bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relation between Storage Time of Erythrocytes and Their Percentage Viability after Transfusion
Authors: Eadie G. S. , Brown Ivan W. , Smith Wirt W.
Published: October 2009

During storage of blood the percentage of viable erythrocytes decreases at such a rate that when these percentages are plotted against time of storage, they fall on an S‐shaped curve. This curve can be explained on the assumption that the resistance of red cells to in vitro aging is normally distributed, i.e., follows the normal probability curve. By a mathematical transformation used in other cases of biological standardization, the curve can be changed to a straight line, the slope of which, if accurately determined with a sufficient number of recipients, is the most accurate method of estimating the rate of in vitro aging.

To illustrate the method, the rate of in vitro aging has been determined for the following storage procedures: (a) addition of ACD solution; (b) addition of two different solutions containing EDTA as anticoagulant; (c) prevention of coagulation by removal of calcium with an ion‐exchange resin and subsequent addition of glucose‐lactate or glucose acetate solution. Of these, the last had the fastest rate of in vitro aging and the first the slowest. Possible reasons for this are discussed. In addition, blood was stored in plastic bags rejected by the manufacturer because of toxic substances in the plastic; here a fraction of the cells was rapidly rendered nonviable while the remainder aged normally.
The Use of ACD Bank Blood and Fresh Heparinized Blood in Open‐Heart Surgery:*
Authors: Britten Anthony , Salzman Edwin W. , Grove‐Rasmussen Morten , Shaw Robert S.
Published: October 2009

A study was undertaken to establish whether the use of stored ACD blood, up to four days old and subsequently heparinized and recalcified, in the pump‐oxygenator for open‐heart surgery would have any detrimental effect upon postoperative coagulation and hemostasis. A comparison was made with cases in which fresh heparinized blood was used.

Postoperative abnormalities were encountered in all patients. There was no significant difference between the two groups. No evidence was found of any disadvantage in the use of ACD blood.
Copper Sulfate Screening of Blood Donors
Authors: Mannarino Antonio D. , Macpherson Colin R.
Published: October 2009

A case is described in which a donor with less than 8 gm. of hemoglobin passed the copper sulfate screening test due to the hyperproteinemia of multiple myeloma. The value of routine inspection of units of stored blood is emphasized, since this led to the detection of the patient's disease.
The Effect of Community and Chapter Characteristics on Blood Donations
Authors: Rockwell T. H. , Hanlon R. F.
Published: October 2009

In an effort to explain why certain communities consistently meet or exceed their collection quotas while others consistently fail, the authors analyzed 50 Ohio counties within the Northern Ohio Red Cross Blood Program and the Columbus Regional Blood Program of the American Red Cross. They measured collection and usage rates, and 18 sociological, demographic and economic dimensions for each county. They found that the best predictor of community collections was the amount of blood used by county residents during that year. Population and population density were also significantly correlated with collection rates. However, education, economic complexity, birth rate, health indices, living conditions and population age, etc., all failed to show a relationship to collection rates when population and usage were removed from the analysis by partial regression technic. Moreover, in the Columbus region less than 5 per cent of the available population gave blood in voluntary blood programs.

The general conclusions of this research were that on a macroscopic basis the prime motivation for community donation is its use of whole blood. All of the economic, sociological and demographic factors investigated failed to explain why one community would produce so much more blood than another. Therefore, this might support the belief of community blood workers that the primary factor responsible for adequate collections of whole blood is the organization and leadership of those individuals responsible for the blood program within the community.
Viral Hepatitis Associated with Sub‐human Primates*
Authors: Hillis William D.
Published: October 2009

Recent epidemiologic evidence has accumulated indicating that certain chimpanzees and other primates act as carriers of human hepatitis virus. Outbreaks of human hepatitis in which primates have been so implicated are summarized in this paper, and the significant epidemiologic findings are emphasized. Isolations of viral agents from the stools of 25 suspect animals, together with experimental attempts to characterize some of the properties of these agents and to relate them to human hepatitis virus, are described.

The paper also gives biochemical and histologic evidence for pathologic involvement of the livers of some of the implicated primates, as a possible consequence of infection by hepatitis virus. Such findings suggest that certain primates may prove useful as experimental hosts for human hepatitis virus.
Studies on the Serum and the Infectious Hepatitis Viruses of Man
Authors: Bolin Vern S. , Brauninger Gordon E. , Pardee Judith , Alsever John B.
Published: October 2009

Serum hepatitis (SH) virus was isolated in tissue culture from the blood of each of the five human volunteers 41 to 90 days following their inoculation with NIH icterogenic plasma pool VI. Six other strains of hepatitis viruses were isolated from patient sources; one from a case of clinical serum hepatitis and the remainder from five (5) cases of clinically diagnosed infectious hepatitis. All agents were grown in human lung cell and rabbit kidney tissue culture systems. SH 204 virus was neutralized by specific rabbit antisera prepared against viruses SH 211, SH 204, SH 210, SH‐Neib, IH‐MJ and IH‐Horst. These antisera at a final dilution of 1:40 neutralized 10 to 1,000 TCID50units of the SH 204 virus. Cross complement fixation tests were carried out with the ten hepatitis viruses against specific rabbit antisera which was prepared against each of the virus agents. Irrespective of the source of isolation of the SH or IH virus, there were no apparent differences in the antigenic structure of the viruses, since all produced a common complement fixing antibody in rabbits immunized with the different viral agents. The complement fixation titers observed ranged from 1:200 to 1:3000. In sharp contrast, normal human serum and normal rabbit kidney and human lung cell tissue culture fluids, when tested against antisera produced to these agents as antigens, fixed complement in a range of titer of only 1:8 to 1:96.

Complement fixation tests were carried out against specific antisera for many of the other human enteric viruses. SH virus did not fix complement with specific antisera prepared against Coxsackie, Group B1virus types one to six; Coxsackie, Group A, Virus, type nine; Echo, types one, three, six, eight, 23, 26, 28; Folio viruses, types one, two and three; and Para‐influenza, type three virus. However, the SH virus was found to fix complement with antisera prepared against Echo virus, types two, seven, 24 and 25, but the titers observed ranged only from 1:64 to 1:128. Complement fixing antibodies were also demonstrated in three of 25 normal calf sera tested, but were not demonstrated in normal serum obtained from guinea pigs, rabbits, rhesus monkey, horse, human infant, sheep or cat. Antisera against infectious canine hepatitis virus did not fix complement with the SH virus. Finally, convalescent sera obtained from the volunteers who had been inoculated with the icterogenic plasma pool, demonstrated a high titer of complement fixing antibodies against the SH virus.
Prevention of Hemolysis of Large Volumes of Red Blood Cells Slowly Frozen and Thawed in the Presence of Dimethylsulfoxide
Authors: Huggins Charles E.
Published: October 2009

Dimethylsulfoxide has been found to afford a major degree of protection to large volumes of human red blood cells against hemolysis from slow freezing and thawing. This protective action appears to be due to reduction of the degree to which solutes concentrate when pure cellular water is partially sequestered in the form of ice.

The presence of hypotonic solutes in a DMSO‐containing medium leads to cellular swelling. Cells swollen by such treatment have been found to be vulnerable to damage during storage in the frozen state. This effect has probably been encountered in the past but has not been previously documented as a cause of cellular death from freezing and thawing.

A middle road can be found that prevents hemolysis from salt hyperconcentration as well as hemolysis of swollen cells during storage. By this means “units” of packed human red blood cells can be slowly frozen, stored for long periods at –85 C, and thawed with minimal hemolysis.

This investigation was supported (in part) by the Public Health Service Research Grant #HE‐05673–03 from the National Heart Institute, and Grant CRTY‐5018 from the National Cancer Institute, National Institutes of Health, Public Health Service. This is publication #1137 of the Cancer Commission of Harvard University.
Jsb of the Sutter Blood Group System
Authors: Walker R. H. , Argall C. I. , Steane E. A. , Sasaki T. T. , Greenwalt T. J.
Published: October 2009

The serum of a Memphis Negress was found to be incompatible with all donors tested. She had had 11 pregnancies and had received 16 pints of blood between 1955 and 1957. She was found to be strongly Js(a+) and her four living children were all Js(a+). Her serum was tested against the red cells of two sisters believed to be homozygous for Jsa because all their ten children are Js(a+). They were found to be compatible. Thirteen of 1,269 Memphis and Milwaukee Negroes were found to be ccmpatible. Twelve of these were tested with anti‐Jsa and all were positive. The probability of selecting 12 consecutive Js(a+) Negroes by chance is only four in a billion. The proportion of 0.0102 non‐reactors among the 1,269 Negroes tested agrees well with Giblett's estimate of 0.0106. The antibody has therefore been designated as anti‐Jsb. No Js(b–) individuals have been found among 1,005 Caucasians tested.
Report on a Family with Six Tja‐Negative Siblings
Authors: Stern Kurt , Busch Shirley
Published: October 2009

A pregnant woman for whom it was not possible to find compatible blood needed for transfusion, was found to have the rare blood type pp (Tja‐negative) with anti‐P + P1 antibodies in her serum. The patient was one of ten living sibs among whom four brothers and one sister had the same rare type as the proposita. Results of genetic and immunohematologic studies on this sibship and their parents were presented. The obstetric history of the proposita included three miscarriages. The fourth pregnancy, terminated by cesarean section, resulted in a premature infant, whose death was attributed to hyaline membrane disease. The fifth pregnancy ended with a full‐term normal infant who remained free of disease. Positive direct antiglobulin tests were obtained with cord blood specimens of both infants, indicative of transplacental transfer of the maternal anti‐P + P1 antibodies. However, manifest hemolytic disease of the newborn did not develop in either infant. The observations made in this study were compared with data recorded in the literature on this subject and discussed in relation to clinical and laboratory problems arising from the presence of the rare blood type p.
Transplacental Hemorrhage
Authors: Finn Ronald , Harper David T. , Stallings Sarah A. , Krevans Julius R.
Published: October 2009

The development of knowledge concerning the phenomenon of transplacental hemorrhage into the maternal circulation is reviewed, and evidence is presented that the acid elution technic provides a simple and accurate method of diagnosing this condition. The data in the present study suggest that transplacental hemorrhage is not a random phenomenon but is related to obstetric abnormalities and procedures, and the relevance of this finding to the management of the Rh negative unsensitized mother is discussed. It is suggested that the acid elution technic will find useful applications in the diagnosis of neonatal anemia due to massive transplacental hemorrhage, and in the further elucidation of the mechanism of Rh sensitization.
Low Molecular Weight Dextran in Open Heart Surgery: Effect on Coagulation Factors and on Red Cell Antibody Activity*
Authors: Perkins Herbert A. , Rolfs Mary R. , McBride Alice , Roe Benson
Published: October 2009

Low molecular weight (40,000) dextran is being extensively used in open heart surgery to minimize the amount of donor blood required and to inhibit red cell aggregation. At equal concentrations, its effects on blood coagulation were less than those of standard dextran plasma substitutes; but in the very high concentrations used in open heart surgery its effects were greater. Addition of low molecular weight dextran to normal plasma caused a gross precipitate and striking inhibition of coagulation. Factor VIII (antihemophilic factor) and fibrinogen were partially removed with the precipitate. Patients subjected to open heart surgery had lower levels of these two clotting factors in their plasma when dextran was used, but it is not certain whether this loss occurred in vivo, or during separation of the plasma from red cells (and precipitate) prior to testing. No proof was obtained in this series of cases that low molecular weight dextran increased the tendency to bleed, but the results indicate that this would be a likely possibility with the use of larger amounts.

The low molecular weight dextran had a slight tendency to induce red cell aggregation by itself. It potentiated the aggregative effect of Polybrene and the agglutinating effect of a saline Rh antibody. On the other hand, it inhibited agglutination of red cells induced by an Rh antibody in a high protein medium. It thus appears likely that high concentrations of low molecular weight dextran in the blood of a patient could lead to erroneous conclusions in compatibility tests.
Transfusion of Human Corpse Blood Without Additives
Authors: Kevorkian Jack , Marra John J.
Published: October 2009

Human corpse blood drawn and stored without the use of ACD solution or other additives and taken within a six‐hour postmortem period from victims of relatively sudden unexpected death is suitable for transfusion into anemic patients. In most cases of sudden death the blood undergoes a peculiar type of fibrinolysis which obviates the need for anticoagulant solutions. Three clinical cases of such transfusion are reported, the first done and recorded in the U. S. There was no trace of difficulty during and after transfusion in any case. The hematologic response was excellent. There was no discernible alteration of clotting mechanisms or red cell fragility in recipients. One patient underwent major surgery immediately after receiving massive amounts of corpse packed cells on two separate occasions; surgery and recovery were entirely uneventful. The results of electrolyte and hematologic studies of untreated blood taken from ten corpses are also reported and demonstrate no appreciable difference from those of routine live‐donor blood. The significance and implications of this work are discussed briefly.
The Rh Antigen Dw (Wiel)
Authors: Chown Bruce , Lewis Marion , Kaita Hiroko , Philipps Sylvia
Published: October 2009

Evidence is brought forward confirming that the antigen “Wiel” (Transfusion 2: 150, 1962) is part of the D segment of the Rh system; is rare in Whites (none in 13,000) but not uncommon in Negroes (9 positive in 253). Its name is changed to Dw, Rh(23) or rhwo, the common genes designated ***Dwe or Rwo, CDwe or Rwo1 and cDwE or Rwo2, and a table of phenotypes and genotypes given. When Dw is not partnered with D it reacts as a Du; its specific nature is recognized by reaction with anti‐Dw.
A Family Pedigree Showing the Transmission of Rare and “New” Rh‐Hr Genes
Authors: Unger Lester J.
Published: October 2009

The serum of a patient with the most probable genotype contained an antibody most probably of specificity anti‐Hr. The patient's brother was found to have blood of the hitherto undescribed phenotype A family study indicated with high probability that both deceased parents had the very rare genotype also hitherto undescribed.
Salivary Secretion of A, B and H Substances in Gastric Cancer in Japan and the U.S.A.
Authors: Desai Rajendra G. , Creger William P. , Shirley R. , Gausepohl N. , Amkraut A.
Published: October 2009

The purpose of this investigation was to examine salivary secretion of A, B and H blood group substances in gastric cancer subjects of two ethnic groups, the Asian Japanese with a known increased incidence of the disease and the U.S.A. Whites with an intermediate incidence of the disorder. Eighty‐two histologically proven cases of stomach cancer and 130 control subjects from U.S.A. and 212 cases of cancer of the stomach and 177 control subjects in Asian Japanese were tested for salivary blood group substances. It was found that by mean tube titer analysis U.S.A. Whites with gastric cancer secreted more H substance than controls (p<0.001), and possibly more A substance (p<0.05). By similar analysis, Japanese with gastric cancer did not secrete more of these substances as compared to their controls.

When all subjects tested were assigned either secretor or non‐secretor status on the basis of bi‐modal distribution behavior, then more secretors were found in the Japanese gastric cancer group than in controls (p = 0.01), and a similar trend was seen in U.S.A. Whites (p.<0.05).

Some observations on blood group secretor phenomena and disease are reviewed, and a speculation is offered in regard to a possible mechanism of importance in the pathogenesis of gastric cancer. This speculation attempts to relate neoplasia of gastric epithelial cells to introduction of viral DNA, and the suggestion is made that virus might find it easier to penetrate a cell containing A substance rather than one containing H substance or none at all.
A Practical Blood Banking System to Maintain Complete Records for a Transfusion Service
Authors: Schoen Irwin , Glover Sorrell N. , Cowell Evelyn Sue , Lange Suzanne
Published: October 2009

A system of blood banking as it relates primarily to a blood transfusion service is presented. It consists of three basic multipart forms; a BB1‐Request Form, a BB2‐Prescription‐Receipt‐Trans‐fusion and Reaction Record Form, and a BBS‐Donor Record and Inventory Form. It appears to be suitable for any size trans usion service and provides a practical scheme of obtaining complete blood banking records. The system serves as a means of establishing and maintaining good blood transfusion practices.
Survey on Blood Bank Fees and Replacement Policies of Institutional Members of the American Association of Blood Banks
Authors: Hemphill Bernice M.
Published: October 2009

As the socio‐economics of blood banking is of great interest, a survey was made to determine the processing and blood replacement fees charged by hospital, community and miscellaneous blood banks. Information furnished by 354 AABB institutional members was analyzed, and weighted mean processing and replacement fees were determined using blood usage as a common base. The replacement policies of the reporting banks also were reviewed.

The author concludes there is no great variance in the fees charged or in blood replacement policies reported by banks in all five AABB districts; but that there is a need for blood banks to adopt more standardized terminology as related to blood transfusion charges.
Comparison of Blood Stored in ACD and in a Solution Containing Heparin, Phosphate, Glucose and Adenine
Authors: Kozek Wieslaw , Bishop Charles
Published: October 2009

Duplicate blood samples were obtained from six healthy young males, one aliquot was collected in ACD and one aliquot in a solution of heparin‐glucose‐phosphate‐adenine (HGPA). All were stored under blood bank conditions for a total of four weeks. The HGPA samples maintained their ATP and nucleotide adenine levels much better than the ACD samples and had generally higher pH's and faster rates of glycolysis. Their osmotic fragility and plasma K+ levels were similar to those of the ACD samples. Because there was considerably more hemolysis in the HGPA samples than in the ACD samples and in the absence of red cell survival data, the HGPA system is not recommended at this time as a substitute for the ACD system but as a comparative system to reveal metabolic shortcomings of the ACD storage system.
A Fatal Hemolytic Transfusion Reaction with Acute Autohemolysis
Authors: Polesky Herbert F. , Bove Joseph R.
Published: October 2009

A fatal hemolytic transfusion reaction due to anti‐Kidd (Jka) is described in a woman with aplastic anemia associated with acute leukemia. Radioactive chromium studies, which were in progress at the time, made it possible to demonstrate that a severe autohemolytic crisis was a part of the reaction. The relationship between a hemolytic transfusion reaction and the initiation or intensification of autohemolysis is discussed. The difficulties of serologic diagnosis and selection of blood for transfusion in patients with nonspecific antibodies are reviewed. This case again illustrates that nonspecific agglutinins can mask the presence of specific anti‐red cell antibodies.
Immunological Relationship between Serum Globulins of Man and of Other Primates, Revealed by a Serological Inhibition Test
Authors: Wiener Alexander S. , Gordon Eve B. , Moor‐Jankowski J.
Published: October 2009

By a quantitative inhibition technic chimpanzee serum reacted to almost the same titer as human serum with rabbit anti‐human immune serum; gorilla serum reacted in considerably lower titer, while serum from gibbons, orangutans and monkeys gave little or no inhibition. Thus, this test for serum gamma globulin indicates that among non‐human primates, chimpanzee is most similar to man. Gorilla is next, while sera of other apes and monkeys show little or no crossreactivity.
The Use of an Albumin‐Enhanced Indirect Antiglobulin System to Detect Immune Anti‐A and Anti‐D in the Serum of the Newborn
Authors: Hamrick Lois
Published: October 2009

A case of hemolytic disease of the newborn is presented. Immune anti‐A and anti‐D were detected in the serum of the mother and the infant. The use of the albumin‐enhanced antiglobulin system proved effective in detecting anti‐A and anti‐D in the infant's serum after all other systems had failed. The need for caution in inferring ABO incompatibility alone in the presence of a strongly reactive direct Coombs test is illustrated.
The Influence of Albumin in the Antiglobulin Crossmatch
Authors: Griffitts James J. , Frank Sally , Schmidt R. Pauline , Müller Susanne
Published: October 2009

The “High Protein Tube” (HPT) technic converted to an antiglobulin (Coombs) test has proponents as a crossmatch procedure. Data are presented to indicate its suitability and its superiority over the conventional saline‐antiglobulin method. Tests employing 30 per cent and 22 per cent bovine albumin were performed in two stages to determine which of two final protein concentrations were optimal. Saline and 30 per cent albumin tests were performed in three stages with subsequent evaluations of each stage. Analysis was also made of the three stages as an integral procedure.

A study of 453 antibodies yielded the following observations. A final protein concentration of 17 per cent was more efficacious than a final protein concentration of 12 per cent for demonstrating antibodies by the high protein tube test. The inclusion of albumin in the indirect antiglobulin test not only strengthened or enhanced the reactions but also revealed antibodies not previously demonstrable by the saline‐antiglobulin test.
Plasmapheresis as a Form of Blood Donation
Authors: Kliman Allan , Lesses Mark F.
Published: October 2009

Plasmapheresis has become a routine form of blood donation and is now an important source of plasma procurement. Procedures and equipment for plasmapheresis may differ but the basic act of bleeding the donor and safely returning the packed red cells remains the same. Care must be taken to avoid exposure of the donor to the risks of blood transfusion and to the iron depletion hazard of blood withdrawal. The donor should meet standard donor requirements, have a normal serum protein level and be able to maintain good nutrition. Plasma withdrawals of 1,000 ml. weekly are feasible but serum protein levels must be determined often enough to detect depletion. A careful system of blood and donor identification must be used and it is well to avoid handling potentially incompatible bloods simultaneously. The packed red cells should be returned to the donor within the shortest possible time after donation to avoid the risks of blood storage especially misidentifica‐tion, bacterial proliferation, and shortened survival of the red cells.
The Use of a Proteolytic Enzyme of Streptomyces Griseus (Protease G) in Blood Banking:
Authors: Buchanan Donald I. , Dierich K. P.
Published: October 2009

Protease G is a comparatively new proteolytic enzyme obtained as a by‐product in the manufacture of streptomycin. In this first study we have found it to be of great value in detecting incomplete anti‐Rh and other antibodies present in the sera of prenatal cases. Five per cent saline suspensions of selected cells were exposed to a 0.1 per cent solution of protease G, and results were compared with those obtained by using trypsinized and ficinized cells. In general, the results compare favorably with those obtained with ficin, and this new enzyme is superior to trypsin in titration studies. It is predicted that protease G will be a useful addition to the proteolytic enzymes that are currently used in many blood banking procedures.
Observations on Recipient Plasma Hemoglobin Concentration after Transfusion with Glycerolized Frozen Blood
Authors: Valeri C. R.
Published: October 2009

Recipient plasma hemoglobin was measured prior to, during, and following infusions of deglycer‐olized red blood cells resuspended in autologous plasma, 5 per cent outdated albumin resuspension medium, and isotonic saline. Blood collected in ACD solution and stored at 4 C was studied in a similar manner. The effect of aggregation and disaggregation of erythrocytes on the recipient plasma hemoglobin was observed. Observations in 12 nonsurgical recipients indicate that the mode of removal of nonviable deglycerolized erythrocytes is primarily through an extravascular mechanism without detectable hemoglobinemia.

The aggregation of erythrocytes in either ACD blood or deglycerolized, reconstituted blood with 5 per cent dextrose and water and their disaggregation with 0.9 per cent sodium chloride in a common channel of intravenous tubing produced no unexplained elevation of the recipient plasma hemoglobin. In seven recipients studied, no abnormal antibodies were detected following repeated transfusions of deglycerolized erythrocytes over a period of time.
Evaluation of Blood Transfusion Therapy
Authors: Diethrich Edward B.
Published: October 2009

The advantage of a “dynamic” rather than retrospective investigation of blood transfusion therapy is illustrated in this study. Positive criteria for the administration of whole blood are discussed in relation to the transfusion practices on the surgical, medical and obstetric‐gynecologic services of a large general hospital. Approximately 25 per cent ol the multiple and 60 per cent of the single unit transfusion were not indicated. The differences between the services regarding administration and indication for blood and the incidence of transfusion reactions are described. This study points out the need for periodic checking and education of persons responsible for blood transfusion therapy.
The Use of Serum Enzyme Determinations to Detect Anicteric Hepatitis
Authors: Prince Alfred M. , Gershon Richard K.
Published: October 2009

The distribution of transaminase values in a series of 1,906 sera drawn from clinically normal Republic of Korea Army recruits has been analyzed statistically. The data have indicated the existence of two normally distributed populations, and the hypothesis has been presented that one of these populations represents the normal population, characterized by absence of hepatocellular damage; and the other represents an “abnormal” population characterized by the presence of definite hepatocellular damage.

The data have been analyzed, and interpreted, with reference to the concept of “normal values,” frequency of anicteric serum hepatitis carriers, ratio of anicteric to icteric serum hepatitis, and the problem of exclusion of anicteric serum hepatitis carriers from blood bank procedures.

It is suggested that climination of bloods having SGPT concentrations of greater than 25 units, in this or similar populations, may result in elimination of approximately SO per cent of cases of anicteric hepatitis, with an associated loss of only about 15 per cent of available blood.
Identification of a Specific Leukocyte Antigen: Another Presumed Example of 5b
Authors: Lalezari Parviz , Bernard Georgette E.
Published: October 2009

A leukocyte agglutinating antibody obtained from a multiparous normal female was studied. By means of cross‐absorption and antibody elution methods, it was established that this antibody detected a single leukocyte antigen, designated as “Ke.” The data suggest a gene frequency of 0.8 for “Ke” and 0.2 for “ke,” the postulated allelic gene. The antigen is shared by granulocytes, lymphocytes‐monocytes, eosinophils and also platelets, but is absent from red cells. The cross reaction studies indicate that this antigen may be identical with group 5b already described by Van Rood.
A Simplified Technic of Open Heart Surgery
Authors: Beall Arthur C. , Cooley Denton A. , Hill William T.
Published: October 2009

Experimental and clinical investigations have demonstrated the superiority of disposable plastic oxygenators primed with 5 per cent dextrose in distilled water and normothermia for open heart surgery. Technical aspects of cardiopulmonary bypass have been simplified considerably by this method. Furthermore, numerous complications associated with the use of pooled homologous blood have been eliminated. Cardiopulmonary bypass now is available immediately in emergency situations, as well as in patients with religious objections to blood transfusion. During the past 28 months, 926 open heart operations have been performed using this method, and the results have been most gratifying.
Evaluation of the Albumin Antiglobulin Technic in Antibody Detection
Authors: Stroup Marjory , MacIlroy Mija
Published: October 2009

Studies were made of 363 sera containing specific antibodies in order to determine the influence of cell suspending media and time of incubation on the sensitivity of the anti‐globulin test. A comparison was made between the strength of the antiglobulin reaction when pooled test cells were suspended (1) in bovine albumin and (2) in saline. A duplicate set of tests compared incubation times of 15 minutes and one hour. Results obtained with the 162 sera tested indicate that the albumin medium for suspending the test cells is superior to the saline medium at either incubation time.

A second series was similar except that test cells were used individually and a 30 minute incubation was included in tests of some sera. The results with the 201 sera in this part of the study indicate no loss of sensitivity of the anti‐globulin test at a shortened incubation time of 15 minutes provided the test cells were suspended in bovine albumin.
Fate of Blood Units—A Retrospective Study
Authors: Shepherd Mary S. , Goff Flora , Henry John B.
Published: October 2009

A retrospective study of blood bank records for a two and a half year period for a relatively stable University Hospital Blood Bank serving a 385 bed teaching hospital and clinics has been completed. The source of blood units in terms of collection under the supervision of blood bank personnel versus blood units received from outside institutions revealed a comparable per cent of utilization but a decisive difference in discard rate with the greatest discrepancy attributed to outdating and reclamation as components. Over a consecutive two year period, percentage utilization remained virtually unchanged while the percentage discard was markedly decreased and reclamation significantly increased. The latter has been attributed to increased proficiency and efficiency of blood bank technical staff, a greater degree of accuracy by the clerical staff, tremendous progress in the education of house staff and faculty in the use of blood components and a shift of fresh frozen plasma procurement to a plasmapheresis system.
Complement Fixing Antibodies in Relation to Hemolytic Disease of the Newborn
Authors: Stratton F. , Gunson H. H. , Rawlinson Violet I.
Published: October 2009

Two cases of hemolytic disease of the newborn are described, based on clinical, hematological and serological findings. In both these cases the maternal serum contained complement fixing γ2‐globulin blood group antibody. In one case antibody was demonstrated in the cord serum. In both cases the direct Coombs test was positive with anti‐C' antiglobulin serum.
Interrelationship of the Various Subgroups of the Blood Group A: Study with Immunofluorescence
Authors: Cohen Flossie , Zuelzer Wolf W. , Evans Margaret M.
Published: October 2009

The various subgroups of A studied with immunofluorescence seemed to form a single antigenic continuum with the A1 bloods at one end, and the “weak” A bloods at the other. Within this continuum each blood except the strongest samples of A1 was characterized by its own individual spectrum of reactivity, which ranged frcm 4+ to no fluorescence. These findings support a quantitative basis for the differences between the various subgroups of A.

It is suggested that “weak” or Aw be used for the various bloods comprising the weak end of the continuum, rather than the numerous designations currently used, since with the fluorescent antibody technic, the differences within this group were no greater than those within the single category of A1 bloods.
Hemolytic Transfusion Reaction Associated with Poorly Detectable Anti‐Jka
Authors: Degnan Thomas J. , Rosenfield Richard E.
Published: October 2009

A hemolytic transfusion reaction, probably attributable to anti‐Jka, occurred in a patient whose serum, before transfusion, reacted only very weakly with Jk(a+) cells.
Titration and Scoring in Disputed Parentage
Authors: Sussman Leon N.
Published: October 2009

The importance of thorough familiarity with the methods of testing for unusual variants of the Rh‐Hr subgroups is demonstrated. Deductions based on serological findings, especially in Negroes in whom the variants are relatively common, must only be made after intensive investigation of all of the known possibilities. Specific antiserums of known characteristics are important in these studies. Titration and scoring technics can frequently be of help. Such sophisticated testing material can be intelligently and profitably used to resolve some complicated problems of genetics, heredity and parentage.
A New Rh Phenotype, Rhorh, G‐Negative
Authors: Zaino Edward C.
Published: October 2009

A new Rh phenotype, Rhorh, G‐negative is described in a Negro woman who developed anti‐G (rhG) antibodies during pregnancy. The baby was Rho, G‐positive and had mild hemolytic disease with a positive direct antiglobulin test. The mother's titer was 1:1024 at delivery, dropping to 1:8 after 14 months. The baby's direct antiglobulin test became negative after two months. The mother most likely became sensitized alter a blood transfusion five years prior.
The Frequency and Properties of pH‐Dependent Anti‐M
Authors: Beattie Kathryn M. , Zuelzer Wolf W.
Published: October 2009

The accidental finding of an agglutinin in ACD plasma, not demonstrable in unmodified serum from the same donor, led to the discovery of a pH‐dependent antibody with anti‐M specificity. Two additional examples were found shortly thereafter. Screening of 1,000 random group N donors disclosed 21 similar examples of pH‐dependent natural anti‐M.

Titers of the 24 antibodies studied in detail ranged from 1:1 to 1:128, with most falling in the lower range. The more potent sera reacted well at room temperature, provided the pH was kept in the proper range, the low‐titered sera were active only at 4 C. With increasing pH the agglutination could be abolished in every case. Under certain conditions, a prozone‐like effect was observed in titrations in which the initial acidification of the serum was kept marginal. This was shown to be the result of the buffemg effect of the serum at low dilutions, preventing acidification by the usually slightly acid (pH 5.6–6.0) saline. The optimum pH for demonstration of this type of anti‐M was found to be 6.5.
A Comparative Observation of the Presence of Anti‐Tja‐like Hemolysins in Relation to Obstetric History, Distribution of the Various Blood Groups and the Occurrence of Immune Anti‐A or Anti‐B Hemolysins Among Aborters and Nonaborters
Authors: Vos G. H.
Published: October 2009

Four hundred and twenty‐two mothers with histories of spontaneous abortion and 300 mothers without such histories were examined for their various red cell blood groups, substances in salivary secretions and for the presence of immune anti‐A and anti‐B hemolysins. These factors in the 722 patients were compared with the occurrence of anti‐Tja‐like hemolysins among aborters in Western Australia. Of significance was the observation that the presence of anti‐Tja‐like hemolysins was associated only with abortion while the presence of immune anti‐A or anti‐B hemolysins occurred more often in mothers with histories of stillbirths and neonatal deaths. The lower pregnancy rate observed among mothers possessing immune anti‐A or anti‐B hemolysins also suggests that infertility could be associated with the presence of these hemolysins.
The Antiglobulin Reaction on Albumin Enriched Cell Suspensions
Authors: Clayton Edwin M. , Brown Richard B. , Bove Joseph R.
Published: October 2009

The strength of the antiglobulin reaction with cells incubated in saline was compared with a similar reaction when albumin was added before or after incubation. In one case studied a weak rh“(E) antibody was not detected by the antiglobulin test with saline suspended cells and a transfusion reaction occurred. The incompatibility could be found by the antiglobulin test if the incubation mixture included added albumin. In another case an unidentified antibody had consistently weaker antiglobulin reactions after incubation in albumin compared to saline. An investigation of the antiglobulin activity of 40 antibodies showed antiglobulin agglutination scores that were significantly greater after incubation in the presence of albumin rather than saline. These data suggest that the sensitivity of the antiglobulin test is usually increased when antibodies and erythrocytes are incubated with added albumin.
Incidence of Antibodies Occurring in Healthy Donor Sera
Authors: Myhre B. A. , Greenwalt T. J. , Gajewski M.
Published: October 2009

A four‐year survey of the incidence of isoimmune antibodies in a volunteer donor population is reported. A yearly a verage of 0.34% of all units of blood was found to contain isoimmune antibodies. Antibodies were found in 0.56% of first time donors. The occurrence and types of antibodies as well as the screening method employed in their detection are outlined.
Increased Red Cell Destruction in the Absence of Demonstrable Antibodies in Vitro
Authors: van Loghem J. J. , van der Hart Mia , Moes Mieke , dem Borne A. E. G. Kr. von
Published: October 2009

Survival studies performed in human subjects, using Cr51‐labeled donor red cells, showed that in the absence of demonstrable humoral iso‐antibodies iso‐immunity can still exist. Three groups of persons were investigated: 1) patients with hypogammaglobulinemia; 2) donors with blood group A lacking anti‐B; 3) patients with hemolytic transfusion reactions.
A Method of Obtaining Sterile Pilot Samples When Drawing Blood into Plastic Containers
Authors: Macenas Lucia , Huestis Douglas W.
Published: October 2009

The authors present a simple method of obtaining sterile clotted pilot blood samples when drawing blood into plastic bags with integral donor tubing.
Effect of Lactose, Dextran and Albumin on Recovery and Survival of Frozen Red Cells
Authors: Strumia Max M. , Strumia Paul V. , Burns M. Elizabeth , Dugan Ann , Alter Burr , Benner Richard
Published: October 2009

We have studied the effect of albumin and dextran, with and without previous modification with lactose, on the recovery and posttransfusion survival of red cells subjected to rapid freezing and thawing.

Dextran and albumin have been found to protect red cells during freezing and thawing, with a recovery rate of 98.5 and 98.57%, respectively. A mean survival of 69.14% of red cells was obtained 24 hours posttransfusion when the red cells were treated with lactose, prior to freezing with dextran.

A relationship has been found to exist between the mean corpuscular volume of the frozen red cells and the posttransfusion survival; potassium loss, stability, dimensional changes and O2 dissociation of frozen red cells were determined.
The Age of Human Erythrocytes Lost During Freezing and Thawing with Glycerol Using the Cohn Fractionator
Authors: Valeri C. Robert , McCallum Linda
Published: October 2009

Three technics to identify the age of erythro‐cytes—Fe50, glucose‐6‐phosphate dehydrogenase activity, and osmotic fragility—were used to investigate the red cell population lost during glyceroli‐zation, freezing, thawing and deglycerolization, using the Cohn fractionator with the slow freeze technic.

The Fe50 study showed that “young” red blood cells (less than 20 days old) were preferentially retained. Both the glucose‐6‐phosphate dehydrogenase activity and osmotic fragility tests indicated random loss of “young” and “old” erythrocytes. However, neither of these methods can be used to determine the age distribution of the erythrocytes lost.
A Clinical Evaluation of the Use of Citrate‐Phosphate‐Dextrose Solution in Children
Authors: Kevy Sherwin V. , Gibson John G. , Button Lawrence
Published: October 2009

Red cells collected in CPD anticoagulant have been shown to have a mean postinfusion survival of greater than 75 per cent after 28 days of storage at 4C, in contrast to blood collected in ACD solution whose mean survival is less than 70 per cent after 28 days.

In a clinical study, 3,704 units of CPD blood collected in double plastic blood packs were utilized for 4,354 transfusions in 2,425 children. Evaluation of the stability of red cell antigens disclosed that blood preserved in CPD showed a minimal loss of antigenicity after 28 days. In contrast, clotted samples were hemolyzed and demonstrated marked loss of antigenicity for Kell, hr′(c) and P after 14 days.

Whole blood preserved in CPD provides two basic advantages over the presently used ACD solution. It provides a more physiologic blood for the recipient and has decreased the outdating percentage by better than 65 per cent.
Enhancement of Immunofluorescent Staining of Erythrocytes by Saponin Hemolysis
Authors: Massey Barbara W. , Klein Sidney J. , Reilly Emmett B.
Published: October 2009

The demonstration of human blood group antigens by the fluorescent antibody technic has been improved by hemolyzing the red cells with saponin. Hemoglobin has a quenching effect on fluorescence. Its removal resulted in dramatic enhancement of the stain. Saponin proved more effective for this purpose than several other common hemolytic agents, all of which caused nonspecific staining.

Antigens A, B, M, and N were readily demonstrated when the saponin step was incorporated into the usual two‐layer staining procedure. Antigen Rho(D) required the additional enhancement provided by the triple sandwich technic.
Prolonged Bleeding Times and Hypofibrinogenemia in Dogs After Infusion of Hydroxyethyl Starch and Dextran
Authors: Thompson W. L. , Gadsden R. H.
Published: October 2009

Dogs bled 25 ml/kg were infused intravenously with 25 ml/kg of 6% solutions of hydroxyethyl starch (HES), medium molecular weight (75,000) dextran, or Tyrode's saline solution. Bleeding times from ear punctures with BD Microlances were significantly prolonged to a similar extent after HES and dextran infusion during periods of observation of up to 10 hours; the increment in bleeding times was less after saline infusion. Paw puncture bleeding times also increased after HES and dextran, but decreased after administration of saline. Ratios of fibrinogen to total plasma protein concentrations decreased to 93 ± S.E. 4% of preinfusion ratios after HES, but decreased more significantly to 81 ± 4% and 78 ± 4% after dextran and Tyrode's saline infusion.
The Risk of Transmitting Toxoplasmosis by Blood Transfusion
Authors: Kimball Anne C. , Kean B. H. , Kellner Aaron
Published: October 2009

Forty‐three patients with thalassemia major who had received 4,805 transfusions were subjected to the dye test for toxoplasma antibodies. Only three (7%) were found to have subclinical toxoplasmosis, a rate of infection that is within the expected rate for this age group. This study, therefore, provides no evidence that toxoplasmosis was transmitted by transfusion.
Platelet Life Span
Authors: Gardner Frank H. , Cohen Phin
Published: October 2009

In the past decade platelet transfusions into thrombocytopenic recipients indicated that the platelet had a curvilinear lifespan. These early studies showed that platelet transfusions could be used to demonstrate shortened lifespans of platelets in idiopathic acute and chronic thrombocytopenic purpura. In addition, progressive shortening of the platelet lifespan followed the administration of multiple transfusions.

A variety of isotopes has been used to gather further information regarding platelet physiology in the non‐thrombocytopenic recipient. For the most part, irregular labeling or re‐utilization of the isotope has made these procedures unsatisfactory except for sodium chromate (Cr51).

Modification of ACD anticoagulant has been helpful in eliminating the initial sequestration of platelets noted earlier with EDTA anticoagulant. These more precise measurements have confirmed the linear, senescent, lifespan of the human blood platelet. A comparison of platelet measurements in the recipient by numerical counting and radioactivity of platelets has indicated that the data may not be comparable. These differences may be related to in vivo elution of the Cr51 label. For complete understanding of the platelet lifespan investigators should confirm isotope data with numerical counting of platelets.
The Anticoagulants of Choice for Platelet Transfusions
Authors: Aster Richard H.
Published: October 2009

A study was made of the recovery of Cr51‐labeled platelets transfused to normal recipients using various anticoagulant solutions. With ethylenediamine‐tetra‐acetate (EDTA) recoveries averaged 27 per cent (range 15% to 35%). With ACD (N.I.H. formula A) recoveries averaged 37 per cent (range 34% to 41%). With a citrate solution containing additional acid so as to reduce the pH of platelet‐rich plasma to 6.5 before concentration of cells, recoveries averaged 62 per cent (range 37% to 81%). Platelet clumping, usually a problem when platelets are concentrated in citrate, was prevented at pH 6.5. It is suggested that a citrate solution containing sufficient acid to buffer platelet‐rich plasma at pH 6.5 will increase the effectiveness of platelet concentrates.