bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo studies of the long‐term 51Cr red cell survival of serologically incompatible red cell units
Authors: Baldwin M. L. , Ness P. M. , Barrasso C. , Kickler T. S. , Drew H. , Tsan M‐F , Shirey R. S.
Published: March 2003

The long‐term survival of serologically incompatible red cell units was measured in five patients with antibodies to high‐frequency antigens. Initially, the survival of 1 ml of 51Cr‐labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1‐hour survival times were successful (greater than 70%), each patient then received 5 ml of the same 51Cr‐labeled red cells followed by the transfusion of the remainder of the red cell unit. The long‐term T ½ Cr survival for each case was patient 1 (anti‐McCa), 15 days; patient 2 (anti‐JMH), 12 days; patient 3 (anti‐Kna), 31 days; patient 4 (anti‐McCa), 12 days; and patient 5 (anti‐Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti‐JMH was the only antibody to react with IgG subclass antisera and was determined to be IgG4. The macrophage assay, IgG subclass testing, and short‐term (1 hour, 1 ml) 51Cr survival studies all indicated that the short‐term survival was good. However, only the measurement of long‐ term survival with transfused units of serologically incompatible red cells was able to determine the actual survival, and “clinical significance” of the alloantibodies. Determining the actual long‐term survival by the method described here can be of importance for patients requiring chronic red cell transfusion.
Survival of Er(a+) red cells in a patient with allo‐anti‐Era
Authors: Thompson Hannis W. , Polesky Herbert F. , Skradski Kathleen , Thoreson Janis
Published: March 2003

51Chromium‐labeled Er(a+) red cells survived nearly normally (T1/2 of 21 days) in a patient with allo‐anti‐Era. Transfusion of Er(a+) blood was without significant reaction and did not affect the anti‐Era titer.
Factors that influence lymphocyte yields in lymphocytapheresis
Authors: Blanchette V. S. , McCombie N. E. , Rock G.
Published: March 2003

The recent use of lymphocytapheresis to treat immune‐mediated diseases such as rheumatoid arthritis prompted a study of factors that influence the cell composition of lymphocytapheresis concentrates. Following single cytapheresis procedures, using protocols recommended by manufacturers, lymphocyte yields were significantly higher with the model 2997 (IBM) and CS‐3000 (Fenwal) cell separators as compared to the model 30 (Haemonetics) separator (9.8 ± 1.1 and 7.1 ± 1.2 × 109 lymphocytes, respectively, versus 4.6 ± 1.1 × 109; p < 0.01). The lymphocyte concentrate obtained with the CS‐3000 separator contained the smallest number of monocytes (0.6 ± 0.4 × 109 versus 1.4 ± 1.6 and 1 ± 0.3 × 109 for the model 2997 and 30 cell separators, respectively). Platelet contamination of the lymphocyte concentrate was highest with the CS‐3000 (6.5 ± 2.4 × 1011, and erythrocyte contamination was highest when the model 30 was used (21 ± 3.0%). Studies using the model 2997 indicated that lymphocyte yields were significantly influenced by donor pre‐apheresis absolute lymphocyte counts, and for this cell separator by specific operating variables, such as channel centrifugation speed and positioning of the red cell interface during lymphocyte collection. Maximal yields were obtained when the channel centrifugation speed was 800 to 1000 rpm (equivalent to 100–150 × g) and the red cell interface was adjusted to yield a cell concentrate with a hematocrit less than 4 percent. These results suggest that it will be necessary to standardize lymphocytapheresis collection protocols in future studies to assess the role of lymphocytapheresis in the management of immune‐mediated diseases such as rheumatoid arthritis.
Predonation hematocrit measurement by whole blood electrical conductivity assay
Authors: Schifman R. B. , Rivers S. L. , Delduca M.
Published: March 2003

The whole blood electrical conductivity method for predonation hematocrit determinations was studied. Forty capillary and venous blood samples were tested concurrently with electrical conductivity and centrifugation methods. The electrical conductivity method demonstrated acceptable accuracy but was less precise than the spun microhematocrit technique. Results from capillary samples were uniformly less precise and significantly lower than determinations from venous specimens. This study and previous reports suggest that capillary hematocrit values by any method may not accurately reflect the blood donor's venous hematocrit level. Blood centers should independently validate their anemia screening methods to avoid unnecessary deferrals and protect the anemic donor.
The potentiation of “incomplete” mouse monoclonal anti‐Leaagglutination with colloids
Authors: Inglis G. , Fraser R. H. , Durosinmi M. A. , Allan E. K. , Mackie A. , Mitchell R.
Published: March 2003

Mouse monoclonal anti‐Leaproduced in this center was found to agglutinate only Le(a+) red cells which had been modified with proteases. In order to provide a stable medium in which the monoclonal anti‐Leawould directly agglutinate unmodified red cells, the potentiating effect of a variety of colloids was assessed. Satisfactory results were obtained when 10 percent (wt/vol) dextran and 2 percent (wt/vol) bovine serum albumin were added to the culture supernatant containing anti‐Lea. It is suggested that direct hemagglutination mediated by these colloids resulted from a combination of increased antibody uptake by Le(a+) red cells and change in the shape of these red cells induced by dextran.
Availability of the inner surface of the red cell membrane to antibodies in digitonin ghosts: Studies on D‐negative cells with anti‐D
Authors: Araszkiewicz P. , Fortier N. L. , Szymanski I. O.
Published: March 2003

Studies were done to determine whether antibodies can detect antigens on the inner red cell stromal membrane. When albumin, anti‐A, anti‐D, or IgG were combined with varying volumes of intact O, Rh‐negative red cells (RBCs), these proteins diluted, on the average, to 76 percent of the total volume, which was almost identical to the volume of the supernatant fluid (mean 77%). In contrast, when the protein markers were combined with packed stroma prepared from O, Rh‐negative RBCs by digitonin, they diluted, on the average, to 94 percent of the total reaction volume rather than to the volume of the supernatant (mean 70%). Similar dilution was observed in the fluid volume harvested from stromal suspensions by ultracentrifugation, indicating that the protein markers occupied the total fluid volume of the reaction mixture (inside and outside the stroma). Nonspecific adsorption of the protein markers to stroma did not occur since their dilution was unaffected by doubling the stromal volume and since they could be totally recovered in the fluid harvested by ultracentrifugation. These data indicate that antibodies easily traverse the membrane of RBC digitonin stroma but not the membrane of intact RBCs. Therefore, antibodies may be used to detect antigenic determinants on the inner stromal membrane. When anti‐ D was incubated with Rh‐negative stroma, we did not observe consumption of this antibody. Thus, our data did not indicate that the D antigen is present on the cytoplasmic membrane of Rh‐negative RBCs.
Management of patients with anti‐Cartwright (Yta)
Authors: Mohandas K. , Spivack M. , Delehanty C. L.
Published: March 2003

Five patients with anti‐Cartwright (Yta) in their serum were observed during a 14‐month period. One of the patients in whom a 51Cr‐labeled donor red cell survival study was done showed increased destruction of infused Yta‐positive red cells while three other patients tested showed a survival of greater than 85 percent at 1 hour. None of the antibodies potentiated interaction between sensitized red cells and heterologous activated mononuclear cells. The fifth patient received many transfusions of Yta‐positive red cells without any adverse reaction. Performance of a 1‐hour red cell survival with 51Cr‐labeled Yta‐ positive cells is recommended when time permits to determine whether patients with anti‐Yta can receive Yta‐positive red cells or, alternatively, whether they must receive Yta‐negative red cells. This approach not only is the safest for the patient, but allows conservation of Yta‐negative blood. Such an approach also should be used in patients with antibodies against other high‐incidence antigens.
Some quantitative aspects of the human monocyte erythrophagocytosis and rosette assays
Authors: Douglas R. , Rowthorne N. V. , Schneider J. V.
Published: March 2003

The sensitivity of peripheral blood mononuclear phagocytes (PBMPs) in the red cell (RBC) adherence and erythrophagocytosis assays were investigated using anti‐D of subclasses IgG1 and IgG3. Particular emphasis was placed on identifying variability between PBMP preparations from different healthy donors. About 500 molecules of IgG1 type anti‐D per RBC and about 100 molecules of IgG3 antibody per RBC were the lowest levels of sensitization which elicited a weak, positive test. Considerable variation between different preparations was seen, and it appeared that the capability of a PBMP preparation to react with weakly sensitized RBCs may not be closely related to its strength of reaction with strongly sensitized cells. PBMPs which were recovered after storage in liquid nitrogen were more reactive in both assays than freshly prepared PBMPs from the same donor. This study demonstrated the importance of weakly sensitized RBCs as part of the control system and indicated a need for caution when establishing a negative test result when the clinical significance of RBC antibody is being investigated.
Plasma separation using a hollow fiber membrane device
Authors: Buchholz D. H. , Lin A. , Snyder E. , McCullough J. , Porten J. , Anderson M. , Smith J. , Dalmasso A. , Helphingstine C. , Path M.
Published: March 2003

A disposable hollow fiber device was evaluated by collecting approximately 550 ml of normal donor plasma (n=43) and by performing sham (n=10) and therapeutic (n=12) plasma exchanges. Blood was processed at 70 ml per min, and plasma flux averaged 23 (collection) and 25 (exchange) ml per min (mean separation efficiencies of 52 and 60%, respectively). The procedures were tolerated well by all donors and patients. The plasma hemoglobin concentration in separated plasma averaged 1 mg per dl, and cell contamination was negligible (mean of 1, 3, and 6 RBCs, platelets and WBCs/μl, respectively). There was no evidence of in vivo classical or alternative pathway complement activation as assessed by total hemolytic complement generation (CH50), alternative pathway hemolytic activity (AP50), C3 conversion, or C5 activation, nor were unexpected changes seen in the results of laboratory tests performed after the procedure. Sieving coefficients during sham plasma exchange averaged as follows: albumin, 1.03; IgM,1.0, IgG, 1.0; IgA, 0.98; factor V, 1.07; factor VII, 0.89; factor VIII, 1.05; and factor IX, 1.19. The device appears to be useful for separation of cell‐free plasma from blood during therapeutic plasma exchange procedures.
The efficacy of performing red cell elution studies in the pretransfusion testing of patients with positive direct antiglobulin tests
Authors: Stec N. , Shirey R. S. , Smith B. , Kickler T. S. , Ness P. M.
Published: March 2003

In order to evaluate the efficacy of performing red cell elutions in pretransfusion testing, the serologic records of 638 patients with positive direct antiglobulin tests (DAT) were reviewed. These patients were identified by routine antibody screening procedures that included an autologous control. DAT results on the red cells of these patients showed 279 with IgG and C3d sensitization, 319 with IgG alone, and 40 with C3d sensitization alone. Of 638 patients' red cell eluates, 401 demonstrated no reactivity, 154 demonstrated panagglutination, and 60 demonstrated passively acquired anti‐A, B. Only 23 of 638 patients had allo‐antibody sensitization of their red cells. Of the 23, 19 had serum antibody corresponding to the specificity of antibody detected in the eluate. Thus, only four of 638 (0.6%) eluates gave results unavailable by serum testing alone. This study indicates that routine eluate investigation provides little useful information in assuring compatibility. Serum antibody testing and careful review of the clinical and transfusion history constitute appropriate pretransfusion testing in patients with positive direct antiglobulin tests. Eluate testing should be restricted to cases in which immune hemolysis is suspected clinically.
Heterogeneity of the phenotype Jk(a—b—) found in Japanese
Authors: Okubo Y. , Yamaguchi H. , Nagao N. , Tomita T. , Seno T. , Tanaka M.
Published: March 2003

Fourteen Jk(a‐b‐) persons were detected by testing 638,460 Osaka blood donors with an automated 2 M urea technique. Two of these 14 Jk(a‐b‐) samples were quite different from the hitherto reported Jk(a‐b‐) phenotype, and a family study showed that the mode of the inheritance was dominant. The red cell membranes of these Jk(a‐b‐) samples were studied by polyacrylamide gel electrophoresis and unusual protein bands (apparent mw, 67,000 d) were detected.
A monoclonal anti‐C4d that demonstrates a specificity related to anti‐Ch
Authors: Giles C. M. , Ford D. S.
Published: March 2003

A monoclonal anti‐C4d reagent, L003, agglutinated untreated and trypsin‐treated C4A Rodgers(Rg)‐ and C4B Chido(Ch)‐coated red cells. Inhibition of the agglutination, regardless of the Rg/Ch phenotype of the C4 coat, showed Ch specificity, more precisely, for the Ch1 determinant. C4A allotypes that express Ch1 and Ch3 rather than Rg1 and Rg2, and C4B allotypes that express Rg1 rather than Ch1, Ch2, or Ch3 confirmed that the inhibition specificity in serologic tests was anti‐Ch1 and not anti‐C4B.
Hemolysis following intravenous immune globulin therapy
Authors: Copelan E. A. , Strohm P. L. , Kennedy M. S. , Tutschka P. J.
Published: March 2003

Two patients who had hemolysis after receiving large doses of intravenous immune serum globulin are reported. Both patients had positive direct antiglobulin tests due to alloantibodies contained in the immune serum globulin. Markedly increased red cell transfusion requirements and elevated serum bilirubin levels provided evidence of hemolysis.
Experience with donors matched for minor blood group antigens in patients with sickle cell anemia who are receiving chronic transfusion therapy
Authors: Ambruso D.R. , Githens J.H. , Alcorn R. , Dixon D.J. , Brown L.J. , Vaughn W.M. , Hays T.
Published: March 2003

Clinically significant alloimmunization to red cell antigens occurred in 28 percent of transfused patients in a sickle cell clinic. Therefore, a prospective study was undertaken to determine whether matching donors carefully for 17 blood group antigens would diminish the risk of further alloimmunization in patients on a chronic transfusion program. Alloantibodies had developed previously in 8 of the 12 patients. After chronic transfusion with selected donors, four new antibodies developed in three patients. Three antibodies were due to errors in phenotyping or matching, and one was due to an antigen that was not tested for in the protocol. The incidence of developing antibodies per unit transfused was diminished tenfold when selected donors were used. Autoantibodies developed in five patients (42%), but these did not seriously interfere with the transfusion therapy. It was concluded that matching for red cell antigens may diminish the incidence of alloimmunization in patients with sickle cell anemia requiring transfusion.
A technique to reduce lymphocyte contamination of plateletapheresis products collected with a centrifugal blood cell separator
Authors: Cullis H. M. , Pearson T. H. , Mintz P. D.
Published: March 2003

It is desirable to minimize the contamination of plateletapheresis products by lymphocytes because of the role these cells may play in febrile nonhemolytic transfusion reactions, alloimmunization, platelet deterioration during storage and also to reduce donor lymphocyte loss. This study attempted to determine whether lymphocyte contamination could be reduced by rapidly depleting plasma from the separation chamber at selected intervals during plateletapheresis with a blood cell separator (CS‐3000, Fenwal). Donors who provided platelet components with more than 0.10 × 10(9) lymphocytes without rapid depletion underwent a second plateletapheresis procedure in which the rapid depletion technique was used. The plasma pump was reprogrammed to remove rapidly 12 ml of plasma from the separation chamber (pump speed 48 ml/min) immediately after the plasma pump reversal. All other collection techniques were identical for all procedures. Significantly fewer lymphocytes were collected in those procedures in which rapid depletion was used (mean, 0.187 × 10(9] than when it was not used (mean, 0.331 × 10(9] (p = 0.001, n = 30). There was no effect on platelet yield, efficiency of platelet collection, processing time, or total collection time. This procedure provides a product that should be considered for routine use.
Viscosity of mixtures of sickle and normal red cells at varying hematocrit levels
Authors: Schmalzer E. A. , Lee J.O. , Brown A.K. , Usami S. , Chien S.
Published: March 2003

Viscosity (eta) in a blood suspension is affected by the total hematocrit (HT) as well as by the deformability of the cells. The impact of these combined factors on the rheologic behavior of sickle cell suspensions and on guidelines for transfusion has not been explored fully. Therefore, the eta of mixtures of washed normal (AA) and sickle (SS) red cells was determined in a rotational viscosimeter as a function of the hematocrit level of SS cells (HS), HT, oxygen tension (PO2), and shear rate. The ratio HT:eta can be taken as an index of potential oxygen delivery. The optimal HT (for maximum HT:eta) became progressively higher as the HS or the HS:HT ratio was lowered: at a given HT, HT:eta rose with a decrease in HS, especially at low HS values. These data support the concept that simple transfusion alone is not as beneficial to the patient as exchange transfusion and that substantial benefit can be obtained by bringing the patient to very low HS levels. The finding that eta rose with HT more steeply when the HS:HT ratio rather than HS was held constant suggested that the absolute level of HS may be more useful than the HS:HT ratio as a guide for a transfusion regimen.
Studies on the blood of a Co (a‐b‐) proposita and her family
Authors: Lacey P. A. , Robinson J. , Collins M. L. , Bailey D. G. , Evans C. C. , Moulds J. J. , Daniels G. L.
Published: March 2003

The serum of a pregnant woman whose red cells typed as Co(a‐b‐) contained an alloantibody that, at the time of the infants delivery, was hemolytic in vitro and had a titer of 32,000 by the antiglobulin test. This antibody, which reacted with cells of all Colton‐phenotypes except the proposita's own cells, showed very weak reactions with other Co(a‐b‐) cells and therefore cannot be called anti‐Co3. The red cells of the proposita may carry a very weak Co3 antigen. No other persons of the Co(a‐b‐) phenotype were found in her members, among three of the four generations tested, suggested that an inhibitor gene may be responsible for the unusual Colton phenotypes in this family. The proposita's infant required one exchange transfusion with red cells obtained from the proposita. Red cells from 40,000 donors reacted with the serum of the proposita.
Human red cell antigens
Authors: Telen M. J. , Bolk T. A.
Published: March 2003

The minor red cell sialoglycoproteins‐beta and gamma (also known as glycophorin C)–are believed to be important to the structural integrity of red cells. The absence of sialoglycoproteins alpha and delta, as seen in En(a‐) and S‐s‐U‐ cells, respectively, results in cells with normal morphology, but the absence of sialoglycoproteins beta and gamma is associated with elliptocytosis. However, cells that lack Gerbich (Ge) antigens but have an abnormal sialoglycoprotein reactive with antibodies to beta have normal morphology. The authors used a monoclonal antibody specific for beta to explore the nature of this abnormal sialoglycoprotein and its interactions with other membrane proteins. The beta‐like sialoglycoprotein of Ge‐Yus‐ red cells appears to react poorly with some antibodies due to steric hindrance by other molecules of sites normally available to immune agglutinins. This steric hindrance is not due to a single interaction with either sialoglycoprotein alpha or delta or band 3. Furthermore, steric hindrance by other molecules does not account for the lack of Ge antigens on these cells.
Anti‐Ata causing mild hemolytic disease of the newborn
Authors: Culver P.L. , Brubaker D.B. , Sheldon R.E. , Martin M. , Richter C.A.
Published: March 2003

We report here a case of moderately severe hemolytic disease of the newborn (HDN) due to anti‐Ata. The gravida 5 proposita was group A rr and previously was found to have anti‐Ata and ‐D. At the 35‐week mark of this pregnancy, her anti‐Ata demonstrated a titer of 256, score 79. Fluid obtained by amniocentesis at 36 weeks showed an optical density at 450 nm of 0.08 (midzone). The baby was delivered at 38 weeks by cesarean section. The cord cells were group A rr with a 3+ direct antiglobulin test. The dichloromethane eluate of the infant's cells demonstrated anti‐Ata specificity only. At birth, the infant's total bilirubin (TB) was 2.1 mg per dl and the hematocrit level (Hct) was 33.8 percent. Within 8 hours, the TB had risen to 3.8 mg per dl. Phototherapy was initiated at 7‐1/2 hours and maintained for 40 hours. The infant's TB rose to a maximum level of 10.5 mg per dl 24 hours after phototherapy was discontinued. At discharge 4 days postpartum, the infant's TB had dropped to 9.2 mg per dl, and the Hct value was 38 percent. On a visit 7 days postpartum, the infant's TB level had fallen to 6.5 mg per dl and the hct value was 38 percent. Transfusions were not necessary.
A rapid method for harvesting autologous red cells from patients with hemoglobin S disease
Authors: Brown D.J.
Published: March 2003

Red cells from patients with sickle cell disease (HbSS and HbSC) are more resistant to lysis in hypotonic NaCl solutions than normal (HbAA) red cells. Taking advantage of this inherent resistance to osmotic stress, patient red cells (HbSS or HbSC) were rapidly isolated from donor red cells (HbAA or HbAS) by washing with hypotonic (0.3%) NaCl. The hypotonic method of washing provides a previously unavailable means for obtaining autologous HbSS or HbSC red cells from samples containing transfused donor red cells. Once isolated, these red cells can be used for phenotyping, autoadsorption, or evaluation of positive direct antiglobulin tests.
Hypergammaglobulinemia can be associated with a positive direct antiglobulin test, a nonreactive eluate, and no evidence of hemolysis
Authors: Heddle N.M. , Kelton J.G. , Turchyn K.L. , Ali M.A.
Published: March 2003

To determine the cause of a positive direct antiglobulin test (DAT), blood banks routinely perform serologic tests on eluates prepared from DAT‐positive red cells. Negative eluates traditionally have been suspected to be associated with drug reactions. This report confirms that the most frequent cause of a positive DAT and a nonreactive eluate is hypergammaglobulinemia. The results of 74 patient samples with positive DATs were analyzed retrospectively. Eluates prepared from the red cells of 54 patients (72.9%) reacted; eluates from 20 patients (27.1%) did not react. This latter group had identical serologic and clinical findings, suggesting that they made up a homogeneous group. In particular, the patients had a positive DAT, a negative indirect antiglobulin test, and a negative eluate; an increased serum concentration of IgG; and no evidence of hemolysis. In a subsequent study, DATs were performed prospectively on red cells from 44 consecutive patients with elevated serum IgG levels. The serum IgG concentration was highest in the three patients whose red cells had a positive DAT. The DAT also became positive in two patients treated with high‐dose intravenous gammaglobulin (IV IgG). These studies indicate that a negative eluate from red cells with a positive DAT, a common serologic finding, is often caused by hypergammaglobulinemia. The authors postulate that IgG binds nonspecifically to the red cells because of the hypergammaglobulinemia.
The value of 10‐minute posttransfusion platelet counts
Authors: O'Connell B. , Lee E.J. , Schiffer C.A.
Published: March 2003

Monitoring of platelet counts 1 hour after transfusion has become standard practice in most centers. In this study, platelet counts obtained 10 and 60 minutes after 48 platelet transfusions were compared. There was a close, linear relationship (r = 0.98) between these values over a wide range of posttransfusion counts, indicating rapid equilibration of transfused platelets. Ten‐minute posttransfusion samples are easier to obtain and are convenient for both patients and medical staff.
Platelet membrane glycoprotein changes during the preparation and storage of platelet concentrates
Authors: George J.N. , Pickett E.B. , Heinz R.
Published: March 2003

Previous studies of platelet membrane glycoproteins during blood bank storage have reported conflicting results. This study assessed two major plasma membrane glycoproteins (GP Ib and GP IIb), an alpha‐ granule membrane protein (GMP‐140), and the concentration of platelet membrane microparticles in cell‐free plasma during routine hospital blood bank platelet storage. 125I‐monoclonal antibody binding was used to measure membrane glycoproteins on the surface of intact platelets and to measure the concentration of membrane microparticles in cell‐ free plasma. Platelet concentrates were stored at room temperature in polyolefin bags for 7 days. In this blood bank, two types of rotators are routinely used for platelet concentrate storage: a 2‐rpm circular tumbler rotator and a 6‐rpm elliptical rotator. Different results were obtained with the rotators. With the tumbler rotator, there was no loss of platelets and antibody binding to GP Ib remained normal. With the elliptical rotator, one third of platelets were lost into clumps during storage, and a 50 percent decrease of antibody binding to GP Ib occurred in the remaining single platelets. There was no loss of antibody binding to GP IIb with either rotator. Antibody binding to GMP‐ 140 increased equally in both rotators indicating that the remaining single platelets had secreted about 16 percent of their alpha‐granule contents. The plasma concentration of platelet membrane microparticles was greater in the bags stored in the elliptical rotator. These results indicate that it is possible to maintain the normal concentration of platelet membrane glycoproteins Ib and IIb during 7 days of room‐ temperature blood bank storage.(ABSTRACT TRUNCATED AT 250 WORDS)
Loss of red cell alloantibodies over time
Authors: Ramsey G. , Larson P.
Published: March 2003

The loss of red cell alloantibodies over time was analyzed in 160 patients with 209 antibodies retested 1 to 60 months after initial identification. The mean follow‐up consisted of 3.6 specimens taken over 18 months. Twenty‐nine percent of clinically significant and 72 percent of clinically insignificant antibodies were not detected on at least one follow‐up screening. Anti‐Jka and anti‐C were lost in 59 and 45 percent of cases, respectively. No significant differences in overall antibody loss were found according to sex, diagnosis, or the presence of multiple antibodies. Patients under 20 years of age may be more likely to lose significant antibodies. Pretransfusion review of previous records is vital for the prevention of delayed hemolytic transfusion reactions, because of the high number of clinically significant antibodies that are undetected in subsequent routine screening.
An antiserum identifying a red cell determinant expressed by Rh:33 and by some “new” depressed Rh phenotypes
Authors: Bizot M. , Lomas C. , Rubio F. , Tippett P.
Published: March 2003

An antibody detecting a determinant on Rh:33 cells and cells with depressed C and/or e antigens was separated by the absorption and elution technique from a serum with antibodies to several low‐frequency antigens. The determinant, tentatively named FPTT, has a frequency of about 0.0094 percent in the South of France.
The Colton blood group locus
Authors: Zelinski T. , Kaita H. , Lewis M. , Coghlan G. , Philipps S. , Belcher E. , McAlpine P. J. , Coopland G. , Wong P.
Published: March 2003

Accumulated family information was compiled in an attempt to verify the chromosomal location of the Colton blood group locus (CO). Two‐point linkage analysis of CO and 46 other polymorphic loci excludes CO from 1p36 to 1q23, 3q21 to 3q26, 4q13 to 4q28, 6p24 to 6 cen, and 19p13.2 to 19 cen and from linkage groups bounded by ABO and ORM, PI and IGHG, and HP and GOT2. The dwindling odds of linkage between CO:JK are reinforced (z =−5.28 at theta = 0.20). Close linkage of CO with ACP1 and D2S5 could not be demonstrated. The proposed chromosome 2 location of CO is therefore questioned.
Virus‐inactivated factor VIII concentrate prevents postoperative bleeding in a patient with von Willebrand's disease
Authors: Furlan M. , Lammle B. , Aeberhard A. , Kirste E. , Sulzer I.
Published: March 2003

A patient with von Willebrand's disease underwent cholecystectomy after replacement therapy with a factor VIII concentrate that had been sterilized by treatment with tri(n‐butyl)phosphate and Tween 80. The patient received 53 units of factor VIII per kg of body weight prior to operation. In addition, a total of 280 units of factor VIII per kg was infused within 10 days after operation. This replacement regimen prevented excessive bleeding during surgery and supported normal hemostasis during the postoperative period. Analysis of the multimeric pattern and the functional assay of von Willebrand factor in factor VIII concentrates indicated that the procedures utilized for virus inactivation had no significant deleterious effect upon the quality of von Willebrand factor molecules.
Quantitation of red cell‐bound immunoglobulin and complement using enzyme‐linked antiglobulin consumption assay
Authors: Kiruba R. , Han P.
Published: March 2003

Various techniques have been described for quantitating IgG or complement (C3) on red cells (RBCs). The techniques either are cumbersome, as the complement consumption test, or use radioactivity. This paper describes an antiglobulin consumption assay using an enzyme‐ linked immunosorbent method that can be used to quantitate IgG, IgM, and C3. With this technique RBCs from normal, healthy donors gave a mean value of 106 ± 60 molecules of IgG per RBC, 4.5 ± 3 molecules of IgM per RBC, and 37 ± 28 molecules of C3 per RBC, respectively. The RBCs of hospital patients, particularly of those with infections or inflammatory conditions, contain increased amounts of nonspecifically bound immunoproteins. The availability of a common method to quantitate RBC‐associated IgG, IgM, and C3 allows easy monitoring or study of the immune mechanism of autoimmune hemolytic anemia.
Semiautomated processing of bone marrow grafts for transplantation
Authors: English D. , Lamberson R. , Graves V. , Akard L. P. , McCarthy L. J. , Jansen J.
Published: March 2003

This report describes experience with a technique for the isolation of mononuclear cells from large quantities of human bone marrow using a blood cell processor. The procedure includes the separation of the bone marrow aspirates by concentrating and collecting interface buffy coat cells. A mononuclear white cell‐enriched fraction is then obtained with ficoll‐hypaque in the blood cell processor. Finally, the bone marrow white cells are washed to remove the ficoll‐hypaque and the contaminating plasma. The entire procedure is carried out in a closed system. The automated method of isolating mononuclear cells proved superior to the manual method in both the recovery of cells and the time needed to process the marrow. Also, the risk of microbial contamination is substantially reduced. When marrow white cells processed by this method and cryopreserved were transfused subsequently into patients who had previously undergone high‐dose chemotherapy and radiotherapy, engraftment, as indicated by a rise in the absolute granulocyte count of >1000 per mm3, occurred within 20 days. This semiautomated technique provides a convenient, rapid, and reliable method for processing and preparing large numbers of viable marrow cells.
Factors in the liquid portion of stored blood inhibit the proliferative response in mixed lymphocyte cultures
Authors: Vliet W. C. , Dock N. L. , Davey F. R.
Published: March 2003

The transfusion of blood may suppress the immune responses of patients with renal transplants and with malignant disorders. To study the in vitro suppressive effects of banked blood, 4 units of blood were stored in CPDA‐1 and ADSOL at 4°C for 14 days. Lymphocytes and plasma or ADSOL supernatants were harvested on Days 0, 4, 7, 10, and 14. Subpopulations of lymphocytes were enumerated by flow cytometry. Recalcified and heat‐treated plasma and supernatants from the units of blood were added to mixed lymphocyte cultures (MLC) composed of cells from normal individuals. No significant changes were noted in the proportions of T or B cells from blood stored under these conditions. A 60 ± 3 percent inhibition in the proliferative response was observed when plasma from CPDA‐1 units was added to MLCs (p < 0.02). Supernatants from ADSOL units demonstrated a 29 ± 4 percent inhibition (p < 0.10) of the proliferative response, and this inhibition of response was observed on all 14 days of the study. When appropriate concentrations of dextrose or adenine were added to other MLCs, adenine (at the concentration found in ADSOL) caused a significant inhibition of the proliferative response. This inhibition was not, however, as marked as that observed with recalcified, heat‐treated plasma from CPDA‐1 units. We conclude that adenine plus some additional factor(s) found in the liquid portion of stored blood inhibits the proliferative response of normal lymphocytes. It is possible that these factors contribute to the immune suppression observed in vivo in some patients who receive blood transfusions.
Prevention of transmission of human T‐lymphotropic virus type 1 (HTLV‐1) through transfusion, by donor screening with antibody to the virus One‐year experience
Authors: Inaba S. , Sato H. , Okochi K. , Fukada K. , Takakura F. , Tokunaga K. , Kiyokawa H. , Maeda Y.
Published: March 2003

To prevent the transmission of human T‐lymphotropic virus, type 1 (HTLV‐1) during blood transfusion, a program was implemented to screen donors for antibodies to the virus, using a newly developed, passive agglutination (PA) method. During the period April 1986 to March 1987, 675 recipients of donor blood in whom the antibody to HTLV‐1 was not present before transfusion were followed for at least 50 days after transfusion. One of these 675 seroconverted despite the transfusion of screened blood, but this seroconversion rate (0.15%) represents a marked decrease from the rate of 8.3 percent prevalent before donor screening began. The rate in the Fukuoka area of donors seropositive for anti‐HTLV‐1 is 5.34 percent, as detected by the PA method and 1.80 percent, as assessed by the indirect immunofluorescence (IF) technique, with PA‐positive but IF‐negative blood units thus accounting for 3.5 percent (5.34–1.80) of the total blood donated. The seroconversion rate among recipients transfused with blood screened by IF (at Kyushu University Hospital only) from 1981 to 1985 was 0.41 percent, which was not significantly different from the rate of 0.15 percent observed after PA screening. The discrepancy between PA and IF in the rate of seropositivity was due, in part, to the higher sensitivity of PA in detecting anti‐HTLV‐1. It is proposed that all donor blood in areas where HTLV‐1 is endemic be screened by PA before transfusion. For reasons of expense and equipment unavailability, it is not possible for IF to be used on a general basis, but because of the possibility of false‐positive results with PA, PA‐positive blood units should be reexamined by IF or Western blot testing to reduce the amount of wasted blood, especially in areas highly endemic for HTLV‐1, such as Kyushu, Japan.
Blood and component wastage report
Authors: Clark J. A. , Ayoub M. M.
Published: March 2003

The transfusion service of a regional referral medical center issues a monthly blood and component wastage report to the Hospital Transfusion Committee. The report includes the amount and type of units wasted, who is responsible, and the cost incurred by the wastage. The individuals responsible for wastage include physicians, nurses, and laboratory personnel. Physicians are responsible for most wastage, principally by failing to administer thawed or pooled blood products. The Hospital Transfusion Committee initiated a wastage‐reduction program that included a letter to physicians indicating the patient's name and the type of blood and/or components that the addressed physicians was responsible for wasting. Simple corrective actions resulted in a 73 percent reduction in our blood and component wastage. Monitoring of blood and component wastage should be a routine quality assurance function of the Hospital Transfusion Committee.
Red cell antibody problems in 1000 liver transplants
Authors: Ramsey G. , Cornell F. W. , Hahn L. F. , Larson P. , Issitt L. B. , Starzl T. E.
Published: March 2003

Liver transplant patients frequently require large amounts of blood. The frequency and nature of their red cell (RBC) antibody problems were examined. Records were reviewed in 496 adults and 286 children undergoing 1000 consecutive transplants. Twenty‐two percent of adults and 14 percent of children had RBC alloantibodies. Antibodies of potential clinical significance were found before transplant in 6.3 percent of adults and 1.0 percent of children; despite immunosuppression, they appeared 1 to 5 weeks after transplant in an additional 7.5 and 5.2 percent respectively. These antibodies probably represented secondary immune responses. Of 58 transplant patients with prior potentially significant antibodies, 8 required 7 to 110 units of antigen‐untyped blood after 8 to 28 units of antigen‐negative blood; of these patients, one had subsequent hemolysis. Positive direct antiglobulin tests in 24 percent of adults and 10 percent of children were most often thought to be due to nonspecific adsorption of IgG. Anti‐recipient ABO antibodies developed in 22 of 60 (37%) evaluable ABO‐unmatched grafts; 13 cases had associated hemolysis. In all, 36 percent of adults and 20 percent of children had diverse RBC antibody problems. Resolution of these problems is an important part of the laboratory support necessary for a liver transplantation program.
The prevalence of immunization to Duffy antigens in a population of known racial distribution
Authors: SoslerMS S. D. , Perkins J. T. , Fong K. , Saporito C.
Published: March 2003

A retrospective study at our hospital determined the race or ethnicity of patients seen in an 8‐year period who had formed antibodies to Duffy antigens. During that time, 9876 serologic investigations had been performed as a result of a positive direct or indirect antiglobulin test. Among these samples, sera from 45 previously transfused or pregnant patients contained anti‐Fya and two contained anti‐Fy3. Twenty‐nine of the sera that contained anti‐Fya (62%) were from blacks, 12 (25%) were from whites, and 6 (13%) were from Hispanics. Both examples of anti‐Fy3 were made by black patients. Red cells (RBCs) from 21 of the black patients were Fy(a−b−), those from 7 were Fy(a−b+), and those from 1 could not be phenotyped. RBCs from 17 of the non‐black patients were Fy(a−b+) and those from 1 could not be phenotyped. The population of transfused patients evaluated in this study was 47 percent black, 29 percent white, and 24 percent Hispanic. Calculations based on an expected Fy(a−) frequency of 88 percent in blacks, 33 percent in whites, and 20 percent in Hispanics predict that the racial makeup of the Fy(a−) population at our hospital would be 73 percent black, 18 percent white, and 9 percent Hispanic, which is not significantly different (p = 0.25) from the racial makeup of the patients forming anti‐Fya and ‐Fy3. These data indicate that blacks make antibodies to Duffy antigens as frequently as non‐blacks.
Immune hemolytic anemia associated with tolmetin and suprofen
Authors: van Dijk B. A. , Rico P. Barrera , Hoitsma A. , Kunst V. A. J. M.
Published: March 2003

This article reports the first case of immune hemolytic anemia possibly associated with the ingestion of suprofen. The patient suffered from massive hemoglobinuria and acute renal failure. Serologic studies of the patient's serum revealed suprofen‐dependent red cell antibodies. However, tolmetin‐dependent antibodies were also found in the serum, showing the same properties as the suprofen antibodies and an even higher titer. The patient not only had drug‐dependent antibodies in the serum, but also had developed autoantibodies, a phenomenon that has been described for several other drugs. The working mechanism by which suprofen and tolmetin caused immune hemolysis had properties of both the immune complex model and the induction of autoimmunity. Although it was unclear whether the immune hemolytic anemia was the result of suprofen, tolmetin, or cross‐reacting antibodies, we feel that suprofen should be added to the list of nonsteroidal anti‐inflammatory drugs associated with a positive direct antiglobulin test.
A serologic study of red cells and sera from 18 Rh:32,‐46 (RN/RN) persons
Authors: le Pennec P.Y. , Rouger P. , Klein M.T. , Kornprobst M. , Brossard Y. , Boizard B. , Salmon C.
Published: March 2003

The red cells (RBCs) and sera from 18 RN/RN persons were studied. The study confirmed the Rh type D+C+E‐c‐e+Cw‐, which is characterized by an increased expression of the D antigen; a markedly decreased expression of the C and e antigens; the presence of a low‐incidence antigen, Rh32; and the absence of a high‐incidence antigen, Rh46, which is associated with an epitope recognized by a murine monoclonal antibody (MR432). Other Rh antigens of low and high incidence were investigated, and the presence of Rh17 and Rh44 on the RBCs was confirmed. Three persons exposed to Rh:46 cells by pregnancy or transfusion (or both) had anti‐Rh46. This antibody gave positive reactions with all RBCs of common and rare Rh phenotype except Rhnull, and those of D–, D ṁ ṁ, DCw‐, and RN homozygotes. This antibody is considered to be of clinical significance in case of transfusion or pregnancy.
Group A variants defined with a monoclonal anti‐A reagent
Authors: Lau P. , Sererat S. , Beatty J. , Oilschlager R. , Kini J.
Published: March 2003

Unusual serologic findings mimicking the B(A) phenomenon were noted in two group B blood donors using blended murine monoclonal anti‐A reagent. With additional studies, including a binding experiment using affinity chromatography, the presence of aberrant group A activities was confirmed. This observation suggests that persons with atypical B(A) phenotype may warrant further investigation to delineate the ABO blood group.
Murine monoclonal antibody MB‐2D10 recognizes Rh‐related glycoproteins in the human red cell membrane
Authors: Mallinson G. , Anstee D.J. , Avent N.D. , Ridgwell K. , Tanner M.J.A. , Daniels G.L. , Tippett P. , von dem Borne A.E.G.
Published: March 2003

The human red cell membrane components reacting with monoclonal antibody MB‐2D10 were examined by immunoblotting. The antibody bound to a diffusely staining band extending from M, 30,000 up to the high‐molecular‐weight region of the gel in normal membranes and in Rhnull U+ membranes, but not in Rhnull U‐ membranes. Treatment of normal red cells with an endoglycosidase F‐containing preparation destroyed the epitope recognized by MB‐2D10. The reactivity of the antibody with purified preparations of Rh‐related glycoproteins D30 polypeptide, D50 polypeptide, R6A32 polypeptide, and R6A45 polypeptide was also examined. Only the purified R6A45 and D50 components reacted with MB‐2D10. These results show that MB‐2D10 recognizes a carbohydrate‐dependent epitope on the R6A45 and D50 group of Rh‐related polypeptides. The results also suggest the possibility that the U antigen arises from interaction between glycophorin B and the Rh‐related components D50 and R6A45.
Donation reactions among autologous donors
Authors: McVay P.A. , Andrews A. , Kaplan E.B. , Black D.B. , Stehling L.C. , Strauss R.G. , Toy P.T.C.Y.
Published: March 2003

Studies of risk factors associated with reactions among autologous blood donors have been limited. Therefore, 2091 autologous and 4737 homologous donations were examined. Donors at greatest risk for reaction were autologous donors who had reactions at first donation; among 45 who made repeat donations for the same surgery, 17 (38%) had repeat reactions. The group least likely to experience reactions were the autologous donors ≥66 years old; they experienced a 1.9≥ percent (6/310) incidence of reactions. More reactions were seen in both autologous and homologous donors in the categories of first‐time donor, female gender, decreasing age, and lower weight. Multiple logistic regression analysis showed that all of these variables were independent predictors of donor reaction, with first‐time donation (odds ratio, 2.4) and female gender (odds ratio, 1.9) being the strongest predictors of reaction. Donor room personnel should be alerted that autologous donors who react at first donation are very likely to react at subsequent donations. Contrary to common concern, elderly autologous donors are least likely to have reactions.
Red cell autoantibodies, multiple immunoglobulin classes, and autoimmune hemolysis
Authors: Sokol R. J. , Hewitt S. , Booker D. J. , Bailey A.
Published: March 2003

The effects and interrelationships of multiple immunoglobulin coating (i.e., increased red cell [RBC]‐bound IgM and/or IgA in addition to IgG) were investigated in 404 patients with warm‐reactive RBC autoantibodies on 590 occasions. Multiple immunoglobulins were detected by enzyme‐linked direct antiglobulin tests in 218 samples (37%), but in only 87 (15%) by agglutination methods. Differences in populations were examined by chi‐square, with p less than 0.005 being required for significance because of the multiple tests. Compared with IgG coating alone, multiple immunoglobulins were significantly associated with larger quantities (greater than 800 molecules/RBC) of IgG, multiple IgG subclasses, IgG3 and C3d bound to the cells, and with serum haptoglobin levels of less than 0.1 g per L. The latter association was still significant when higher levels of RBC‐bound IgG and subclass pattern were taken into account. In samples with multiple immunoglobulin coating, there was no significant relationship (p greater than 0.05) between haptoglobins of less than 0.1 g per L and either C3d or multiple IgG subclasses. It was concluded that multiple immunoglobulin coating, even when undetected by agglutination methods, is a major cause of hemolysis: it is part of a more generalized autoimmune response and acts with other factors such as the quantity of bound IgG, the IgG subclass pattern, and complement; it also has an important hemolytic effect in its own right.
HLA, GM, KM, and Diego blood group typing of Chippewa Indians
Authors: Lee T. D. , Zhao T. M. , Chow M. P. , Lee G.
Published: March 2003

This is the first report characterizing HLA antigen distribution in North American Indians of the Chippewa tribe. One hundred seventy‐four Chippewa from Minnesota underwent HLA‐A,B,C,DR, and DQ typing in a search for a single unrelated bone marrow donor. The high matching rate of this successful search is attributed to homozygosity and the extreme frequency of certain antigens in this small ethnic community. It is emphasized that smaller donor pools are required in searches within a minority population. GM and KM allotype typing as well as blood group Diego typing show patterns similar to those reported in other North American Indian groups.