bluuebunny/crossref_metadata_2025 huggingface dataset:
The Renal Effect of Intravenous Adenine in Humans
Authors: Roth G. J. , Moore G. L. , Kline W. E. , Poskitt T. R.
Published: September 2010

The purine base, adenine, improves the posttransfusion viability of liquid stored blood. However, adenine in high doses may cause kidney damage because of the precipitation in renal tubules of its insoluble metabolite, 2,8‐dioxyadenine. Adenine is not licensed for use in the United States because it may be nephrotoxic. In a controlled, randomized, double‐blind study, eight human subjects received 10 mg/kg of adenine infused intravenously over one hour, four subjects received 5 mg/kg, and four subjects received no adenine. Renal function tests were performed on each subject before adenine infusion and one day and one week following the infusion. Tests included an assessment of glomerular function (serum creatinine, creatinine clearance, protein excretion), proximal tubular function (amino acid and glucose excretion), and distal tubular function (maximal acidifying and concentrating ability). Plasma and urine levels of adenine and 2,8‐dioxyadenine were measured. Renal function tests showed no evidence of kidney damage secondary to adenine.
Glanzmann's Thrombasthenia; Assessment of the Response to Platelet Transfusions
Authors: Brown C. H. , Weisberg R. J. , Natelson E. A. , Alfrey C. P.
Published: September 2010

The response to platelet transfusions was studied in two patients with Glanzmann's thrombasthenia. Antibodies to platelets were detected in one patient who had failed to respond to platelet transfusions, and bled during and after surgery despite fresh whole blood transfusions. The other patient had no detectable antiplatelet antibodies, exhibited improved platelet function when normal platelets were added to her platelet‐rich plasma and experienced a favorable response to platelet transfusions during major surgery. These cases demonstrate the importance of antiplatelet antibodies as a determinant of a patient's response to platelet transfusion, the value of this therapy in qualitative platelet disorders, and the potential usefulness of in vitro studies to predict the outcome of platelet transfusions in such patients.
Identification of Strong Sd(a+) and Sd(a++) Red Cells by Hemagglutinins from Salvia horminum
Authors: Moore B. P. L. , Marsh S.
Published: September 2010

Anti‐Sda is difficult to identify, unless a special technique and strongly reacting Sd(a+) red blood cells are used. Sda has a broad distribution of antigen strength. The strongest examples [Sd(a++) or “Super Sid” and strong Sd(a+)] may be readily identified by using an extract from the seeds of Salvia horminum.
In Vitro Metabolism of Packed Erythrocytes Stored in CPD‐Adenine
Authors: Bensinger T. A. , Metro J. , Beutler E.
Published: September 2010

In vitro metabolism of erythrocytes packed at 70 and 90 per cent hematocrits and stored in various CPD‐adenine preservatives was studied. It was found that maintenance of acceptable levels of adenosine triphosphate (ATP) for the full 42 days of storage could be accomplished only if glucose levels were doubled from the standard 138.7 mM concentration to 277.5 mM level. If glucose levels were doubled, the amount of adenine could be decreased from 4.07 mM (0.50 mM final concentration) to 2.04 mM (0.25 mM final concentration) with maintenance of ATP at greater than 2.0 μmoles/g Hb. 2,3‐diphosphoglycerate concentrations were essentially absent by 21 days in the various media studied. Thus, in vitro levels of ATP appear to be maintained at acceptable levels in a CPD media modified to contain 2 × glucose and 2.04 mM adenine.
The Effect of Agitation on In Vitro Metabolism of Erythrocytes Stored in CPD‐Adenine
Authors: Bensinger T. A. , Metro J. , Beutler E.
Published: September 2010

Agitation of blood stored in plastic containers has been reported to lead to improved posttransfusion survival and it has been found that, in some media, agitation has improved erythrocyte 2,3‐diphosphoglycerate (2, 3‐DPG) levels. Using CPD II media (CPD with 277.5 mM glucose and 2.04 mM adenine), we were not able to identify any improvement in levels of adenosine triphosphate, 2.3‐DPG or glucose in whole blood under various agitation conditions when compared with the nonagitated control. The 2,3‐DPG level was moderately improved through 28 days in the 90 per cent hematocrit packed erythrocytes but the results were not considered to be significantly beneficial to warrant agitation. Thus, the application of agitation to the CPD II blood storage system was of no great benefit in improving metabolic intermediate levels.
Potassium Load in CPD‐Preserved Whole Blood and Two Types of Packed Red Blood Cells
Authors: Michael J. M. , Dorner I. , Bruns D. , Ladenson J. H. , Sherman L. A.
Published: September 2010

The potassium load of transfused blood must be minimized. We have compared the total plasma potassium content of units of CPD‐preserved stored whole blood (SWB), stored packed cells (SPC), and packed cells prepared from stored whole blood (WB‐PC). Plasma potassium concentrations, unit weights, and hematocrits of 20 units of SWB, 27 units of SPC, and 20 units of WB‐PC of various ages were measured. During the 21‐day storage period, total plasma potassium content per unit increased in units of SPC at the same rate as in units of SWB, because plasma potassium concentration increased in SPC at three times the rate of SWB. The values for total plasma potassium per unit at 14 and 21 days in mEq/unit were: SWB, 4.4, 5.8; SPC 3.1, 4.4; and WB‐PC 1.9, 2.5. Thus, SPC units may contain substantial amounts of plasma potassium when stored for two to three weeks. However, removal of most of the remaining supernatant plasma from SPC units just prior to administration provides a readily available supply of low potassium blood while allowing maximum conservation of scarce blood resources.
Two Further Examples of Anti‐Gya
Authors: Massaquoi J. M.
Published: September 2010

Two new patients with anti‐Gya (Gregory) are reported. Both patients are from an area where consanguineous marriage is common. The two kindreds may be related.
Blood Banking as a Professional Discipline in Medicine
Authors: Kuhns W. J. , Allen F. H. , Kellner A.
Published: September 2010

A closer orientation of blood banking toward optimal donor and patient care will depend upon an enlargement of the manpower pool of physicians with specific competence in this area. Toward this end, programs must be developed within medical school curricula, and comprehensive postgraduate training programs must be available for those interested in committing themselves fully to this specialty. Continuing education must be made available to part‐time blood banking professionals in order that they remain abreast of newer developments. Recognition of their skills can now come about through competence testing and certification programs. Improvements in management of the blood resource may then be expected to occur in parallel with the increase in numbers and quality of the professionals within this unique specialty.
Donors and Nondonors: Communication and Information
Authors: Bettinghaus E. P. , Milkovich M. B.
Published: September 2010

Donors and nondonors from six states were surveyed to determine differences in: 1) socioeconomic and demographic characteristics, 2) knowledge about blood donation, 3) access to information about donating, and 4) motivation to donate. The findings indicate that the present donor pool consists largely of socioeconomically advancing young adults. There was little difference between donors' and nondonors' knowledge of the donating process and access to mass media‐disseminated information about blood donation. Nondonors receive more information about donating from friends than do donors and interpersonal influence is an effective means of donor recruitment. The use of motivators other than humanitarianism may also be useful for inducing volunteer donations. Nondonors do lack knowledge about the location of local collection facilities. The present sample is socioeconomically and demographically representative of the U.S. adult population. As such, it provides information useful for developing effective donor recruitment strategies.
Granulocyte Harvest for Transfusion: Donor Response to Repeated Leukapheresis
Authors: Buchholz D. H. , Schiffer C. A. , Wiernik P. H. , Bwits S. W. , Reilly J. A.
Published: September 2010

Leukapheresis of normal donors with the NCI‐IBM Continuous Flow Blood Cell Separator was compared with the method of filtration leukapheresis. An average of 5.7 × 109 (range 1.4 to 10.9 × 109) granulocytes were collected on 25 occasions with the blood cell separator compared with an average of 36.6 × 109 (range 20.1 to 61.3 × 109) obtained by filtration leukapheresis on 85 occasions. Donor platelet counts decreased following donation by an average of 29,000/μl (14%) with continuous flow centrifugation (CFC) and an average of 40,‐ 000/μl (17%) with filtration leukapheresis (FL). Estimated donor packed red blood cell loss, including blood obtained for investigative purposes, was 80 ml per donation with CFC and 67 ml per donation when FL was used. FL resulted in at least a 25 per cent increase in the granulocyte count of donors by donation completion in 61 per cent of donors, although postdonation granulocytosis did not correlate with increased cell harvest. CFC donors generally displayed a postdonation decrease in granulocyte count. Normal numbers of granulocytes were maintained in donors undergoing frequent leukapheresis and no donor's health was compromised by the removal of large numbers of granulocytes. Repeated donations were possible with both systems. Although platelet counts dropped more with FL, the procedure was performed as frequently as eight times in a ten‐day period without development of severe donor thrombocytopenia. Donor red blood cell loss appears to be the limiting factor in the repeated use of either system. Blood loss could be significantly decreased under routine conditions if fewer samples were obtained for investigational purposes. Filtration leukapheresis offers the advantage of significantly greater granulocyte yields than is possible with CFC unless modifications such as arterio‐venous shunts or the use of steroids and/or rouleaux‐inducing agents are employed.
Simplification of the Methods for Adding and Removing Glycerol During Freeze‐Preservation of Human Red Blood Cells with the High or Low Glycerol Methods: Biochemical Modification Prior to Freezing
Authors: Valeri C. R.
Published: September 2010

Simple methods have been developed for adding and removing glycerol during freeze‐preservation with 20 per cent W/V glycerol at –150 C, or with 40 per cent W/V glycerol at –80 C. A one‐step method with a 35 per cent W/V glycerol solution is used to prepare 20 per cent W/V glycerolized red blood cells, and a two‐step method with a 57 per cent W/V glycerol solution is used to prepare 40 per cent W/V glycerolized red blood cells.

The systems for washing glycerolized red blood cells have been simplified. This method consists of dilution of the thawed glycerolized red blood cells prior to recovery, followed by on‐line dilution of these red blood cells with wash solutions during continuous flow centrifugation. This can be done in any of three commercially available washing systems, and they all use the same sodium chloride solutions. For the 40 per cent W/V glycerolized red blood cells, this process takes about 30 minutes and uses 2.2 to 3.2 liters of the sodium chloride solutions, whereas the 20 per cent W/V glycerolized red blood cells can be processed in about 20 minutes using 1.5 to 2.5 liters.

After storage in CPD for three days at 4 C, red blood cells can be freeze‐preserved with 40 per cent W/V glycerol at –80 C or with 20 per cent W/V glycerol at –150 C. When the thawed red blood cells are washed in the Fenwal Elutramatic, the IBM Blood Processor, or the Haemonetics Blood Processor and stored at 4 C in sodium chloride‐glucose‐phosphate for at least 24 hours before transfusion, they have excellent posttransfusion survival values and normal or slightly decreased oxygen transport function. Alternatively, these red blood cells can be rejuvenated before freeze‐preservation so that their 2,3‐DPG levels are increased and their affinity for oxygen is reduced. Red blood cells that are stored in CPD at 4 C for as long as 28 days can be rejuvenated with a solution containing pyruvate, inosine, glucose, phosphate, and adenine (PIGPA, Solution A) before freeze‐preservation with 40 per cent W/V glycerol at –80 C. Any one of the above systems can be used to wash these red blood cells and they can be stored at 4 C in a sodium chloride‐glucose‐phosphate solution for four days and have acceptable posttransfusion survival.

Before transfusion the red blood cells are concentrated, the supernatant solution is removed, and the hematocrit is adjusted to about 90 V per cent. Any of the washing procedures will effectively recover the red blood cells and remove most of the products of hemolysis, glycerol, 125I albumin, and additives used for rejuvenation.
Occurrence of Granulocyte Cytotoxins and Agglutinins
Authors: Hasegawa T. , Bergh O. J. , Terasaki P. I. , Graw R. G.
Published: September 2010

Granulocyte cytotoxic activity in sera from over 257 patients was shown to be distinct from HL‐A lymphocytotoxic activity. Granulocyte cytotoxins occur in approximately 25 per cent of sera from patients having leukemia, 45 per cent with aplastic anemia, 22 per cent with kidney disease on hemodialysis, and 19 per cent of pregnant women. By testing sera on the same panel of cells, the granulocyte cytotoxic activity was shown not to be associated with granulocyte agglutination activity or lymphocytotoxic activity. It is likely that granulocyte cytotoxins and granulocyte agglutinins will be useful in transfusion and bone marrow transplantation as a separate tool from the more widely used lymphocyte cytotoxicity reaction.
The Effect of Continuous Dialysis on Platelet Preservation
Authors: Hardeman M. R.
Published: September 2010

Serotonin uptake and response to hypotonic shock were studied after storage of platelet‐rich plasma for three days at 4, 25, and 37 C. Both properties were best maintained at 25 C. The greatly impaired serotonin uptake and hypotonic shock response of platelets stored for three days at 37 C were partly restored by resuspension of the platelets in fresh autologous plasma. No improvement was found when platelets stored at 4 C were resuspended in fresh autologous plasma.

When platelet suspensions were stored for three days at 4, 25, and 37 C under continuous dialysis against plasma, the results obtained at 37 C were even better than those obtained with platelets stored at 25 C. These results indicate that if the accumulation of metabolites in the plasma milieu, which in addition to other changes results in a drop of pH, is prevented, the effective storage time of platelet concentrates can be prolonged. The use of a closed plastic dialysis system, based on the triple‐bag transfusion set is suggested.
Some Observations on “Bombay” Bloods, with Comments on Evidence for the Existence of Two Different Oh Phenotypes
Authors: Moores P. P. , Issitt P. D. , Pavone B. G. , McKeever B. G.
Published: September 2010

Bloods from three individuals, one each of the phenotypes OhA, OhB and OhO have been studied. The work of Dzierzkowa‐Borodej, et al.10 was confirmed when it was shown that all three samples of Oh red blood cells had increased I antigen strength. The i, Sda, Lea and Lex antigens were not found to be increased. Attempts were made to adsorb and elute anti‐A, anti‐B and anti‐A, B with the Oh red blood cells, using sera that contained high titered anti‐I antibodies. This was done in the belief that previously reported positive results in such tests might be due to the high level of I on the Oh red blood cells, anti‐I in the sera containing the ABO antibodies, and the Matuhasi‐Ogata phenomenon. However, in no instance were we able to adsorb an ABO antibody onto the Oh red blood cells. Contrary to the report of others10 the titers of anti‐A, anti‐B and anti‐H in the sera of the three Oh individuals studied did not differ significantly.

We suggest that the evidence from our findings and the work of others is sufficient to show that at least two forms of the Oh phenotype exist: one representing total suppression of H, A, and B antigens, and the other marked but not total suppression, with partial inhibition of antibody production.
Chemical and Hematological Changes in Stored CPD Blood
Authors: Bailey D. N. , Bove J. R.
Published: September 2010

Blood was drawn from ten healthy volunteer donors into citrate‐phosphate‐dextrose (CPD) anticoagulant and placed on the quarantine shelf of the blood bank refrigerator. Plasma dextrose, sodium, potassium, chloride, bicarbonate, GOT, LDH, and hemoglobin as well as WBC, hematocrit, MCV, MCHC, whole blood pH, and ammonia were measured on all samples initially and at one, two, seven, 14, 21, and 28 days of storage at 4 C. Whole blood lactate also was analyzed serially on five of the units. An additional 27 units of CPD bank blood (two to 21 days of age), routinely processed, handled, and stored by the blood bank, were submitted to the same analyses on the day of administration to the patient. Five of these processed units, 21 days old, were resampled at 28 days. Results of the analyses are presented and discussed. The most pronounced changes were seen for dextrose, potassium, bicarbonate, lactate, LDH, ammonia, and hemoglobin. Plasma dextrose and bicarbonate declined in concentration while potassium, lactate, LDH, ammonia, and hemoglobin rose with storage. In general, changes in the regularly processed, singly sampled bank units were greater than those observed in the specially processed, quarantined units sampled serially. This study indicates that routine transportation, processing, and handling of bank blood may lead to increased biochemical alteration.
Compatibility of Common Intravenous Solutions with CPD Blood
Authors: Ryden S. E. , Oberman H. A.
Published: September 2010

Blood anticoagulated with CPD was mixed with lactated Ringer's solution, S per cent aqueous dextrose, 5 per cent dextrose in 0.225 per cent saline, 5 per cent dextrose in 0.9 per cent saline, and 0.9 per cent saline solution in varying concentrations and incubated at room temperature and 37 C. Clots formed in the blood‐lactated Ringer's mixture after five minutes at a citrate:calcium molar ratio of 4:1 or lower. Aqueous dextrose‐blood mixtures showed immediate clumping with gross hemolysis after 30 minutes incubation. Blood mixed with S per cent dextrose and 0.225 per cent saline hemolyzed within ten minutes incubation at 37 C. No hemolysis occurred in blood mixed with 5 per cent dextrose in 0.9 per cent saline or with 0.9 per cent saline. Traces of solutions labeled with Evans blue dye remained in intravenous administration tubing even 30 minutes after a simulated transfusion was begun. Lactated Ringer's solution and 5 per cent dextrose in 0.225 per cent saline should not be administered concurrently with blood. Lactated Ringer's solution may also be harmful when used to start transfusions as it rapidly produces clots when mixed with CPD blood.
Evaluation of Bacterial Contamination in Blood Processing
Authors: Elin R. J. , Lundberg W. B. , Schmidt P. J.
Published: September 2010

In the routine deglycerolization of frozen red blood cells, a bottle of solution intended as a final wash (0.8% NaCI, 0.2% dextrose) was found to be abnormally colored and slightly turbid. Close inspection revealed a small crack in the base of the bottle. A pure growth of Klebsiella pneumoniae was cultured. The rabbit pyrogen test on the solution was positive using 2.5 μl as was the limulus amebocyte lysate (LAL) test at a dilution of 1:105 for endotoxin. Studies of the growth of this organism are described and the clinical implications are discussed.
Successful Transfusion of Chido‐Positive Blood to Two Patients with Anti‐Chido
Authors: Moore H. C. , Issitt P. D. , Pavone B. G.
Published: September 2010

Two cases are described in this report in which patients with anti‐Chido in the serum were transfused with Chido‐positive blood. Since there was evidence of normal survival of the transfused red blood cells, these findings do not support a suggestion that patients with anti‐Chido may require transfusion with Chido‐negative blood. In spite of the apparently normal survival of the Chido‐positive blood, a previous report in which it was shown that weakly Chido‐positive blood can stimulate the production of anti‐Chido was confirmed.
Viability of Granulocytes Obtained by Filtration Leukapheresis
Authors: Roy A. J. , Yankee R. A. , Brivkalns A. , Fitch M.
Published: September 2010

Nylon filtration alters the morphology of human granulocytes and slightly reduces their phagocytic ability as measured by activation of the hexose monophosphate shunt (HMS) pathway of glucose metabolism. In addition, the ability of rat granulocytes to circulate in granulocytopenic rats is reduced, and this is not attributed to HMS activation during filtration. The activation of the hexose monophosphate shunt is related to the size of the particles rather than to the nature of the material.
Granulocyte Transfusion: A Controlled Study in Patients with Acute Nonlymphocytic Leukemia
Authors: Fortuny I. E. , Bloomfield C. D. , Hadlock D. C. , Goldman A. , Kennedy B. J. , McCullough J. J.
Published: September 2010

Granulocyte transfusions are frequently used during the leukopenic phase of induction chemotherapy for acute nonlymphocytic leukemia (ANLL) although no controlled study has documented their usefulness. We have compared the morbidity and mortality of febrile episodes in granulocytopenic (< 500/mm3) adults with ANLL who received granulocytes and those who did not. Granulocytes were obtained from related normal donors using a continuous flow centrifuge. Seventeen patients who received 98 transfusions during 23 febrile episodes were compared with 22 patients who received no granulocytes during 35 febrile episodes. No significant difference in clearing of documented infection occurred between the transfused (71%) or the control (76%) group. Granulocytes did not result in more rapid termination of febrile episodes nor in significant decrease in fever 24 hours following the transfusion. Factors contributing to the lack of obvious clinical benefit are discussed.
Use of Hydroxyethyl Starch To Improve Granulocyte Collection in the Latham Blood Processor
Authors: Huestis D. W. , White R. F. , Price M. J. , Inman M.
Published: September 2010

This report describes a practical, relatively inexpensive system of leukapheresis and plateletpheresis, utilizing the Haemonetics blood processor. The results of 236 phereses of normal donors are reported, with particular attention to an evaluation of five different anticoagulant mixtures: ACD, 2 per cent citrate in saline, and three different combinations of citrate and hydroxyethyl starch (HES). These mixtures were compared with respect to their effectiveness in the harvesting of granulocytes and platelets, respectively. The best harvest of granulocytes (3.5 × 109 cells per liter of blood processed) was with 6 per cent HES anticoagulated with trisodium citrate. All solutions gave about the same platelet yields (a mean of 1.6 × 109 per liter of blood processed). Because of its higher citrate content, ACD caused three times as many donor reactions as the other solutions. The use of HES thus permits this widely available plateletpheresis system to be used for leukapheresis with only minimal procedural modification.
Plasma Exchange in the Treatment of Immune Disease
Authors: Branda R. F. , Moldow C. F. , McCullough J. J. , Jacob H. S.
Published: September 2010

Plasma exchange was investigated as an alternative to the use of toxic drugs to remove unwanted antibody. Studies in rabbits immunized with bovine serum albumin demonstrate that exchange transfusion after a primary immunization results in a rebound of antibody to above preexchange levels. However, exchange transfusion seven, 11, or 18 days after secondary immunization results in permanent lowering of antibody levels.

Plasma exchange with the continuous flow centrifuge was used in four patients with hematologic diseases. White cell isoantibodies were removed in a septic leukopenic patient, permitting white cell transfusions. Two patients with immune thrombocytopenia were exchanged; one showed prompt and permanent elevation of platelet count, while the other did not improve. A patient with immune hemolytic anemia had stabilization of hemoglobin levels and decreased Coombs reactivity following plasma exchange.
Unusual Response to ABO Incompatible Blood Transfusion
Authors: Buchhilz D. H. , Bove J. R.
Published: September 2010

Three units of group A blood were inadvertently administered to a group O recipient during surgery without evidence of hemoglobinemia, hemoglobinuria, hypotension, disseminated intravascular coagulation, acute renal tubular necrosis, or other signs and symptoms of transfusion reaction. The recipient had normal concentrations of IgG, IgA, and IgM as well as complement (C3) prior to transfusion and anti‐A agglutinins titered to 64 (titer of 128 by the antiglobulin technique). Seventeen hours following the transfusion, 28 per cent of the circulating red blood cells were group A (equivalent to 475 ml of packed cells); they were eliminated by day 5 without evidence of hemoglobinuria, hemoglobinemia or hyperbilirubinemia. Anti‐A titers (antiglobulin) had risen from a posttransfusion low of 4 to 4,096 by day 10. After treatment of serum with 2‐mercaptoethanol, however, hemolytic activity which was first noted on day 5 was lost and the antiglobulin titer dropped to 24 which suggested that most of the anti‐A produced in response to the transfusion was IgM rather than IgG. The anti‐A titer had dropped to essentially pretransfusion levels and the majority of anti‐A present was IgM by day 91. The recipient suffered no untoward effects from the transfusion and was in good health three months following the transfusion.
An Adverse Pulmonary Reaction to Cryoprecipitate in a Hemophiliac
Authors: Reese E. P. , McCullough J. J. , Craddock P. R.
Published: September 2010

An adult with classic Hemophilia A experienced a very severe reaction to transfusion with cryoprecipitate which was manifested as an adverse pulmonary reaction with marked hypoxemia in spite of oxygen therapy. The patient had neither leukoagglutinins nor lymphocytoxic, anti‐platelet, or anti‐Gm antibodies. His IgA level was normal. The possibility that debris in the cryoprecipitate from leukocytes and platelets contributed to the reaction is discussed.
In Vivo Platelet Function Following Cardiopulmonary Bypass
Authors: Umlas J.
Published: September 2010

In order to test the in vivo hemostatic function of platelets exposed to cardiopulmonary bypass, template bleeding times (TBT) were performed prebypass, three hours postbypass and 18 to 20 hours postoperatively in 22 patients undergoing open‐heart surgery. The Harker‐Slichter formula was applied to platelet counts below 100,000/cu mm to determine the expected TBT if the platelets function normally but were associated with a prolonged bleeding time merely from thrombocytopenia. Half of the patients received only frozen erythrocyte transfusions. Twenty of the 22 patients (91%) had normal or shorter than the expected TBT. Eight of the ten patients with platelet counts under 100,000/cu mm had shorter than predicted TBTs. All of the patients receiving only frozen erythrocytes had normal or shorter than predicted TBTs. It is concluded that in vivo platelet hemostatic function is usually normal postbypass, that routine platelet transfusions are therefore not necessary, and that most open‐heart surgical procedures can be performed using frozen erythrocyte transfusions exclusively.
Banked and Fresh Autologous Blood in Cardiopulmonary Bypass Surgery
Authors: Silver H.
Published: September 2010

When 50 patients having autologous transfusion of two units of blood collected intraoperatively during coronary bypass surgery were compared with 50 patients receiving only homologous donor blood, it was found that a two‐unit (20%) decrease in homologous blood usage per case occurred in the group receiving the autologous blood. No decrease occurred in total units of blood used per case. In 15 patients undergoing coronary bypass surgery, in addition to the two units of autologous blood collected during surgery, two or four units of autologous blood were obtained preoperatively and administered intraoperatively. When four units were collected, the red blood cells were frozen until just prior to surgery. Total blood usage per case remained unchanged but a 4.6 unit (41%) decrease in homologous donor blood usage was noted. Patients phlebotomized preoperatively took 325 mgm of oral iron t.i.d. through the postoperative recovery period. These patients had an average decrease in hematocrit of 4.25 to 4.3 per cent following the final phlebotomy and just prior to surgery.
Anti‐Holley (Hy): Characterization of Another Example
Authors: Hsu T. C. S. , Jagathambal K. , Sabo B. H. , Sawitsky A.
Published: September 2010

Anti‐Hy, in the serum of a black man who had received multiple blood transfusions, was found to be a warm reactive and polyclonal IgG antibody which did not bind complement in vitro.51Cr‐labeled Hy‐positive red blood cells in the patient showed a shortened “2‐component” survival curve. Hy antigens were not detected on leukocytes, platelets, or in the serum of Hy‐positive individuals.
The Solid Phase Radioimmunoassay Technique for Hepatitis B (Surface) Antigen: Effects of Progressive Modification
Authors: Ni L. Y. , Dodd R. Y. , Brown N. , Salmon R. , Greenwalt T. J.
Published: September 2010

Serum specimens submitted for confirmation of hepatitis B antigen (HBsAg) reactivity were tested by counterelectrophoresis (CEP) and by three modifications of the solid phase radioimmunoassay “sandwich” technique (SPRIA). In addition, the specificity of each reaction was determined for two of the SPRIA test methods. One hundred seventy‐five of the 688 specimens were reactive by all techniques and a further 60 were specifically reactive by two of modifications of SPRIA. An additional five specimens were positive by a third SPRIA modification. The primary SPRIA technique, using a homologous guinea pig antibody sandwich, detected 184 nonspecific reactive samples. With the same test done at 45C with a reduced incubation time, there were only 37 nonspecific reactive samples. None of the nonspecific samples was detected when the SPRIA technique used a heterologous guinea pig‐human antibody sandwich. The results provide a basis for estimating the effectiveness of the SPRIA technique for H BsAg testing.
ABO Discrepancy Caused by an Auto Anti‐N
Authors: Winn L. C. , Eska P. L. , Grindon A. J.
Published: September 2010

This report describes an auto anti‐N reacting at a high thermal amplitude that caused an ABO cell and serum discrepancy.
Setting Inventory Levels for Hospital Blood Banks
Authors: Brodheim E. , Hirsch R. , Prastacos G.
Published: September 2010

A method is devised to predict the hospital blood bank inventory of each of the eight blood types that will be adequate on all but a given fraction of days (shortage rate). Analysis of the model confirms and extends prior statistical models and provides a rationale for a number of observations made on some common blood inventory practices. Comparison of the relationship between inventory levels and shortage rates predicted by the model and that calculated from data from 21 hospital blood banks of varying sizes, located in four separate parts of the country, reveals agreement within approximately 10 per cent. A procedure is presented that allows blood banks to select inventory levels and shortage rates based on their mean demand for blood.
Storage of Platelet Concentrates
Authors: Kahn R. A. , Meryman H. T.
Published: September 2010

The American National Red Cross has initiated a cooperative clinical study designed to evaluate the therapeutic effectiveness of fresh platelets and platelets stored at 4 or 22 C for up to 72 hours. Preliminary results, in confirmation of earlier work, indicate an inverse relationship between platelet count and bleeding time in patients with thrombocytopenia transfused with fresh platelets. Also, the observed rise in platelet count immediately following transfusion of fresh platelets is generally maintained for four to eight hours after which time it declines significantly.
In Vivo Distribution of Injected14C‐Dioxyadenine in Tissues and Organs of Normal Rats
Authors: Devenuto F. , Wilson S. M. , Billings T. A. , Shields C. E.
Published: September 2010

A large dose of 2, 8‐dioxyadenine‐14C was injected intravenously into rats and its fate followed at several intervals during the first 24 hours after administration. The distribution of the radioactive material throughout the various tissues or organs was calculated and expressed as a percentage of the injected dose as well as a specific activity per unit organ weight. It appears that dioxy‐adenine is rapidly distributed throughout the organs and tissues of the rats and that specific concentration occurs in a few organs. High retention of the radioactive material and a very high specific activity are observed in the kidney. Smaller but significant concentrations of the14C‐compound are also observed in muscle and skin, and cannot be attributed to the presence of residual blood. The radioactive material is gradually released from these tissues and, by 24 hours after injection, 92 per cent of the injected dose is found in the urine. Microscopic observation shows deposition of crystals in the kidney. Crystals are also present in the urine and appear as small slightly yellow spheres.
The Use of Pluronic Polyols in the Precipitation of Plasma Proteins and Its Application in the Preparation of Plasma Derivatives
Authors: Garcia L. A. , Ordonez G. A.
Published: September 2010

Pluronic F‐38 was used as a precipitant of plasma proteins under varying conditions of pH and polymer concentration. Results indicated that marked differences in the solubility of the plasma proteins in F‐38 solutions can be applied to the separation of plasma components. The feasibility of the industrial application of this fractionation method was tested in several experiments. Conditions were established for the preparation of albumin, human plasma protein fraction (HPPF), and immune serum globulin (ISG) with similar yield and purity as those prepared by the Cohn method. Current procedures for the preparation of antihemophilic A (Factor VIII) concentrate and prothrombin complex (Factors II, VII, IX, and X) were adapted to the F‐38 process by removal of the clotting factors from the starting plasma prior to polymer precipitation. In addition, a plasma protein solution free of lipoproteins, isoagglutinins, and clotting factors was developed which has proven useful as a perfusion medium in organ preservation.
Hemagglutination Inhibition Studies for the Evaluation of Blood Group Antigens in Ethanol Soluble Substances (ESS) Obtained from Human, Baboon and Vervet Monkey Red Blood Cells
Authors: Vos G. H. , Moores P. P. , Downing H. J. , Mohideen A. F. C.
Published: September 2010

Soluble blood group substances, isolated from the red blood cells of humans, baboons, and vervet monkeys by ethanol extraction, possessed serologically active specificities for the following antigens: A, B, H, Lea, LebL, P, P1, Pk, and I. Human red blood cells lacking any of these specificities by the direct hemagglutination test also lacked the related antigens in their soluble extract. The only exception was in ‘Bombay’ Oh cells, from which soluble H substance could be readily isolated. Soluble substances obtained from baboon and vervet monkey red blood cells, which lack the human variety of A, B, and H antigens on their red blood cells, inhibited both human and lectin anti‐H reagents. The detection of ‘hidden’ H activity in Oh cells will pose some important questions regarding membrane characteristics and the role of immune surveillance.
Granulocyte Kinetics in Donors Undergoing Filtration Leukapheresis
Authors: Rubins J. M. , MacPherson J. L. , Nusbacher J. , Wiltbank T.
Published: September 2010

Normal blood donors undergoing filtration leukapheresis (FL) have a profound transient neutropenia early in the procedure which is followed by a “rebound” neutrophilia. This phenomenon occurs in unstimulated donors as well as in donors pretreated with either prednisone or dexamethasone. The mechanism for development of the neutropenia was investigated in volunteers not undergoing FL. It was found that when autologous heparinized plasma was infused into volunteers through a nylon filter at 37 C, a significant but transient neutropenia was observed. Plasma rendered cell and stroma‐free achieved the same result indicating that plasma alone, when exposed to nylon fibers, is capable of producing neutropenia.
Unexpected Limitations in the Use of Commercial Antiglobulin Reagents
Authors: Beck M. L. , Hicklin B. , Pierce S. R.
Published: September 2010

The majority of antiglobulin sera used in blood banks in the USA are commercially prepared immune rabbit sera, designed to be reactive only with human red blood cells sensitized with immunoglobulins or complement components. Current manufacturing methods result in a product that gives reliable specific reactions provided that the test red blood cells are normal, particularly with respect to sialic acid levels. This report describes our findings of false positive antiglobulin tests caused by incompletely absorbed antiglobulin reagents when cells with low sialic acid levels were tested. An evaluation of nine commercially prepared antiglobulin reagents revealed, in many of them, the presence of anti‐species antibody, anti‐T, and anti‐Tn. Blood bank personnel must be aware of these characteristics especially when testing either enzyme premodified or polyagglutinable cells. The use of incompletely absorbed reagents might account for positive direct antiglobulin tests that are encountered occasionally in apparently normal healthy individuals. Furthermore, recent protocols advocating the use of trypsinized cells for the evaluation of anti‐C3d activity of antiglobulin sera are invalid if the reagent is inadequately absorbed of anti‐species agglutinins.
Preparation and Storage of Platelet Concentrates
Authors: Slichter S. J. , Harker L. A.
Published: September 2010

A technique of platelet concentrate preparation and storage is presented which permits the maximum number of viable and functional platelets to be preserved for periods of 72 hours. Although the storage conditions must be followed precisely, the method is nevertheless simple to perform and does not require specialized expensive equipment. Critical factors include: 1) preparation of the platelet concentrates with an initial centrifugation of 1000 × g for 9 minutes and a second centrifugation of 3000 × g for 20 minutes (86% ± 1 platelet yield), 2) a storage bag composed of either Fenwal's PL‐146 or McGaw plastic, 3) constant gentle mixing, 4) a 70 ml residual plasma volume, and 5) room temperature storage (22 C ± 2). In Vivo platelet recovery after 72 hours of storage at room temperature averaged 46 per cent ± 3 and survival was 7.9 days ± 0.3 (81% of fresh platelet viability). The function of these platelets as measured by the correlation between bleeding time and platelet count after transfusion of pooled platelets into unimmunized, aplastic thrombocytopenic recipients was as good as that of fresh platelets. Both viability and function of concentrated platelets stored at 4 C are severely compromised.
The Fate of Bacteria in Frozen Red Cells
Authors: Kahn R. A. , Meryman H. T. , Syring R. L. , Flinton L. J.
Published: September 2010

Units of blood were intentionally contaminated with suspensions of either Aerobacter aerogenes, Escherichia coli, Bacillus subtilis, Enterobacter cloacae, Pseudomonas aeruginosa, Sarcina lutea, Seratia marcesens, Staphylococcus epidermidis, Streptococcus faecalis, Paracolabacterum aerogenoides (Enterobacter hafriae), Mima polymorpha or Acinetobacter calcoaceticus. When inoculation was made prior to glycerolization, the subsequent glycerolization, freezing, thawing, and deglycerolization resulted in roughly a two log reduction in the number of bacteria. When inoculation was made with a final concentration of between 101 and 105 organisms per milliliter, immediately following deglycerolization or following washing without glycerolization and freezing, no increase in the number of bacteria was seen after 72 hours storage at 4 C. Three of the 12 organisms studied decreased in number during 72 hours of storage. These data suggest that the current 24‐hour limit on the post‐thaw storage of frozen red blood cells may be unnecessarily restrictive.
Autologous Blood Transfusion in Coronary Artery Bypass Surgery
Authors: Cove H. , Matloff J. , Sacks H. J. , Sherbecoe R. , Goldfinger D.
Published: September 2010

Forty‐four patients undergoing coronary artery bypass surgery participated in an autologous blood donor program. Blood was collected at weekly intervals up to three days prior to the scheduled date of surgery. Sixteen patients donated a total of two autologous units each, and 28 patients donated one autologous unit each. No donor morbidity or mortality was encountered during or following blood donation. Autologous blood accounted for more than one‐third of all blood required by these patients throughout their hospital courses. Autologous transfusion appears to be a safe procedure for patients with severe coronary artery disease.
Adenine Metabolism During and After Exchange Transfusions in Newborn Infants with CPD‐Adenine Blood
Authors: Kreuger A.
Published: September 2010

CPD‐adenine blood (adenine in a final concentration of 0.25 mmol/l) was used in exchange transfusions in four newborn infants. The amount of adenine in one exchange transfusion ranged from 27 to 29 μmol per kg bodyweight. The maximum P‐adenine concentration during the exchange transfusions ranged from 4 to 8 μmol/1 but decreased to pretransfusion levels 20 minutes after the exchange transfusions. During a 24‐hour period following the exchange transfusions, the total urine excretion of adenine and 2, 8‐dihydroxyadenine corresponded to 0.5 to 1.3 per cent of the given adenine dose calculated on a molar basis. Accumulated data indicate that CPD‐adenine blood can be used even in repeated exchange transfusions in newborn infants.
Leukapheresis of Patients with Chronic Granulocytic Leukemia (CGL), Using the Haemonetics Blood Processor
Authors: Huestis D. W. , Price M. J. , White R. F. , Inman M.
Published: September 2010

By the use of citrated hydroxyethyl starch (HES) as anticoagulant, the Haemonetics blood processor can be used to obtain large numbers of granulocytes from patients with CGL. This report is of 67 leukaphereses on 11 different patients. A median of 1.14 × 1011 granulocytes was obtained per 6‐cycle pheresis (3.4 × 1010 per liter of blood processed), or eight to ten times the number obtained from comparable leukaphereses of normal donors. High yields of platelets were also obtained, although not in proportion to granulocytes, since some of the patients used as donors have normal or even low platelet counts. The patients tolerated the procedure well, and no adverse reactions to HES were observed. The patients experienced a mean 35 per cent drop in the postleukapheresis WBC count, but in no case was this drop sustained for more than a few days, and no lasting effect on the disease process was observed.
Blood‐Legend Laden Liquid of Life
Authors: Myhre B. A.
Published: September 2010

Blood banking is still plagued with the double problem of an inadequate supply of donors and inappropriate ordering policies by many physicians. Attempts to change these conditions by educational programs have met with only limited success. This paper lists and discusses many of the folklore beliefs attributed to blood and shows that many of these primitive beliefs still can be found today. Both donors and physicians, being human, may be influenced by these myths, many of which couple blood with the soul or with a vital essence in the blood. The reluctance to donate and the use of blood as a tonic rather than a therapeutic medium may both be based on a carryover of some of these beliefs. If this thesis is correct, education of both the physician and donor must be based as much on a psychotherapeutic approach to erase firmly established misconceptions as on a strict scientific educatory method.
Use of a Low‐Ionic‐Strength Medium in Manual Tests for Antibody Detection
Authors: Moore H. C. , Mollison P. L.
Published: September 2010

The present observations confirm the value of suspending red blood cells in a low‐ionic‐strength medium in the first stage of the indirect antiglobulin test; that is, during the period of incubation with antibody‐containing serum. The main advantage of this procedure is to shorten the time of incubation. In this respect a low‐ionic‐strength medium appears to be superior to albumin as a suspending medium for the red blood cells. A further advantage is to increase the uptake of certain antibodies; this effect was pronounced with selected Rh antibodies believed to be of low affinity.
The Significance of Red Cell Bound Complement Components in Development of Standards and Quality Assurance for the Anti‐Complement Components of Antiglobulin Sera
Authors: Garratty G. , Petz L. D.
Published: September 2010

Human red blood cells, sensitized with complement in vivo and by a variety of methods in vitro, (e.g. blood group antibody, low ionic strength, alternate pathway), were tested with a battery of anti‐complement sera (anti‐C3, ‐C3c, ‐C3d, ‐C4, ‐C4c). Red blood cells could be prepared by relatively simple methods to yield cells sensitized with C3 and C4, C3 but not C4, C4 but no C3, C3d with no C3c and C4d with no C4c. These cells are suitable for standardization and quality assurance of antiglobulin sera (AGS). Anti‐C3d is necessary for optimal detection of sensitization of red blood cells by complement in vivo by the direct anti‐globulin test (DAT). Anti‐C3d may also be optimal for the indirect antiglobulin test (IAT) especially if incubation periods greater than one hour are employed.

Potent anti‐C4 and anti‐C3 antisera made in the authors' laboratory resulted in numerous weakly positive antiglobulin tests when testing red blood cells from refrigerated clots (especially anti‐C4) but red blood cells from refrigerated anticoagulated segments gave negative results. When red blood cells were incubated in normal serum at room temperature (as in the room temperature phase of a compatibility test), some positive results were again obtained with the potent anti‐C4 and anti‐C3 antisera. However, one commercial antiglobulin serum containing anti‐complement antibodies that were at least as potent as any other commercial antiglobulin serum gave uniformly negative results under the above conditions. Anti‐C4 antibodies may be omitted from antiglobulin sera without decreasing the efficacy of such antisera to be used in compatibility testing. Thus, positive results in the compatibility test due to detection of clinically insignificant cold antibodies in the IAT by the anti‐complement antibodies in AGS, may be avoided if anti‐C4 is omitted or is in low concentration and if the concentration of anti‐C3d is carefully standardized. A higher concentration of anti‐C3d could be used for compatibility tests if red blood cells from anticoagulated segments were used instead of those from clots and if a separate tube were used for the IAT at 37 C rather than using one tube for both room temperature and 37 C incubations.