bluuebunny/crossref_metadata_2025 huggingface dataset:
Membrane‐bound immunoglobulins and complement components on young and old red cells
Authors: Freedman J.
Published: March 2003

In order to characterize changes in membrane‐bound immunoglobulins and complement components, red cells (RBCs) were separated into young and old populations by simple centrifugation. Old RBCs had reduced mean corpuscular hemoglobin volume, increased mean corpuscular hemoglobin concentration, and reduced sialic acid. Using radioactive anti‐ antiglobulin techniques, old RBCs were shown to have more IgG, IgM, IgA, and C3d on their surfaces than did young RBCs; there was no increase on old RBCs of C3b, factor B, C4b, or C5. Similar results were observed with RBCs strongly coated with C3d in vivo from a patient with cold agglutinin disease. RBCs taken into ethylenediamine tetraacetate, washed thoroughly in saline, and then stored for prolonged periods in Alsever's solution or kept in autologous ethylenediamine tetraacetate plasma, at 4 degrees C, showed no increase in RBC‐bound C3d with increased storage time. If, however, blood was taken into citrate‐ phosphate‐dextrose and maintained at 4 degrees C in autologous plasma, a significant increase in RBC‐bound C3d was observed in the mixed‐cell population with prolonged storage time. Order donor blood units, taken into citrate‐phosphate‐dextrose and stored at 4 degrees C as packed red cells, showed higher levels of RBC‐bound C3d in the mixed‐cell population than did units stored for a shorter time. In no case did donor unit RBCs give a positive direct antiglobulin test on serologic testing with anti‐C3d. The findings complement data already collected on membrane and cytoplasmic changes in aging RBCs and may contribute to an understanding of RBC senescence.
Granulocyte concentrates
Authors: Glasser L. , Fiederlein R. L. , Huestis D. W.
Published: March 2003

Neutrophil metabolism is dependent on the available stores of either exogenous or endogenous glucose. We studied 38 granulocyte concentrates collected by four different centrifugal cytapheresis systems: Haemonetics model 30, IBM 2997, Fenwal CS‐3000, and Fenwal Celltrifuge II. Extracellular glucose concentrations were measured immediately following collection and after 24 hours of storage. The Fenwal CS‐3000 produced the highest concentrations of platelets and leukocytes, and the units had the lowest initial glucose levels and pH. After 24 hours of storage, there was a mean glucose of 1.7 mg per dl in the Fenwal CS‐ 3000 granulocyte concentrates and 9 of 12 units had no detectable glucose. In contrast, concentrates collected from other systems had sufficient glucose available to support neutrophil metabolism for a longer period.
Automated detection of red cell antibodies in donor sera using an automated technology
Authors: Theuriere M. , Zelenski K. R. , Moore V. K. , Logulo A. C.
Published: March 2003

The evaluation of two automated (AutoGrouper‐16C) antibody detection techniques, designed for routine use is reported. Three channels on the instrument were modified for low‐ionic‐strength or enzyme methods. The incidence of antibody detection was 90.5 percent, and all antibodies that were not detected had titers of 4 or less and would be unlikely to cause adverse clinical reactions if transfused. The adaptation of this automated instrument for donor antibody screening resulted in substantial time and cost savings.
NBTS/BRIC 8
Authors: Holt P. D. J. , Donaldson C. , Judson P. A. , Johnson P. , Parsons S. F. , Anstee D. J.
Published: March 2003

A stable mouse hybridoma line secreting monoclonal anti‐C3d antibody (NBTS/BRIC 8) was produced. Ascitic fluid containing BRIC 8 can be used at a final dilution of 1 to 5000 to provide an excellent antiglobulin reagent when mixed with a conventional polyclonal rabbit anti‐human IgG serum.
Mitogen responses and T4/T8 ratios in asymptomatic hemophiliac patients
Authors: Snyder A. J. , Zeevi A. , Duquesnoy R. J. , Gill J. C.
Published: March 2003

Lymphocyte responses to mitogen stimulation were studied in healthy hemophiliac patients. To study kinetics and dose response, three different concentrations of the mitogens phytohemagglutinin (PHA) and pokeweed mitogen (PWM) were used, and proliferation was measured on each of 6 days. Patients with T4/T8 ratios of less than 1.00 showed decreased proliferation compared to normal controls and to hemophiliac patients with ratios greater than 1.00. These findings were more pronounced with PWM than with PHA. Over the range of concentrations tested, patients and controls showed similar dose responses to PHA; no dose responses to PWM were demonstrable. There were no significant differences among the patient and control groups in kinetics of response to either mitogen. Interleukin‐II (IL‐2) activity produced in response to PHA stimulation also was studied. Hemophiliac patients with T4/T8 ratios less than 1.00 showed decreased IL‐2 activity in 48‐hour PHA culture supernatants compared to normal controls and hemophiliac patients with ratios greater than 1.00.
Use of white cell counts to select units of whole blood for granulocyte preparation
Authors: Newman R. S. , Ocariz J. A. , Simpkins H. , Kaplan H. S.
Published: March 2003

Multiple variables that are easily determined, including donor white cell count, were studied for possible value in selecting single units of whole blood for isolation of granulocytes. Whole blood units selected on the basis of total white cell count were shown to have a 78 percent greater granulocyte content than randomly selected units (3.0 × 10(9) granulocytes/unit vs. 1.7 × 10(9) granulocytes/unit, p less than .001). White cell counts determined on 5‐hour‐old segments of whole blood were demonstrated to have a high coefficient of correlation with white cell counts determined on freshly drawn EDTA specimens (r = 0.918) and fresh segments of whole blood (r = 0.926). We conclude that yields of granulocytes from single units of whole blood stored for up to 5 hours at room temperature can be increased by selecting units with high total white cell counts performed on blood unit segments.
Effects of 4000 rad irradiation on the in vitro storage properties of packed red cells
Authors: Moore G. L. , Ledford M. E.
Published: March 2003

Immunosuppressed patients who require red cell transfusions receive irradiated (1500–3000 rad) packed red cells. These cells are irradiated immediately before infusion. If a large group of patients become immunosuppressed due to exposure to radiation or chemicals, the ability to supply large volumes of irradiated blood at the time of use might not be possible. An alternate solution to providing quantities of irradiated blood is to irradiate the units prior to storage. This study presents in vitro data comparing storage of paired packed red cell units either irradiated or not irradiated. Five units of fresh blood drawn into citrate‐phosphate‐dextrose‐adenine (CPDA‐1) were packed to a hematocrit of 75 +/− 1 percent, and then each unit was divided in two equal parts. One of each pair was irradiated (4000 rads), and both parts of each unit were stored for 35 days at 4 degrees C. Samples were analyzed every 7 days. Irradiation caused a slight drop in red cell adenosine triphosphate and 2,3 diphosphoglycerate and a slight increase in plasma hemoglobin compared to controls. Methemoglobin, pH, and glucose consumption were identical to the controls. The evidence indicates that irradiation did not cause biochemical or metabolic changes in the red cells that would lead us to suspect a difference between irradiated and nonirradiated stored red cells in function or viability. These negative findings require in vivo confirmation.
Platelet storage for 7 days in second‐generation blood bags
Authors: Hogge D. E. , Thompson B. W. , Schiffer C. A.
Published: March 2003

Plastic storage bags designed to optimize O2 and CO2 transfer to preserve platelets for 7 days prior to transfusion were studied in vivo and in vitro. Platelets stored 7 days in second‐generation CLX bags were compared to platelets stored 3 days in standard (CL‐3861) 3‐day storage bags and platelets transfused within 24 hours of collection. The CLX bags maintained concentrate pH at a mean of 6.85 ± 0.03 (SEM) after 7 days, while in standard bags after 3 days of storage, the mean pH was 6.46 ± 0.03. A smaller proportion of platelets stored 7 days in CLX bags were discarded because of a pH less than 6.0 compared to those stored 3 days in CL‐3861 bags (10 vs 21%). Poststorage pH showed strong correlation with concentrate platelet count and weak correlation with concentrate white cell count in both bag types. There was no significant difference in the mean corrected platelet count increments between platelets stored 7 days in second generation CLX bags and those stored 3 days in CL‐3861 bags (10,000 and 12,200 at 1 hour, and 7000 and 7500 at 24 hours, respectively) following transfusion to 16 thrombocytopenic recipients. However, transfusion of fresh platelets achieved mean corrected increments at both 1 and 24 hours posttransfusion that were higher than seen with either group of stored platelets (20,100 at 1 hour and 10,800 at 24 hours). Platelets can be stored 7 days in second‐generation CLX blood bags with results comparable to those of platelets stored 3 days in standard bags.
Transfusion‐associated noncardiogenic pulmonary edema
Authors: Levy G. J. , Shabot M. M. , Hart M. E. , Mya W. W. , Goldfinger D.
Published: March 2003

Although noncardiogenic pulmonary edema (NCPE) is a recognized complication of blood transfusion, the precise etiology is not well understood. NCPE may be secondary to complement‐mediated pulmonary capillary injury initiated by either donor or recipient anti‐leukocyte antibodies. It is not caused by simple volume overload. Recent blood banking texts and published case reports continue to suggest diuretics as part of the initial therapy for this complication. We report a case of transfusion‐associated NCPE in which empirical diuretic therapy clearly was detrimental and suggest that the use of diuretics for treatment of this condition is not warranted. Reversal of progressive hypoxemia is the mainstay of therapy. Hemodynamic monitoring is important in differentiating NCPE from pulmonary edema secondary to cardiac failure or volume overload and should be used as a guide for further therapy.
The association of anti‐P and early abortion
Authors: Shirey R. Sue , Ness P. M. , Kickler T. S. , Rock J. A. , Callan N. A. , Schlaff W. D. , Niebyl J.
Published: March 2003

The current report details the serologic findings in a case reported previously of a P1k woman, para 0 gravida 13, who was treated during her fourteenth pregnancy with plasmapheresis to reduce the anti‐P titer. These studies suggest that anti‐P can induce early abortion in Pk women and that the abortions are immunologically mediated. Further, this case supports the disputed proposal that the anti‐P component of anti‐PP1Pk is responsible for pregnancy loss in p women.
Storage of platelets on flatbed agitators in polyvinyl chloride blood bags plasticized with tri(2‐ethylhexyl) trimellitate
Authors: Champion A.B. , Chong C. , Carmen R.A.
Published: March 2003

Data are presented showing that platelets in polyvinyl chloride blood bags plasticized with tri(2‐ethylhexyl) trimellitate can be stored on flatbed agitators (shakers) without the pH falling below 6.0. The lowest pH seen after 7 days of storage in 46 units with platelet yields ranging from 3.6 to 13.3 × 10(10) per unit was 6.43. These bags have a O2 transmission rate of 13.3 mumol per hour per bag. Platelet bags with a O2 transmission rate of 7.9 mumol per hour per bag experience a pH fall after 5 days of storage on the shaker in units whose platelet yield on average exceeds 10 × 10(10). Platelets can be stored on first‐ generation shakers (70 cycles/min, stroke = 1 inch) without an attempt at manual resuspension of the platelet button. The count after 30 minutes on the shaker averaged 89 +/− 15 percent of the expected count, indicating that resuspension was nearly complete after a relatively short period. Red cells, but not platelets, settled out during storage on the shaker.
Recovery and survival in vivo of platelet concentrates prepared with prostaglandin E1
Authors: Menitove J.E. , Kagen L.R. , Aster R.H.
Published: March 2003

In follow‐up to previous studies showing that stimulators of adenylate cyclase inhibit the activation of platelets in platelet concentrates (PC), the posttransfusion recovery and survival of autologous platelets prepared and stored after the addition of prostaglandin E1 (PGE1) to platelet‐rich plasma at a concentration of 1.3 × 10−8 M were investigated. Six normal subjects were studied on the two occasions, using PC stored with and without PGE1 and radiolabeling with 51Cr. The mean recovery of platelets prepared with PGE1 (35.2 ± 8.1%) was significantly lower (p < 0.013) than that of routinely prepared platelet concentrates (46.3 ± 9.4%). The mean life‐spans of platelets prepared with and without PGE1 were 7.1 ± 0.4 and 6.2 ± 1.0 days, respectively (p = NS). Despite its ability to inhibit the activation of platelets during concentration and storage, prostaglandin E1 appears to reduce posttransfusion recovery of platelets significantly in this experimental model and cannot be recommended at this time as an adjunct for PC preparation.
Successful conservative management of thrombocytopenia in adult hemophiliacs
Authors: Goldsmith J.C. , Kisker C.T.
Published: March 2003

Hematologic abnormalities, including thrombocytopenia, have been reported in persons with acquired immune deficiency syndrome and in hemophiliacs. Seven of 92 adult hemophiliacs followed in a comprehensive hemophilia center developed mild to moderately severe thrombocytopenia in 1983. All had benign courses. None required therapy for thrombocytopenia, although several had increased cutaneous bleeding. Infection with human immunodeficiency virus may be important in the pathogenesis of these patients‘ thrombocytopenia as it has been in that of homosexual men.
A severe transfusion reaction associated with anti‐EnaTS in a patient with an abnormal alpha‐like red cell sialoglycoprotein
Authors: Postoway N. , Anstee D.J. , Wortman M. , Garratty G.
Published: March 2003

A 71‐year‐old woman (Ped) received 3 units of red cells (RBCs), compatible by the indirect antiglobulin test but strongly (4+) incompatible by direct agglutination at 37°C. The next day, her plasma hemoglobin was 1252 mg percent and the direct antiglobulin test (DAT) was weakly positive (IgG and C3). Less than 5 percent of the transfused cells could be detected 48 hours posttransfusion. Her clinical condition deteriorated and renal failure developed. The patient died of pulmonary embolism. Her serum contained a strong (4+) IgM agglutinin and a weakly reactive (microscopically positive) IgG antibody, with anti‐EnaTS specificity. EnaFS and EnaTS antigens were severely depressed or absent from the patient's RBCs; the ficin‐ resistant Ena antigen (EnaFR) appeared to be present. Pretransfusion RBC sialic acid level was 53 ± 2 percent of normal. The patient's RBC membranes were shown to contain sialoglycoproteins beta and delta by sodium dodecyl sulphate polyacrylamide gel electrophoresis with periodic acid Schiff's base staining, with weak staining of components in the regions corresponding to alpha, alpha 2 and alpha delta. The nature of these components was not identified, but their presence suggested that the patient's RBCs expressed a previously undescribed sialoglycoprotein alpha variant.
Approaches to preventing or reversing platelet alloimmunization using animal models
Authors: Slichter S. J. , Weiden P. L. , Kane P. J. , Storb R. F.
Published: March 2003

Animal transfusion models were established to assess treatment programs for preventing or reversing platelet alloimmunization. Five control baboons given weekly transfusions of radiolabeled platelets from a single unrelated donor became immunized after an average of 2.4 +/− 2.1 transfusions. Similarly, 18 of 21 (86%) dogs given up to eight platelet transfusions from a single unrelated donor became immunized after an average of 2.3 +/− 1.7 transfusions. In six of seven baboons, prednisone or antithymocyte globulin alone or in combination effectively delayed platelet alloimmunization. In contrast, only two of 12 (17%) dogs given prednisone or antithymocyte serum (ATS) resisted alloimmunization. Neither splenectomy nor cyclophosphamide prevented alloimmunization in the baboon. In addition, attempts to reduce the immunogenicity of transfused platelets by inactivating the contaminating leukocytes with gamma radiation or by giving leukocyte‐ poor platelets were of no benefit in dogs. Reversal of platelet alloimmunization was achieved in two of three dogs treated with ATS and procarbazine hydrochloride. However, neither splenectomy, cyclophosphamide, ATS plus prednisone, nor vincristine sulfate produced any improvement. These studies show that the highly immunogenic nature of platelet transfusions in animals makes feasible the study of the prevention and reversal of platelet alloimmunization.
Bacterial contamination of bone marrow grafts intended for autologous and allogeneic bone marrow transplantation
Authors: Rowley S.D. , Davis J. , Dick J. , Braine H.G. , Charache P. , Saral R. , Sensenbrenner L.L. , Santos G.W.
Published: March 2003

In a series of 100 bone marrow harvests, the incidence of bacterial contamination of the bone marrow graft was 17 percent. Ex vivo manipulation of some of the grafts prior to infusion may have caused additional bacterial contamination. All isolated bacteria were common skin flora, and no serious sequelae were observed in the patients receiving the culture‐positive bone marrow grafts. Samples of harvested bone marrows purposely contaminated with an isolate of Staphylococcus epidermidis demonstrated a bactericidal property that was maximal early after bone marrow collection. Bone marrow collection and ex vivo manipulation may result in considerable bacterial contamination. Procedures must be developed to assure that marrow collection and processing do not result in clinically significant contamination.
Direct quantitation of IgG subclasses 1, 2, and 3 bound to red cells by Rh1 (D) antibodies
Authors: Shaw D.R. , Conley M.E. , Knox F.J. , Khazaeli M.B. , LoBuglio A.F.
Published: March 2003

The authors developed quantitative radioimmunoassays to allow direct measurement of total human IgG and individual IgG subclasses among antibodies bound to cell surfaces. The assays use four mouse monoclonal radioiodinated antibodies, one that reacts equally well with all four human IgG subclasses and three that are specific for human IgG subclasses 1, 2, or 3. The assays were used to analyze IgG subclass composition in 21 high‐titer anti‐D samples from Rh‐negative volunteers immunized for Rh immunoglobulin production. Anti‐D activity was restricted primarily to the IgG1 and IgG3 subclasses. Eleven of 21 sera demonstrated red cell antibodies with a marked predominance of IgG1 (87 +/− 3.6% of total IgG antibody, +/− SEM) and low levels of IgG3 (1.4 +/− 0.73%). In the remaining 10 sera, IgG3 made up a greater proportion of total IgG antibody (32 +/− 3.8%), although IgG1 was still predominant (61 +/− 4.1%). This observed dichotomy in the IgG subclass profiles of different anti‐D sera may be a consideration in the selection of anti‐D sera for the production of the immunoglobulin used in the prophylaxis of Rh‐incompatible pregnancies.
Evidence of an anti‐A1 inhibited by EDTA
Authors: Tedrow H.E. , Zeigler Z.R.
Published: March 2003

EDTA is added to some commercial A and B cells as a means of preventing hemolysis in serum testing. Unexpected results in serum testing have been reported with EDTA‐dependent agglutinins, but not with agglutinins inhibited by EDTA. A serum sample was found to contain an anti‐A1 undetected by serum testing, but resulting in incompatible crossmatches. Studies indicated that reactivity was inhibited by the EDTA present in the diluent of the A reagent red cells.
Epidemiologic characteristics of blood donors with antibody to human immunodeficiency virus
Authors: Ward J.W. , Kleinman S.H. , Douglas D.K. , Grindon A.J. , Holmberg S.D.
Published: March 2003

From March 1985 through July 1986, blood donors who were positive for antibody to human immunodeficiency virus (HIV) were evaluated at three major blood centers in the United States. Of 818,629 donations, 450 (0.05%) were HIV antibody‐positive. The seroprevalence decreased from 0.07 to 0.04 percent during the study period, due perhaps to a decline in repeat donors. HIV‐seropositive donors tended to be 20 to 29 years old (52%) and male (88%). HIV seroprevalence among white donors (2/10,000 donations) was less than that among Hispanic (9/10,000; p < 0.0001) and black donors (31/10,000; p < 0.0001). Of 152 seropositive men interviewed, 77 percent reported sexual contact with men; of this latter group, 53 percent were bisexual. Fifteen (44%) of 34 seropositive women had apparently acquired infection from heterosexual contact, and an equal number denied having any known risk factors for HIV infection. Educational efforts must address women and bisexual men who do not perceive themselves to be at risk for HIV infection and should be specifically designed for the mores of different racial and ethnic groups.
Antibodies to hepatitis B core antigen in blood donors screened for alanine aminotransferase level and hepatitis non‐A, non‐B in recipients
Authors: Sugg Udo , Schenzle Dieter , Hess Georg
Published: March 2003

ABSTRACT: Four‐hundred and seventeen patients undergoing open‐heart surgery were followed for more than 9 months after transfusion. All 2270 blood units transfused had alanine aminotransferase levels ≤ 30 U/l. Blood units positive for antibodies to hepatitis B core antigen (anti‐HBc) were more frequently associated with recipient hepatitis non‐A, non‐B (HNANB) (13.7%) than anti‐HBc‐negative units (4.2%) (p < 0.001). The frequency of HNANB among recipients of at least 1 anti‐HBc‐positive blood unit (8/79, 10.1%) was fivefold greater than among recipients of exclusively anti‐HBc‐negative blood units (7/338, 2.1%) (p < 0.01). In this study the exclusion of donors positive for anti‐HBc (4.2%) might have reduced the incidence of recipient HNANB by 42 percent. These results support the introduction of anti‐HBc donor screening to prevent recipient HNANB.
Blood component use in orthotopic liver transplantation
Authors: Farrar R. P. , Hanto D. W. , Flye M. W. , Chaplin H.
Published: March 2003

Blood component use during orthotopic liver transplantation (OLT) was evaluated after an initial 23‐month experience with 37 consecutive transplant procedures. Blood component support of OLTs in 24 adult and 13 pediatric patients was reviewed. Adult procedures required intraoperatively a mean of 24.5 units of red cells (RBCs), 38.7 units of fresh‐frozen plasma (FFP), 26.1 random‐donor platelets (RDP), and 12.2 units of cryoprecipitate (Cryo); pediatric procedures required 4.8 units of RBCs, 5.8 of FFP, 3.9 of RDP, and 1.2 of Cryo. RBC salvage constituted 17 percent of the RBCs transfused intraoperatively. Intraoperative support in adult and pediatric OLT patients accounted for the majority of the total components required for the entire hospital stay. OLT blood component use constituted 1.3, 7.0, 3.6, and 8.1 percent of hospital‐wide use of RBC, FFP, RDP, and Cryo, respectively, during the period of the study.
Antibody response in an ABO‐incompatible blood transfusion
Authors: Rydberg L. , Breimer M. E. , Samuelsson B. E.
Published: March 2003

The anti‐A response in a group B patient accidentally given 1 unit transfusion of A1 blood is described. The antibody response is characterized both with conventional agglutination techniques and with radioimmunoassay using pure group A antigens with different core saccharide structures (type 1, 2, and 4 chains) and class‐specific second antibodies. The anti‐A titer rose to a maximum Days 11 to 14 after the incompatible transfusion. The antibodies involved were mainly of the IgG and IgA types, while the IgM response was moderate. The IgA antibodies seemed to be nonselective with respect to group A antigen type, while the IgG antibodies showed a specificity against type 2 chain group A antigens.
Purification and physical characteristics of a hemoglobin solution modified by coupling to 2‐nor‐2‐formylpyridoxal 5‘‐phosphate (NFPLP)
Authors: van der Plas J. , de Vries‐Van Rossen A. , Koorevaar J. J. , Buursma A. , Zijlstra W. G. , Bakker J. C.
Published: March 2003

Human stroma‐free hemoglobin (Hb) was crosslinked with 2‐nor‐2‐ formylpyridoxal 5′‐phosphate (NFPLP), purified over crosslinked dextran, and eluted with a linear salt gradient. The oxygen dissociation curve of this crosslinked hemoglobin appeared to be shifted to the right with a standard P50 of 49 torr (PO2 for 50% saturation with oxygen at a pH of 7.40, a PCO2 of 40 torr, and a temperature of 37°C) compared with a P50 of 12 to 15 torr for the unmodified Hb. The Hill coefficient n of HbNFPLP was 2.1, versus 2.8 for Hb. The proton Bohr factor of HbNFPLP, calculated from P50 values in the pH range of 7.1 to 7.7, was found to be −0.19, versus − 0.29 for unmodified Hb. The oxygen capacity of HbNFPLP was not affected by the crosslinking and was found to be 1.410 ml of O2 per g of HbNFPLP, versus 1.407 ml of O2 per g of Hb for unmodified Hb. Four derivatives of HbNFPLP, i.e., deoxyhemoglobin, oxyhemoglobin, carboxyhemoglobin, and methemoglobin, were prepared, and the light adsorption spectra were recorded in the region of 480 to 680 nm. No differences were detected in comparison with the spectra of unmodified Hb. The α and β chains of the tetramer were separated by reverse‐ phase chromatography. Comparison of the elution patterns of the chains of Hb and HbNFPLP revealed a retardation of the β chains due to crosslinking with NFPLP. This indicates that the binding of NFPLP to Hb occurred only between the β chains. Moreover, sodium dodecyl sulfate polyacrylamide gel electrophoresis of the separated chains showed a doubling of the molecular mass of the β chains (˜31 kD), whereas that of the α chains was unchanged (˜15 kD). A HbNFPLP solution can be classified as a well‐defined product with physiologic oxygen‐binding characteristics.
Noncellular immunoadsorbents for preparing typing sera that recognize high‐frequency red cell antigens
Authors: Gee S. W. , Lubenko A.
Published: March 2003

The feasibility of using salivary ABH substance, covalently coupled to an affinity gel as an immunoadsorbent for anti‐A and ‐B in sera containing antibodies to high‐frequency antigens was investigated. Several examples of anti‐Hy (n = 4), ‐Jra (n = 3), ‐U (n = 3), ‐Lub (n = 3), ‐Tja (n = 8), and ‐Vel (n = 6), plus one anti‐Coa, were treated by batch adsorption with the affinity gel. Titration of the adsorbed sera with ABO‐incompatible cells lacking the relevant high‐frequency antigen, in parallel with ABO‐compatible cells expressing the high‐ frequency antigen, revealed that ABO antibodies could be adsorbed to exhaustion without loss of the sera's activity against cells bearing high‐frequency antigens.
Effect of delayed blood processing on the yield of factor VIII in cryoprecipitate and factor VIII concentrate
Authors: Hughes C. , Thomas K. B. , Schiff P. , Herrington R. W. , Polacsek E. E. , McGrath K. M.
Published: March 2003

Current standards for the preparation of factor VIII (FVIII) concentrates from human plasma recommend separation of plasma from red cells (RBCs) within 6 hours of blood donation, thereby reducing the volume of plasma from donated whole blood available for processing to FVIII concentrate. The decay of FVIII clotting activity (FVIII:C) in whole blood and plasma stored at 22 and 4°C and the recovery of FVIII:C in cryoprecipitate and FVIII concentrate prepared from plasma separated from whole blood stored overnight at 4°C were investigated. In whole blood stored at 22°C and plasma stored at either 4 or 22°C, 90 percent of the original FVIII:C was present at 6 hours, 80 percent at 12 hours, and 65 to 70 percent at 18 hours. At these times lower levels of FVIII:C were recovered from whole blood stored at 4°C, that is, 84, 68, and 56 percent, respectively. In cryoprecipitates prepared from plasma separated from RBCs after 18 hours' storage at 4°C (18‐hour plasma), 43 percent of FVIII:C activity was recovered, as compared with 61 percent recovered from standard plasma separated within 6 hours of donation (6‐ hour plasma), p < 0.05. With large‐scale preparation of FVIII concentrates, however, the yield of FVIII:C was similar whether 18‐ or 6‐hour plasma was used. Thus FVIII concentrates‐but not cryoprecipitates‐can be prepared from plasma separated from whole blood stored at 4°C for up to 18 hours without undue loss of potency.
Blood transfusion history in colorectal cancer patients and cancer‐free controls
Authors: Tartter P. I.
Published: March 2003

Pretransplantation blood transfusions associated with immunosuppression and prolonged allograft survival may contribute to the high incidence of subsequent malignancy in transplant recipients. The relationship of blood transfusion to malignancy was investigated in 354 patients with colorectal cancer, matched by age and sex to control subjects with hernia (105 patients) or gallbladder (249 patients) disease. The incidence of prior blood transfusion was significantly lower in the cancer patients than in the control group (9 versus 17%, chi‐square = 9.98, p < 0.01). Control subjects differed from cancer patients by having more prior transfusions for major joint, cardiac, and urologic procedures. The mean intervals between transfusion and operation were 11.7 years for the cancer patients, 9.7 years for the gallbladder patients, and 7.4 years for the hernia patients. A comparison of cancer patients with and without prior blood transfusion revealed no differences in age, sex, stage of disease, tumor location, or tumor differentiation. Cancer has recurred in 33 percent of patients with previous transfusion and in 18 percent of those without previous transfusion (p = 0.2). This study does not support an association between prior blood transfusion and the development of colorectal cancer.
Human immunodeficiency virus seroprevalence among blood product recipients in San Francisco before transfusion
Authors: Hwang L. Y. , Beasley R. P. , Busch M. P. , Lane P. K. , Vyas G. N.
Published: March 2003

To determine the incidence of transfusion‐associated human immunodeficiency virus (HIV) infection after routine screening of donated blood, a pilot study estimated the pretransfusion prevalence of HIV infection among blood product recipients in San Francisco. Among the 911 nonduplicate pretransfusion specimens from recipients without a clinical history of acquired immune deficiency syndrome (AIDS) or AIDS‐related complex (ARC), the overall prevalence of antibody to HIV was 2.9 percent (5.2% among males and 0.6% among females; p = 0.00002). If recipients in specifically defined or possible high‐risk groups (n = 348) were excluded, a seropositivity rate of 1.8 percent (10/563) was detected, with all the positives occurring in men (10/242, 4.1%) and none in women (0/321, 0%). This demonstrated prevalence of HIV infection among blood product recipients in San Francisco before transfusion was substantially higher than the known 0.02 to 0.04 percent prevalence in the donor population. Therefore, the population of women without known risk for AIDS is the best in which to assess the risk of HIV infection in patients who are currently receiving seronegative blood transfusions.
Production of human warm‐reacting red cell monoclonal autoantibodies by Epstein‐Barr virus transformation
Authors: Andrzejewski C. , Young P. J. , Goldman J. , Spitalnik S. L. , Silberstein L. E.
Published: March 2003

Monoclonal antibody technology has been used in both murine and human systems to produce a variety of antibodies that react with the human red cell (RBC). RBC monoclonal autoantibodies have been obtained from animal models of autoimmune hemolytic anemia (AIHA), but to date no warm‐reactive monoclonal autoantibodies have been generated from human B cells. Using the Epstein‐Barr virus (EBV) transformation method, clones of RBC autoantibodies were generated from two patients with AIHA. These antibodies reacted preferentially at 37° C, agglutinated or bound to a variety of different RBC phenotypes, and were IgM in nature. The serologic reactivity of one clone showed a relative specificity to e+ RBCs that was similar to that seen in the patient's serum. These results are the first to demonstrate that warm‐reactive RBC autoantibodies can be obtained from patients with AIHA using the technique of EBV transformation, and they further substantiate the existence of warm‐reactive IgM RBC autoantibodies in the spectrum of warm AIHA.
Scales for the measurement of attitudes toward blood donation
Authors: Breckler S. J. , Wiggins E. C.
Published: March 2003

Attitudes toward blood donation are frequently assumed to vary along a single dimension from unfavorable to favorable. In contrast, theories of attitude structure specify three distinct attitude components: affect, cognition, and behavior. This article describes the development of three new scales for the measurement of affective, cognitive, and behavioral components of attitudes toward blood donation. The scales were developed using the method of equal‐appearing intervals and were administered to both donors of blood and nondonors. Correlations among the scales were relatively small and supported the three‐component distinction. Affect was more strongly correlated with the number of prior donations than was cognition, which suggested an important role for emotional factors in blood donation. Scores on all three scales showed the attitudes of blood donors to be more favorable than those of nondonors.
The effect of storage on the metastatic potential of tumor cells collected in autologous blood
Authors: Lane T. A.
Published: March 2003

Malignancy in a potential autologous blood donor is considered by some as a relative contraindication for the collection of autologous blood. There is, however little experimental information regarding the safety of transfusion of autologous blood that may contain viable tumor cells. The purpose of this study was to determine if tumor cells seeded into autologous blood retain their metastatic potential and, if so, for how long. A well‐established model of the pulmonary metastasis of B16/F10 (F10) melanoma in C57BL/6 mice was used. Equal numbers of F10 cells were seeded into CPDA‐1 blood from the mice or into saline, and the number of lung tumors was evaluated 14 days after infusion of blood or saline. The CPDA‐1 blood seeded with F10 cells was stored for up to 21 days in transfer packs at 4 to 6° C, and the metastatic potential of F10 cells in the stored blood was ascertained as above. F10 cells seeded into autologous blood that was then transfused without storage gave rise to the same number of metastatic foci (404 ± 32 metastases) as did those cells transfused in saline (374 ± 38, p = 0.5). In contrast, the number of metastatic foci resulting from the transfusion of blood containing F10 cells decreased progressively after storage of the blood (7 days = 124 ± 14 metastases; 14 days = 7 ± 1; 21 days = 2 ± 1; all p values <0.001 vs fresh blood). Also, the predilection of F10 cells to metastasize to the lung was unchanged by storage in blood. These studies show that, in this animal model, 1) the infusion of F10 cells coincident with the transfusion of autologous blood is not associated with a greater number of metastases than would have been expected from the same number of circulating tumor cells in the absence of the autologous blood transfusion, and 2) the storage of autologous blood containing F10 cells is associated with a progressive decrease in the metastatic potential of the F10 cells after their reinfusion. These findings support the currently accepted practice of including patients with cancer as autologous blood donors.
Disappearance of inhibitor to factor VIII in HIV‐infected hemophiliacs with progression to AIDS or severe ARC
Authors: Ragni M. V. , Bontempo F. A. , Lewis J. H.
Published: March 2003

The spontaneous disappearance of the inhibitor to factor VIII (FVIII) was observed in two human immunodeficiency virus (HIV)‐infected men with hemophilia A. Both men had end‐stage HIV infection, one with acquired immune deficiency syndrome (AIDS) and one with severe AIDS‐related complex (ARC). Loss of the inhibitor was associated with a fall in T4 helper lymphocytes to <100 per mm3 in both patients. Subsequent spontaneous and traumatic hemorrhages were treated successfully with standard doses of FVIII concentrate, resulting in adequate FVIII: C levels and good hemostasis. The mechanism by which the anti‐FVIII inhibitor disappears is not known, but it is likely to be related to a quantitative decline in T4 cell number.
Evaluation of technical and behavioral issues in predonation alanine aminotransferase testing
Authors: Gimble J. , Kline L. , Friedman L.I.
Published: March 2003

To evaluate the technical and behavioral impact of predonation alanine aminotransferase (ALT) testing, one group of 2914 donors (Reflotron group) were tested with the Boehringer Mannheim Reflotron instrument; 3042 control group donors had no predonation test. Mobile blood collection sites in three regional blood centers were studied. More Reflotron group donors than control group donors thought that predonation testing did not add time and was a good idea. Both groups were equally satisfied with the donation process and indicated they would donate again even if testing added time. Comparison of the Reflotron and standard laboratory tests showed excellent correlation with low variability. The mean r value was 0.934, with a mean sensitivity of 94.4 percent and a specificity of 99.8 percent. The staff working with the Reflotron group found predonation testing easy to incorporate into donor screening. They observed that donors were pleased with testing and accepting of deferral counseling for elevated ALT. The control group staff was concerned that predonation testing would require more time and would have a negative effect on the donor return rate. This did not appear to be the case as judged by donor response and the 6‐month return rates of 50 percent for Reflotron group and 54 percent for control group donors.
Effectiveness of two synthetic fiber filters for removing white cells from AS‐1 red cells
Authors: Pikul F. J. , Farrar R. P. , Boris M. B. , Estok L. , Marlo D. , Wildgen M. , Chaplin H.
Published: March 2003

Two commercially available synthetic fiber filters were studied for their effectiveness at removing white cells (WBCs) from AS‐1‐preserved red cells (RBCs) stored ≤14 days. In all, 65 filtrations were performed. An automated microprocessor‐controlled hydraulic system designed for use with cellulose acetate fiber filters was employed to prepare filtered RBCs before release for transfusion. Studies were also carried out on polyester fiber filters, which are designed to be used in‐line during transfusion. Residual WBCs were below the accurate counting range of Coulter counters and of conventional manual chamber counts. An isosmotic ammonium chloride RBC lysis method, plus a modified chamber counting technique, permitted a 270‐fold increase over the number of WBCs counted by the conventional manual method. For the polyester fiber‐filtered products, residual WBCs per unit were not affected by speed of filtration, prior length of storage, or mechanical tapping during filtration. The effectiveness of WBC removal (mean 99.7%), total residual WBCs (means, 4.8 and 5.5 × 106), and RBC recovery (mean, 93%) was the same for both filters. The majority of residual WBCs were lymphocytes. WBC removal and RBC recovery were strikingly superior to results reported with nonfiltration methods.
Cytomegalovirus infections in seropositive patients after transfusion
Authors: Adler S. P. , McVoy M. M.
Published: March 2003

Antibody responses to cytomegalovirus (CMV) after red cell (RBC) transfusion were studied in 84 seropositive surgery patients and 82 seropositive oncology patients. The surgery patients were randomized to receive RBCs stored either 3 to 8 or 20 to 42 days after donation. Of 38 patients receiving RBCs stored 8 days or less, 3 developed a rise in titer (4‐fold increase) of IgG antibody to CMV 8 to 12 weeks after transfusion. This rate of response (8%) did not differ significantly (p = 0.23) from that (16%) in the 46 patients receiving RBCs stored 20 to 42 days. Seropositive oncology patients were randomized to receive RBCs from seronegative or random donors. Five (19%) of 27 oncology patients receiving seronegative RBCs and 13 (23%) of 55 patients receiving random RBCs (mean, 2 seropositive RBC units/patient) developed a rise in titer of antibody to CMV. No CMV morbidity occurred in either patient group. For both patient groups, a rise in titer of antibody to CMV was associated with the number of transfused RBC units. These results confirm that CMV‐seronegative RBCs are unnecessary for infrequently transfused seropositive patients. They also suggest that multiple transfusions of stored RBCs are as immunosuppressive as multiple transfusions of RBCs used within a few days after donation.
Characterization of the epitope recognized by a monoclonal antibody highly specific for blood group M antigen
Authors: Jaskiewicz E. , Moulds J.J. , Kraemer K. , Goldstein A.S. , Lisowska E.
Published: March 2003

The mouse monoclonal antibody M2A1 of IgG1 class, which is highly specific for blood group M antigen, was obtained and characterized by means of hemagglutination, enzyme‐linked immunosorbent assay, immunoblotting, and inhibition assays. The use of modified M glycoprotein preparations for inhibition tests and of variant MCN and Henshaw red cell membranes for immunoblotting showed that M2A1 recognized an epitope including the NH2‐terminal serine and sialic acid residues of glycophorin A, whereas the fifth glycine residue was not involved. The reactivity of the antibody with M antigen was distinctly dependent on ionic strength and pH; the optimum was at pH 8 to 9. The α‐amino group of terminal serine residue was not necessary for the reaction with M2A1 antibody, and the results obtained suggested that the positive charge of this group contributed to decreasing antigen‐antibody reactions at pH below 8. The reaction of the antibody with blood group N antigen was not detectable in any of the assays used.
Preparation of IgA‐deficient platelets
Authors: Sloand E.M. , Fox S.M. , Banks S.M. , Klein H.G.
Published: March 2003

The IgA‐deficient patient presents a difficult transfusion problem, particularly if he or she has previously been immunized and has formed IgA antibodies. Blood components from IgA‐deficient donors may be used safely but are often not accessible to transfusion facilities. A satisfactory red cell component may be obtained by standard freezing and washing methods. There is no comparable platelet concentrate that uniformly affords protection against anti‐IgA‐mediated reactions. A method has been developed for the preparation of an IgA‐deficient platelet concentrate by washing with citrate‐buffered saline. Platelets prepared in this manner were transfused successfully to an IgA‐deficient patient with a history of anaphylaxis related to transfusion. It was further demonstrated that the removal of IgA is enhanced if platelets are washed within 48 hours of collection. When platelets were stored for more than 48 hours, similar washing techniques resulted in significantly higher levels of IgA in the platelets washed with either buffered (p = 0.004) or unbuffered (p = 0.0002) saline. Platelets washed with unbuffered saline (pH 4.5–5.5) contained substantially more IgA than did platelets washed in a similar manner with citrate‐buffered saline (pH 6.5–6.8) (p = 0.001).
Effects of blood donation on cerebral blood flow velocity
Authors: Silvani C. , Zanella A. , Rossi F. , Cabrini G. , Ferrari C. , Cesana B. , Sirchia G.
Published: March 2003

Eighteen healthy male blood donors, nine with hematocrit (Hct) of 0.40 to 0.45 (normal Hct) and nine with Hct of 0.49 to 0.52 (upper‐limit Hct), were monitored by continuous‐wave internal carotid Doppler sonography and hematologic tests for 28 days after blood donation, to ascertain whether and to what extent a single standard donation may modify the velocity of cerebral blood flow. The two groups had similar mean predonation values of internal carotid flow velocity (ICFV): blood donation was followed in both groups by a slight, transient decrease of ICFV at the end of phlebotomy, due to donation‐induced hypovolemia, and then by an increase of ICFV lasting 7 to 10 days. Analysis of individual profiles revealed that only four of nine upper‐limit and six of nine normal Hct donors displayed a positive trend (increase) in the ICFV within the first week after donation, and that it was due mainly to a rise in systolic flow velocity. Mean Hct and arterial oxygen content showed a negative trend (decrease) within the first week that was opposite to the ICFV trend. Other laboratory variables, including serum proteins and plasma fibrinogen concentration, and the iron status indicators did not change, except for serum ferritin, which also decreased within the first week after phlebotomy. It can be concluded that blood donation may result in a short‐term increase of blood flow velocity that is independent of Hct predonation levels in approximately one‐half of the donors.
In vivo viability and functional integrity of filtered platelets
Authors: Brecher M. E. , Pineda A. A. , Zylstra‐Halling V. W. , Chowdhury S. , Forstrom L. A.
Published: March 2003

The in vivo viability and functional integrity of filtered platelets were compared with those of nonfiltered platelets in a controlled study. On two occasions, after template bleeding time, 14 healthy volunteers underwent plateletpheresis and received 600 mg of aspirin. Autologous 111In‐labeled platelets were transfused without further manipulation (control) on one occasion and after filtration on a second occasion. The filter was primed and flushed with a buffered 12.6‐ percent solution of ACD‐A in 0.9‐percent normal saline (pH 6.5). After transfusion, the bleeding time was measured at 1, 4, and 24 hours and platelet survival at 10 minutes; 1, 4, and 24 hours; and daily for 6 days. The decrease in the bleeding time was not significantly different from that after transfusion of nonfiltered platelets (p greater than 0.2). Filtering of platelets did not affect 1‐hour in vivo recovery (filtered, 69.5%; nonfiltered, 66%: p = 0.56) or the platelet survival (filtered platelet t1/2 = 83.0 hours, nonfiltered platelet t1/2 = 82.9 hours: p = 0.96). It can be concluded that filtration does not adversely affect in vivo recovery, survival, or functional integrity of platelets.
Efficiency of white cell filtration and a freeze‐thaw procedure for removal of HIV‐infected cells from blood
Authors: Bruisten S.M. , Tersmette M. , Wester M.R. , Vos A.H.V. , Koppelman M.H.G.M. , Huisman Johannes G.
Published: March 2003

Strategies for diminishing the risk of blood transfusion‐associated transmission of HIV‐1 were evaluated. HIV‐1‐infected peripheral blood mononuclear cells were added to blood that was subsequently filtered by using different white cell (WBC) filters (cellulose acetate and polyester). The average log reduction of infected cells with polyester filters was at least 2.5 as measured by ID50 titration and polymerase chain reaction. In two WBC filtration experiments with blood from seropositive donors diluted 1:4 with seronegative blood, log reductions of 2.4 and greater than 2.5 were observed. No cell‐free virus was retained by the filter used. A freeze‐thaw procedure applied to HIV‐1‐ contaminated blood resulted in a minimal log reduction. These results indicate that the reduction of HIV‐1 infectivity as a result of filtration is mainly due to the removal of HIV‐1‐infected WBCs, and that complete removal of infected WBCs cannot be achieved by the current filtration or freeze‐thaw procedures. However, the development of filters with enhanced ability to remove (possibly infected) WBCs may have the added benefit of improving the safety of donor blood, especially in multiply transfused patients.