bluuebunny/crossref_metadata_2025_split huggingface dataset:
P40 A Novel Variant in the Ok Blood Group System
Authors: Karamatic Crew V. , Thomas R. , Gillen B. , Poole J. , Daniels G. 
Published: September 2006

Introduction  Oka (OK1), the only antigen of the Ok blood group system, occurs with a very high frequency in all populations studied. Oka is located on the immunoglobulin superfamily glycoprotein CD147, also known as M6 leukocyte activation antigen, basigin (BSG) or extracellular matrix metalloproteinase inducer (EMMPRIN), which is encoded by the CD147 gene located on chromosome 19p13.3. The only known polymorphic forms of Oka are the extremely rare Ok(a‐) phenotypes described in eight families of Japanese origin (Spring et al. (1997) Eur. J. Immunol. 27, 891–897) and one Caucasian individual of Iranian background (Karamatic Crew et al. (2003) Transfusion Med 13(1), P32). In both cases, the molecular basis of the Ok(a‐) phenotype were unique missense point mutations leading to amino acid changes within the carrier protein.Case Study and Methods  We investigated a case of a prenatal patient of Hispanic origin whose serum contained an antibody to an unknown high frequency antigen, with a suspected Oka specificity. There was no known history of transfusion or previous pregnancies. Serological tests were performed by standard agglutination techniques. Genomic DNA was isolated from whole blood of the patient and all the exons of the CD147 gene were amplified by PCR and directly sequenced.Results  The patient's serum reacted with all tested cells of rare and null phenotypes, with the exception of three examples of Ok(a‐) cells. Her red cells were positive with all examples of anti‐Oka tested, indicating a novel Oka phenotype. Sequencing of CD147 revealed a novel homozygous mutation in exon 2 178G>A, causing Val60Met change in CD147 protein.Conclusion  We report the second non‐Japanese individual with a variant Oka phenotype. We have confirmed that patient's serum contained an antibody associated with Oka, although it was different from the anti‐Oka examples described previously. This rare novel Oka variant results from a single point mutation in CD147 leading to a Val60Met change. This new Oka variant and the distribution of the mutations within CD147 indicate a more complex blood group system.
P44 Review of Hospital Transfusion Committee Membership and Attendance in the West Midlands
Authors: Watkins E. , Baker C. E. 
Published: September 2006

Introduction  Hospital transfusion committees (HTC) are now well established. Over the last 5 years blood usage has declined by 15%. It is now well established that surgical patients utilise less than 50% of red cells despite initiatives to reduce the number of patients waiting for surgery. It was perceived that physicians were under represented on HTCs. As physicians are responsible for an increasing proportion of blood used we decided to quantify attendance at HTCs.Methods  Minutes from 18 Trusts’ HTC meetings held in 2005 and 2006 within the West Midlands were reviewed and job title was recorded for members of and those attending their HTC. Sufficient data was available from 14 HTCs to review their last three meetings.

The most common posts/departments represented are as follows:

Member
Members of X % of HTCs

Consultant Haematologist
100

Transfusion Practitioner/Co‐ordinator
89

Anaesthetics
89

Blood Bank Manager/Chief BMS
83

Orthopaedics
61

Obs and Gynae
67

Haematology Lab/Pathology Manager
56

Clinical Risk
61

Consultant Surgeon
56

Matron
44

Remaining categories/groups

Member
Members of X % of HTCs

Paediatrics
50

Clinical Governance
39

A and E Consultant
33

Medical Director
33

Physician
28

Director of Nursing (and Midwifery)
28

Theatres/Recovery
22

PCT Representative
22

Quality Manager
17

Clinical Audit
11

‘Others’
89

Invitation and Attendance at HTCs by each group

Group
% of 42 HTCs to which each group was invited
% of 42 HTCs to which each group attended

C. Haematologist
100
90

TP/Co‐ordinator
79
76

BB Manager
100
88

Anaesthetics
93
69

Clinical Risk
64
31

Clinical Governance
36
19

C. Surgeon
50
21

Obs and Gynae
64
43

Matron
43
21

Haematology Lab
43
29

C. Physician
7
2

Orthopaedics
64
17

Percentage of 14 Trusts with ≥1 attendance in the last 12 months, by group/member

Group
% of 14 Trusts with ≥1 attendance in the last 12 months

C. Haematologist
100

TP/Co‐ordinator
79

BB Manager
100

Anaesthetics
86

Clinical Risk
36

Clinical Governance
29

C. Surgeon
36

Obs and Gynae
64

Matron
36

Haematology Lab
36

C. Physician
7

Orthopaedics
29

Results  Conclusions  Of medical staff, physicians are members of only 28% of the HTCs. More worrying is that in the period under review for which there was comprehensive data only once did a physician attend an HTC meeting. There is an urgent need to engage more physicians on to the membership of HTCs and to ensure that they attend, review their current practice and disseminate best practice to their colleagues.
P47 Inherited Familial Thrombocytopenia due to an Autosomal Dominant Mutation in the Cytoplasmic Domain of Platelet β3‐Integrin that is Associated with the Expression of Activation‐Dependent Epitopes
Authors: Watkins N. A. , Ghevaert C. , Schaffner‐Reckinger E. , Rankin A. , Garner S. F. , Stephens J. , Smith G. A. , Kieffer N. , Laffan M. , Ouwehand W. H. 
Published: September 2006

Background  Glanzmann's Thrombasthenia (GT) and Bernard Soulier Syndrome (BSS) are the two most common inherited forms of thrombasthenia. They are caused by alterations in expression or function of integrin alphaIIb/β3 or glycoprotein (GP) Ib/IX/V respectively. We identified an individual with chronic mild macrothrombocytopenia (range 59–100 × 109 L−1) but no overt bleeding diathesis. The propositus was found to have atypical binding of monoclonal antibodies (mAb) to β3 integrin and increased expression of GPIbVIX.Methods and Results  The exons and flanking intronic sequences of ITGB3, ITGA2B GPIBA, GPIBB, GP9 and GP5 genes were sequenced. Heterozygous, non‐synonymous single nucleotide polymorphisms (SNP) were identified in the ITGB3 and the GPIBA genes. These result in the substitution of Histidine for Aspartate at residue 723 (D723H) in ITGB3 and Leucine for Proline at residue 69 (P69L) in GPIBA. Asp723 in ITGB3 is known to form a critical salt‐bridge with ITGA2B and charge reversal at residue 723 causes constitutive activation of the integrin in vitro. In agreement with this, mutant alphaIIb/β3‐His723 expressing CHO cell lines showed an increased expression of activation dependent epitopes relative to wild‐type as measured by mAb PAC‐1 binding. Increased PAC‐1 binding was also observed on resting platelets of affected individuals compared with non‐affected family members. Further investigation of three generations of the propositus’ family identified several individuals with both SNPs each of whom had an identical platelet phenotype. However, in the one family member identified who carried the GPIBA mutation alone, normal platelet size and count were observed suggesting that the ITGB3 D723H substitution is the causative mutation. Genotyping a panel of 1127 unrelated controls for the two SNPs identified five individuals with the GPIBA mutation and none with the ITGB3 mutation.Conclusions  We report a novel autosomal dominant cause of a mild form of macrothrombocytopenia caused by a D723H substitution in the beta3 integrin. We postulate that the low platelet count is due to increased consumption of platelets due to enhanced levels of surface expressed, activated GPIIbIIIa.
P50 Novel Activatory and Inhibitory Platelet Receptors Identified Through Comparative Gene Expression Profiling of Megakaryocytes and Erythroblasts
Authors: Macaulay I. C. , Tijssen M. R. , Thijssen‐Timmer D. , Gusnanto A. , Carr P. , Steward M. , Langford C. , Ellis P. , Dudbridge F. , Zwaginga J. , Watkins N. A. , Van Der Schoot E. , Ouwehand W. H. 
Published: September 2006

Summary  Platelets are derived from a polyploid precursor cell, the megakaryocyte (MK). The MK and the precursor of red cells, the erythroblast (EBs) share a common bipotent progenitor and have closely linked differentiation pathways. We hypothesized that the subset of genes that are differentially expressed between MKs and EBs would contain novel, previously uncharacterized, ‘lineage specific’ genes. We have used cDNA microarrays to identify genes differentially expressed between CD34+ Haematopoietic Stem Cell (HSC) derived MKs and EBs.Methods  CD34+ HSCs were purified from Umbilical Cord Blood by magnetic cell separation. For differentiation into MKs, HSCs were cultured for 7 days in serum‐free medium containing Thrombopoietin and IL‐1β. For differentiation into EBs, HSCs were cultured for 10 days with Erythropoietin, IL‐3 and Stem Cell Factor. Differentiated cells were purified by Fluorescence Activated Cell Sorting to >95% purity, RNA isolated and then compared on Sanger Hver2.1.1 15K cDNA arrays. The data was statistically and bioinformatically analysed to identify novel transcripts encoding proteins with transmembrane domains. Taqman Real‐time PCR was used to validate the differential expression of both known and novel transcripts and to investigate blood cell distribution. Murine polyclonal antisera were raised against recombinant protein and used to confirm expression of these genes at protein level in platelets and MKs by western blot.Results  Known lineage specific markers, including CD41, CD42a and CD42b were upregulated in MKs relative to EBs. A number of novel transmembrane proteins were also identified as being upregulated in MKs. These include the immunoglobulin fold domain containing proteins c6orf25 (G6b) and c6orf21 (G6f). Transcript profiling of blood cells demonstrated that G6b and G6f expression is restricted to the platelet and megakaryocyte lineages. Western blotting confirmed the presence of G6b and G6f as glycosylated proteins of the platelet plasma membrane. Functional studies have shown that cross‐linking of G6b with polyclonal antisera can inhibit platelet aggregation in response to both collagen and ADP, suggesting that this protein has an inhibitory role in vivo. In addition, we have identified a novel G‐protein coupled receptor in platelets that may have a co‐stimulatory role in platelet aggregation.Conclusions  The comparative analysis of the MK and EB transcriptomes provides an overview of gene expression in these two cells and has identified novel platelet‐specific transmembrane proteins. Experiments are underway to characterise the role of these novel proteins in the regulation of platelet function.
P61 Producing a Safer Bone Allograft by Procesing Single Femoral Heads
Authors: Rooney P. , Mann J. , Eagle M. , Hogg P. , Kearney J. 
Published: September 2006

Introduction  The majority of bone allografts in the UK are supplied as fresh‐frozen single femoral heads which still contain the donor's bone marrow and this donor bone marrow may actually be included in the grafting procedure. Due to the possibility of disease transmission, removal of marrow components from banked allograft femoral heads is desirable. In this study we have set out to develop a protocol to remove donor bone marrow from single femoral heads in a time period and in a manner such that it could be easily implemented into routine production.Methods  A 12‐step protocol has been devised which involved sonication, rinsing, three centrifugation steps, a hydrogen peroxide wash, an ethanol wash and a total of five warm water washes at 56–59oC. At the end of the procedure, the bone was morcellised into a fine powder and used for residual values. The amount of soluble protein, double stranded DNA and haemoglobin removed at each step was measured using commercial kits and the percentage removed at each step was evaluated.Results  The total time for the 12‐step protocol was less than 4 h. The protocol resulted in the removal of in excess of 99% of soluble protein, DNA and haemoglobin. Soluble protein and DNA exhibited similar patterns of removal, with the highest proportion of removal occurring at the first centrifugation step whereas haemoglobin removal was highest in the initial sonication wash.Conclusion  The data presented here indicate that single femoral heads can be individually processed in a four‐hour time period with the resultant removal of the vast majority of bone marrow components. The cleaning protocol may be useful in reducing the possibility of disease transmission in allograft bone.
The potential geographic distribution of the invasive weed Senna obtusifolia in Australia
Authors: DUNLOP E A , WILSON J C , MACKEY A P 
Published: September 2006

Summary Senna obtusifolia (sicklepod) is an invasive weed of northern Australia, where it significantly impacts agricultural productivity and alters natural ecosystem structure and function. Although currently restricted to northern regions, the potential for S. obtusifolia to spread south is not known. Using the eco‐climatic model CLIMEX, this study simulated the potential geographic distribution of S. obtusifolia in Australia under two scenarios. Model parameters for both scenarios were derived from the distribution of S. obtusifolia throughout North and Central America. The first scenario used these base model parameters to predict the distribution of S. obtusifolia in Australia, whilst the second model predicted the distribution of a cold susceptible S. obtusifolia ecotype that is reported to occur in the USA. Both models predicted the potential for an extensive S. obtusifolia distribution, with the first model indicating suitable climatic conditions occurring predominantly in coastal regions from the Northern Territory, to far north Queensland and into northern Victoria. The cold susceptible ecotype displayed a comparatively reduced distribution in the southern parts of Australia, where inappropriate temperatures, a lack of thermal accumulation and cold stress restrict the invasion south to the coastal regions of central New South Wales. The extent of the predicted distribution of both ecotypes of S. obtusifolia reinforces the need for strategic management at a national scale.
The implication of stubble tillage for weed population dynamics in organic farming
Authors: PEKRUN C , CLAUPEIN W 
Published: September 2006

SummaryIn practical farming, early and shallow stubble tillage is carried out post‐harvest to stimulate germination of freshly ripened crop and weed seeds, to kill the resulting seedlings and hence to reduce the input into the soil seedbank. Additionally, it aims at reducing perennial weeds by mechanical damage. In this paper, field experiments and laboratory studies are presented which show that stubble tillage can reduce perennial weeds. However, it had a variable effect on annual weeds. After 5 years of experimentation, no effect of stubble tillage was seen on the aboveground vegetation. In contrast, the soil seedbank of the control was roughly doubled where the stubble had been left uncultivated until autumn ploughing. These results indicate that practical experience which assumes that stubble tillage reduces annual weed populations may be correct, despite the fact that in other published studies stubble tillage exerted no control on annual weeds or had a variable effect. This will have practical application in organic arable production systems.
L/I‐10 Anesthetic management of pediatric living related liver and small bowel transplants
Authors: Campise‐Luther R. 
Published: September 2006

Living related liver and small bowel transplants, in combination or staged, are now considered an acceptable therapy for children with short gut syndrome who do not tolerate parenteral nutrition and suffer from liver dysfunction and portal hypertension secondary to cholestasis.The anesthetic management of a pediatric living related liver and small bowel transplant is very challenging. Preoperatively, the focus is on the extensive preparation needed for these cases. Intraoperatively, fluid management requires maintenance of a delicate balance between low CVP to prevent venous congestion of the transplant and adequate blood pressure to maintain perfusion, especially during the reperfusion phase. Monitoring the coagulation status and platelets is important, in order to be able to react appropriately to uncontrollable bleeding; however, overcorrection, which can lead to hepatic or mesenteric artery thrombosis and graft failure, should not be risked. Temperature control is crucial in children independent of the surgical procedure, but poses a special challenge in light of large volume shifts, cold transplanted organs, and large surface area exposure. Fluctuation in glucose levels, acid‐base status, and electrolytes have to be anticipated and treated. Postoperatively, these children have to be monitored in the ICU and cared for in a similar manner as intraoperatively. The team has to be prepared for emergent reexploration for complications, e.g., bleeding, at any time.These are some of the considerations that demonstrate the complexity of the anesthetic care of these children.References:  Socol E. et al. Liver and intestinal transplantation in children; JPGN Vol. 35 (2) Supplement; Aug. 2002.Gregory GA. Pediatric Anesthesia, 4th Edition, p. 541‐567, Churchill/Livingston 2002.Borland LM. Anesthesia for organ transplantation in children. Int Anesthesiol Clin 23:173, 1985.
L/I‐13 Donor hepatectomy morbidity based on the Clavien scale
Authors: Kinkhabwala M. , Davidzon G. , Lapointe Rudow D. , Brown R. , Emond J. 
Published: September 2006

Introduction and methods:  Reported rates of complications after donor hepatectomy vary widely. One reason may be lack of standardization of reporting. In order to assess 1‐year morbidity after donor hepatectomy based on the modified Clavien scale (MCS), which has been proposed as a quantitative scoring system for postsurgical complications, we conducted a retrospective review of 127 living donors at our center through December 2004 (minimum 1‐year follow‐up).Results:  A total of 76 donors underwent right hepatectomy (RH); 51, left or lateral hepatectomy (LH). In all, 36% of donors experienced a complication as defined by the MCS: 27% of LH donors and 42% of RH donors. The distribution of complications is illustrated in the table below. The most common grade 1 complications were wound infection (7.8%) and ileus (7.1%); grade 2, psychiatric problems and urinary tract infection; grade 3, hernia/wound revision (11.8%). The rate of bile leak was 3.9%; heterologous transfusion, 1.6%. There was 1 aborted procedure. The mean length of stay was 6.3 days for LH donors and 7.2 days for RH donors (p=.02).Conclusion:  Our data indicate that RH donors experience a higher severity of complications than LH donors, according to Clavien scoring, and the length of hospital stay for RH donors is longer. Systematic application of the MCS may permit large‐scale comparisons of reported complications and thus help improve results of donor hepatectomy.

*Clavien score
LH
RH
Total

0
37
44
81

I
8
12
20

II
3
7
10

III
3
14
16

IV
0
0
0

Total
11
76
46

*Chi‐squared p = 0.046 comparing Clavien 0/I vs. II/III/IV.
L/I‐4 Living donor liver transplants with alemtuzumab induction and steroid‐free tacrolimus monotherapy
Authors: Tan H. , Tom K. , Thai N. , Marsh J. , Shaw‐Stiffel T. , Fontes P. , DeVera M. , Daily M. , Donaldson J. , Starzl T. , Marcos A. 
Published: September 2006

Introduction:  Alemtuzumab (Campath‐1H) is a humanized anti‐CD52 monoclonal antibody that results in prolonged depletion of T and other immune cells.Patients and methods:  Alemtuzumab (30 mg IV x1) was used for induction in 45 consecutive right lobe adult‐to‐adult living donor liver transplants (RLALDLTs) from 6/10/03 to 9/20/05 at the Starzl Transplantation Institute. Maintenance immunosuppression was with steroid‐free tacrolimus monotherapy, which was weaned when possible. The mean preoperative MELD score was 12.4 (6 to 25); mean follow‐up was 18.6 + 8.6 months.Results:  Our 1‐year recipient and graft survival rates were 93.3% and 91.1%, and compare well to UNOS data (89.1%, 79.3%). The cumulative acute cellular rejection (ACR) incidence was 0% at 1 mos, 2.4% at 2 mos, 4.8% at 3 mos, 7.3% at 4 mos, 8.9% at 12 mos, and 11.1% at 18 mos. Preweaning ACR was 8.9% (n=4) and only 1 patient had post‐weaning ACR. Weaning was attempted in 38% (n=17) of recipients. At follow‐up, of the 39 living patients, 19 are maintained on daily tacrolimus monotherapy, 7 on qod tacrolimus monotherapy, and 7 on 3x/week tacrolimus monotherapy. The 18.6‐mos recipient and graft survival rates were 88.9% and 86.7%. The mean total bilirubin of our survivors is 0.83 (+ 0.51). There were minimal infectious complications, with no incidence of tissue‐invasive CMV disease, no PTLD, and no posttransplant insulin‐dependent diabetes.Discussion:  This study represents the largest series to date of RLALDLT recipients undergoing alemtuzumab induction and steroid‐free tacrolimus monotherapy, and confirms the short‐term safety and efficacy of this approach.
L/I‐6 Late retransplants using living donors: case‐control outcome analysis
Authors: Sainz‐Barriga M. , Ricciardi S. , Carbotta G. , Cesana A. , Berrevoet F. , De Gendt S. , De Hemptinne B. , Troisi R. 
Published: September 2006

Background:  Survival after retransplants (ReLTs) is inferior to that after primary liver transplantation. Adult‐to‐adult living donor liver transplants (AALDLTs) are an emerging method to treat patients with end‐stage liver disease. The aim of this study is to analyze outcomes of ReLTs as compared with those achieved with deceased donors (ReDDLTs) and living liver donors (ReLDLTs), by determining variables affecting allograft and patient survival.Methods:  From January 2000 through November 2005, 23 (8%) of 288 LTs were late ReLTs (>6 months). Recipients were divided into 2 groups: ReDDLTs (n=14) and ReLDLTs (n=9). The overall M/F ratio was 16/7 (mean age, 49 years). Secondary biliary cirrhosis and HCV recurrence were the main indications for ReLTs.Results:  Both groups were comparable for MELD and Child status (CTP) at the time of their ReLTs, with the exception of higher median serum creatinine levels in the ReDDLT group. Waiting list time from decision to retransplant was 48±80 days in the ReLDLT group and 199±207 days in the ReDDLT group (p=0.006). Living donor morbidity consisted of 1 biliary leak and 1 incisional hernia. According to univariate analysis, recipient BMI, vascular thrombosis at ReLT, and creatinine levels were independent predictors of graft survival, whereas CTP score ≥ 10 was the only predictor of mortality after late ReLT. Our 1‐ and 3‐year patient survival rates in ReDDLT vs. ReLDLT recipients were 79% and 79% vs. 89% and 89% (p = 0.33); our 1‐ and 3‐year graft survival rates were 79% and 79% vs. 67% and 67% (p=0.25).Conclusions:  Our results suggest that the severity of graft failure based on CTP increases the risk of death after ReLTs, whereas renal insufficiency and previous vascular thrombosis are predisposing factors for early graft loss. Late ReLTs with a living donor graft allow ReLTs to take place in due time, with acceptable donor morbidity and without hampering the deceased donor liver pool. However, better patient selection is warranted.