bluuebunny/crossref_metadata_2025 huggingface dataset:
Procainamide‐induced Hemolytic Anemia
Authors: Jones G. W. , George T. L. , Bradley R. D.
Published: December 2004

The paper reports a case of hemolytic anemia induced by procainamide hydrochloride treatment. Decreases in hemoglobin concentration are correlated with 11 months of procainamide treatment along with a marked increase in hemoglobin following cessation of the drug. The paé tient exhibited no symptoms suggestive of drug‐induced Lupus Erythematosus that has been frequently reported as a sequela of procainamide therapy. Direct antiglobulin tests were consistently positive throughout the clinical course, and an ether‐eluate prepared from the patient's red blood cells showed panagglutinability. The antibody in the eluate reacted with Rhnull, D–, LW negative, and U negative red blood cells without addition of proé cainamide or pretreatment of red blood cells with the drug. It is noted that this antibody reacts similarly to the antibody produced as a consequence of alpha‐methyldopa therapy.
LISS—an Effective Way to Increase Blood Utilization
Authors: Rock G. , Baxter A. , Charron M. , Jhaveri J.
Published: December 2004

The low ionic strength solution (LISS) of Low and Messeter was compared with both the automated low ionic strength Polybrene and the manual IDAT techniques. A five minute incubation with the LISS was sufficient to detect all significant antibodies. By extending the incubation period to 15 minutes it was possible to increase the sensitivity of the reaction (as measured by titer) beyond that of either of the other methods. This LISS procedure has enabled us to greatly extend the applications of a “standby procedure” for elective surgery. In this procedure routine crossmatching is not done. Rather, the blood is placed on standby and if required, transfusion is provided by using the LISS. In one general hospital this resulted in the reduction by 1,600 units of unnecessary crossmatches and an increase of 10 per cent in the total blood utilization rate over a nine‐month period.
Matuhasi‐Ogata Phenomenon Involving Anti‐Ampicillin
Authors: Bell C. A. , Zwicker H. , Whitcomb M.
Published: December 2004

A 47‐year‐old group A, Rh1Rh1 woman treated with intravenous ampicillin for chronic pyelonephritis received two units of blood and also received oral cephalexin. Three months after the transfusions she was noted to have allo‐anti‐E and anti‐c, and a 2 + positive direct antiglobulin test. Anti‐E and anti‐c could be eluted from her cells, yet neither antigen could be demonstrated on the patient's circulating red blood cells. Also present in the serum and in the eluate was anti‐ampicillin antibody. Studies of the patient's red blood cell eluates using ampicillin‐treated R1R1 and untreated R2R2 cells demonstrated anti‐E complexed with anti‐ampicillin in a drug‐related example of the Matuhasi‐Ogata phenomenon. Artificially created mixtures of anti‐E and drug antibody could reproduce the effect in vitro. No effect of cephalexin could be demonstrated. The variability of the Matuhasi‐Ogata phenomenon is discussed with regard to the sequence of antibody attachment, and the possible relationship to cephalexin is discussed. Drug antibodies may be involved in the Matuhasi‐Ogata phenomenon in cases where another red blood cell antibody cannot be shown to be present.
Plasmapheresis Using the IBM 2991 Blood Cell Processor
Authors: Buchholz D. H. , Bove J. R. , Charette J. R.
Published: December 2004

The IBM 2991 Blood Cell Processor, normally used to wash or deglycerolize red blood cells, has been modified to permit serial plasmapheresis using a small roller pump, an adapter line and the disposable processing set usually used for cell washing. Blood is withdrawn from the donor, pumped into the plastic centrifuge bag and the plasma removed after centrifugation. Donor erythrocytes are pumped from the processing bag to a reservoir bag from which they are returned to the donor by gravity. Multi‐unit plasmapheresis to harvest plasma for transfusion or to remove plasma as a therapeutic measure is possible using the modified system. A four‐unit plasmapheresis can be done in 65 to 75 minutes at a cost of $27.61, including disposables and technologist labor. This modification allows the IBM 2991 to function for red blood cell washing and as an efficient instrument for plasmapheresis.
Donor Recruitment and Blood Collection Costs for Red Cross Blood Centers
Authors: Jacobs P. , Rawson W. S.
Published: December 2004

This paper presents a statistical analysis of the hypothesis that there are economies of scale in the collection of blood. Based on a national sample of Red Cross collection centers, an analysis was conducted to determine the relationship between total costs of obtaining blood as well as its recruitment and collection components, and explanatory factors such as local costs, mobile units used, and scale of operations. Adjusting for other factors, our results indicate slight diseconomies of scale at all levels of operation: that is, as scale of operations increase, collection costs rise. Only the costs associated with the recruitment and collection functions are examined in this study.
Anti‐M in Children with Acute Bacterial Infections
Authors: Kao Y. S. , Frank S. , de Jongh D. S.
Published: December 2004

Four children, 7 to 24 months old, were found to have anti‐M at the time of admission to the hospital for severe acute bacterial infections. All were M‐N +. Two patients had meningitis, one had septic arthritis, and the fourth had a third‐degree burn of the left hand. In follow‐up studies the anti‐M of patients #3 and #4 were no longer detectable after 12 and 11 months respectively. In all patients no demonstrable antibody was in either maternal or cord sera at time of birth. The clinical data and bacterial isolations lead us to postulate that bacterial infections account for the formation of naturally occurring anti‐M in M‐negative persons.
Simple Method of Improving the Quality of Platelet Concentrates and the Importance of Production Control
Authors: Berséus O. , Högman C. F. , Johansson A.
Published: December 2004

Some technical improvements of the method to prepare platelet concentrates (PC) have been developed. The contamination of the PC with red blood cells (RBC) and white blood cells (WBC) is thereby kept at a low level. A majority of routinely prepared PC did not show any visible RBC contamination which means that they contained less than 0.4 × 109 RBC per PC unit. None of the tested examples contained more than 1 × 109 RBC per PC unit. The WBC contamination was less than 0.1 × 109 cells per PC unit in 75 per cent of tested examples and did not exceed 0.6 × 109 cells per PC unit. Routine platelet counting by thrombocounter applied on samples from all PRPs was found to be a reasonably simple way to make routine PC quality control. By sufficient supervision of the details of the procedure the main yield can be maintained at about 100 × 109 cells per unit. By follow‐up of the weekly yield any deterioration of production efficiency can easily be detected.
Blood Preservation XXVI. CPD‐Adenine Packed Cells: Benefits of Increasing the Glucose
Authors: Dawson R. B. , Hershey R. T. , Myers C. , Holmes S.
Published: December 2004

In searching for the optimal glucose concentration, this lab has monitored ATP, 2,3‐DPG, pH, and glucose levels of samples taken from full blood units stored for 6 weeks at 4 C. The blood was collected into CPD‐adenine containing 100, 125, 150, 175, and 200 per cent of the glucose present in CPD. The units were stored as whole blood, soft packed (50 to 70% Hct), or hard packed units (80 to 95% Hct). ATP values in general did not decrease very greatly in whole blood units and only moderately in soft packed units. However, in hard packed units a steady progressive decrease in the ATP values was seen to begin at day 14. In these hard‐packed units the only improvement with extra glucose was seen beginning at day 14 when ATP maintenance was better with 200 per cent glucose, but the improvement was not significant until day 42. However, at 35 days the ATP values for 200 and 175 per cent glucose were noticeably better than for the other preservatives. Therefore, it appears from this study that the glucose concentration in CPD‐adenine for hard‐packed cells should be at least 175 per cent of that in regularly formulated CPD. Also, there would appear to be an advantage of having 200 per cent glucose in those units of blood that may be stored beyond 35 days for emergency blood shortage times.
The Effect of Aspirin on the Hypotonic Shock Response
Authors: Rock G. , Trepanier J.
Published: December 2004

The effect of aspirin on the hypotonic shock response was studied at 2, 6, 24, and 48 hours after ingestion of 1.6 g of acetylsalicylic acid. There was a marked acceleration of the recovery phase of the response at two hours. This steadily decreased and by 48 hours had returned to near normal values. In most cases there was also a change in the initial phase of the shock response. We have interpreted these results to indicate a change in membrane permeability (first phase effect) as well as an activation of the energy‐dependent recovery (second phase). The latter process possibly is the result of an increase in the levels of available ATP. As previously reported, the response to aggregating agents was impaired in the presence of ASA. Normal and aspirinated platelets were mixed in an attempt to overcome the ASA effect. Using two hour postingestion samples we noted considerable impairment of both the hypotonic shock response and aggregation even in the presence of very high concentrations of normal platelets.
Temporary Suppression of Circulating Antiplatelet Alloantibodies by the Massive Infusion of Fresh, Stored, or Lyophilized Platelets
Authors: Nagasawa T. , Kim B. K. , Baldini M. G.
Published: December 2004

Survival of 51Cr‐labeled allogenic platelets was repeatedly measured in rabbits previously sensitized by weekly intradermal injections of platelets from donor animals. When values of recovery and survival time were reduced to very low levels, a massive infusion of platelets from randomly selected donor rabbits was given and survival study was repeated. A large increase in platelet survival and recovery was seen in every experiment. Similar results, although of lesser magnitude, were obtained with the infusion of platelets made nonviable by prolonged storage and, also, of lyophilized platelets. A significant increase in life span and recovery of allogenic platelets was also observed in two patients with thrombocytopenia due to aplastic anemia, severely allosensitized to platelets. After one massive infusion of viable or of nonviable platelets, survival and hemostatic effectiveness of subsequently infused allogenic platelets was greatly improved in both patients. Experimental blockade of the RES and titration of the serum alloantibody by the 14C‐serotonin release method demonstrated that the favorable effect of the massive platelet infusions was due to the temporary adsorption of the alloantibody in the circulation of the sensitized animals. This two‐step procedure of one massive infusion of viable, nonviable or lyophilized allogenic platelets followed by a small infusion of freshly collected platelets may be of practical value in arresting hemorrhage in selected thrombocytopenic patients refractory to all types of available donor platelets because of severe and complex alloimmunization.
The Immunocompetence of Residual Lymphocytes at Various Stages of Red Cell Cryopreservation with 40% W/V Glycerol in an Ionic Medium at –80 C
Authors: Kurtz S. R. , Van Deinse W. H. , Valeri C. R.
Published: December 2004

Potentially immunocompetent cells have been found in washed liquid‐stored red blood cells, in washed liquid‐stored red blood cells to which a 40% W/V glycerol concentration was added, and in washed red blood cells freeze‐preserved with 40% W/V glycerol at –80 C. A glycerol concentration of 40% W/V in an ionic medium, in addition to its cryoprotective effect on red blood cells, has a damaging effect on leukocytes. The freeze‐thaw‐wash process appears to produce the most damage to leukocytes and the remaining lymphocytes can be categorized into two groups: one that is capable of responding to phytohemagglutinin (PHA), and one that is not. Our study confirmed the presence of PHA‐responsive lymphocytes in red blood cells freeze‐preserved with 40% W/V glycerol in an ionic medium at –80 C. Although the relative proportions of these cells were variable and the results of the study somewhat erratic, we continue to recommend that liquid‐preserved and freeze‐preserved red blood cells be irradiated before transfusion to patients in whom graft‐versus‐host disease is a possible complication.
Utilization of Nursing Teams in the Collection of Blood
Authors: Rutman R. , Bray J. , Miller W. V.
Published: December 2004

The practice of nursing is group oriented. This was recognized in the past, but has only recently gained full acknowledgment by nursing management. The concept of team assignment for the nursing staff was implemented in the blood program several years ago. The problems of the professional nurse in blood banking are not the same as in an acute or an extended care facility. Team assignments can improve both the delivery of care and the efficiency of the operation in the blood program. This paper describes many of the problems incurred under the system of conventional staffing and will show how these problems can be either eliminated or modified through the use of team assignment. Two centers experienced with permanent team assignments report these conclusions.
Blood Group Testing of Ancient Material with Particular Reference to the Mummy Nakht
Authors: Hart G. D. , Kvas I. , Soots M.
Published: December 2004

An international multidisciplinary team performed an autopsy on the mummy of Nakht, a 16‐year‐old Egyptian boy who died 3200 years ago. Excavation records and translation of hieroglyphics provide a positive identification. The histological techniques, both at the light and electron microscope levels, demonstrate remarkable preservation of normal and diseased structures. Splenic material and dark brown substance obtained from the inside of the sigmoid sinus of Nakht, during the examination of the contents of the cranial cavity, were tested using the SMM and IAT procedures. Repeated testing of the splenic material using SMM produced no agglutination and was complicated by hemolysis of the absorbed group O cells due to contaminating bacteria and fungi. However, when used in the IAT, splenic material gave a positive result for blood group B. The sigmoid sinus material produced a positive reaction for blood group B when used with the SMM and with the IAT. The blood cells recovered from Nakht are believed to be the oldest known preserved human red and white blood cells. The authors also believe that the testing techniques employed in this study are reliable and hence feel confident that the Egyptian boy Nakht, who is 3200 years old, was blood group B.
HLA Antigens in Plasma Protein Fraction and Albumin
Authors: Dickerson J. M. , Perkins H. A.
Published: December 2004

Renal allograft survival is significantly worse than average in recipients who have never had blood transfusions. It has been speculated that this might be explained by the fact that patients on chronic dialysis often received plasma protein fraction (PPF) instead of blood and that HLA antigens from serum were likely to be present in PPF. We have examined four different lots of both PPF and albumin for the presence of HLA antigens. Using the microlymphocyto‐toxicity technique, each lot was tested for the ability to neutralize ten different antisera containing antibodies against well‐defined HLA antigens. In every case, no inhibition was observed—even when the ratio of blood derivative to antiserum was as high as 256:1. These results suggest that if PPF and albumin do contain HLA antigens, they are present at levels too low to be detected by the cytotoxicity test routinely used in HLA typing.
A Survey about Blood Bank Policies and Procedures
Authors: Waheed A.
Published: December 2004

A questionnaire about blood bank policies and procedures was prepared and sent out to 170 hospitals across the nation, 50 per cent responded. There is wide variation in both technical and nontechnical policies and procedures. Serum is separated from the original tube within 8 hours by 68 per cent of the hospitals and in 32 per cent serum is never separated from the original tube. Auto‐control is included by 66 per cent of hospitals in at least one phase of the antibody testing, 34 per cent do not include auto‐control in any phase. Du testing of the recipient is done in 85 per cent of the hospitals and in 15 per cent Rho type is determined by the immediate spin reactions alone. Slide type is the only method used to determine ABO group of cells of the recipients in 10 per cent of the hospitals, 18 per cent use serum‐cell suspension, 10 per cent use the applicator stick method and only 62 per cent use washed saline‐cell suspension routinely. Compatibility testing between a recipient and a donor vary from a one‐tube major crossmatch to a three‐tube major crossmatch and minor crossmatch.
Reversal of the Storage Lesion of CPD Bank Blood: A Problem in Clinical Medicine
Authors: Gibson J. G. , McCue J. P.
Published: December 2004

The effect of phosphate buffer on the course of pH, ATP, and 2,3‐DPG of CPD red blood cells stored at three temperatures was observed. Basic phosphate at an equilibrated level of 10 mM (as iP) maintained pH above 7.00 and ATP and 2,3‐DPG above 70 per cent of initial value in cells stored at 37 C for 24 hours. In contrast however, at 25 and 4 C no buffering was obtained with basic phosphate concentrations up to 50 mM. but values for both ATP and 2,3‐DPG were higher in phosphate treated aliquots than in controls throughout storage. When the pH of blood stored at 4 C was adjusted into the range 7.15 to 7.25 with tromethamine and the level of iP raised to 10 mM by addition of Na2HPO4 on day seven, it was found that ATP and 2,3‐DPG levels were maintained at 90 and 120 per cent, while control levels fell to 60 and 12 per cent, respectively at 21 days. The process described parallels the normal repair of damaged red blood cells of bank blood that occurs in vivo following transfusion.
The Accumulation of Mono‐2‐Ethylhexylphthalate (MEHP) During Storage of Whole Blood and Plasma
Authors: Rock G. , Secours V. E. , Franklin C. A. , Chu I. , Villeneuve D. C.
Published: December 2004

The accumulation of the plasticizer di‐2‐ethylhexyl‐phthalate (DEHP) in blood and blood components has been of considerable concern for some time. We have followed the accumulation of DEHP and one of its major metabolites, mono‐2‐ethylhexylphthalate (MEHP) during storage of whole blood, platelet‐rich plasma, platelet concentrates, and platelet‐poor plasma for periods ranging from 72 hours to four weeks. Both phthalates showed a progressive increase in concentration with time. While the levels of DEHP were much greater than those of MEHP, there was nonetheless a significant and continual increase in MEHP in all preparations. The highest concentrations of both DEHP and MEHP were found in the platelet‐poor plasma, indicating that platelets do not have a major role in the accumulation of the phthalates in blood. The accumulation of MEHP was shown to be a direct result of the metabolism of DEHP by plasma protein(s) rather than leaching from the blood bag.
Massive Transfusion During Major Surgery in a Child with Anti‐Knopsa and One Kidney
Authors: Griffith E. M.
Published: December 2004

Massive transfusion has been defined as the replacement of one‐third to one‐half of the blood volume of the patient. It usually implies the presence of shock and is associated with multiple traumatic injuries. Blood replacement is almost always banked blood given in large quantities. However, massive transfusion with autologous blood can also be applied to elective cases and is becoming a useful and clinically beneficial service both in the quality of the products transfused and avoidance of diseases transmitted by blood transfusion from heterologous blood donor sources. Operations which regularly require the transfusion of three or more units of blood include open heart surgery, orthopedic reconstructive procedures, vascular surgery land abdominal surgical procedures. The case presented Here, an orthopedic procedure, describes an example of elective massive transfusion, successfully performed in the presence of a rare alloantibody to red blood cells.
Further Studies on the Relationship of Anti‐Ena and Anti‐Wrb in Warm Autoimmune Hemolytic Anemia
Authors: Bell C. A. , Zwicker H.
Published: December 2004

The red blood cell eluates of two patients with warm autoimmune hemolytic anemia (AIHA) were found to have anti‐dl and anti‐Wrb in a study of 150 individuals with positive AHG tests.7 In that series 39 per cent of AIHA cases had anti‐Wrb as part of the autoantibody specificity. The eluates of these two patients were of further interest since they showed weaker reactions with En(a–) cells than with En(a+), Wr(a+b–) cells. Further absorption of the eluates confirmed a second component that reacted with the En(a+), Wr(b–) cells but not the En(a–) cell, interpreted as autoanti‐Ena. In one of the cases anti‐Ena was recovered from the En(a–) absorbing cell although these cells were not agglutinated by the autoantibody. This effect was not due to polyagglutinability, the Matuhasi‐Ogata phenomenon or the decreased sialic acid content of the En(a–) red blood cell membranes and remains unexplained.
Particulate Material in Antihemophilic Factor (AHF) Concentrates
Authors: Eyster M. E. , Nau M. E.
Published: December 2004

Antihemophilic factor (AHF) concentrates contain noncellular particulate material which is retained by a screen filter of 40μ pore size. This material is composed in part of IgG, fibrinoprotein, and cold insoluble globulin. The clinical significance of this material is uncertain, but a possible association with pulmonary and cerebral microemboli is suggested.
Is Very Fresh Blood Needed in Preparing Leukocyte‐Poor Red Blood Cells by Inverted Centrifugation?
Authors: Chapman R. G. , Dougherty S. M.
Published: December 2004

It is recommended that units selected for inverted centrifugal preparation of leukocyte‐poor red blood cells be less than 24 hours old. The reason for this is unclear and the recommendation poses practical problems. We evaluated the effectiveness of inverted centrifugation in reducing the WBC:RBC ratio in 31 units stored up to six days at 4 C. Leukocyte removal was at least as effective with six‐day stored units as with units less than one day old, averaging 77 per cent reduction with 76 per cent recovery of red blood cells. No reduction in leukocytes occurred with six days storage alone. It appears to be unnecessary to restrict leukocyte removal by inverted centrifugation to units less than 24 hours old.
Recycling Older Blood by Integration into the Inventory of a Single Large Hospital Blood Bank: A Computer Simulation Application
Authors: Abbott R. D. , Friedman B. A. , Williams G. W.
Published: December 2004

Recycling units of older blood from hospital blood banks with high outdate rates to other hospital blood banks with a high level of transfusion activity and a low outdate rate to increase the probability of utilization of the blood prior to outdating is an accepted method of inventory control. The purpose of this study was to determine with the use of a computer simulation the effects of integrating a variable number of units of ten‐day‐old blood into the inventory of a single large hospital blood bank. The analysis involved separate consideration of the recycling of 30, 60, 90, 120, 180, 240, 300, and 360 units of ten‐day‐old blood with one, three, and five deliveries per week into the modeled blood bank inventory. With one delivery per week and a 30 per cent outdate rate for blood ten days old or older at the hospital or hospitals from which the blood is recycled, the net saving achieved per week by recycling these variable quantities is 5, 4, 13, 17, 7, 0, –17, and –50 units; for a 50 per cent outdate rate, the net saving achieved is 11, 16, 31, 41, 43, 48, 43, and 22 units. Possible net saving of blood based on three and five deliveries per week and other outdate rates is also given. The frequency of blood delivery has no significant effect on the net saving of blood in the blood recycling plans evaluated. The implementation of an automatic blood recycling program, a practical and effective method for reducing blood outdating in a multi‐hospital regional blood system, is discussed in detail.
Filtration of Cryoprecipitate: a Microscopic Assessment of Filter Deposition
Authors: Inwood M. J. , Barr J. D. , Warren B. A. , Chauvin W. J.
Published: December 2004

A recent survey indicated that many Canadian hemophiliacs and physicians did not consider it necessary to filter cryoprecipitate prior to infusion. Experiments were performed to demonstrate that no loss of factor activity resulted from filtration of cryoprecipitate through standard blood filters. Furthermore, examination of the material retained on standard and ultrafiltration elements using scanning and transmission electron microscopy demonstrated the presence of amorphous and fibrillar proteins that proved to be largely composed of fibrin. This was accompanied by cellular material including intact and disintegrating leukocytes, erythrocytes, and platelets. Nonbiologic material was also discovered, including cellulose and plastic debris. This study emphasizes the need for effective filtration of cryoprecipitate.
Crossmatch Compatible Blood for Patients with Anti‐P1
Authors: Cronin C. A. , Pohl B. A. , Miller W. V.
Published: December 2004

Anti‐P1 is a cold‐reactive antibody often found in the serum of P2 individuals. For the past two years our reference laboratory has encouraged the use of crossmatch compatible blood for patients with Anti‐P1 rather than the use of reagent‐typed P1 negative units. The authors recently surveyed those hospitals that referred patient samples with anti‐P1 to determine the safety of blood selected in this manner. Nineteen patients received 53 units without incident using this procedure. This report is a summary of the authors' findings.
Confirmation of Bg–HLA Relationships by Antiglobulin Microcytotoxicity Testing
Authors: Crawford M. N. , Pollack M. S.
Published: December 2004

Antiglobulin reagents have been reported to increase the sensitivity of lymphocytotoxicity procedures for the detection of HLA antibodies that may affect the survival of transplanted kidneys or cause nonhemolytic transfusion reactions. This paper describes how such a procedure may also be used to demonstrate the presence of specific HLA antibodies in sera containing anti‐Bg antibodies but lacking HLA antibodies that can be detected by conventional procedures. With the use of more sensitive procedures for the detection of both anti‐Bg and HLA antibodies, studies of the relationship between specific HLA and Bg antigens can be extended, and the genetics of the expression of the Bg antigens can more easily be studied.
Stability of Neutrophil‐Releasing Activity of Plasma Obtained from Leukapheresed Rats and Stored at 4 C
Authors: Roy A. J. , Ramirez M. , Valeri C. R.
Published: December 2004

When granulocyte‐donor rats were treated prior to pheresis with plasma obtained from previously leukapheresed rats (PPP), granulocytosis and a significant increase in granulocyte yield were observed. Previous studies have demonstrated that such plasma stored at –150 C for up to two weeks preserved the neutrophil‐releasing activity. This study demonstrates that neutrophil‐releasing activity was satisfactorily preserved when plasma from previously leukapheresed rats was stored at 4 C for three weeks.
Factor VIII Procoagulant and Antigen Content of Antihemophilic Factor (AHF) Concentrates
Authors: Yang H. C. , Duffy C.
Published: December 2004

Antihemophilic factor concentrates from six manufacturers were studied for factor VIII procoagulant and antigen content. Marked lot‐to‐lot differences were found in the factor VIII antigen:procoagulant ratio. The average antigen content was 2.33 times that of procoagulant activity in 21 lots studied, indicating a significant loss of activity during the fractionation process.
Plasma Factor VIII, Variables Affecting Stability under Standard Blood Bank Conditions and Correlation with Recovery in Concentrates
Authors: Pepper M. D. , Learoyd P. A. , Rajah S. M.
Published: December 2004

Some of the variables affecting factor VIII during storage of plasma at 4 C prior to preparing factor VIII concentrates and cryoprecipitates were investigated. No significant difference in factor VIII levels could be demonstrated between whole blood, platelet‐rich plasma or plasma depleted of platelets when stored at 4 C. However, in frozen plasma platelets were shown to have a deleterious effect on factor VIII. No significant difference in factor VIII levels was found in whole blood or plasma stored at 4 C for 6 hours as compared with blood or plasma stored for 18 hours (p ? 0.1). There was, however, a highly significant difference (p ? < 0.001) between plasma and whole blood stored at 4 C for 4 hours as compared with storage for 18 hours. There was a significant correlation (correlation coefficient 0.714) between factor VIII levels in the starting material and the factor VIII recovered in cryoprecipitates, but in a small pilot study no correlation between factor VIII levels in the starting material and that recovered in freeze‐dried concentrates could be found. There was no significant difference in factor VIII levels between the Group O and Group A donations used in this study (p = >0.1), and no correlation was found between the drop in pH during storage and the factor VIII decay pattern.
Notes on the Ena and U Antigens of Ena(En.OP) Heterozygotes, and the U Antigen of En(a–) Individuals
Authors: Issitt P. D. , Pavone B. G.
Published: December 2004

Using two anti‐Ena antibodies, from which anti‐Wrb had been removed, and anti‐U antibodies, the authors have failed to demonstrate any difference in the amounts of Ena and U antigens on the red blood cells of individuals with one and two functioning Ena (En.OP) genes. Two En(a–) samples, one from an individual who is En/En (En.op/En.op) and the other En/Mk (En.op/Mk), could not be distinguished from U‐positive samples from individuals with two functioning U (U.OP) genes in dosage studies with anti‐U.
Pedi‐Pack Transfusion in a Newborn Intensive Care Unit
Authors: Kakaiya R. M. , Morrison F. S. , Rawson J. E. , Lotz L. L. , Martin J. W.
Published: December 2004

Two hundred and ninety‐one transfusions using 221 pediatric frozen red blood cell packs (Pedi‐Packs) were given to 141 newborn babies and infants in the newborn intensive care unit. In 18 patients, 47 transfusions were studied for transfusion and clinical characteristics. Two possible hemolytic episodes are described in detail and remain unexplained. Blood loss for laboratory tests was found to average 3.1 ml/kg per day spent in the newborn intensive care unit. The rise in hematocrit was found to be excellent. Overall, the transfusion of thawed pediatric red blood cell packs was found to be convenient, safe and effective. Because of pretesting possibilities with the use of this source of red blood cells, one of the problems associated with a walking donor program is eliminated.
Ripley‐Like Anti‐Rh Associated with Red Blood Cell‐Bound IgG Aggregates
Authors: Hsu T. C. S. , LeDoux R. G. , Sussman I. I. , Steinberg J. , Sawitsky A.
Published: December 2004

A commercial Rho (D) immune globulin after heating at 63 C became Ripley‐like in the Rh‐positive red blood cells coated with this heated globulin carried biologic activities similar to those of red blood cells coated with Ripley anti‐CD serum. These coated red blood cells fixed complement and were agglutinated by all 20 sera containing rheumatoid factor (RF). The RF‐Rh‐hemagglutinations were more readily inhibited by heated than by unheated human IgG. The heated globulin had no such effect on Rh‐negative red blood cells. Fractionation studies by Na2SO4 precipitation and/or Sephadex G‐200 gel filtration revealed that heat‐induced IgG aggregates in heated globulin were responsible for the biological activities. In contrast, these activities in Ripley serum were carried by IgG monomers. Another anti‐CD serum (Heyman), tested in paralledl, was found to be indistinguishable from Ripley. a pooled RF serum, after multiple adsorptions with red blood cells coated with globulin, lost its agglutination activity to red blood cells coated with Ripley or Heyman serum.
Hemophilia: Cost Considerations for Prescribing Therapeutic Materials
Authors: Linney D. R. , Lazerson J.
Published: December 2004

Costs for therapeutic products utilized in treating hemophilia can be prohibitive to patients. The costs can be effectively reduced by understanding the elements comprising the total cost of these products. By calculating appropriate dosage schedules, avoiding indiscriminate purchasing practices, and monitoring costs to patients, physicians can help reduce the total financial burden to patients and third party payers.
Donor Antibody Detection Using Plasma in Place of Serum
Authors: Kitagawa S. , Lee C. L. , Behzad O.
Published: December 2004

Twenty‐two types of erythrocyte antibodies from 53 individuals were studied for their detectability in serum versus CPD, ACD and EDTA plasma samples. In no specimen thus far tested was there an antibody detectable in serum but not detectable in plasma. These results suggest that blood samples collected in anticoagulant are suitable not only for antigen typing but also for antibody screening.
Plasma Adenine and Cellular ATP in Red Cell Concentrates Collected and Stored in Modified CPD at 4 C
Authors: Moore G. L. , Ledford M. E. , Brooks D. E.
Published: December 2004

Eight units of blood were drawn into modified CPD containing 25 per cent higher glucose and 17.3 mg adenine (0.25 mM in blood). Red blood cell concentrates (RCC) were prepared to a mean hematocrit (Hct) of 70, the cells stored at 4 C, and plasma adenine and red blood cell adenosine triphosphate (ATP) were measured weekly for 42 days. The removal of plasma in the preparation of RCC reduced by 39 per cent the available adenine. As a result measurable plasma adenine was depleted by 21 days. The loss of ATP in RCC occurs at a significantly faster rate than in whole blood stored under the same conditions. When red blood cells are stored at higher Hct or for periods longer than 35 days, increased anticoagulant adenine levels are recommended.
The Effects of Red Blood Cell Suspending Media on Hemagglutination and the Antiglobulin Test
Authors: Fitzsimmons J. M. , Morel P. A.
Published: December 2004

Evaluation of the effects of four suspending media for test cells in antibody detection and identification is reported. The media under investigation are normal saline, low ionic strength salt solution, 22% bovine albumin and polymerized albumin. Hemagglutination at 37 C was enhanced in the test systems employing polymerized albumin. With shortened incubation times, the antiglobulin test was enhanced in tests against red blood cells suspended in the low ionic strength salt solution. When incubation times were extended to 30 minutes, all suspending media were apparently equally effective.
The Effect of Temperature Variations on Cryoprecipitate
Authors: Rock G. A. , Tittley P.
Published: December 2004

The effect of temperature on Factor VIII levels in blood and cryoprecipitate was assessed. Freshly collected units of blood required several hours to reach 4 C, but this delay seemed of little importance since equal amounts of cryoprecipitated Factor VIII were recovered from blood stored either at 22 C or at 4 C. Freezing at −80, −60, or −40 C produced identical yields of Factor VIII, whereas freezing at −20 C resulted in significantly lower recoveries. This might be expected if one considers the physiochemical changes that occur during the freezing process.
Lack of Predictive Value of Antileukocyte Antibody Screening in Granulocyte Transfusion Therapy
Authors: Ungerleider R. S. , Appelbaum F. R. , Trapani R. J. , Deisseroth A. B.
Published: December 2004

To clarify the relationship between recipient presen‐sitization and response to granulocyte (PMN) transfusion, we tested 187 non‐HL‐A matched donor‐recipient pairs for the presence of antileukocyte antibody using granulocytotoxicity (G), lymphocytotoxicity (L), micro‐leukoagglutination (M), and capillary leukoagglutination (C) assays. PMN increments per 1011 transfused PMNs per square meter of body surface area, ascertained one hour following termination of transfusion, and the occurrence of nonhemolytic transfusion reactions, were correlated with the assay results. Although circulating anti‐donor‐leukocyte antibody was detected in 52 per cent of recipients, there was no statistically significant relationship between the presence of these antibodies and either PMN recovery or incidence of transfusion reaction. We conclude that the prospective use of these assays is of little value in predicting the recipient's response to PMN transfusion.
Studies on Platelets Contained in Eluates Following Filtration Leukapheresis
Authors: Kernoff L. , Shackleton D. , Dubovsky D. , Blake K. , Jacobs P.
Published: December 2004

Platelets eluted from nylon fiber filters after filtration leukapheresis have been studied. The platelet yield from 61 routine donations was 1.25 ± 0.18 × 10,11 (mean ± SEM) corresponding to 1.78 × 1010 per 500 ml blood processed. Filtered platelets labeled with radiochromate demonstrated reduced recovery in vivo 15 minutes after infusion (38.5 ± 1.7%) when compared to the control value (68.5 ± 6.8%, p < 0.001). The survival of those platelets remaining in the circulation after 15 minutes did not however differ from the control value. ADP (10 μM, 100 μM, 1 mM), adrenaline (100 μM) and collagen (7.25 mg/ml) added in vitro induced less aggregation of filtered platelets than normal control platelets and electron microscopy revealed structural abnormalities. It is concluded that recipients of granulocyte transfusions obtained by filtration leukapheresis are unlikely to be benefited by the platelets contained in these transfusions.
Technique for Increased Granulocyte Recovery from Human Whole Blood by Counterflow Centrifugation Elutriation
Authors: Jemionek J. F. , Contreras T. J. , French J. E. , Shields L. J.
Published: December 2004

Human granulocytes were isolated from 120 ml of whole blood by a modified counterflow centrifugation‐elutriation (CCE) technique. Overall recovery of isolated granulocytes averaged 2.82 ± 0.25 × 108 cells or 77 per cent yield from whole blood with 96 per cent granulocyte purity and 4 per cent mononuclear leukocytes. The granulocyte fraction was assayed in vitro to determine chemotactic response, stimulated oxygen consumption in the presence of latex beads, bactericidal capacity, and enzyme activities. Cellular integrity was determined by scanning and transmission electron microscopy as well as by cell volume analysis. The data suggest that granulocytes isolated by CCE suffered no discernible loss of function or morphologic damage. The granulocytes are free of platelets and most mononuclear leukocytes and erythrocytes, and have not been exposed to sedimenting agents or surface adhesive agents such as dextran, nylon or glass wool.
The Effect of Dexamethasone on Platelet Function
Authors: Lichtenfeld K. M. , Schiffer C. A.
Published: December 2004

To assess the effects of dexamethasone on platelet function, aggregation studies were performed on nine healthy adults before and after ingestion of a single dose of dexamethasone 10 mg, and on six patients receiving daily dexamethasone. Bleeding times were done on 14 volunteers before and after a similar drug dose. Platelet aggregation by ADP, epinephrine and collagen was unchanged after dexamethasone in the healthy subjects and aggregation curves in the patient group were comparable to the normals. Bleeding times were moderately prolonged in women (from 284 ± 58 seconds to 389 ± 114 seconds) but not in men. This prolongation was much less pronounced than that which occurs with low doses of aspirin and no subject experienced delayed bleeding. Dexamethasone in single high doses probably does not cause a clinically important effect on platelet function.
Cryopreservation of Human Lymphocytes: A Brief Review and Evaluation of an Automated Liquid Nitrogen Freezer
Authors: Glassman A. B. , Bennett C. E.
Published: December 2004

Successful cryopreservation of human lymphocytes has been previously described. Cryopreserved lymphocytes are useful for a variety of in vitro immunologic studies. This study was performed to determine the applicability and/or advantages of using a programmable freezing system, and compares glycerol versus dimethyl sulfoxide (DMSO) at varying concentrations on post‐thaw viability, E‐rosetting and immunoglobulin fluorescence. Prefreeze T and B lymphocyte percentages were determined. Cells were then frozen in varying concentrations of glycerol and DMSO. Optimum cryoprotectant type and concentration was determined. Lymphocytes from seven individuals were frozen by the batch method in a mechanical freezer and with the automated liquid nitrogen injection system. Data on post‐thaw T and B percentages and viability revealed 10% DMSO and liquid nitrogen control freezing method at 1 C/minute as the best conditions for lymphocyte preservation as reflected by post‐thaw in vitro testing.
A New Method of Antibody Elution From Red Blood Cells
Authors: Chan‐Shu S. A. , Blair O.
Published: December 2004

A method of antibody elution from red blood cells using xylene is described. It can be completed in 15 minutes after cell washing and requires no special equipment. For warm antibodies, the eluates prepared were more potent than those prepared by Rubin's ether method. It was as effective as Landsteiner and Miller's heat elution method in investigations of ABO hemolytic disease of the newborn. The clinical application of this method in the investigation of hemolytic disease of the newborn, delayed transfusion reaction and autoimmune hemolytic anemia was described.
Platelet Glycolysis in Platelet Storage
Authors: Tegos C. , Beutler E.
Published: December 2004

Sixteen glycolytic enzymes were measured in essentially leukocyte‐free platelets before storage and daily after room temperature storage of platelets as concentrates. Most of the glycolytic enzymes proved to be very stable to storage. Even the most severely affected enzymes, enolase, triosephosphate isomerase, and lactate dehydrogenase lost less than one‐quarter of their enzyme activity. Depletion of glycolytic enzymes does not seem to be a major factor in the storage lesion of platelets.
False Positive and False Negative Reactions in HLA B‐27 Antigen Testing
Authors: Larsen A. E.
Published: December 2004

The recent commercial availability of HLA B‐27 antiserum now enables laboratories without prior experience in HLA typing to test for this antigen. False positive and false negative reactions frequently occur and require judicious interpretation. In our laboratory, 30 of 100 specimens were positive for B‐27 and 70 were negative. Of the 30 positives, 10 (33%) failed to react against every antiserum tested. Twenty‐nine of the 70 negative specimens (41%) reacted falsely with one or more B‐27 antisera. A significant cause of false positive reactions was cross‐reaction of the B‐7 antigen with B‐27 antisera (13 of 15 B‐7 positive, B‐27 negative specimens). For valid B‐27 testing, use of more than one B‐27 antiserum is indicated.
Complement Fixation by Rh Blood Group Antibodies
Authors: Hidalgo C. , Romano E. L. , Linares J. , Suarez G.
Published: December 2004

Rh blood group antibodies normally do not fix complement. Rh ‐ positive intact red blood cells treated with papain do not lyse when incubated with corresponding antibody and complement. This study was done to determine if complement fixation occurs when antibodies were combined with Rh positive red blood cell ghosts untreated or treated with papain. Complement fixation was observed with IgG anti‐D, anti‐DC and anti‐c when papain treated ghosts were used. No complement fixation or a smaller degree of it was observed in the case of untreated Rh positive red blood cell ghosts when incubated with similar anti‐Rh antibodies. It is concluded that the papain treatment of Rh positive red blood cell ghosts, possibly by inducing aggregation of antigen sites, allowed complement binding by Rh antibodies.
Autoimmune Hemolytic Anemia Associated with IgG Auto Anti‐N
Authors: Cohen D. W. , Garratty G. , Morel P. , Petz L. D.
Published: December 2004

A second case of autoimmune hemolytic anemia mediated by an IgG auto Anti‐N is described. The patient's red blood cells were sensitized with both IgG and complement. The serum antibody was not inactivated by 2‐mercaptoethanol treatment, and reacted by indirect antiglobulin test at 37 C with monospecific anti‐IgG. The IgG antibody eluted from the red blood cells and in the serum showed anti‐N specificity. The patient was thought to have systemic lupus erythematosus. Following steroid therapy, the hemolytic anemia resolved with disappearance of the anti‐N.
Serum Opsonins and Chemotactins in Neutropenic Oncology Patients
Authors: Stempel D. A. , Eden O. B. , Gilkerson E. , Berberich F. R.
Published: December 2004

Serum opsonins and chemotactins, C3 and C5, were studied in neutropenic oncology patients. Our data indicate that these individuals possess normal serum chemotactins and adequate opsonin activity regardless of disease status or prior chemotherapy. Their sera should therefore support function of transfused granulocytes.
Detection of Complement (C3d) Coated Cells in a Newborn due to Maternal Anti‐i
Authors: Branch D. R.
Published: December 2004

A case of a positive direct antiglobulin test on a newborn's cord red blood cells caused by maternal anti‐i is reported. The direct antiglobulin test was moderately positive using polyspecific antiglobulin reagent and monospecific anti‐C3d, but negative using monospecific anti‐IgG. The infant showed no clinical signs of hemolytic disease of the newborn.
Therapeutic Transfusions of Previously Frozen Washed Human Platelets
Authors: Zaroulis C. G. , Spector J. I. , Emerson C. P. , Valeri C. R.
Published: December 2004

The platelets used in this study were collected by serial centrifligation, and within four hours of collection were frozen with 5% dimethylsulfoxide (DMSO) at an overall rate of 2 to 3 C per minute by storage in a mechanical refrigerator at ‐80 C. The frozen platelets were stored for four to ten weeks before thawing and washing. After washing, the units were kept at room temperature for six to eight hours before transfusion. The units were pooled, and an average of eight units was given to each of four patients, with a range of three to 14 units per transfusion. In vitro recovery after washing was about 65 per cent and in vivo recovery of the 51chromium labeled (51Cr) platelets was about 35 per cent. The infusion of these previously frozen washed platelets corrected prolonged bleeding times in patients. The homologous platelets were transfused along with other blood products to treat patients with hematologic disorders. The circulation and function of the donor platelets were influenced by compatibility of the platelets, the quality of platelet preservation and the patient's disease state.