 C, had improved oxygen transport function at the time of transfusion.
Paraben‐associated autoanti‐Jka antibodies
Authors: Judd W. J. , Steiner E. A. , Cochran R. K.
Published: December 2004

Three examples of autoantibodies with Jka specificity are reported. They all react preferentially by low‐ionic strength salt (LISS) techniques, but only in the presence of parabens (butyl, ethyl, methyl, and propyl esters of p‐hydroxybenzoate) or certain other neutral aromatic compounds. They were detected through the use of commercially prepared LISS solution containing parabens as preservatives. While it is unlikely that these autoantibodies are of clinical significance, the parabens can now be added to the list of reagent preservatives that may give rise to anomalous serologic reactions.
Determination of homozygote vs heterozygote of Rh blood group antigens via rosette assays
Authors: Loren A. B. , Matsuo Y. , Charmax D. , Yokoyama M. M.
Published: December 2004

By sensitizing human red blood cells with antisera specific for corresponding blood group antigens and subsequent rosette formation, we were able to distinguish homozygosity of the antigens from heterozygosity. Three types of rosette assays were utilized: a protein A rosette, an immunoglobulin‐coated bead rosette, and an erythrocyte‐ antibody rosette with human lymphocytes. In the Rh blood group system, we were able to demonstrate the dosage effect of the Rho(D) antigen by rosette assay in addition to determining that the deletion of the C and/or E alleles increased the rosette forming cell count when red blood cells with different genotypes were sensitized with Rh immune globulin (anti‐D). The assay proved to be reproducible in distinguishing between homozygous and heterozygous Rh red blood cell antigens, and may be adaptable to study many antigenic markers on cell surfaces.
Survey on the current use of leukapheresis and the collection of granulocyte concentrates
Authors: French J. E. , Solomon J. M. , Fratantoni J. C.
Published: December 2004

This study was designed to define leukapheresis practice. A voluntary questionnaire on leukapheresis was sent to 280 FDA‐registered blood‐ collecting establishments performing leukapheresis. Of the facilities questioned, 67.9 percent responded. The survey results indicate that most facilities use intermittent‐flow blood cell separators, while 22.6 percent use more than one separation method. Establishments routinely use 6% hydroxyethyl starch (HES 450/0.70) and the majority using trisodium citrate as the anticoagulant. Forty‐eight percent use corticosteroids, primarily dexamethasone, to pretreat the donor. The frequency of donation was not specified by 25.3 percent of the report. Forty‐two percent chose an individual donation frequency of two times per week. A limit on the total number of donations allowed per donor was not specified by 78.4 percent of the facilities. Community blood banks (including regional centers) performed 55.6 percent of all leukocyte concentrate collections. The donor reaction incidence was of 3.64 percent. Hospitals, of all types, performed 37.8 percent of the collections. The adverse reaction rate ranged from 2.84 to 9.72 percent. Adverse reactions occurred in donors 54.9 times per 1000 procedures. Ninety‐four percent of reported reactions were mild, whereas moderate and severe reactions accounted for 5.9 and 0.4 percent, respectively. Granulocyte yields varied by the type procedure and the use of corticosteroids as well as among facilities. The majority (56.3%) held leukocytes at 22 to 25 degrees C prior to transfusion, while most of the remainder stored at 4 degrees C.
Antibody elution from red blood cells by chloroform and trichloroethylene
Authors: Massuet L. , Martin C. , Ribera A. , Argelagues E. , Duran‐Suarez J.R. , Triginer J.
Published: December 2004

Antibody elution by chloroform and trichloroethylene was compared with the Rubin ether method modified by Hughes‐Jones for IgG antibodies and the Landsteiner and Miller heat method for IgM antibodies. After washing the cells, the chloroform and trichloroethylene method was done at 37° C for 10 minutes. With this technique the eluate remained on the upper layer above the red blood cell stroma layer, while with Rubin's method the eluate remained below the cell stroma. The reported technique was as effective as the Landsteiner and Miller heat method for IgM antibodies, and a double volume of eluate was obtained.
Storage and survival of red blood cells with elevated sodium levels
Authors: Wallas C.H. , Harris A.S. , Wetherall N.T.
Published: December 2004

Approximately 25 percent of black blood donors have an elevated red blood cell (RBC) sodium (Nai) level compared with white donors. This elevation results in a significant increase in the mean Nai from black (9.00 ± 2.96 mmoles/l RBC) as compared to white blood donors (7.04 ± 1.48 mmoles/l RBC, p less than 0.001). Red blood cells from four black donors with mean Nai levels of 15 ± 2.8 mmoles/l RBC were stored for 35 days in citrate‐phosphate‐dextrose‐adenine and compared to that of four donors with normal levels of Nai. Serial measurements of red blood cell adenosine triphosphate, diphosphoglycerate, glucose‐6‐phosphate dehydrogenase, pyruvic kinase, lactate production rates, and intracellular cations showed no differences between the two donor groups. Furthermore, the mean 24‐hour posttransfusion survival was not significantly different for the high Nai group (83.2 ± 5.6%) as compared with the control group (82.3 ± 6.9%). Based on this study, it is not necessary to eliminate individuals with an elevated red blood cell Nai level as blood donors.
Use of whole blood exchange transfusion to supply neutrophils to septic, neutropenic neonates
Authors: Christensen R.D. , Anstall H.B. , Rothstein G.
Published: December 2004

When neutropenia due to exhaustion of the marrow neutrophil reserve, develops in a neonate with bacterial sepsis the likelihood of survival is very small. We report such a case who was treated with a double‐ volume exchange transfusion using fresh unstored whole blood. We were able to determine a net gain of 5 × 10(8) neutrophils per kg. Then, in neutropenic neonatal animals, neutrophil transfusion by double‐volume exchange transfusion with unstored blood was investigated.
Preparation and in vitro characteristics of polymerized pyridoxylated hemoglobin
Authors: Sehgai L. R. , Rosen A. L. , Gould S. A. , Sehgal H. L. , Moss G. S.
Published: December 2004

Stroma‐free hemoglobin solutions have been the subject of extensive studies as potential acellular oxygen carriers. Oncotic pressure considerations limit the hemoglobin concentration of the solutions (6–8 g/dl) to one‐half the normal whole blood values. Furthermore, the free hemoglobin has a short plasma half‐life (2–4 hours). In principle, polymerization offers a means of normalizing the oxygen‐carrying capacity as well as extending the plasma half‐life. Pyridoxylation of hemoglobin prior to polymerization provides an acceptable P50. Pyridoxylated hemoglobin (14–16 g/dl) was polymerized with a 12.5 percent glutaraldehyde solution. Since the goal was to obtain a 15 g per dl solution iso‐oncotic with plasma, the polymerization reaction was monitored by the drop in colloid osmotic pressure. The reaction was quenched with 1.3 M lysine when the colloid osmotic pressure reached normal values (20–25 torr). The polymerization yield was 80 percent, with molecular weights ranging from 120,000 to 600,000 Dalton. The polymerized hemoglobin had a binding coefficient of 1.32, a Pso of 16 torr, a Bohr coefficient of –0.12, and a Hill coefficient of 1.7. The viscosity of the solution was 4.5 centipoise. The methemoglobin levels were comparable to that of unpolymerized stroma‐free hemoglobin. Polymerized hemoglobin solutions provide a normal oxygen‐carrying capacity with a P50 comparable to that of unpolymerized stroma‐free hemoglobin solutions.
Description and use of the CS‐3000 blood cell separator for single‐donor platelet collection
Authors: Buchholz D. H. , Porten J. H. , Menitovea J. E. , Rzad L. , Bucheger R. R. , Aster R. H. , Lin A. T. , Smith J.
Published: December 2004

A new computer‐controlled seal less continuous flow blood cell separator has been developed to harvest platelets, plasma, or leukocytes and perform plasma exchange. One hundred seven platelet collection procedures were performed using an instrument prototype during developmental evaluation of a number of differently configured platelet collection chambers. An average of 3.6 (range 2.6‐5.5) × 1011 platelets was collected during a 90‐minute period (blood withdrawl rate, 32 ml/minute) with the best chamber. Only a small number of other cells, from 0.1 to 0.2 times 109 white blood cells and 0.7 to 1.0 times 109 red cells was collected with the platelets. Total procedure time averaged 115 to 120 minutes and included 5 minutes to install the blood processing pathway, 10 minutes to prime the system under computer control, 5 minutes to return donor erythrocytes at the completion of the procedure, and 5 minutes to remove the processing set and resuspend the platelets. The average donor platelet count declined 48 times103per μ (19%) by the completion of the procedure, and, with the exception of a decline in inorganic phosphorus from 3.4 to 2.5 mg per dl, no unexpected changes in serum chemistry levels were seen.

Use of either of two larger separation chambers in a production version of the instrument permitted more rapid blood processing rates (≃45 ml/minute); an average of 4.2 (range 2.1–7.8) × 1011 platelets was collected in 90 minutes using a larger chamber designed for platelet separation (n = 164). Platelets could also be collected using the chamber designed for white blood cell collection by omitting the use of hydroxyethyl starch and by selecting the platelet collection computer program rather than the white cell collection program. Using that chamber, an average of 4.3 ± 1.8 times 1011 platelets was collected in 90 minutes (56% collection efficiency; n = 31). Leukocyte contamination of platelets was greater using the larger chambers. Infusion of autologous platelets labeled with 51Cr demonstrated a 70 percent average recovery and a mean survival of 9.1 days (n = 10). Seven nonalloimmunized thrombocytopenic patients were transfused with platelets collected using the prototype cell separator and an average of 86 percent of the expected number of platelets was present in the circulation 2 hours after transfusion with 63 percent of the cells remaining in the circulation at 24 hours. Template bleeding times were corrected in six of seven recipients following transfusion, and hemostasis was achieved in three bleeding recipients. Therapeutically useful numbers of functionally effective platelets can be collected using this blood processing instrument.
White cell related red cell antibodies
Authors: Grindon A. J. , Deans J. P.
Published: December 2004

Occasional sera react weakly with a few red cells In the antiglobulin phase but without a recognizable pattern. We sought to identify the nature of such antibodies in 27 samples referred to our HLA laboratory for lymphocytotoxin testing. All samples were tested against a panel of 15 red cells by a capillary tube antiglobulin technique developed to conserve sera. This technique correlates well with tube antiglobulin tests, and can be performed with either fresh or thawed red cells. Of 27 sera, 14 contained anti‐HLA B7, B17, or A28, since they reacted only with red cells from donors whose lymphocytes were B7, B17, or A28. Eight further sera probably contained anti‐B7, ‐B17, or ‐A28, but reacted with one or two additional red cells. Two samples agglutinated all panel red cells so the presence of anti‐B7, B17, or A28 could not be determined. In three additional sera, lymphocytotoxin testing suggested that specificity other than anti‐B7, B17, or A28 was present. Of 27 sera containing weak unidentified red cell antibodies, 22 (81%) contain definite or probable anti‐B7, ‐B17, or ‐A28. The identity of these troublesome antibodies can be determined by maintaining red cell panels of donors whose HLA phenotypes are known. TRANSFUSION 1983:23:240–243.
Inconsistent leukocyte removal by IBM 2991 blood cell processor
Authors: Bijou H. , Brady M.T. , Fortes P. , Hawkins E.P.
Published: December 2004

ABSTRACT: Studies done in the 1970's have documented the efficiency of leukocyte removal by saline washing using the IBM 2991 Blood Cell Processor. In June 1982, an evaluation of 52 consecutive units washed using the IBM 2991 yielded results for leukocyte removal that varied considerably from the results determined by previous published studies. Evidence from our institution and others within the last year supports a recent alteration in the ability of the IBM 2991 to remove leukocytes. Since the machine has not changed considerably since previous successful studies, alterations in the product being washed need to be considered as a cause of the inconsistency in leukocyte removal by the IBM 2991. Until consistent leukocyte‐removal can be achieved, individual blood banks should carefully scrutinize their washed units and be prepared for possible leukocyte‐associated reactions.
In vitro function and in vivo viability of stored platelet concentrates
Authors: Lindberg J. E. , Slichter S. J. , Murphy S. , Schroeder D. D. , Nelson E. J. , Champion A. B. , Carmen R. A.
Published: December 2004

Previous studies have shown that CL‐2399 (Cutter) and PL‐130 (Fenwal) polyvinyl chloride (PVC) plastic bags are unsatisfactory for storage of platelet concentrates (PC) at 22°C. In an effort to explain the effects of plastic bags, the chemical make‐up of CL‐2399 and PL‐130 PVC films was determined and compared with that of P1‐146 (Fenwal) PVC, which is satisfactory for PC storage at 22°C. The only significant difference between the three materials was the incorporation of tetrahydrofurfuryl oleate (THFO) as a secondary plasticizer in CL‐2399 and PL‐130. The response of platelets to aggregating agents, uptake of serotonin, recovery from hyptonic stress, and serotonin release during storage following storage in a modified CL‐2399 plastic prepared without THFO and designated CL‐3000 (Cutter) was equivalent to PL‐146 and far superior to CL‐2399. In vivo studies in two laboratories of platelets stored in CL‐3000 bags showed satisfactory recovery (56 ± 4.2% and 46.7 ± 2.7%) and survival (6.4 ± 0.4 days and 7.4 ± 0.6 days). From these studies we conclude that the THFO secondary plasticizer component of PL‐130 and CL‐2399 is the cause of the poor platelet viability of platelets stored in these plastic bags. The mechanism of impairment is not known. The causative agent(s) may be degradation products of THFO (formed during manufacture of the PVC film) that are leached from the plastic into PC during storage.
Anti‐JMH identified in serum and in eluate from red cells of a JMH‐negative man
Authors: Whitsett C. F. , Moulds M. , Pierce J. A. , Hare V.
Published: December 2004

Anti‐JMH was identified in the serum of an 80‐year‐old JMH‐negative man. Before transfusion, his direct antiglobulin test was weakly positive with polyspecific reagents, anti‐C3 and anti‐lgG. An eluate prepared from his red cells contained anti‐JMH. Chromium‐51‐labeled JMH‐positive cells which were weakly incompatible in vitro appeared to survive normally. Following transfusion with three JMH‐positive units, the patient's hematocrit increased from 20.7 percent to 32.1 percent.
Hemolytic disease of the newborn following maternal self‐injection of blood
Authors: Wong L. K. , Smith L. H. , Jensen H. M.
Published: December 2004

A teenage primigravida with no prior history of transfusion presented with anti‐D, anti‐C, and anti‐E in her serum and subsequently developed anti‐Fya. The infant had hemolytic disease of the newborn. The antibodies were provoked by the girl's self‐injection of her partner's blood for emotional gratification. Clinicians and transfusion services should be aware that hemolytic disease of the newborn in a first pregnancy can be caused by self‐inflicted maternal immunization. Close communication between clinicians and transfusion service is emphasized.
Anti‐PP1Pk and early abortion
Authors: Cantin G. , Lyonnais J.
Published: December 2004

Anti‐PP1Pk is found in the serum of individuals of phenotype p. Recurrent first trimester miscarriages have been reported in nearly 50 percent of mothers with the p phenotype. A comparative serologic study of three p phenotype mothers is reported. The proposita had three miscarriages while her two identical twin sisters had normal pregnancies. Following serum fractionation on DEAE‐cellulose, serial agglutination with P1 and P2 erythrocytes indicated a possible association between IgG anti‐P and the increased risk of abortion.
Dosage effects in the Duffy, Ss, and Rh systems
Authors: Mourant A.E.
Published: December 2004

EDITOR'S NOTE: In order to permit timely publication of correspondence, the references have not been verified as they have been for articles appearing in TRANSFUSION, and, therefore, the accuracy of cited references in Correspondence is the sole responsibility of the authors.
Stability of plasma fibrinogen during storage of platelet concentrates at 22° C
Authors: Murphy S. , Martinez J. , Holburn R.
Published: December 2004

Platelet concentrates (PC) are stored for up to 5 days at 22° C prior to infusion. Since considerable suspending plasma is infused with the platelets, we examined the integrity of plasma fibrinogen from stored PC. The concentration of fibrinogen after storage was normal. After purification, fibrinogen from stored PC had normal thrombin time and rate of polymerization of fibrin monomer, and after reduction, its Aα, Bβ, and y chains had normal mobility on sodium dodecyl sulfate polyacrylamide gel electrophoresis. Assays of plasma from stored PC for fibrinogen‐fibrin degradation products were negative. When 125l‐fibrinogen was added to PC prior to storage and supernatant plasma was filtered in a sepharose 4B column after storage, radioactivity eluted in a single, symmetrical peak with no evidence for formation of low or high molecular weight material. These results make it unlikely that thrombin, plasmin, or other proteolytic activity is generated during storage. The levels of factors V and VIII fell to 40 to 65 percent of control values while the activities of factors IX, X, and XI did not change significantly during storage. We conclude that suspending plasma fibrinogen and other coagulation factors are remarkably stable during PC storage. They should be of value during the support of patients with massive hemorrhage.
Effect of intense leukocytapheresis in pancytopenic phase of hairy cell leukemia
Authors: Choudhury A.M. , Bhoopalam N.B. , Hoffstadter L.K.
Published: December 2004

The efficacy of leukocytapheresis in a pancytopenic patient with hairy cell leukemia in postsplenectomy stage is reported. Cytapheresis as the only therapy was effective on more than one occasion in inducing remission and reducing transfusion requirements. Fourteen months after the last leukocytapheresis, the patient's hemoglobin and hematocrit remain normal. The leukocyte concentrates removed contained 90 percent lymphocytes consisting of 75 percent T cells, 15 percent B cells, and only 2 to 4 percent hairy cells. Thus, the removal of a large number of lymphocytes, not necessarily hairy cells, induced a sustained clinical improvement and indicated that cytapheresis may be a useful alternative to chemotherapy for these patients.
Hemophilic dogs response to Bridge anticoagulant neutralizing agent
Authors: Nour‐Eldin F.
Published: December 2004

ABSTRACT: When Bridge anticoagulant neutralizing agent, prepared by column fractionation, was infused with factor VIII concentrate into a hemophilic dog, the apparent level of circulating factor VIII was markedly increased. Material isolated from 30 ml donor plasma raised the level of factor VIII nearly three‐fold, during the first post‐transfusion hour. This was achieved without shortening the period during which a hemostatlcally‐effective level of factor VIII was maintained. The same dose also reduced the amount of factor VIII required for prompt and successful nemostasis after standardized template gingival biopsy.
Simian foamy virus infection in a blood donor
Authors: Boneva R.S. , Grindon A.J. , Orton S.L. , Switzer W.M. , Shanmugam Vedapuri , Hussain A.I. , Bhullar V.B. , Chamberland M.E. , Heneine Walid , Folks T.M. , Chapman L.E.
Published: December 2004

BACKGROUND: Infections with simian foamy virus (SFV) are widely prevalent in nonhuman primates. SFV infection was confirmed in a worker, occupationally exposed to nonhuman primates, who donated blood after the retrospectively documented date of infection. Human‐to‐human transmission of SFV through trans‐ fusion and its pathogenicity have not been studied.

STUDY DESIGN AND METHODS: Recipients of blood from this donor were identified and blood samples from such recipients were tested for SFV infection by Western blot and PCR assay.

RESULTS: One recipient of RBCs and another recipient of FFP had died; retroviral infections were not implicated. One platelet recipient could not be tested. Recipients of RBCs (two), a WBC‐reduced RBC unit (one), and a platelet unit (one) tested SFV‐negative 19 months to 7 years after transfusion. Tested recipients had transfusions 3 to 35 days after blood donation. Samples of one lot of albumin and three lots of plasma protein fraction (manufactured from recovered plasma from two donations) tested negative both for antibodies and for viral RNA.

CONCLUSION: SFV transmission through transfusion was not identified among four recipients of cellular blood components from one SFV‐infected donor. Derivatives containing plasma from that donor tested negative for SFV.
Absence of HBV and HCV, HTLV‐I and ‐II, and human herpes virus‐8 activation after allogeneic RBC transfusion in patients with advanced HIV‐1 infection
Authors: Asmuth David M. , Kalish Leslie A. , Laycock Megan E. , Murphy Edward L. , Mohr Beth A. , Lee Tzong‐Hae , Gallarda James , Giachetti Cristina , Dollard Sheila C. , Van Der Horst Charles M. , Grant Robert M. , Busch Michael P. ,   for the Viral Activation Transfusion Study Group
Published: December 2004

BACKGROUND: The Viral Activation Transfusion Study was a prospective, randomized, double‐blind comparison of transfusion with WBC‐reduced versus non‐WBC‐reduced RBCs to HIV+ patients. The primary study characterized the effect of transfusion on HIV and CMV activation by monitoring viral load changes. The present study analyzed HBV, HCV, HTLV‐I and ‐II, and human herpes virus‐8 (HHV‐8) viral load before and after transfusion to evaluate the further hypothesis that global immune stimulation following allogeneic RBC transfusion results in activation and increased viral proliferation of chronic viral infections other than HIV and CMV.

STUDY DESIGN AND METHODS: Baseline samples from 519 to 523 subjects were screened for HBV, HCV, HTLV‐I and ‐II, and HHV‐8 infection, and baseline, serial weekly, and quarterly blood samples from infected subjects in the non‐WBC‐reduced arm were evaluated for changes from baseline in viral nucleic acid and ALT levels.

RESULTS: Seroprevalence of HBV, HCV, HTLV‐I and ‐II, and HHV‐8 was 68, 25, 5, and 30 percent, respectively. No significant induction of HBV, HCV, HHV‐8, or HTLV‐I and ‐II viral replication following allogeneic transfusion of non‐WBC‐reduced blood was observed. A significant, albeit small, association was observed between transfusion and ALT.

CONCLUSIONS: Based on these results and our previous finding that no adverse effect on HIV and CMV viral load and disease progression results from allogeneic transfusion, no evidence is found to support the selective use of WBC‐reduced blood components for HIV‐infected patients.
Temporal trends in the prevalence of HIV and other transfusion‐transmissible infections among blood donors in northern Thailand, 1990 through 2001
Authors: Nantachit Niwes , Robison Valerie , Wongthanee Antika , Kamtorn Nuonchuen , Suriyanon Vinai , Nelson Kenrad E.
Published: December 2004

BACKGROUND: Thailand's epidemic of HIV infection, which began in 1988, has primarily involved heterosexual transmission of the virus. This study describes changes in prevalence of HIV and other infectious diseases among blood donors in northern Thailand from 1990 through 2001.

STUDY DESIGN AND METHODS: Serologic screening results and demographic data were analyzed from 276,066 donors screened at two blood collection facilities in Chiang Mai, Thailand, from 1990 through 2001.

RESULTS: The HIV prevalence peaked in 1991 to 1993 at 4.04 percent and then declined to 0.38 percent in 2001. The overall prevalence of HIV infection was 2.16 percent; HIV prevalence was higher among male (2.24%) than among female (0.64%) donors, in first‐time donors, and in replacement volunteer donors. The majority of the donors were men and first‐time donors throughout this study. The prevalence of antibodies to syphilis decreased significantly in both men and women. However, the prevalence of antibodies to HCV and HBsAg were stable.

CONCLUSIONS: The declining HIV prevalence from 1990 through 2001 among blood donors in two large blood banks in northern Thailand indicates significant progress toward recruitment of a safer donor population in a developing country despite a major HIV and AIDS epidemic involving the general population.
Circulatory arrest during PBPC apheresis in an unrelated donor
Authors: Cassens Uwe , Baumann Claudia , Hillmann Hartmut , Reinecke Holger , Silling Gerda , Booke Michael , Wawer Angela , Sibrowski Walter
Published: December 2004

BACKGROUND: Nowadays, the collection of PBPCs by apheresis from healthy donors is a routine method. The mobilization with rHu G–CSF and the apheresis procedures are usually well tolerated without severe side effects.

STUDY DESIGN AND METHODS: We report a severe complication in a 41‐year‐old unrelated female donor who was allowed to donate PBPCs and was mobilized with 10 μg of G–CSF per kg per day. During PBPC apheresis, she experienced a circulatory arrest after 132 minutes and processing of 7078 mL of blood (twice the donor's blood volume).

RESULTS: Immediate cardiopulmonary resuscitation restored sinus rhythm and regulatory respiration without sequelae. Subsequent cardiologic examinations (heart catheterization, electrophysiologic testing, tilting table test) resulted in the diagnosis of a neurocardiogenic syncope. Other cardiac or circulatory disorders could be excluded. The implantation of a cardiac pacemaker was recommended to the donor. The 4‐year‐old recipient was successfully transplanted with the partial product collected until the arrest occurred. The patient received a total of 2.54 × 106 CD34+ cells per kg of body weight.

CONCLUSION: After exclusion of other cardiac diseases, the diagnosed neurocardiogenic syncope probably induced the circulatory arrest during apheresis rather than the administration of G–CSF.