bluuebunny/crossref_metadata_2025 huggingface dataset:
Spectrin extractability in blood storage
Authors: Beutler E. , Villacorte D.
Published: December 2004

The extractability of spectrin from red blood cell membranes was measured both by dialysis against 1 mM EDTA for 44 hours and by incubation with 1 mM EDTA for 60 minutes. We confirmed that the extractability of spectrin is somewhat impaired when membranes are prepared from metabolically depleted erythrocytes, but the extent of impairment was considerably < has been previously reported. Red blood cells which had been rendered nonviable by prolonged storage in citrate phosphate dextrose solution manifested normal spectrin extractability. We conclude that the loss of spectrin extractability is an insensitive manifestation of loss of red blood cell viability, and that it is not suitable for the prediction of loss of viability during red blood cell storage.
Freezing in the Primary Polyvinylchloride Plastic Collection Bag: A New System for Preparing and Freezing Nonrejuvenated and Rejuvenated Red Blood Cells
Authors: Valeri C. R. , Valeri D. A. , Anastasi J. , Vecchione J. J. , Dennis R. C. , Emerson C. P.
Published: December 2004

Red blood cells were stored at 4 C in the primary bag with an integrally attached empty transfer pack so that the red blood cells could be rejuvenated or not, as desired before glycerolization and freezing. The rejuvenation and glycerol solutions were added through ports in the system. After glycerolization, the red blood cells were concentrated by centrifugation to remove the supernatant glycerol before freezing with 40% w/v glycerol in the primary polyvinylchloride (PVC) plastic container at −80 C.

After thawing, the red blood cells were washed using either the Haemonetics Blood Processor 115 or the IBM Blood Processor 2991‐1 or 2991‐2. In each system, 50 ml of 12% sodium chloride and 1.5 to 1.6 liters of 0.9% sodium chloride‐0.2% glucose‐25 meq/l disodium phosphate were used. Recovery of red blood cells in vitro was 91 per cent. After three days of postwash storage at 4 C, nonrejuvenated red blood cells had a mean 24‐hour posttransfusion survival of 88 per cent, and outdated‐rejuvenated red blood cells a value of 81 per cent. This new system is simpler and safer than methods previously used in this laboratory, and red blood cell recovery and 24‐ hour posttransfusion survivals were comparable or better.
Platelet Storage: An Assessment of the Requirements for Plasma and Oxygen
Authors: Rock G. , Tittley P. , Sherring V. , Culley C. , Wong S. C.
Published: December 2004

Platelets from several units of plasma were pooled, and then resuspended either as platelet concentrate (PC) (60 ml) or as platelet rich plasma (PRP) (220 ml) and followed during 72 hours of storage at 22 C. Aggregation, pH, and hypotonic shock response are better maintained in the larger volume of plasma. However the decreased pH and function in the PC is not the result of lactate production. While the relative concentration, expressed in mg/dl, is higher in the PC, the absolute production per platelet and, therefore, the total amount of lactate is higher in PRP. Glucose levels are always sufficiently high to permit glucose to be used as a metabolic substrate even after 72 hours. PC maintained in nitrogen have better in vitro function than do platelets stored either in oxygen or CO2. CO2 can easily diffuse through the plastic bag; the same is not true of oxygen. Less than 15 per cent of the volume of oxygen introduced into the bag passed out through the PVC plastic over a 72‐hour period. The data suggest that during storage, anaerobic glycolysis is the preferred metabolic route. The relatively poor performance of the PC maybe the result of limitation of some unidentified substrate or cofactor which is present in plasma and which is necessary for maintaining function.
The Rapid Identification of Chido and Rodgers Antibodies Using C4d‐ Coated Red Blood Cells
Authors: Judd W. J. , Kraemer K. , Moulds J. J.
Published: December 2004

A simple method for the recognition of anti‐Ch and anti‐Rg, using red blood cells coated in vitro with C4d, is described. Of 58 anti‐Ch and 20 anti‐Rg sera studied, all caused direct agglutination of C4d‐coated red blood cells in tests incubated at room temperature. Moreover, selected sera were shown to react strongly (3+ to 4+) with C4d‐coated red blood cells when tested by the indirect antiglobulin test without prior incubation at 37 C. Sera containing other high‐titer, low avidity (HTLA) antibodies were either nonreactive with C4d‐coated red blood cells, or reacted to the same degree with “non‐C4d‐coated” trypsin‐ treated red blood cells. Similar findings were obtained in tests with non‐HTLA antibodies of assorted specificities, including a variety of alloantibodies to high‐incidence red blood cell antigens. These findings indicate that the use of C4d‐coated red blood cells in investigative immunohematology may aid in the rapid identification of Ch and Rg antibodies.
Red Cell Exchange: Treatment of Babesiosis in a Splenectomized Patient
Authors: Cahill K. M. , Benach J. L. , Reich L. M. , Bilmes E. , Zins J. S. , Siegel F. P. , Hochweis S.
Published: December 2004

A splenectomized woman with a history of hepatic disorders was diagnosed as having babesiosis. The patient was unsuccessfully treated with chloroquine and with pentamidine isothionate. A parasitemia of 15 per cent was reduced permanently to less than 1 per cent after a red blood cell exchange, but a low grade parasitemia still existed 10 months after onset. On two separate occasions, the patient was found to have selective IgA deficiency, a reduction of T lymphocytes, and a reduction in function of both T and B lymphocytes. This case represents the highest and the longest duration of parasitemia ever recorded. It reports the first use of pentamidine and red blood cell exchange transfusion in human babesiosis, one of the earliest diagnosed cases of babesiosis, and the most severe clinical case to survive.
Review of the Effects of Hydroxyethyl Starch on the Blood Coagulation System
Authors: Strauss R. G.
Published: December 2004

The literature related to the effects of hydroxyethyl starch on blood coagulation was reviewed to determine whether or not recipients are placed at risk of hemorrhage or thrombosis. Effects on coagulation observed when blood and HES were mixed in vitro were trivial and seemed related simply to dilution. HES affected coagulation in vivo in a dose‐ related fashion. When infused in moderate amounts (as employed in leukapheresis), HES rarely, if ever, caused overt bleeding, and only minor changes of laboratory coagulation tests were detected. Following massive infusions, however, a wide variety of laboratory abnormalities were observed, and hemorrhage was documented in some reports. It must be emphasized that information is limited. Not all investigators employed a complete battery of modern techniques; data regarding massive infusions are derived almost exclusively from animal studies; and data are insufficient to determine the effects of HES on thrombosis. Additional studies are required to completely define the relationship between HES and coagulation in man.
Application of ELISA and ELADA Assay (Double Substrate Immunoassay) to Red Blood Cell Antigens
Authors: Makler M. T. , Pesce A. J. , Campbell J. A. , Green T. R.
Published: December 2004

A double substrate immunoassay has been developed that allows simultaneous quantitation and localization of red blood cell surface antigens. The assay can be used to quantitate surface antigens, or the titer of antisera specific to cell‐surface antigens, on the red blood cell. The assay has been adapted to the study of both D antigen and erythrocyte membrane (EM) antigen, which were found to be uniformly dispersed over the surface of the cell. The number of EM antigens per cell appeared to be approximately twenty times that of the D antigen. For typing antisera, this assay makes it feasible to express antibodies in absolute units (μg antibody) rather than conventional dilution titers, and thus offers a simpler means of rapidly comparing antisera.
Two Examples of Antibodies Dependent upon the Presence of Inosine
Authors: Vengelen‐Tyler V. , Dearolf S. J. , Haley S.
Published: December 2004

Two sera were found to react with red blood cells suspended in diluents containing inosine. The antibody in both cases was IgM in nature, of a low titer, and optimally reactive at temperatures of 22 and 4 C. The antibody was removed from the sera when absorbed with red blood cells suspended in inosine. Washing reagent red blood cells free of the preservative solutions prevented hemagglutination. Although these antibodies may mimic a high‐frequency antibody, they may be easily identified by washing the commercially prepared red blood cells free of the diluent solutions. Individuals demonstrating antibodies to components of the red blood cell diluent are relatively rare, and routine washing of commercially prepared red blood cells is not recommended.
Hemagglutination in Capillaries: Correlation with Blood Group Specificity and IgG Subclass
Authors: Hardman J. T. , Beck M. L.
Published: December 2004

Two hundred four examples of blood group antibodies, reactive only by the indirect antiglobulin test, were examined by the two‐layer albumin capillary (TLAC) technique. Fifty‐nine per cent of the examples tested were reactive by this technique. TLAC reactivity appeared to be related to antibody specificity, but a positive association between TLAC reactivity and IgG subclass composition was not confirmed.
Duffy Antigen Changes on Red Blood Cells Stored at Low Temperature
Authors: Williams D. , Johnson C. L. , Marsh W. L.
Published: December 2004

Red blood cells stored in saline solution for two weeks at 12 C lose some of their Fya, Fyb, and Fy3 antigenicity. At the same time substances with specific inhibitory activity against appropriate Duffy antibodies appear in the saline. Similar changes could not be recognized in time‐expired commercial reagent red blood cell samples.
Hepatitis B Due to Transfusion of Mislabeled Blood
Authors: Seder R. H. , Chopra S. , Schumacher R. , Koff R. S.
Published: December 2004

Transfusion of a misidentified and mislabeled unit of hepatitis B surface antigen (HBsAg)‐positive blood was recognized 18 hours after the transfusion episode. Within 24 hours of transfusion the recipient became HBsAg‐positive, and antibody to the hepatitis B core antigen (anti‐HBc) was detected. Despite hepatitis B immune globulin (HBIG) administration of 28 hours after transfusion, the serologic markers persisted for at least one month. Clinically apparent hepatitis developed about two months after transfusion. At this time HBsAg could not be detected, but antibody to HBsAg (anti‐HBs) was present and anti‐ HBc persisted. The recipient recovered and became a plasmapheresis donor for several hepatitis B research programs.
Antibody to Hepatitis B Core Antigen in Blood Donors with a History of Hepatitis
Authors: Tabor E. , Hoofnagle J. H. , Barker L. F. , Pineda‐Tamondong G. , Nath N. , Smallwood L. A. , Gerety R. J.
Published: December 2004

Sera and questionnaires from 3,230 prospective U.S. volunteer blood donors were obtained in an earlier study to determine the prevalence of serologic markers of hepatitis B virus (HBV) and hepatitis A virus (HAV) among prospective blood donors with or without a history of either hepatitis or blood transfusion. These sera were reevaluated using a radioimmunoassay for antibody to hepatitis B core antigen (anti‐ HBc). Anti‐HBc in the absence of hepatitis B surface antigen (HBsAg) or its antibody (anti‐HBs) was detected in 30 of 1,151 (2.6%) prospective donors with a history of hepatitis, compared to four of 1,086 (0.4%) with no history of hepatitis (p < 0.001). Although end‐point dilution titers of anti‐HBc ≥ 1:100 and the presence of IgM anti‐HBc were more frequently detected among donors with a history of hepatitis than among donors with no history of hepatitis, the difference was not statistically significant. Unlike a history of hepatitis, a history of transfusion or a history of exposure to persons with hepatitis had no significant association with the detection of anti‐HBc in the absence of other HBV serologic markers.
The effects of irradiation on blood components
Authors: Button L.N. , DeWolf W.C. , Newburger P.E. , Jacobson M.S. , Kevy S.V.
Published: December 2004

The functional properties of formed elements of whole blood were studied following irradiation doses of 500 to 20,000 rads. Irradiated lymphocytes retained only 1.5 per cent of their 3H thymidine uptake after a 5,000‐rad exposure and none after 7,500 rads. Red blood cells stored for 21 days and then irradiated with 5,000 rads had the same survival as nonirradiated controls. In contrast, 5,000 rads reduced platelet yields. However, transfused irradiated platelets produced the expected increases in platelet counts and controlled hemostasis in thrombocytopenic patients. After 5,000 rads, granulocytes had normal bacterial killing capacity, chemotactic mobility, and normal superoxide production after high‐dose stimulation. Nitroblue tetrazolium reduction and ingestion stimulated by complement opsonized oil droplets were not diminished by 5,000‐ and 10,000‐rad irradiation. The functional qualities of cellular blood components other than lymphocytes are not compromised by 5,000 rads. This irradiation dose may be an effective means of controlling incidence of graft‐vs‐host disease in immunosuppressed patients.
Alloimmunization in two multitransfused patient populations
Authors: Coles S.M. , Klein H.G. , Holland P.V.
Published: December 2004

A retrospective study was undertaken to determine the frequency of alloimmunization in two multitransfused patient populations. Three hundred eighteen unselected patients whose transfusion records were available were studied. One hundred fifty‐seven patients had sickle cell disease (SCD) and 161 had thalassemia. Forty‐four antibodies were detected in 23 of the 99 transfused SCD patients. The predominate antibodies were in the Rh group: seventeen were anti‐rh”(E), eight were anti‐rh'(C), and four were anti‐rh'w(Cw). Of the remaining antibodies, five were anti‐Kell, three were anti‐Jka, two were anti‐Jkb, three were anti‐Fya, one was anti‐Bga, and one was anti‐S. In the thalassemic patients, six antibodies were detected in 4 of the 39 transfused patients. Of these, there were two anti‐Kell and one anti‐Rho (D), anti‐ rh'(C), anti‐rh'w(Cw), and anti‐Fya each. Although the SCD patients were more likely to have been transfused at the parent institution than were the thalassemic patients (69% vs. 24%, p less than 0.05), the frequencies of alloimmunized patients, the total number of antibodies, and the number of Rh antibodies did not differ significantly (p greater than 0.05) for transfused patients in the two populations.
Principles of antibody elution
Authors: Howard P.L.
Published: December 2004

Antibody‐antigen binding depends upon ionic, hydrophobic, and hydrogen bonds, as well as van der Waals forces and three‐dimensional conformation. Antibody elution techniques attempt to break those forces by alterations of ionic strength, pH, thermal agitation, and the use of organic solvents. Because of the heterogeneity of the physical forces involved in binding, no single elution technique finds universal applicability to the disruption of all types of antibody‐antigen bonds.
Anti‐Tm is anti‐N polypeptide
Authors: Issitt P.D. , Wilkinson S.L.
Published: December 2004

Anti‐Tm defines an antigen in the MN blood group system, and 382 Tm + samples were found in tests on 900 random Caucasian, and 500 random Negro bloods. Of the 382 Tm + samples, 373 were also N +, but a further 625 N+ samples were nonreactive with anti‐Tm. We have now shown that when the original anti‐Tm serum is adsorbed free of anti‐T, and is tested against neuraminidase‐treated red blood cells, it has anti‐N specificity. Further, while anti‐Tm cannot be inhibited by sialoglycoprotein (SGP) preparations from untreated N+ red blood cells, it is inhibited by SGP fractions prepared from N+ red blood cells that have been pretreated with neuraminidase. It seems that anti‐Tm is directed against a part of the polypeptide backbone of the N SGP.
The detection of clinically significant erythrocyte alloantibodies using a human mononuclear phagocyte assay
Authors: Schanfield M.S. , Stevens J.O. , Bauman D.
Published: December 2004

Red blood cell (RBC) allo‐ or autoantibodies, which markedly reduce the survival of transfused or autologous RBC, are considered to be clinically significant antibodies. The occurrence of antibodies against high‐incidence antigens, which are occasionally associated with clinically significant RBC destruction or are of unknown clinical significance, often creates delays in providing blood to patients. In the majority of cases these antibodies are benign; however, clinically significant examples of these antibodies have been reported. An in vitro homologous human mononuclear phagocyte assay (MPA) was used to study antibodies directed against specificities associated with variable clinical significance. Two antibodies reported to be clinically significant and 25 antibodies known to be clinically insignificant were tested by MPA. The results indicate that clinically significant antibodies have a significantly higher score than do clinically insignificant antibodies, with no overlap observed between the two groups. An additional eight antibodies with unknown clinical significance were tested. None of these antibodies had scores in the clinically significant range.
Hemolytic anemia complicating infectious mononucleosis due to the interaction of an IgG cold anti‐i and an IgM cold rheumatoid factor
Authors: Gronemeyer P. , Chaplin H. , Ghazarian V. , Tuscany F. , Wilner G.D.
Published: December 2004

This is the case of a 25‐year‐old man who presented with infectious mononucleosis complicated by hemolytic anemia and hepatitis. Antibody evaluation revealed a cold‐reactive IgG anti‐i and an IgM cold rheumatoid factor. The patient's hemolytic anemia improved following treatment with corticosteroids.
Factors influencing yield of plateletpheresis by discontinuous centrifugation
Authors: Ogata H. , Nagashima K. , Iinuma N. , Hosogaya S. , Akabane T.
Published: December 2004

Plateletphereses performed by the Haemonetics Model 30 Blood Processor under a fixed condition were retrospectively analyzed. The mean platelet yield was 5.97 × 10ll (± l.46 × 10ll. Prepheresis platelet count was significantly correlated to platelet yield (p < 0.001), but hematocrit was not (p > 0.1). Blood‐drawing time showed a significant correlation (p < 0.01) and may suggest than an infusion rate of 60 ml/minute is a technique of choice.

A large number of platelets (% platelet recovery = 73.0 ± 14.1%) was discarded in order to remove erythrocytes and leukocytes from the initial product. The recovery was negatively correlated to the percentage removal of leukocytes (p < 0.01), which means that a platelet product of good quality not containing leukocytes can be prepared at the sacrifice of a large quantity of platelets. It is desirable to devise a simple and practical technique to obtain pure platelets without loss.
A study of ABO incompatibility and neonatal jaundice in Black South African newborn infants
Authors: Vos G.H. , Adhikari M. , Coovadia H.M.
Published: December 2004

In order to establish the role of fetomaternal ABO incompatibility as a cause of overall neonatal jaundice, its relationship to the degree of jaundice, and its etiologic contribution to severe jaundice necessitating exchange transfusion in South African blacks, a retrospective analysis of both laboratory and clinical data was undertaken. Two thousand forty‐two blood samples were submitted for laboratory investigation from mothers and their jaundiced newborn infants and categorized according to ABO blood groups and levels of serum bilirubin. At levels of serum bilirubin below 301 μmol/l, ABO incompatible combinations occurred as frequently as ABO compatible combinations. However, at serum bilirubins above 301 μmol/l, ABO incompatibility was a major cause of jaundice in almost 58 per cent of infants. In the nursery‐based clinical studies, ABO incompatibility accounted for 41.7 per cent of those severely jaundiced (> 301 μmol/l) and 44.4 per cent of newborn infants who had exchange transfusions. ABO incompatible combinations however did not assume a significant role in the cause of overall neonatal jaundice. Both laboratory and clinical findings therefore confirm the importance of fetomaternal ABO incompatibility as a cause of severe jaundice and an unimportant cause of overall jaundice in newborn black babies.
Microaggregate blood filtration in patients with compromised pulmonary function
Authors: Snyder E. L. , Hezzey A. , Barash P. G. , Palermo G.
Published: December 2004

To determine the effect of microaggregate blood filtration on patients with compromised pulmonary function, we divided 50 patients having elective coronary bypass surgery into two groups. One group received all blood transfusions via a 170‐micron standard filter (SF). The other group received blood through a 20‐micron microaggregate blood filter (MF). Patients were monitored pre‐ and postoperatively for changes in arterial blood gases and cardiopulmonary function. Mean transfusion volume was seven units (SF) and six units (MF). Preoperatively, patients in both groups showed abnormal lung function with elevated intrapulmonary shunting (Qs/Qt) and alveolar‐arterial gradients (A‐ aO2). Postoperatively, no significant differences (p greater than 0.05) were found between the groups for any of the tests of cardiopulmonary function evaluated. Posttransfusion, none of the patients in either group showed clinical signs of respiratory distress. We conclude that even for patients with some degree of pretransfusion pulmonary dysfunction, use of a microaggregate blood filter for six‐ to seven‐ unit transfusions does not provide significant clinical benefit.
IgA content of frozen‐thawed‐washed red blood cells and blood products measured by radioimmunoassay
Authors: Yap P. L. , Pryde E. A. D. , McClelland D. B. L.
Published: December 2004

The IgA concentration of various blood products was examined by a radioimmunoassay, and the lowest IgA concentrations were seen in frozen‐ thawed‐washed red blood cells. The routine Regional Blood Transfusion Centre preparation contained a mean IgA concentration of 0.117 mg/l (n = 21) in the frozen‐thawed‐washed red blood cell supernatant fluid. Further washing of frozen‐thawed‐washed red blood cells with saline reduced supernatant IgA concentrations to below the limit of IgA detection (less than 0.003 mg/l). Ordinary washed red blood cells and other blood plasma fractions contained substantial quantitites of IgA, supporting the view that frozen‐thawed‐washed red blood cells should be used for transfusion of patients at risk of developing reactions to IgA, and the need for caution in the use of other blood products in such patients.
Radioimmunoassay evaluation of anti‐C3d reactivity in broad spectrum commercial antiglobulin reagents
Authors: Chaplin H. , Hoffmann N. L.
Published: December 2004

The study was undertaken to assess the potential of a labeled C3d radioimmunoassay method as a standardization criterion for antiglobulin reagents containing anti‐C3d reactivity. Over an 18‐month interval, four different lots of broad‐spectrum antiglobulin reagents were purchased from each of seven United States manufacturers. Anti‐C3d antibody concentration and Ko in each lot were assayed initially and at four‐month intervals over 16 to 21 months storage at 4 degrees C. The results permitted 1) comparison of anti‐C3d antibody concentrations among different manufacturers, 2) comparison among different lots from the same manufacturer, and 3) assessment of stability of anti‐C3d during storage. In addition, serial dilutions of reagents in each manufacturer's diluent were compared for their anti‐C3d agglutinating properties by the spin‐antiglobulin method against red blood cells (RBC) coated by C3d in vitro and against in vivo C3d‐coated RBC from 16 patients. Most reagents were shown also to contain anti‐C3c, anti‐C4c and anti‐C4d reactivities when tested against suitably coated RBC. Anti‐ C3d antibody concentrations ranged from approximately 1 to 3.5 microgram/ml for 27 of the 28 reagents and were stable over 16 to 21 months of storage. Anti‐C3d agglutination titer scores showed a general correlation with anti‐C3d antibody concentrations when tested against in vitro C3d‐coated RBC; correlations were less good against C3d‐coated cells from patients. The radioimmunoassay provided reproducible objective measurements and appeared to have merit as a standardization criterion.
Serological complications of a major ABO incompatible bone marrow transplantation in a Polynesian with aplastic anemia
Authors: Ockelford P. A. , Hill R. S. , Nelson L. , Blacklock H. A. , Woodfield D. G. , Matthews J. R. D.
Published: December 2004

A 24‐year‐old, blood‐group O Polynesian woman with multiple red blood cell antibodies received a group A, HLA‐compatible, sex‐matched bone marrow transplantation as treatment for severe aplastic anemia. High retransplantation titers of ABO isohemagglutinins were successfully reduced by repeated plasmaphereses. Despite gross in vitro incompatibility in the routine crossmatch, technetium‐labelled red blood cell survival studies performed immediately prior to transplantation predicted that a small proportion of the donor erythrocytes would neutralize residual postplasmapheresis isoantibody. Donor marrow was subsequently infused without significant hemolysis. Although anti‐A titers were low immediately posttransplantation, these rose progressively, approaching pretransplantation levels at the time of documented marrow engraftment at day 18. One week later the bone marrow graft was rejected. Retransplantation was successfully performed using marrow from an ABO compatible, sex‐mismatched sibling donor. Radioisotopic studies were helpful in evaluating donor‐recipient red blood cell incompatibility during the ABO incompatible transplantation, and again at retransplantation in the presence of circulating isoantibody to donor red blood cells. High levels of ABO isoagglutinins prior to plasmapheresis and rapidly rising titers posttransplantation may have predicted bone marrow graft rejection in this patient.
A delayed transfusion reaction caused by anti‐K6
Authors: Taddie S. J. , Barrasso C. , Ness P. M.
Published: December 2004

This case report documents the demonstration of anti‐K6 as the single antibody responsible for a delayed transfusion reaction. A 42‐year‐old white woman received three units of red blood cells for an episode of gastrointestinal bleeding from a duodenal ulcer. Twenty‐three days following transfusion, laboratory and clinical evidence of hemolysis was noted. An anti‐K6 was identified in the serum and in an eluate prepared from the patient's red blood cells. One of the three units transfused was positive for the K:6 antigen.
Jk(a−b−) red blood cells resist urea lysis
Authors: Heaton D. C. , McLoughlin K.
Published: December 2004

Falsely high automated platelet counts in a patient with aplastic anemia were found to be due to increased resistance of the red blood cells to urea lysis. The patient's blood group Jk(a‐b‐). Further investigation revealed that this phenomenon occurred with all of eight bloods of the phenotype Jk(a‐b‐) but not with red blood cells of other phenotypes tested. We therefore report an association of a rare blood group phenotype with unusual red blood cell behavior in vitro.
Rh immune globulin and the Rh‐positive Du variant, mother
Authors: Konugres A.A. , Polesky H.F. , Walker R.H.
Published: December 2004

ABSTRACT: Questions have been raised by statements of the American College of Obstetricians and Gynecologists that Rh immune globulin should be given to all Rh positive, Du variant, mothers who have recently delivered Rh positive infants. This practice is not recommended. However, blood banks must assure that a positive Du test on a mother's blood sample is not caused by a massive fetal‐maternal hemorrhage. Failure to recognize this cause of a positive Du test may result in the administration of an inadequate dose of Rh immune globulin.
Circulation and function of human platelets isolated from units of CPDA‐ 1, CPDA‐2, and CPDA‐3 anticoagulated blood and frozen with DMSO
Authors: Vecchione J. J. , Melaragno A. J. , Hollander A. , Defina S. , Emerson C. P. , Valeri C. R.
Published: December 2004

Platelet concentrates (PC) were isolated by serial differential centrifugation from units of blood anticoagulated with one of the citrate‐phosphate‐dextrose‐adenine solutions (CPDA‐1, CPDA‐2, CPDA‐2). The platelet concentrates were frozen with six percent dimethylsulfoxide at 2–3 degrees C per minute and stored in a −80 degrees C mechanical freezer in polyvinyl chloride or polyolefin plastic containers. After frozen storage at −80 degrees C for up to three months, the concentrates were thawed at 42 degrees C within 2.5 to 4.0 minutes, washed with autologous plasma, two percent dimethylsulfoxide and 10 percent acid‐citrate‐dextrose solution, and then resuspended in plasma. The washed platelets were labeled with 51Cr and transfused back to the donor from whom they had been obtained. In vitro recovery from whole blood to platelet concentrate was 70.5 ± 17 percent (mean ± one SD). In vitro freeze‐thaw‐wash recovery determined by phase microscopy was 78.5 ± 12.8 percent, in vivo 51Cr platelet recovery two hours after transfusion was 41.3 ± 13.5 percent, and the platelets had a linear lifespan of about eight days. A single unit of previously frozen platelets shortened an aspirin‐ prolonged bleeding time two and 24 hours after infusion. Results were similar with platelets isolated from all three anticoagulants and stored in both plastics. The results also were comparable to previous findings in this laboratory with platelets isolated from ACD and CPD anticoagulated blood.
Characterization of an anti‐Dia antibody causing hemolytic disease in a newborn infant
Authors: de Lima L. M. Alves , Sad W. E. , Berthier M. E. , DiNapoli J. , Johnson C. L. , Marsh W. L.
Published: December 2004

A case of hemolytic disease in a newborn infant caused by anti‐Dia is described. The parents are Japanese. The antibody was an IgG of subclasses IgG1 and IgG3, did not bind complement, and gave a 27 percent phagocytosis rate when used to sensitize red blood cells for a macrophage binding assay. The antibody was not detected during antenatal serologic testing. This case suggests the need for reagent red blood cell panels selected to match antibody specificities likely to be encountered in a particular population.
Subclinical hemolytic disease of the newborn associated with IgG anti‐ Lub
Authors: Dube V. E. , Zoes C. S.
Published: December 2004

An anti‐Lub antibody with a titer of 128 to 256 was found in a pregnant woman. The antibody was IgG of the IgG1 subclass. Two newborns of successive pregnancies were free of clinical hemolytic disease of the newborn. The failure of this antibody to cause clinical hemolytic disease is ascribed to the weak expression of the Lub antigen on cord red blood cells.
Red blood cell membrane abnormalities during storage: Correlation with in vivo survival
Authors: Schrier S. L. , Sohmer P. R. , Moore G. L. , Ma L. , Junga I.
Published: December 2004

Experiments with citrate‐phosphate‐dextrose supplemented with adenine, 0.5 mM final concentration (CPD‐A2), provided an opportunity for study of red blood cells (RBC) membrane storage lesions which could limit extension of storage. Impairment in drug‐induced endocytosis in intact RBC occurred with storage, but the changes produced did not quantitatively predict or reflect the 24‐hour in vivo 51Cr‐labelled RBC survival. Abnormalities in RBC membrane protein did appear after storage, but these alterations neither paralleled nor predicted the in vivo 24‐hour 51Cr‐labelled RBC survival. The RBC membrance protein changes were not reminiscent of those produced by either acute adenosine triphosphate depletion, oxidative attack, or calcium accumulation. Therefore, while storage produces significant alterations in RBC membrane protein and function, the changes detected were not those that determined in vivo RBC survival.
The Jk(a−b−) phenotype in New Zealand Polynesians
Authors: Woodfield D. G. , Douglas R. , Smith J. , Simpson A. , Pinder L. , Staveley J. M.
Published: December 2004

The Kidd locus phenotype Jk(a‐b‐) was detected in 0.9 percent of Polynesians living in New Zealand. Over a period of 13 years, nine examples of anti‐Jk3 were detected, one of which caused a delayed hemolytic transfusion reaction. Other examples resulted in mild hemolytic disease of the newborn. The anti‐Jk3 reacted as an inseparable antibody, confirmed that inheritance of the Jk(a‐b‐) phenotype was best explained by the presence of a silent Jk allele.
A possible null phenotype in the Cromer blood group complex
Authors: Daniels G.L. , Tohyama H. , Uchikawa M.
Published: December 2004

The red blood cells of a Japanese man failed to react with anti‐Cra sera and with three Cromer‐related sera, B.P., G.T., and K.T.O. His serum reacted with all red blood cells tested except his own. This phenotype, which may represent a null phenotype in the Cromer complex, supports the suggestion that the phenotypes of B.P., G.T., and K.T.O. are Cromer related.
Defective energy metabolism in stored granulocytes
Authors: Lane T.A. , Lamkin G.E.
Published: December 2004

Previous studies suggested that a general metabolic defect might be responsible for impaired chemotaxis of stored granulocytes (PMN). We studied PMN energy metabolism in fresh and stored PMN.

Adenosine triphosphate (ATP) decreased slightly in unstimulated PMN after 48 hours of storage at room temperature. Exposure of fresh PMN to opsonized zymosan resulted in a 12 percent decrease in ATP. In contrast, PMN stored for 24 or 48 hours at room temperature and then exposed to opsonized zymosan, showed significant decreases in ATP. Incubation of fresh or stored, stimulated (opsonized zymosan) or resting PMN with potassium cyanide resulted in no change in the pattern of ATP decrements during storage. Likewise, incubation of fresh or stored, stimulated or resting PMN in the presence or absence of extracellular glucose, resulted in no change in the pattern of ATP decrements during storage. Preincubation of PMN with 2‐deoxy‐glucose obscured the differences in ATP maintenance between fresh and stored PMN. ATP decrements were also observed in unstimulated PMN which had been stored at high cell concentrations. Decrements in ATP correlated stronglywith decreased glucose (r = .82) and pH (r = .89) in the storage medium.

These decrements were partially reversed by incubation of PMN in fresh buffer. The ATP decrements in stored, concentrated granulocyte preparations thus were prevented by maintenance of pH. ATP decrements were not prevented by additional glucose. Thus, in PMN stored for 24 or 48 hours at room temperature, there was a defect in ATP maintenance which was occult in unstimulated cells, but was evoked by the energy‐dependent process, phagocytosis. These findings are compatible with a major role for glycolysis and glycogenolysis in maintaining ATP in fresh and stored PMN. Storage of PMN at high cell concentrations was accompanied by impaired ATP maintenanceand decreased pH in the storage medium, both of which were preventable by addition of alkali to the PMN concentrate prior to storage.
Effect of delayed refrigeration on plasma factors in whole blood collected in CPDA‐2
Authors: Sohmer P.R. , Bolin R.B. , Scott R.L. , Smith D.J.
Published: December 2004

Extension of the time within which whole blood may be separated into components offers logistic advantages for the operation of remote mobile drawing teams. We evaluated the effect of an 8‐hour hold of whole blood at room temperature before preparation of components. Plasma coagulation activity and opsonic factor content were studied in 14 units drawn into the anticoagulant‐preservative solution citrate‐ phosphate‐dextrose‐adenine (CPDA‐2). At the time of collection, an additional 7‐ml aliquot was drawn into 1 ml of CPDA‐2, the plasma separated and frozen immediately. Components were prepared from whole blood units allowed to rest undisturbed at 22 ± 1 degrees C for 8 hours. After 8 hours, a significant decrement of about 10 percent was found in the concentration of fibrinogen, plasminogen, fibronectin, and activity of Factor V. Factor VIII activities (VIIIAHF and VIIIAGN) were not significantly different after 8 hours. Our results indicate that room temperature storage for 8 hours before component processing has minimal effects on potentially labile plasma protein factors using CPDA‐ 2 anticoagulant‐preservative solution.
An in vivo comparison of CPD and CPDA‐2 preserved platelet concentrates after an 8‐hour preprocess hold of whole blood
Authors: Bolin R.B. , Cheney B.A. , Smith D.J. , Gildengorin V. , Shigekawa R.
Published: December 2004

To see if citrate‐phosphate‐dextrose‐adenine‐two (CPDA‐2) anticoagulant‐ preservative had an effect on the viability of platelets, we studied autologous in vivo recovery and survival in humans for platelet concentrates prepared from six units of blood drawn into CPDA‐2 and compared them to six units drawn into citrate‐phosphate‐dextrose (CPD). These units were prepared from whole blood held at room temperature for 8 hours after collection and were then stored for 3 days at 22 ± 2 degrees C. The recovery for platelets preserved in CPD was 39.0 +/0 4.8 percent and for platelets preserved in CPDA‐2, 32.5 ± 4.4 percent. The difference was not significant (p greater than 0.10). In order to estimate population differences, in vitro effects on in vivo viability were also evaluated. Six in vitro variables were studied but only pH at 72 hours (r = 0.77), platelet count (r = 0.64), and morphology score (r = 0.66) correlated to recovery. Only pH at 72 hours significantly influenced recovery (p = 0.007). By adjusting for individual pH differences, mean recovery for platelets stored in CPD was 37.5 percent, and for platelets stored in CPDA‐2, 34.0 percent. The mean lifespan was 6.7 ± 0.7 days for platelets preserved in CPD and 6.1 ± 1.0 days for those preserved in CPDA‐2. Although hemostatic function was not studied, these data support in vitro observations that platelets preserved with CPDA‐2 are not different from platelets preserved with CPD, even after 8‐hours of storage of whole blood at room temperature prior to platelet concentrate preparation.
Red blood cell‐bound C3d in normal subjects and in random hospital patients
Authors: Freedman J. , Barefoot C.
Published: December 2004

Red blood cells (RBC) drawn into EDTA from 103 normal adults, 26 newborn infants, and 203 randomly selected hospital patients, and into citrate‐phosphate‐dextrose (CPD) from 87 Red Cross donors, were evaluated for RBC‐bound C3d by agglutination with anti‐C3d and by a radiolabeled anti‐antiglobulin technique. Positive agglutination reactions were observed only with RBC from 26 hospital patients; however, by the radiolabeled antiglobulin method, C3d was demonstrable on all RBC, but its amount varied widely among different subjects. A normal range for RBC‐bound C3d was established. RBC‐bound C3d levels were not related to the age (18–88 years) or sex of the subjects and remained unchanged over 9 months. Red blood cells taken into CPD had more RBC‐bound C3d than cells taken into EDTA; cord RBC had less than adult RBC. In 39 percent of the hospital patients (excluding those with autoimmune hemolytic anemia) RBC‐bound C3d was above the normal range and a good correlation was found between values obtained by the radiolabeled anti‐antiglobulin method and by agglutination titration scores. There was a threshold level of RBC‐bound C3d below which agglutination reactions were negative. Evaluation of RBC‐bound C3d in health and disease is important for determining optimal characteristics of anticomplement antiglobulin reagents.
Enhanced nonenzymatic glycosylation of blood proteins in stored blood
Authors: Szelényi J. G. , Foldi J. , HollAn S. R.
Published: December 2004

Significantly enhanced nonezymatic glycosylation of hemoglobin, plasma, and erythrocyte membrane proteins was demonstrated following storage of whole blood in the liquid state under conventional blood bank conditions. Among the blood components studied, the proteins of the erythrocyte membrane were mainly involved, although the levels of glycosylated hemoglobin and plasma proteins were also significantly increased. In contrast to the nonenzymatic glycosylation observed in vivo in patients with diabetes, the in vitro process is less intensive and most probably results in less functional alteration
Effects of storage of granulocytes on their fate in vivo
Authors: McCullough J. , Weiblen B. J. , Fine D.
Published: December 2004

During storage of granulocytes, the chemotactic response deteriorates first and to the greatest extent. Because in vitro assays such as chemataxis may not adequately predict the fate of granulocytes in vivo, we determined the intravascular kinetics and migration into skin windows of indium‐111 labeled granulocytes. Granulocytes stored for 24 hours at either 1 to 6 or 20 to 24°C had significantly reduced intravascular recoveries and migration into skin windows. Granulocytes stored for only eight hours at 20 to 24°C had normal intravascular recovery and migration into skin windows. In granulocytes stored for eight hours at 1 to 6°C, the intravascular recovery and migration into skin windows were reduced. Because of the method of calculating migration, this observation suggests that granulocytes which do circulate after storage at 1 to 6°C had decreased ability to migrate into the skin windows. Granulocytes can be stored for up to eight hours at 20 to 24°C without reduction in their ability to circulate and migrate to a site of inflammation. However, since many practical issues in granulocyte storage are not resolved, granulocytes should be transfused as soon as possible after collection
A clinically significant erythrocyte antibody detectable only by 51Cr survival studies
Authors: Baldwin M. L. , Barrasso C. , Ness P. M. , Garratty G.
Published: December 2004

Hemolytic transfusion reactions typically are explained by red cell serologic incompatibilities. We describe a patient in whom a clinically significant red cell alloantibody could not be demonstrated, despite the occurrence of several clinically severe hemolytic reactions. Serologic studies using multiple techniques demonstrated only an anti‐Bga; these studies included standard procedures as well as more sensitive experimental techniques. A 51Cr survival study using red cells from a random unit, compatible in vitro with conventional techniques, showed 72 percent survival at 1 hour and 7 percent survival at 24 hours. R2R2 (hr″(e) negative) red cells in a second 51Cr survival study showed 90 percent survival at 1 hour and 92 percent survival at 6 hours. The patient was transfused with R2R2 units which were tolerated well and survived normally. Extensive serologic testing still demonstrated only an anti‐Bga. A third 51Cr survival study, 10 months after the first study, with an R1R1 (hr″(e) positive) sample showed 90 percent survival at 1 hour and 42 percent survival at 6 hours. A fourth study using a larger aliquot of R2R2 (hr″(e) negative) 51Cr‐labeled red cells, examined over 2 weeks showed a near normal 21‐day survival of 50 percent. These 51Cr survival studies, along with normal survival of hr″(e) negative units, suggest that this patient destroys hr″(e) positive red cells despite negative serologic testing
Stability of red cell antigens and plasma coagulation factors stored in new formulation plastic blood containers
Authors: Snyder E. L. , Hezzey A. , Weirich F. , Mosher D. F. , Davisson W. , Buchholz D. H.
Published: December 2004

The stability of red blood cell antigens and plasma coagulation factors stored in new plastic blood packs containing either citrate‐phosphate‐dextrose (CPD) or citrate‐phosphate‐dextrose‐adenine (CPDA‐2) was studied. The containers were made of either polyolefin (PL 732™) plastic without a plasticizer, or polyvinyl chloride with a non‐diethylhexyl phthalate (non‐DEHP) plasticizer (PL 1240). All studies were done in parallel using standard polyvinyl chloride (PL 146) bags containing DEHP plasticizer as controls. Red blood cell antigen scoring was performed for the A, B, c, D, K, Fya, Lea, Jka, M, and P antigens using cells obtained from both the blood container and tubing segments. Units of fresh frozen plasma and cryoprecipitate were prepared, and age and donor‐matched sets of each of these blood components were stored in both test and control plastic containers.

The red blood cell antigens showed no decrease in reactivity over 21 (CPD) or 35 (CPDA‐2) days of storage in either test plastic compared with controls. For fresh frozen plasma (factors V, VIII, IX) and cryoprecipitate (factor VIII) the factor activity found for the test plastics ranged from 94 to 115 percent of that recorded for the age and donor‐matched control plastic. The concentration of fibronectin found in cryoprecipitate stored in the test plastics averaged 90 to 99 percent of the activity found in PL 146 plastic. We conclude that the red blood cell antigens and coagulation factors tested remain stable in the plastic‐anticoagulant combinations studied
The impact of adenine and inventory utilization decisions on blood inventory management
Authors: Cohen M. A. , Pierskalla W. P. , Sassetti R. J.
Published: December 2004

The use of citrate‐phosphate‐dextrose‐adenine as an anticoagulant for whole blood increases the storage period permitted for whole blood and red cells from 21 to 35 days. A simulation model was used to analyze the possible consequences for outdates and shortages of the addition of adenine. The model accepts as input (1) the maximum age (21 or 35 days), (2) parameters describing the demand and supply distributions, and (3) parameters describing inventory control (crossmatch recycle period, transfusion fraction, deviation from optimal target inventory levels). These parameters were varied over wide ranges, and a full factorial design was carried out. The observed shortage and outdate rates were then related (via multiple regression) to the parameter values. The resulting shortage and outdate functions indicated the effect of parameter changes, including extending the lifetime from 21 to 35 days, and the joint effect of changing more than one parameter. Conclusions indicate that, while the contribution of an increased lifetime to reducing shortages and outdates can be substantial, this contribution can be easily dissipated by relaxing the tightness of other inventory management controls
Rejection of prospective blood donors due to systematic errors in hematocrit measurement
Authors: ROSS D.G. , ROSS W.B. , SCHREINER D.E. , HEATON W.A.L.
Published: December 2004

ABSTRACT: Following a change from earstick to fingerstick hemoglobin estimations, donor deferrals increased from 8.8% to 13.6%. Coincident with the change to fingersticks, hematocrit measurement with miniature centrifuges was begun as the reference method to verify donor rejection by the copper sulfate test. A study of 525 donors deferred for fingerstick hematocrits showed that 46.7% were deferred inappropriately as determined by venous hematocrit measurements. The difference between fingerstick and venous hematocrits persisted even after an intensive staff inservice on technique. In further studies, no significant difference was found between venous and fingerstick hematocrits measured on the same centrifuge, but there was a significant difference between measurements on the miniature centrifuges versus a standard laboratory microhematocrit centrifuge. This small error resulted in the loss of 3.8% of presenting donors during the study period. Hematocrit measurements have now been replaced by a fingerstick cyanmethemoglobin method.