bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apheresis donor safety ‐ changes in humoral and cellular immunity
Authors: Strauss Ronald G. 
Published: February 2007

AbstractModern techniques of mechanical hemapheresis have made it possible to selectively remove vast quantities of lymphocytes and plasma immunoglobulins, and the concentration of these substances in donor blood can fall below the normal range. It is feared that this may lead to immunosuppression; a condition associated in some clinical settings with infections, malignancy and autoimmune diseases. Using primary immunodeficiency diseases and induced immunodeficiency states (for example, therapeutic lymphocytapheresis, chronic thoracic duct drainage and intestinal lymphangiectasia) as models to judge competency of the immune system, it can be predicted that body defense mechanisms can become defective when serum IgG levels are < 200 mg/dl or the blood lymphocyte count is < 1000/μl. However, impaired immunologic function can occur in the presence of normal quantities of these substances in the blood stream; conditions that may be related either to imbalances of immune regulatory factors or to qualitative (rather than quantatitive) abnormalities of the immune system.A number of investigators have documented the losses of lymphocytes and plasma immunoglobulins incurred by donors experiencing mechanical hemapheresis. In addition, both the immediate and long‐term decreases in the concentration of these substances in donor blood have been reported. In summary, the immediate decreases in blood lymphocyte counts and serum immunoglobulin concentrations are of slight to moderate degree and are without known adverse effects. Less information is available regarding long‐term alterations of the immune system, and little data have been collected from prospective studies in which large numbers of donors have been thoroughly evaluated by modern techniques. In general, results of many laboratory studies have been altered. However, these abnormalities have been transient for the most part, and it has been difficult to document clinically significant adverse effects. Thus, the quantities of blood lymphocytes and plasma immunoglobulins that can be removed from healthy donors without causing significant immediate or long‐term harm is unknown.Bearing these limitations in mind, the following recommendations are suggested regarding the frequency of repeated mechanical plasma‐and‐cytapheresis. 1) The usual requirements for whole blood donation must be met if the frequency of mechanical hemapheresis does not exceed once every eight weeks. 2) Individuals expected to experience mechanical apheresis at more frequent intervals should comply with the following additional requirements in an attempt to avoid severe lymphocytopenia (blood lymphocytes < 1000/μl): a) subjects should not be permitted to donate with a preapheresis lymphocyte count < 1200/ 1; b) donor blood lymphocyte counts should be measured initially and again after each cumulative loss of 5 × 1010 lymphocytes; c) donors who develop lymphocytopenia (< 1000/μl of blood) should be excluded from donation until the blood lymphocyte count is > 1200/μl.
Exchange transfusion as an alternative to granulocyte concentrate administration in neonates with bacterial sepsis and profound neutropenia
Authors: Christensen Robert D. , Hill Harry R. , Anstall Harold B. , Rothstein Gerald 
Published: February 2007

AbstractA high rate of mortality is observed in the subset of neonates with early‐onset bacterial sepsis who develop profound neutropenia and depletion of the marrow neutrophil reserve. Several studies suggest that transfusion of apheresis‐collected adult neutrophils into such subjects can be beneficial, yet inherent delays in preparation of neutrophil concentrates can limit their clinical utility. In six neonates with sepsis and profound neutropenia, we performed double‐volume exchange transfusions using freshly drawn donor blood and determined that a net gain of 0.3–0.7 × 109 neutrophils/kg body weight had occurred. The blood neutrophil count of the patients increased from 220 to 1,660/mm3 before the transfusion to 1,650–5,140/mm3 immediately afterward. We next attempted to further increase the number of neutrophils delivered by exchange transfusion by subjecting blood donors to 2 min of physical exercise in order to induce neutrophilia. After such exercise, 30% (range 18–55%) more neutrophils were harvested. The metabolic burst activity and in vitro migration of neutrophils after exercise did not differ from paired preexercise values.
Treatment of thrombotic thrombocytopenic purpura with plasma exchange: Five cases
Authors: Gupta Sharda , Funkhouser James W. 
Published: February 2007

AbstractFive patients with thrombotic thrombocytopenic purpura (TTP) were treated with corticosteroids, plasma exchange (PE), and antiplatelet agents. ABO‐ and Rh‐compatible fresh‐frozen plasma (FFP) was used as the replacement fluid. None of the patients received FFP infusion without PE.The patients were followed for 14–32 months after initial treatment. Four of the five patients are in complete clinical remission. One responded to plasma exchange but died of heart disease. This report shows an 80% survival rate which is markedly better than that without the use of PE and FFP infusion. We found dramatic clinical and hematologic improvement beginning shortly after initiating treatment.Two patients showed reversal of their initial clinical and hematologic improvement when PE was discontinued, despite continuing treatment with antiplatelet drugs and in one with corticosteroids. Both patients showed hematologic and clinical remission after reinstitution of PE. None of the survivors had any neurologic or renal deficit. They were maintained on aspirin and dipyridamole for 1 year after discharge.
The clinical effectiveness and safety of chronic plasmapheresis in patients with primary biliary cirrhosis
Authors: Ambinder Edward P. , Cohen Larry B. , Wolke Anita M. , Field Steven P. , Adelsberg Bernard , Schaffner Fenton , Zaroulis Charles G. 
Published: February 2007

AbstractPrimary biliary cirrhosis (PBC) is a chronic nonsuppurative, destructive cholangitis, whose etiology is unknown. Morbidity arises early from pruritus and later from hypercholesterolemia with xanthoma formation. Therapy is supportive and directed at the complications of cholestasis. Plasmapheresis has been reported to benefit patients with hyperlipidemia and PBC; thus a pilot study of plasmapheresis utilizing the Haemonetics Model 30 with replacement by albumin and saline was conducted. Five patients (four female and one male) with a mean age of 43 (range 29–58) and a mean duration of illness of 9.5 years (range 6–21) with marked jaundice, xanthomas, xanthelasma, hepatomegaly, fatigability, anorexia, and pruritus, as well as mild nausea were studied. Peripheral neuropathy was present in two patients. Two patients had splenomegaly. Two patients had an associated Sjogren syndrome. All patients had high serum bilirubin, alkaline phosphatase, and cholesterol levels and mild elevations in aspartate amino transferase and alanine amino transferase activities. Immune complexes measured in four patients were present. Antimitochondrial antibody titers were significant in all patients. Patients underwent a mean of 63 plasmapheresis procedures over a mean of 112 weeks removing a mean of 94.7 liters of plasma. No serious toxicity was seen.All patients showed a reduction in pruritus, xanthomas, xanthelasmas, and serum cholesterol values. The two patients who had evidence of Sjogren syndrome noted subjective improvement. All patients who had fatigue, anorexia and nausea also noted moderate improvement. There was no change in hepatomegaly or splenomegaly in patients demonstrating such organomegaly. Liver function did not change significantly. Overall, four patients had improvement in their condition and one patient achieved stability. We strongly recommend the use of chronic plasmapheresis for patients with PBC who have failed more “conventional” regimens.
Effect of plasmapheresis on E‐rosette receptors in sle patients
Authors: Vangelista Alba , Frascà Giovanni M. , Nanni‐Costa Alessandro , Bonomini Vittorio 
Published: February 2007

AbstractThe present study reports on the effects of plasmapheresis on both cellular (E‐rosette receptor‐ and Fc receptor‐bearing lymphocytes) and humoral (antilymphocyte antibodies) immunity in patients with active SLE. Ten untreated patients were studied before and after two plasma exchanges. The E‐rosette receptor‐positive cells were studied by OKT11 monoclonal antibody and Fc receptor‐bearing cells by Leu 15 monoclonal antibody. Antilymphocyte antibodies were studied before and after plasma exchange by an indirect immunofluorescence technique on autologous and normal lymphocytes. A reduction in OKT11+ and Leu 15+ lymphocytes was observed in all patients before plasmapheresis. Antilymphocyte antibodies were detected in five patients. After plasma exchange, an increase in E‐rosette receptor‐ and Fc receptor‐bearing lymphocytes was observed along with a reduction in the amount of antilymphocyte antibodies.
Optimization of parameters for maximization of plateletpheresis and lymphocytapheresis yields on the haemonetics model V50
Authors: Aubuchon James P. , Carter Charles S. , Adde Melissa A. , Meyer Donna R. , Klein Harvey G. 
Published: February 2007

AbstractAutomated apheresis techniques afford the opportunity of tailoring collection parameters for each donor's hemato‐logic profile. This study investigated the effect of various settings of the volume offset parameter as utilized in the Haemonetics Model V50 instrumentation during platelet‐ and lymphocytapheresis to optimize product yield, purity, and collection efficiency. In both types of procedures, increased product yield could be obtained by using an increased volume offset for donors having lower hematocrits. This improvement was related to an increase in collection efficiency. Platelet products also contained fewer contaminating lymphocytes with this approach. Adjustment of the volume offset parameter can be utilized to make the most efficient use of donors and provide higher‐quality products.
Centrifugal elutriation as a method for isolation of large numbers of functionally intact human peripheral blood monocytes
Authors: Turpin Jim , Hester Jeane P. , Hersh Evan M. , Lopez‐Berestein Gabriel 
Published: February 2007

AbstractCentrifugal elutriation was used further to isolate human peripheral blood monocytes (HPBM) from mononuclear‐enriched cells harvested as a secondary component following platelet concentration collection samples. HPBM were recovered in either one or two populations consisting of either total HPBM or small (SM) and large monocytes (LM). The elutriation was carried out at 3,500 ± 5 rpm for the separation of lymphocytes and HPBM in Ca++ −and Mg ++ ‐free PBS without EDTA. An average of 5.05 ± 1.50 × 108 HPBM were recovered in the total HPBM with a purity of 95% ± 3%. The SM and LM were obtained by splitting the total HPBM into two equal populations with an HPBM purity of 92% ± 3% and 93% ± 3%, respectively, by nonspecific esterase staining. The elutriation media were shown to have no effect on viability by trypan blue exclusion. All three HPBM populations were shown to be histochemically (lack of reactivity to leu‐1 and leu‐7) and functionally (depletion of NK cell activity) purified from the lymphocyte population. The HPBM populations were enriched in HLA‐Dr, OKM‐1, OKM‐5, MY‐8, and leu M‐3 monoclonal antibody marker staining. There were no differences in percent positive cells between SM and LM populations for any of the monocyte‐specific monoclonal antibodies. All three monocyte populations mediated antibody‐dependent cell‐mediated cytotoxicity to human red blood cells, with LM mediating more lysis (27.0% ± 5%) than SM (7% ± 3%). The HPBM produced H2O2 and were activatable by bacterial lipopolysaccharide (LPS) and recombinant interferon gamma. HPBM did not have any spontaneous cytostasis to K562; HPBM, could be activated by 24‐hour exposure to 1.0 μg/ml of LPS (28.0%). The data obtained shows that mononuclear cell enriched plateletpheresis samples can be used to obtain large numbers of functionally active, highly purified HPBM.
The use of plasmapheresis, lymphocytapheresis, and staph protein‐A immunoadsorption as an immunomodulatory therapy in patients with aids and aids‐related conditions
Authors: Kiprov Dobri D. , Lippert Randolph , Miller Robert G. , Sandstrom Erik , Jones Frank R. , Cohen Richard J. , Abrams Donald , Busch David F. 
Published: February 2007

AbstractCirculating immune complexes, autoantibodies, and suppressor factors to normal lymphoproliferation may play an important role in the induction and maintenance of the cellular immunodeficiency characteristic for the acquired immunodeficiency syndrome (AIDS) and its related conditions. In order to explore the possiblity that the removal of circulating humoral factors may have an immunomodulatory effect in patients with AIDS and AIDS‐related conditions (ARC), we used apheresis procedures to treat patients with different clinical presentations of AIDS and ARC. Five patients with AIDS and opportunistic infections were treated with plasmapheresis. Four patients with AIDS and Kaposi's sarcoma without opportunistic infections were treated with staph protein‐A immunoadsorption and two patients with ARC and peripheral neuropathy were treated with lymphoplasmapheresis. The treatments were tolerated well by all patients. Effective removal of circulating humoral immune factors was observed in all three groups. No significant clinical benefit was seen in the patients with AIDS and opportunistic infections treated with plasmapheresis. Partial tumor responses were observed in three of the four patients with AIDS related Kaposi's sarcoma treated with staph protein‐A plasma perfusion, and resolution of neurologic symptoms was seen in both patients with ARC and peripheral neuropathy treated with lymphoplasmapheresis. Our preliminary results suggest that lymphoplasmapheresis may be an effective treatment modality for patients with ARC related peripheral neuropathy, that protein‐A immunoadsorption is well tolerated by patients with AIDS‐related Kaposi's sarcoma, and that this treatment has antitumor and immunomodulatory effects in these patients.
Successful preoperative apheresis of factor VIII antibody using factor VIII concentrate as a replacement fluid
Authors: Apter Beth , Maccarthy Verna , Shapiro Sandor S. , Ballas Samir K. 
Published: February 2007

AbstractPlasma exchange was performed on a patient with hemophilia A and inhibitor to factor VIIIC prior to bilateral cataract removal. Koate was used as replacement fluid with effective reduction of the inhibitor level. From the technical standpoint we found out that factor VIII is best reconstituted in water and directly infused through the venous line and not the centrifuge bowl.
Lack of short‐term effects on the donor during continuous‐flow selective mononuclear cell collection
Authors: Jacobs Peter , Wood Lucille 
Published: February 2007

AbstractIn 50 individuals, intensive harvesting of relatively pure mononuclear cell fractions from the peripheral circulation was carried out in 195 procedures. Serial collections from bone marrow donors (group 1: n = 35) or isolated procedures from volunteers (group 2: n = 15) were without morbidity. A median yield of 4.0 × 109 mononuclear cells were recovered in a final volume of 104 ml of cell‐rich plasma, for which 4,300 ml of venous blood was processed in 107 minutes. In neither group were changes documented in donor white cell count or lymphocyte numbers. In group I, a statistically significant but clinically unimportant and transient fall occurred in the platelet count at the end of the 5‐day intensive schedule. It is concluded that mononuclear fractions can efficiently be collected from normal donors without the development of relevant cell depletion.
Use of arteriovenous shunts and right atrial catheters for daily granulocyte collection
Authors: Williams B. M. , Sanders J. E. , Clift R. A. , Hickman R. O. , Bensinger W. I. , Buckner C. D. , Thomas E. Donnall 
Published: February 2007

AbstractBetween June 1982 and April 1984, 67 adult granulocyte donors were randomized to receive external arteriovenous shunts or modified right atrial catheters as vascular access for daily granulocyte collections using blood cell separators. Six of 32 donors with shunts and 2 of 35 donors with right atrial catheters experienced failure of the access method. Local infection occurred in one donor with a shunt and one donor with a right atrial catheter. Bacteremia occurred in one donor with a right atrial catheter. Specified whole blood flow rates of 50‐65 ml/minute were achieved with 28 of 32 shunts and 29 of 35 right atrial catheters (P = NS). The majority of the donors in each group tolerated the vascular access without significant problems. This study demonstrates that modified right atrial catheters can be successfully used as method of vascular access for single donor granulocyte collection with blood cell separators.
Evaluation of apheresis platelet concentrates stored for 5 days in PL 732 bags
Authors: Kiraly Thomas R. , Kalish Robert I. , Norton Diane F. 
Published: February 2007

AbstractTo assess the functional viability of platelets collected by standard apheresis techniques using the Fenwal CS‐3000 “closed system” and stored in Fenwal PL 732 plastic bags for 5 days at room temperature with agitation, a number of in vitro parameters (pH, morphology, platelet volume distribution, osmotic recovery, aggregation, and platelet‐associated IgG) were examined as a function of storage time. During the first 24 hours of storage, minimal changes were observed in the test parameters with the exception of ADP‐induced aggregation (75% decrease [10 uM], 84% decrease [5 μM]). Significant differences were observed between fresh (day 0) and 5‐day‐old platelet concentrates in all parameters except median platelet volume. These observed changes in in vitro test parameters with storage time are similar to those previously observed for comparably stored random single‐donor platelet concentrates. Thus, the “closed‐system” PL 732 apheresis platelet concentrates would be expected to be as effective in vivo as random single‐donor platelet concentrates, while minimizing recipient exposure to transmissible agents of infectious disease.
Waldenstrom macroglobulinaemia treated with sequential hemibody irradiation
Authors: Jacobs Peter , Wood Lucille , Roux Ingrid Le , Prior Clive , King Helen S. 
Published: February 2007

AbstractA 40‐year‐old man presented with symptoms of anaemia and blurred vision. Waldenstrom macroglobulinaemia was diagnosed on the basis of plasmacytoid lymphocytes in the peripheral blood, extensive bone marrow involvement, and an IgM kappa monoclone in the plasma of 48 g/liter. Symptoms were immediately reversed by isovolaemic continuous‐flow plasmapheresis coupled with red cell transfusion. Specific therapy was undertaken with sequential hemibody irradiation. At two years of follow‐up the patient enjoys excellent health, has improved haematopoietic reserve in the bone marrow, and the only therapy required is intermittent plasmapheresis to control symptoms relating to rising viscosity. Thus, systemic irradiation, which is well tolerated and objectively reduces marrow tumour bulk, offers an alternative to chemotherapy in the palliative management of active macroglobulinaemia and may diminish but not prevent the need for intermittent plasmapheresis.
Nomograms for the prediction of patient's plasma volume in plasma exchange therapy from height, weight, and hematocrit
Authors: Sprenger Kuno B. G. , Huber Klaus , Kratz Werner , Henze Eberhard 
Published: February 2007

AbstractThe knowledge of plasma volume (PV) is a basic requirement for the standardization of plasma exchange therapy. PV has to be determined by calculation, as the measurement of PV before every plasma exchange is too cost‐and time consuming. A known correlation with measured values results from calculation of plasma volume by means of patient's height and weight. But the present equations are only reliable at normal hematocrit. For this reason we modified the Retzlaff‐equations and compared the validity of plasma volume predictions, calculated by these and own equations, with plasma volume measured by the 51Cr‐method in 59 patients with pathological hematocrit.The correlation coefficient was 0.82 for men and 0.81 for women (2 0.001) with the modified Retzlaff‐equations. On the average the relative error was ‐ 1.5% for all and 2.8% for fat and thin men. No significant improvement of accuracy was achieved with other equations. Thus, plasma volume can accurately be calculated from height, weight, and hematocrit with our modified Retzlaff‐equations in patients with pathological hematocrit, even if they are very fat or thin.Nomograms for men and women were constructed in order to facilitate the calculation.
Effects of plasmapheresis on peripheral blood mononuclear cell populations from patients with macroglobulinemia
Authors: Paglieroni Teresa , Caggiano Vincent , Mackenzie Malcolm R. 
Published: February 2007

AbstractEffects of plasmapheresis on peripheral blood T‐cell, B‐cell, monocyte, and natural‐killer‐cell populations were studied in ten macroglobulinemia patients with hyperviscosity syndrome. Following plasmapheresis, there was a transient decrease in the number of T4 + helper cells and a longer‐lasting decrease in the number of Leu‐7 + natural killer cells and Mo2+ monocytes. In addition, there was a greater than 50% decrease in the in vitro ingestion capacity of monocytes. Although no significant changes in the numbers of IgM +, B1+, B4 +, or PCA + B cells (P > .05) were detected, there was a highly significant (P < .01) increase in I2 antigen density on the surface of IgM + B cells and in the bromodeoxyuridine uptake by these cells 7‐9 days after plasmapheresis. These findings suggest that following plasmapheresis, IgM+ B cells are activated. Using flow cytometry to determine when maximum IgM+ B cell activation occurs by measuring I2 antigen density on the cell surface may be useful in determining the postplasmapheresis timing of chemotherapy in macroglobulinemia patients with hyperviscosity syndrome who require more aggressive treatment.
Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis
Authors: Mascaro G. , Cadario G. , Bordin G. , Tarditi M. , Ferraris G. , Monteverde Anna , Castano L. , Monteverde Angelo 
Published: February 2007

AbstractTen patients suffering from progressive systemic sclerosis, who responded poorly to conventional therapy, underwent plasma exchange (PE) therapy in conjunction with drug therapy. The frequency of PE was twice weekly for 4‐6 weeks, two or three times per year, with a summer interruption, when in our own experience a spontaneous relief of symptoms occurs. To judge the efficacy of our therapeutic device, we assessed several laboratory and clinical parameters before and after therapy. The changes in circulating immune complexes, in IgG and IgA, and in some functional indices were significant (P < 0.001). Eight of 10 patients improved satisfactorily. The remaining two did not improve sufficiently to continue the apheretic treatment. In conclusion, our study suggests that the PE, together with conventional therapy, can be an effective therapeutic device in the treatment of progressive systemic sclerosis.