bluuebunny/crossref_metadata_2025 huggingface dataset:
A Human Monoclonal IgM k Cold Agglutinin Recognizing Oligosaccharides with Immunodominant Sialyl Groups Preferentially at the Blood Group M‐Specific Peptide Backbone of Glycophorins: Anti‐PrM
Authors: Roelcke D. , Dahr W. , Kalden J.R.
Published: March 2009

Abstract. A k‐monotypic IgM high titer cold agglutinin reacting like anti‐Pr at low, like anti‐M at higher temperatures, is described. It recognizes tetra‐ and/or trisaccharides with immunodominant sialyl groups on glycophorins A, B, C like anti‐Pr. Its affinity to the oligosaccharides is, however, approximately 10‐fold increased when they are attached to the M‐specific peptide backbone of glycophorin A. The antibody, termed anti‐PrM, occurred in a blood group MN patient with chronic cold agglutinin disease and caused autoimmune hemolytic anemia.
Reduced Survival of Isotope‐Labelled Rh(D)‐Negative Donor Red Cells in a Patient with Anti‐LWab
Authors: Herron R. , Bell A. , Poole J. , Clark M. , Smith D. S. , Hamblin T. J.
Published: March 2009

Abstract. The serum of an 85‐year‐old Caucasian male with no history of blood transfusion contained an IgG3 antibody with anti‐LWab specificity. The antibody failed to react with dithiothreitol‐treated red cells, and there was a marked reduction in titre of the antibody with pronase‐treated cells, findings consistent with an antibody having this specificity. High association values were obtained in a mononuclear phagocyte assay when LW‐positive red cells, sensitised in vitro with the patient's serum antibody, were incubated with peripheral blood monocytes from the patient. In vivo red cell survival studies demonstrated that 99mTc‐labelled rhesus‐negative (rr), LW‐positive red cells had 53% survival at 1 h. The IgG subclass of the antibody, mononuclear phagocyte assay results and in vivo survival studies predicted a significant reduction in the posttransfusion survival of therapeutic volumes of rhesus‐negative (rr), LW‐positive red cells.
Rhesus Du Incompatibility in a Newborn with High Levels of Anti D and a Benign Clinical Course
Authors: Dias R. , Finney R. D. , Humphreys D. , Graham L.
Published: March 2009

Abstract. The Rhesus variant Du is regarded as a weak form of the Rhesus D antigen, but haemolytic disease of the newborn may occur if the maternal serum contains Anti‐D [5]. We describe the case of an infant with Rhesus Du incompatibility and high levels of Anti‐D in the maternal serum, but without clinical evidence of haemolytic disease of the newborn.
Neonatal Alloimmune Thrombocytopenia due to Fetomaternal Zwb Incompatibility
Authors: Mueller‐Eckhardt C. , Becker T. , Weisheit M. , Witz C. , Santoso S.
Published: March 2009

Abstract. A case of neonatal alloimmune thrombocytopenia due to fetomaternal incompatibility against the platelet‐specific antigen Zwb (P1A2) is described. The antibody was of the IgG class and did not fix complement in vitro. Its specificity was established by panel identification and by comparison to a Zwb antiserum. Gene dosage determinations of Zwa antigens on platelets of parents and child revealed that the mother was homozygous Zwa Zwa while father and child were heterozygous for this antigen.
Application of Network Planning Methodology to Workflow Analysis in a Reference Laboratory
Authors: AuBuchon J. P. , Anderson H. J.
Published: March 2009

Abstract. Efficient organization of the workflow in a reference laboratoy is essential to timely resolution of serological problems. This study investigated the usefulness of network planning methods to streamline workflow in a blood center reference laboratory. The investigation of a patient serological problem which included a positive direct antiglobulin test was chosen for analysis. Individual steps in the resolution process were identified. All possible logical sequences of these steps were investigated to determine which steps were along the ‘critical path’, the sequence of steps which is rate‐limiting. By implementing new procedures for these steps, faster resolution of a problem should result. The Program Evaluation Review Technique predicted that altering procedures to shorten 3 steps (autoadsorp‐tion, antibody identification panel at 37°C and screening for antigen‐negative units) would result in a decrease in the time required to complete a patient problem by 29%. Time‐motion studies documented a 35% improvement in problem resolution time with the new procedures (p>0.05). Utilization of the network planning techniques in an immunohematological laboratory may allow for more efficient and expedient operation.
A Human Monoclonal Antibody to rhG
Authors: Foung Steven K.H. , Blunt Judy , Perkins Susan , Winn Linda , Grumet F. Carl
Published: March 2009

Abstract. Hybridomas secreting a human monoclonal IgG1 antibody against a variant of the rhG antigen were produced from B lymphocytes of an Rh‐negative donor with serum antibodies to D and C antigens. The antibody reacts by indirect hemagglutination with nearly all C‐ or D‐positive cells, confirming the strong association in the expression of G with D or C antigens. The lack of antibody reactivity to C‐negative Du cells suggests a particular epitope on the D complex associated with the G antigen.
Interdonor Incompatibility Due to Anti‐Kell Antibody Undetectable by Automated Antibody Screening
Authors: West N.C. , Jenkins J.A. , Johnston B.R. , Modi N.
Published: March 2009

Abstract. A unit of whole donor blood, the plasma of which contained anti‐Kell antibody, was transfused into a Kell‐negative patient who had received a unit of Kell‐positive blood 4 weeks previously. A haemolytic transfusion reaction ensued. The antibody had gone undetected in routine automated screening of the donor blood. Automated antibody detection techniques do not offer reliable detection of anti‐Kell antibodies.
A Rare Blood Group Antigen, Ola (Oldeide), Associated with Weak Rh Antigens1
Authors: Kornstad Leif
Published: March 2009

Abstract. A ‘new’, rare blood group antigen, Ola (Oldeide), is described. Only one Ol(a+) person was found among the 7, 151 blood donors tested. Examination of the family of the proposita revealed 10 additional Ol(a+) persons. The study indicated that Ola is inherited as a Mendelian dominant character and segregates independently of the ABO, MNSs, P, Rh and Kidd blood group systems, of the ABH secretor genes, and of sex. Ol(a+) family members had depressed Rh antigens, while the Ol(a‐) members had Rh antigens of normal strength. The depression was particularly pronounced for the C and E antigens, less marked for the D antigen. Individual antisera differed in their ability to demonstrate the presence of the antigens. Depression of the c and e antigens could not be demonstrated conclusively with the antisera available.
Modified Glycine Precipitation Technique for the Preparation of Factor VIII Concentrate of High Purity and High Stability
Authors: Brodniewicz‐Proba Teresa , Beauregard Denyse
Published: March 2009

Abstract. A modification of the glycine precipitation method for the production of factor VIII concentrate is reported. In this procedure, cryoprecipitate was prepared, washed and dissolved in buffer. Contaminating fibrinogen was precipitated by the addition of 2.8 M glycine buffer at 30°C. The fibrinogen precipitate was removed by filtration using a layer of glass beads. Factor VIII was then precipitated from the filtrate by adding solid NaCl. After centrifugation, the precipitate was resuspended in buffer, desalted, sterilized by filtration, lyophilized and subjected to dry‐heat treatment. The procedure gave a good recovery of factor VIII (280IU/1) and seems applicable to large‐scale production. The resulting factor VIII concentrate was especially characterized by its high purity (10 IU/mg) and stability both in the liquid state and during dry‐heat treatment.
Finnish En(a‐) Propositus with Anti‐EnaFS and Anti‐EnaFR: In vitro and in vivo Characteristics
Authors: Walker P.S. , Bergren M.O. , Busch M.P. , Carmody A.M. , Perkins H.A.
Published: March 2009

Abstract. A third Finnish En(a–) individual (ERP) with alloanti‐Ena has been identified. Subsequent family studies revealed that ERP is distantly related to the 2 previous Finnish En(a–) propositi. Serologically, ERP's erythrocytes were found to be M‐N‐‘N’+S‐s+U+En(a–)Wr(a‐b‐) and were sialic acid deficient. SDS‐PAGE studies confirmed that the red cell membranes lacked the MN‐sialoglycoprotein, glycophorin‐A. ERP's serum contained an IgG antibody which demonstrated two separable specificities, a ficin‐sensitive specificity (anti‐EnFS) and a ficin‐ resistant specificity (anti‐EnFR), which reacted by the indirect antiglobulin technique. The antibodies were probably pregnancy induced, as ERP had never been transfused. A 51Cr‐labelled red cell survival study showed that the antibodies were capable of causing significant destruction of incompatible red cells.
WES, a ‘New’ Infrequent Blood Group Antigen in Finns
Authors: Sistonen P. , Nevanlinna H.R. , Virtaranta‐Knowles K. , Tuominen I. , Pirkola A. , Green C.A. , Tippett P.
Published: March 2009

Abstract. A previously unrecognized infrequent blood group antigen WES occurs with a frequency of 0.56% in the Finnish population, but has an ethnically restricted distribution. Apart from Finns it was found only in 2 donors, most likely of African origin, among 4,655 people tested who represented many different ethnic groups. WES is shown to be a dominant autosomally inherited character different from previously published infrequent antigens. The data allow exclusion from almost all established blood group systems. The WES antigen is destroyed by enzymes α‐chymotrypsin and pronase. It is also present in plasma of WES+ individuals. Evidence suggests that the soluble form of the antigen is a high molecular weight protein constituent of plasma. Unlike many other antigens present on red cells as well as in plasma, the WES antigen is well developed on red cells of neonates and can also be found in cord serum.
Allo‐Anti‐Chido in a Ch‐Positive Patient
Authors: Giles Carolyn M. , Hoffman Mary , Moulds Marilyn , Harris Michael , Dalmasso Augustin
Published: March 2009

Abstract. Allo‐anti‐Chido (Ch) was detected in a patient whose red cells typed as Ch+. The C4 allotype of the patient was A4,B2 which associates strongly with the Ch phenotype Ch:1,‐2,3,4,‐5,6. Anti‐Ch2 + Ch5 were the Ch specificities identified. Absence of only Ch2 and Ch5 determinants on the C4B protein allowed this unique immune response to blood transfusion.
Plateletapheresis Using Single Vein Access: A Comparison of Haemonetics V‐50 and Fenwal CS‐3000 Blood Cell Separators
Authors: Vados Wanda , Thompson Hannis , Scott Edward
Published: March 2009

Abstract. Donors were randomly selected for plateletapheresis using either the Haemonetics V‐50 surge procedure or the Fenwal CS‐3000 with special modifications. Six procedures using the V‐50 were performed with 6 collection cycles. Platelet yields averaged 3.9times1011 with an average white cell contamination of 3.8times108. Ten procedures were performed with 8 collection cycles. Platelet yields averaged 4.5times1011 with an average white cell contamination of 1.2times108. CS‐3000 procedures were performed using either 4,000 or 4,800 ml whole blood processed as the endpoint. Concentrates obtained using 4,000 ml (n=10) as the endpoint contained 3.9times1011 platelets with a white cell contamination of 9.2times108. A 4,800 ml (n=5) endpoint produced concentrates with a yield of 4.5times1011 and white cell contamination of 10.4times108.
The pH Optima for Papain and Bromelain Treatment of Red Cells
Authors: Scott Marion L. , Johnson Carole A. , Phillips P.K.
Published: March 2009

Abstract. The action of papain and bromelain, prepared over a pH range from 4.6 to 8.6, was evaluated for the ability to render red cells agglutinable by five incomplete antibodies of differing blood group specificities using a two‐stage technique. The optimal pH for treatment of red cells by activated papain or bromelain was between 5.4 and 5.8. Above this pH range, a fall in serological sensitivity was apparent which was much more pronounced with papain than with bromelain. The optimal pH for enzyme treatment of red cells can be achieved in two‐stage techniques, but not in one‐stage techniques due to the buffering effect of serum proteins.
Monoclonal Anti‐K14 and Anti‐K2
Authors: Nichols Margaret E. , Rosenfield Richard E. , Rubinstein Pablo
Published: March 2009

Abstract. Mouse hybridoma clones have produced monoclonal antibodies directed against the K:14 and K:2 high‐incidence antigens of the Kell blood group system. Two examples of anti‐K14 were isolated, each arising from a separate fusion procedure. All three monoclonal antibodies are of the immunoglobulin class IgGl. Serological activity is consistent with that seen with human antibodies to high‐incidence Kell system antigens, and their epitopes are destroyed, as usual, by 2‐aminoethylisothiuronium bromide treatment. Specificity was further confirmed by adsorption and elution studies. Tests against nonhuman primate red cells demonstrated the expression of K:14 only by the great apes, whereas K:2 was present on all red cells tested. These findings emphasize the usefulness of monoclonal antibodies to elucidate the evolutionary patterns of blood group variants.
An Enzyme‐Linked Immunosorbent Assay Utilizing Monoclonal Antibodies for the Characterization of Immunoglobulin Classes and Subclasses of Anti‐Red Cell Antibodies
Authors: François‐Gérard Christiane , Opret‐Meunier Carine
Published: March 2009

Abstract. The destruction of transfused red cells results from both humoral and cellular immune mechanisms. Numerous factors are likely to affect this destruction. Among them, the class and subclass of antibody‐carrying immunoglobulins are of great importance. Compatibility testing routinely realized in vitro in Blood Group Laboratories is not always very helpful in predicting the in vivo significance of alloantibodies. In this sense, we have investigated an enzyme immunoassay that makes it possible to identify the isotype profile of any auto‐ or alloantibody. This solid‐phase immunoassay utilizes mouse monoclonal antibodies specific for individual human IgG subclasses in a double‐sandwich test, in which the sample to be analyzed is an eluate obtained by classical absorptionelution methods.
Effects of Partial and Total Isovolemic Exchange Transfusion in Fully Conscious Rats Using Pyridoxylated Polyhemoglobin Solution as a Colloidal Oxygen‐Delivering Blood Replacement Fluid1
Authors: Keipert P. E. , Chang T. M. S.
Published: March 2009

Abstract. Stroma‐free hemoglobin (SFHb) treated with pyridoxal 5′‐phosphate (PP) was intermolecularly cross‐linked with glutaraldehyde to give pyridoxylated polyhemoglobin (PP‐PolyHb) solution (14.0 g/dl) with colloid osmotic pressure = 25 torr and a P50 = 20 torr. To evaluate PP‐PolyHb as a blood substitute, fully conscious rats with chronic cannulations were subjected to blood replacement (30–100%) by a new continuous isovolemic exchange transfusion set up. Crystalline SFHb, PP‐SFHb, PP‐PolyHb, bovine serum albumin (BSA) and Ringer's solution were tested. Respiration, pulse and arterial blood pressure were more stable following transfusion with PP‐PolyHb or PP‐SFHb compared to BSA. By 7–8 days post‐exchange, hematological changes returned to normal. Plasma retention of PP‐PolyHb was 10–15 times longer than either crystalline SFHb or PP‐SFHb for major blood exchanges. A T 1/2 of 30 h was obtained for PP‐PolyHb after total replacement. Long‐term survival rates of 80, 63 and 50%, following replacement of 70, 85 and 100%, respectively, were significantly higher (p<0.05) than survival obtained for all other solutions tested. Superiority of PP‐PolyHb over other fluids was clearly demonstrated.
Post‐Thaw Storage at 4°C of Previously Frozen Red Cells with Retention of 2,3‐DPG1
Authors: Moore Gerald L. , Ledford Mary Edith , Mathewson Peter J. , Hankins Dennis J. , Shah Shruti B.
Published: March 2009

Abstract. Fresh human blood was collected in CPD, frozen by either the Meryman or the Valeri high glycerol technique, and stored at ‐80 °C. Later the red cells were thawed, deglycerolized by the appropriate technique and resuspended in either saline‐glucose wash solution or an additive solution containing ascorbate‐2‐phosphate, ade‐nine, glucose (dextrose), mannitol and sodium phosphate. The cells were stored at 4–6 °C for 21 days and assayed weekly for ATP, 2,3‐DPG, pH, P50, glucose utilization and lysis. The additive solution maintained red cell 2,3‐DPG at fresh blood levels for 3 weeks and maintained ATP levels sufficiently well to suggest good red cell viability for 21 days. There was no difference in results between the Meryman or the Valeri freezing methods if sodium phosphate was used with the saline‐glucose wash solution in the Valeri method. If this additive solution is coupled with sterile deglycerolization techniques, 3 weeks of post‐thaw red cell preservation would be practical. Using this additive solution would make frozen blood a reasonable source of red cells for emergency needs in both military and civilian blood banking.
The Role of HIV Infectivity and Composition of Factor VIII Concentrates on the Immunity of Haemophiliacs Positive for HIV Antibodies
Authors: Allain J.P. , Frommel D. , Bosser C. , Gazengel C. , Larrieu M.J. , Sultan Y. ,   AIDS‐Haemophilia French Study Group
Published: March 2009

Abstract. Forty‐six subjects (44 HIV antibody‐positive) with some degree of immune deficiency (at least TH/TS ratio below 1) were randomly distributed into 4 treatment groups. Each group was assigned to 1 of 4 products to be used exclusively for a 1‐year period: 1 concentrate was of intermediate purity and not heat‐treated, and 3 were heat‐treated in order to inactivate HIV, 2 of them being of higher purity. At 4–6‐month intervals, check‐ups, including as markers clinical examination, platelet, lymphocyte and T cell subset counts, IgG levels and delayed hypersensitivity test, were carried out. At entry as well as at the end of the study, groups were not statistically distinguishable. No intra‐ nor inter‐group differences were demonstrable for any of the markers. In contrast, using a scoring system for each marker and the results of check‐up at entry as reference, significant differences between groups appeared on subsequent check‐ups. Patients receiving intermediate‐purity factor VIII, whether heat‐treated or not, were mostly steady, while groups receiving heat‐treated concentrates of a higher purity significantly worsened. This surprising outcome was no related to differences in anti‐HIV titers or specificities. From this study, the potential long‐term predictive value of this scoring system could not be established.
Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p
Authors: Shechter Yael , Timor‐Tritsch Han E. , Lewit Nathan , Sela Ruth , Levene Cyril
Published: March 2009

Abstract. Women with the rare blood group p are known to have an increased rate of abortions. The case of a 36‐year‐old woman is presented who had had 7 spontaneous abortions in the first trimester and no live child. When treated by plasma exchange begun early in pregnancy and continued until the 29th week, she delivered a normal child. Time to begin, amount and length of time necessary to continue plasma exchange in these patients are considered. In addition, the question of which fraction of the anti‐PP1Pk could be responsible for abortion is discussed. To our knowledge, this is the first case of a woman of p phenotype with no live children but with multiple abortions treated by this method, which should be seriously considered in similar cases.
Transfusion Significance of LWa Allo‐Antibodies
Authors: Napier J.A.F. , Rowe G.P.
Published: March 2009

Abstract. An example of anti‐LWa, arising as a complication during a RhD immunization programme, has been studied for evidence of its likely in vivo haemolytic properties. In vitro testing of the anti‐LWa showed it to be largely IgG1 acting by the antiglobulin technique. Results of antibody‐dependent cellular cytotoxicity and macrophage phagocytic assays were both negative. However, 99mTc‐labelled Lw(a+) donor cells showed a slight reduction in t1/2> (18 h) compared with the normal survival of autologous cells. Despite this observation, and bearing in mind the difficulties of interpreting apparently accelerated destruction of small volumes of serologically incompatible red cells, it was concluded that the presence of this example of anti‐LWa should not be a bar to urgent transfusion.
Detection of the Human Erythrocyte Surface Antigen Gerbich by Flow Cytometry using Human Antibodies and Phycoerythrin for Extreme Immunofluorescence Sensitivity
Authors: McHugh Thomas M. , Reid Marion E. , Stites Daniel P. , Chase Eric S. , Casavant Conrad H.
Published: March 2009

Abstract. We used indirect immunofluorescence and flow cytometry to detect the human erythrocyte surface antigen Gerbich. The procedure consisted of sequential erythrocyte‐labeling with human antibody to Gerbich, biotinylated goat anti‐human IgG and finally phycoerythrin‐conjugated streptavidin. With maximal excitation of phycoerythrin at 546 nm, an increase in the fluorescence sensitivity was achieved. All erythrocytes from normal controls had detectable Gerbich antigen with little variation in antigen density between individuals. Six Gerbich‐negative patients had no detectable antigen. By diluting the erythrocytes, as few as 0.1% antigen‐positive cells in an antigen‐negative population could be detected. These studies indicate that flow cytometry is a useful technique for the detection of erythrocyte surface antigens.
Non‐A Non‐B Hepatitis and the Safety of Intravenous Immune Globulin, pH 4.2: A Retrospective Survey:
Authors: Rousell Ralph H. , Good Robert A. , Pirofsky Bernard , Schiff Richard I.
Published: March 2009

Abstract. Evidence for transmission of non‐A non‐B hepatitis (NANB) was sought in 41 patients with primary immune deficiency who were receiving human intravenous immune globulin (IGIV) over periods ranging from 6 to 15 months at a monthly dosage of 400 mg/kg body weight. One lot of a reduced and alkylated IGIV and three lots of a nonmodified preparation stabilized at pH 4.2 were used. No evidence of NANB was found, although transient elevations in serum glutamic pyruvic transaminase (alanine aminotransferase) were found in 6 of the patients. The possible causes of the elevated levels in these 6 patients are discussed.
Inactivation of Lipid‐Enveloped Viruses in Labile Blood Derivatives by Unsaturated Fatty Acids
Authors: Horowitz Bernard , Piët Marcel P.J. , Prince Alfred M. , Edwards Carol A. , Lippin Arnold , Walakovits Lori A.
Published: March 2009

Abstract. Virus sterilization of blood plasma derivatives by addition of several naturally occurring fatty acids was evaluated using vesicular stomatitis virus and Sindbis virus as markers for lipid‐enveloped virus inactivation and human immunodeficiency virus (HIV). Inactivation of ≥104tissue culture infectious doses (TCID50) of marker viruses added to antihemophilic factor (AHF) concentrates, with 60–100% retention of AHF activity, was achieved with oleic, 11‐eicosenoic, linoleic, linolenic, palmitoleic and arachidonic acids. Elaidic, gamma‐linolenic, palmitic, and arachidic acids and another fat‐soluble compound previously reported to inactivate virus, butylated hydroxytoluene, were less effective. A long chain mono‐ but not a di‐ or triglyceride also displayed virucidal properties. Evaluation of the inactivation of HIV added to an immune globulin solution on exposure to 0.033% sodium oleate for 20 min indicated inactivation of ≥1034TCID50. The degree of virus inactivation depended on the sample composition. A favorable balance was achieved between degree of virus inactivation and retention of protein function for AHF concentrate, prothrombin complex concentrate, antithrombin III concentrate, and immune globulin solution on incubation with 0.033% (w/v) sodium oleate at 24 °C for 4–6 h. Virus inactivation in whole plasma and plasma cryoprecipitate was not complete despite use of higher concentrations of sodium oleate and/or incubation at 37 °C. Reduced virus kill in these less purified derivatives probably is a consequence of their endogenous lipid and/or albumin.
HIV Antibody Screening of Blood Donations in the United Kingdom
Authors: Gunson Harold H. , Rawlinson Violet I.
Published: March 2009

Abstract. Routine screening of blood donations for anti‐HIV commenced in the UK during October 1985 and by the end of February 1987 approximately 3.7 million donations had been tested. Seventy‐two were confirmed anti‐HIV positive, i.e. 0.002%. Of the anti‐HIV‐positive donors interviewed to date, the majority are young homosexual or bisexual men or intravenous drug abusers. Included in the study are data collected on approximately 470,000 donors giving blood for the first time. Twenty of these have been confirmed anti‐HIV positive (0.004%), and 19 interviewed have admitted to being in risk categories. In 5 instances a positive anti‐HIV donor was found negative on a previous occasion, and in 1 instance the products from the donation led to seroconversion in the recipients. The majority of anti‐HIV‐positive donors attending for blood donation did so because they did not consider that the self‐exclusion categories specified in the leaflet issued to donors applied to them since homosexual activity or drug abuse was not currently being practised.
An Immunoblotting Technique for Direct Visualization of Chido and Rodgers Reactivity on C4 Variants after Electrophoresis
Authors: Sklarin Peter M. , Awdeh Zuheir L. , Alper Chester A.
Published: March 2009

Abstract. An immunoblotting technique allows direct visualization of Chido and Rodgers antigenic determinants on intact C4 proteins. C4 molecules separated by electrophoresis are selectively transferred to nitrocellulose membranes saturated with goat antiserum to human C4. The membranes are then incubated in alloanti‐Chido or anti‐Rodgers followed by enzyme‐conjugated goat antihuman IgG. Molecules with Chido or Rodgers reactivity are visualized by incubation with an indicator substrate for the bound enzyme.
Zulu XX/XX Dispermic Chimaera from Natal with Two Populations of Red Blood Cells and Patchy Skin Pigmentation
Authors: Moores Phyllis P. , Watkins Winifred M. , Greenwell Pamela , Dunn D. , Bird Angela
Published: March 2009

Abstract. The chimaera is female and has two children. Her blood contains 99% group 0, type AcP: BA, Pep‐A: 8–2 and 1% group A2B, type AcP:RA, Pep‐A: 1 red cells. H‐, A‐ and B‐transferase activities were demonstrated in her serum. The level of the H enzyme activity is low but is at the lower end of the normal range for group 0 persons. The levels of the A and B enzymes are also low but are higher than expected in a person with 1% A2B red cells in the blood. The levels of the A and B enzymes indicate that tissues other than the chimaera's haemopoietic tissue carry her genetically A2B cell line and are contributing the corresponding transferases to her plasma. Gross patchy skin pigmentation is present on the upper part of her body. The chimaera has evidently inherited two dissimilar germ nuclei from each parent.
Major Histocompatibility Complex Markers in Patients with Nomifensine‐Induced Immune Hemolytic Anemia
Authors: Mueller‐Eckhardt Gertrud , Giers G. , Salama A. , Schendel Dolores J. , Fass G. , Mueller‐Eckhardt C.
Published: March 2009

Abstract. To evaluate a possible role of major‐histocompatibility‐complex (MHC)‐related immune‐response genes for the selective production of drug‐induced antibodies, HLA class I (ABC), class II (DR, DQ), class III (BF, C2, C4A, C4B) as well as glyoxalase‐1 allotypes were investigated in 26 patients with nomifensine‐induced immune hemolytic anemia. No statistically significant deviations of MHC antigen frequencies were noted. The possible implications of these findings are discussed.
Evaluation of Three Second‐Generation and Three Confirmatory Assays for Antibodies to Human Immunodeficiency Virus
Authors: Lelie P. Nico , Reesink Henk W. , Huisman Han
Published: March 2009

Abstract. The second‐generation enzyme immunoassays (EIAs) for antibodies against human immunodeficiency virus (HIV) from three manufacturers (Abbott, Organon, Wellcome) and three anti‐HIV confirmatory tests, i.e. Western Blot (WB, Biotech, Dupont), radioimmunoprecipitation assay (RIPA, CLB) and a competitive immunoassay (CIA, Abbott) were evaluated on a panel of 6,488 serum samples, which had previously been used for the comparison of seven first‐generation EIAs. For the present study the panel was expanded with sequential serum samples from 12 individuals followed at 1 ‐ to 3‐month intervals during seroconversion for anti‐HIV. The second‐generation EIAs and confirmatory tests were significantly more sensitive than the first‐generation EIAs as was demonstrated by detection of 10‐ to 100‐fold higher endpoint titers in anti‐HIV‐positive sera as well as by earlier detection of anti‐HIV in 7–11 of the 12 subjects, who seroconverted. In all sera obtained during early HIV infection anti‐gp160/120envantibodies (WB, CIA) were found in addition to anti‐p24 (WB, RIP A) and in serial twofold dilutions of these ‘seroconversion samples’ the new Abbott EIA and RIPA were significantly more sensitive than WB (p < 0.05), whereas CIA and the new Organon EIA were significantly less sensitive than WB (p < 0.05). The new Wellcome EIA was not statistically less sensitive than WB. The CIA was as sensitive as WB for antibodies to envelope proteins (gp 41, gp 160, gp 120), but considerably less sensitive for core (p24) antibodies, as was shown in sera obtained during early as well as later clinical stages of HIV infection. The frequencies of false‐positive reactions by the second‐generation EIAs on a panel of 292 tricky samples from patients with e.g. autoimmune diseases and acute viral infections and in a panel of 283 selected donor sera, with false‐positive reactivities in the first‐generation EIAs were: Abbott 1.0%, 0.3%, Wellcome 0%, 0%, and Organon 0.3%, 0%. By the confirmatory tests they were: WB (anti‐p24) 1.7%, 10.2%; RIPA (anti‐p24) 0.3%, 1.1%; and CIA 0.3%, 0.3%. It is concluded that application of highly sensitive second‐generation EIAs in blood banks is important to further reduce the risk of posttransfusion HIV infection.
Neonatal Alloimmune Amegakaryocytosis:
Authors: Bizzaro Nicola , Dianese Gianfranco
Published: March 2009

Abstract. A case of neonatal alloimmune thrombocytopenia with amegakaryocytosis is described. The baby was treated by double‐volume exchange transfusion with only a temporary benefit; 2 weeks of steroid treatment were unsuccessful but the platelet count did increase transiently after infusion of random donor platelets. The newborn recovered after intravenous immunoglobulin, with restoration of the megakaryocyte thrombocytopoiesis and platelet number. The rare antigen Koaon the paternal platelets and maternal immunization against it were detected.
Progressive Loss of Fibronectin‐Mediated Opsonic Activity in Plasma Cryoprecipitate with Storage
Authors: Blumenstock Frank A. , Valeri C. Robert , Saba Thomas M. , Cho Eshin , Melaragno Anthony , Gray Alan , Lewis Martin
Published: March 2009

Abstract. Septic injured patients often manifest a deficiency of plasma fibronectin. Several studies have shown improvements in organ function in such patients following infusion of fibronectin‐rich plasma cryoprecipitate, while other studies found no improvement. One explanation for these differences may be the use of plasma crypoprecipitate which has been stored for various time intervals prior to its use as a source of fibronectin. This investigation tested the hypothesis that the opsonic activity of fibronectin in cryoprecipitate may decline with increased storage duration. Using a bioassay of opsonic activity, we evaluated human plasma cryoprecipitate that was stored at either ‐20 or ‐80°C for various intervals (2 weeks to 12 months) after its preparation from fresh donor plasma. Our findings demonstrated that the opsonic activity of fibronectin in cryoprecipitate declined with increasing time of storage. Significant loss (p < 0.05) of opsonic activity was first evident after 2 months of storage. Storage at ‐80°C did not prevent this decline in opsonic activity as compared to storage at ‐20 °C. Immunoblot analysis revealed extensive fragmentation of the dimeric fibronectin (440 kdaltons) and the presence of lower molecular weight fragments in 4‐ to 12‐month‐old plasma cryoprecipitate. Therefore, plasma cryoprecipitate of varying ages (storage time) when used as a source of fibronectin for replacement therapy to support phagocytic function in septic injured patients may result in different fibronectin‐mediated responses. The decline in activity may be due, in part, to fragmentation of the fibronectin molecule.
IgM Anti‐D as Auto‐Antibody in a Case of ‘Cold’ Auto‐Immune Haemolytic Anaemia
Authors: Longster G.H. , Johnson E.
Published: March 2009

Abstract. A case is reported of an auto‐immune haemolytic anaemia caused by IgM anti‐D. This antibody, although active at 37 °C, gave stronger reactions at lower temperatures and appeared to activate complement. The auto‐immune haemolytic anaemia was probably secondary to a non‐Hodgkins lymphoma.
The Swann Phenotype 700:4,‐41; Genetic Studies
Authors: Lewis M. , Kaita H. , Philipps S. , Coghlan G. , Belcher E. , Zelinski T. , McAlpine P.J. , Coopland G.
Published: March 2009

Abstract. Serological analysis of the red cells from members of a large French‐Canadian kindred proved that the Swa antigen is not part of the P1, Dombrock or Yt blood group systems. A linkage analysis of the SW blood group locus in relation to 27 other loci indicates that SW is not closely linked to ABO, ACP1, ADA, AK1, C3, D2S5, DO, ESD, F13A, FY, GLO1, GPT, HP, IGHG, JK, LU, MYCL, P1, PGP, PGM1, PLG, RH or YT. By inference the study also allows exclusion of Swa from the Landsteiner‐Wiener, Radin and Scianna blood group systems and exclusion of SW from the p22.1 to p34 segment of chromosome 1.
Pattern of Immunoglobulin Classes and IgG Subclasses of Platelet‐Associated Immunoglobulin in HIV‐Seropositive Haemophiliacs
Authors: Taaning E. , Scheibel E. , Laursen B. , Ingerslev J.
Published: March 2009

Abstract.Abnormal amounts of platelet‐associated immunoglobulins (PAIg) and seropositivity for HIV were demonstrated in 18 haemophiliacs suffering from thrombocytopenia of varying severity. Among 34 non‐thrombocytopenic haemophiliacs seropositivity for HIV was found in association with increased levels of PAIg in 18 patients, whereas increased amounts of PAIg were seen only in 4 of the 16 patients seronegative for HIV. In most of the haemophiliacs with thrombocytopenia, the PAIg represented all classes of immunoglobulins and in half of the cases all subclasses of IgG, while in 33 patients with autoimmune thrombocytopenic purpura (AITP), PAIg was IgG1 and IgM in most cases. Our data show a difference in the pattern of PAIg in AITP patients and in thrombocytopenic haemophiliacs seropositive for HIV. We suggest that the thrombocytopenia in haemophiliacs is related to the polyclonal B cell activation also found in other patients seropositive for HIV and perhaps indicative of AIDS‐related complex.
Complement‐Independent Lysis of Human Red Blood Cells by Cold Hemagglutinins
Authors: Salama A. , Göttsche B. , Vaidya V. , Santoso S. , Mueller‐Eckhardt C.
Published: March 2009

Abstract. Hemolysis mediated by human antibodies is generally ascribed to the attack of red blood cells (RBC) by complement. We here extend earlier in vitro observations which indicate that potent cold agglutinins can directly cause lysis of RBC without the participation of complement. We have noted that EDTA plasma taken from patients with cold agglutinin disease is frequently reddish if the plasma is not immediately separated from the cells at 37°C. Moreover, eluates prepared in such cases from plasma or heat‐inactivated serum (30 min at 56°C) by absorption (at 4–20°C) and elution (at 37°C) are usually contaminated with hemoglobin, and a large number of RBC used for absorption is lost during the procedure. To characterize this phenomenon further, we examined the effect of different hemagglutinating antibodies in vitro on normal RBC in the absence of complement. Hemolysis (5–17%) of RBC only occurred after treating the cells with potent antibodies at low temperatures (0–20°C). This hemolysis increased 2‐ to 3‐fold when the RBC were treated with an enzyme and decreased with rising temperature. Unlike cells hemolyzed by complement activation, no C5b‐9 complexes could be detected on RBC damaged by this mechanism.
High‐Titer, High‐Thermal‐Amplitude Cold Autoagglutinin Not Associated with Hemolytic Anemia
Authors: Sniecinski Irena , Margolin Kim , Shulman Ira , Oien Linda , Meyer Elisabeth , Branch Donald R.
Published: March 2009

Abstract. An example of an unusual cold autoagglutinin is reported. The antibody was monoclonal IgMKappa able to fix complement, and, in the presence of albumin, had both a high titer (>4,096 at 4 °C) and a wide thermal range (4–37 °C). The patient was closely followed over a 3‐year period with no evidence of hemolysis ever documented, despite a persistently positive direct antiglobulin test and the presence of the cold autoagglutinin. In contrast to previous reports regarding cold‐agglutinin disease, this case demonstrates that in vivo hemolysis is not always associated with cold autoagglutinins that in vitro show a high thermal range in the presence of albumin.
Separation of Mononuclear Bone Marrow Cells using the Cobe 2997 Blood Cell Separator
Authors: Faradji A. , Andreu G. , Pillier‐Loriette C. , Bohbot A. , Nicod A. , Autran B. , Bergerat J.P. , Rio B. , Leblond V. , Binet J.L. , Zittoun R. , Oberling F.
Published: March 2009

Abstract. In the present study, we report the results of our evaluation of the use of the continuous‐flow cell separator Cobe 2997 to isolate from human bone marrow (BM) aspirates the mononuclear cell (MNC) fraction containing hematopoietic stem cells. This MNC concentrate is isolated in 15% of the original BM volume and contains 23% of the initial nucleated cells. It is enriched as concerns the BM MNC fraction (lymphocytes + monocytes recovery; 80%), whereas the contamination with granulocytes, red blood cells and platelets is reduced to 7.2, 1.5% and 41%, respectively, of the cells initially present in the BM suspensions. Furthermore, it is demonstrated that this MNC concentrate is highly enriched in granulocyte‐macrophage‐colony‐forming cells (CFU‐GM; recovery 83%). The method is simple, inexpensive, efficient and reproducible. It allows rapid processing of a large volume of BM without substantial loss of hematopoietic progenitor cells. It represents a valuable method of BM MNC concentration prior to further in vitro manipulations such as T cell or tumor cell depletion or cryopreservation.
HIV Antibody Screening and Confirmatory Testing of Italian Blood Donors
Authors: Ferroni Pierino , Tagger Alessandro , Pasquali Marina , Profeta Maria Luisa ,   The Retrovirus Study Group of The Italian Society of Blood Transfusion (SIITS‐AICT, Lombardia)
Published: March 2009

Abstract. During the first year (1986) of blood donor screening for antibody to HIV, 201, 750 subjects were tested in 40 blood banks of Lombardia (Italy). All sera repeatedly positive by ELISA were submitted to our reference center for confirmation by Western blot (WB). Only 40 (0.02%) of 286 repeatedly reactive donors were positive by WB, whereas another 45 (0.022%) gave atypical antibody reactivities on WB, mainly directed against HIV core proteins. Of the 16 donors with inconclusive WB results followed for 4–12 months, 3 developed a full‐blown antibody response, 5 maintained the anti‐core reactivity throughout the follow‐up period, and 8 lost all reactivities. The use of recombinant env and core antigen ELISAs seems to decrease the proportion of sera with inconclusive WB reactions, and to identify as true positive all seroconverting donors in advance of the WB test. The large majority (35 out of 40) of WB‐positive donors and all seroconverters for antibody to HIV admitted to belong to a group at risk for AIDS. Among the 19 first‐time donors with HIV infection, we found 3 subjects with serological evidence of LAV‐2 infection. We describe also the diagnostic and ethical issues when a donor notification policy is based on WB confirmatory procedures.
Persistent Alanine Aminotransferase Elevation in Healthy Swedish Blood Donors ‐ Mainly Caused by Obesity
Authors: Wejstål R. , Hansson G. , Lindholm A. , Norkrans G.
Published: March 2009

Abstract. Five hundred consecutive healthy blood donors were tested for serum alanine aminotransferase (ALT) and 44 (8.8%) had increased levels. Donors with and without raised ALT were compared in several aspects but only weight (expressed as percentage of ideal body weight) and sex differed significantly (119.1 ± 14.5 and 106.3 ± 12.8%, respectively; p<0.001 and males 97.7 and 77.1%, respectively; p <0.01). The 44 donors with raised ALT were followed up and in 13 out of 15 donors with persistently raised ALT without obvious reason, a liver biopsy was performed. Ten donors had various degrees of liver steatosis, 2 had normal liver morphology and in 1 donor chronic hepatitis could not be ruled out. If ALT screening is introduced as a surrogate test for non‐A, non‐B hepatitis in Swedish blood donors, we suggest that a correction for overweight must be considered in order to minimize donor loss.
Human Alloantibodies Detecting a Red Cell Antigen Apparently Identical to MER2
Authors: Daniels G.L. , Levene C. , Berrebi A. , Schechter Y. , Moulds M. , Sela R. , Poole J. , Lacey P. , Atkins C.J.
Published: March 2009

Abstract. Three examples of an antibody were found to be detecting a red cell polymorphism probably identical to MER2. The antibodies were made by Jews originating from India and living in Israel. Two of them were sibs and the third was unrelated. All 3 had kidney disease requiring renal dialysis and regular blood transfusion. In 2 cases the antibodies were detected before dialysis was started and before the patients had been transfused. The human antibodies reacted with red cells of 90% of Israeli blood donors tested. In tests on selected blood donors, 82 English and 56 Israeli, one of the human antibodies gave almost identical reactions to those given by monoclonal anti‐MER2. Anomalous reactions were probably due to anti‐Bga. Two of the human antibodies completely blocked, and one partially blocked, the reaction of monoclonal anti‐MER2 with MER2+ red cells.
Studies on the Stability of VIII:C during the Manufacture of a Factor VIII Concentrate for Clinical Use1
Authors: Foster Peter R. , Dickson Ida H. , McQuillan Thomas A. , Prowse Christopher V. , Boulton Frank E. , Greedharry Prema , Bloom Arthur L.
Published: March 2009

Abstract. The stability of VIILC was investigated by monitoring samples taken at different points from a routine process for the manufacture of factor VIII concentrate and by examining the stabilising influence of a number of product formulations. Loss of VIII:C over process‐finishing procedures (formulation, 0.22 μm filtration, dispensing) was associated with a citrate‐induced inactivation which could be prevented by controlling the ionised calcium concentration of the solution. These results were obtained using a one‐stage clotting assay but were not observed using a two‐stage assay. No evidence for activation was found in vitro (e.g. by FPA generation and VIII:C stability) and the yield increase suggested by the one‐stage assay was supported by results from a controlled clinical evaluation.
Leukocyte‐Poor Platelet Concentrates at the Bedside by Filtration through Sepacell‐PL
Authors: Miyamoto Masaki , Sasakawa Shigeru , Ishikawa Yoshihide , Ogawa Atsuko , Nishimura Takao , Kuroda Toru
Published: March 2009

Abstract. We developed a new filter, ‘Sepacell‐PL’, consisting of a blood administraiton set for the preparation of leukocyte‐poor platelet concentrates at the patient's bedside. This filter is packed with 1.8 μm polyester fibers coated with a new polymer, and has a volume of 14 ml. Sepacell‐PL removed more than 99% of the leukocytes while approximately 93% of platelets were recovered from 10 units of platelet concentrates which contained 5 times 108 leukocytes and 3 times 1011 platelets. The functions of pre‐ and postfiltrated platelets were unchanged. The filtration procedure is very simple, without priming with saline to remove air and wet the filter. Moreover, platelet concentrates can be passed through the filter at a flow rate of 4 ml/min, or at a higher flow rate of 54 ml/min by gravity.
Development of an Immunoassay for the Detection of Minute Amounts of IgG‐Coated Erythrocytes in Whole Blood and Its Application for the Assessment of Fc‐Mediated Clearance of Anti‐D‐Coated Erythrocytes in vivo
Authors: Ekdahl Kristina Nilsson , Lööf Lars , Nilsson Ulf R. , Nilsson Bo
Published: March 2009

Abstract. A rapid and sensitive immunoassay for the detection of minute quantities of IgG‐coated erythrocytes in whole blood was developed. Washed red blood cells were incubated in two steps with anti‐human IgG antiserum followed by 125I‐labelled protein A. The assay was able to detect amounts of sensitized erythrocytes as small as 0.5 ml of packed erythrocytes in a total blood volume of 5 liters and hematocrit 40%. A linear relation between increasing amounts of IgG‐coated red cells in whole blood and the binding of 125I‐labelled protein A was obtained. We applied the technique on the assessment of the removal of IgG anti‐D‐coated erythrocytes from the circulation of test individuals. T1/2 for the elimination of approximately 4 ml packed red cells sensitized with 62 μg of anti‐D in 14 normal subjects was 20±5 min (mean±SEM). A splenectomized person did not clear the injected cells from the circulation during the test period of 70 min. If a standard curve was constructed the total blood volume in the test subjects could be calculated. This value correlated well (r = 0.99) with the blood volume calculated from the height and weight of the test individuals.
Phannacokinetics of Intravenous Immunoglobulin in Neonates
Authors: Weisman Leonard E. , Fischer Gerald W , Marinelli Philip , Hemming Val G. , Pierce John R. , Golden Stephen M. , Peck Carl C.
Published: March 2009

Abstract. Intravenous immunoglobulin (IVIG) may be a therapeutic adjunct to antibiotic treatment of neonatal infections. We examined the pharmacokinetics and safety of IVIG in human neonates. Thirty neonates with suspected sepsis were randomly assigned either to a treatment (receiving either 250, 500, or 1,000 mg/kg of IVIG plus antibiotics) or control (antibiotics alone) group. The 500 mg/kg dose produced a rise in total IgG for >8 and in group B streptococcus (GBS) type‐specific IgG for > 4–14 days. The type‐specific antibody elevation varied with the amount of pathogen‐specific antibody and dose of IVIG. Pharmacokinetic analysis suggests a Vdss of 42ml/kg, Cl of 3.0ml/kg/day, a biphasic elimination curve, and a terminal elimination half‐life of 24.2 days. No toxicity was observed. These data may be valuable in determining optimal dosing schedules for IVIG in treating or preventing neonatal infections.