bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Trial of Acute Normovolemic Hemodilution Compared to Preoperative Autologous Blood Donation in Total Knee Arthroplasty
Authors: Goodnough Lawrence Tim , Monk Terri G. , Despotis George J. , Merkel Kurt 
Published: December 2004

AbstractThe value of acute normovolemic hemodilution (ANH) compared to preoperative autologous blood donation (PAD) in elective surgery is controversial. We therefore conducted a prospective, randomized study to compare these techniques in patients undergoing total knee arthroplasty. ANH patient underwent up to 4 units phlebotomy or to target hematocrit level of 28% after induction of anesthesia. PAD patients were asked to donate 1 (unilateral) or 2 (bilateral, revisions) units before admission. Mean baseline hematocrit levels were not different between ANH and PAD patients (40.6±4.1 vs. 38.4±3.4, p = 0.09). Eight (73%) of 11 patients undergoing bilateral revision procedures received a total of 22 allogeneic blood units, whereas only 3 (14%) of 21 patients undergoing primary, unilateral procedures received a total of 3 allogeneic units (p = 0.002). We found no differences in allogeneic blood transfusions between ANH and PAD cohorts for all (n = 32) patients (1.0±1.2 vs. 0.6±1.4, p = 0.45), for unilateral knee (n = 21) replacement (0.25±0.46 vs. 0.08±0.28, p = 0.29), or for bilateral/revision (n = 11) procedures (1.9±1.3 vs. 2.5±1.9, p = 0.53). We conclude that each technique is equally effective in reducing allogeneic blood exposure. Patients undergoing revision or bilateral knee arthroplasties require adjunctive therapy to autologous blood procurement to further reduce allogeneic blood exposure.
Adverse Events in Platelet Apheresis Donors: A Multivariate Analysis in a Hospital‐Based Program
Authors: Despotis G.J. , Goodnough L.T. , Dynis M. , Baorto D. , Spitznagel E. 
Published: December 2004

Abstract
Objectives:
This study was designed to review the incidence of adverse events during nearly 20,000 apheresis procedures over a 4‐year period in a hospital‐based program. Methods: Data were obtained from a review of: (1) apheresis adverse event forms (2) hospital or emergency room medical records (3) the databank for donor and procedure‐related variables. Adverse events during or after the apheresis procedures were analyzed according to the following categories: (1) complications related to citrate toxicity; (2) hypotensive or vasovagal episodes; (3) complications or symptoms consistent with coronary ischemia; (4) complications related to percutaneous needle insertion, and (5) miscellaneous procedure‐related events or nonspecific symptoms. Serious adverse events were categorized as persistent or severe hemodynamic changes as well as other events that required further medical evalution. Results: Of 19,736 apheresis procedures, 159 (0.81%) were associated with adverse events. In 2,376 first‐time donations, 26 (1.09%) developed adverse events compared to 133 (0.77%) of 17,360 repeat procedures (p = 0.10). Seventy (0.35%) of 159 donation‐related adverse events involved hemodynamic or citrate‐related complications and 73(0.37%) involved venipuncture‐related complications, of which 2 required subsequent neurologic consultation. The remaining 23 (0.12%) adverse events involved procedure‐related, nonspecific complications. Forty‐seven (0.24%) of the 19,736 apheresis procedures were associated with serious adverse events (SAEs). Seven of these serious adverse events required admission to an emergency department, and 2 required admission to an emergency department, and 2 required hospitalization for further evaluation. Multivariate analysis revealed that apheresis machine model, donor gender and weight, the concomitant harvesting of plasma, the frequency of donation, and citrate‐related symptoms (e.g. paresthesias) were independently associated with severe hypotensive reactions. Conclusions: Apheresis procedures have a 150‐fold higher incidence of SAEs requiring hospitalization compared to whole blood donation. Identification of donors at risk for complications can facilitate modification of the apheresis procedure in order to reduce the likelihood of adverse events. Although our study did not demonstrate a cause‐effect relationship between platelet donation and the development of acute coronary syndromes; underlying cardiovascular disease was detected in 2 donors during or after the apheresis who were otherwise asymptomatic.
Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom
Authors: Williamson Lorna M. 
Published: December 2004

AbstractIn 1996, the United Kingdom launched a voluntary ‘haemovigilance’ system for confidential reporting of transfusion‐related deaths and major adverse events. The Serious Hazards of Transfusion (SHOT) initiative provided the first comprehensive overview of transfusion safety in the UK, with 12 fatalities reported in the first year. The most important finding was that of a total of 169 reports, 47% were ‘wrong blood to patient’ episodes, of which 16 were ABO‐incompatible. There were eight transfusion‐transmitted infections, three bacterial, four viral and one malarial. A number of other initiatives exist in the UK which also have importance in contributing to transfusion safety. This article reviews these other key contributors, allowing SHOT to be placed in context.
Collection of Heparinized Plasma by Plasmapheresis
Authors: van der Meer P.F. , Vrielink H. , Pietersz R.N.I. , Dekker W.J.A. , Reesink H.W. 
Published: December 2004

Abstract
Background and Objectives:
Heparinized plasma can be used for exchange transfusions in neonates and is usually collected by drawing whole blood using heparin as anticoagulant. The heparinized red blood cells and buffy coat cannot be used and are therefore discarded. To collect heparinized plasma more efficiently, a method was developed using an apheresis machine. Materials and Methods: With an MCS3p apheresis machine (Haemonetics), plasma was collected from volunteer donors as anticoagulant, heparin in saline (30,000 IU/I) was added in a 1:9 ratio. The activated partial thromboplastin time (APTT) of the donors was measured before and immediately after the procedure, and various parameters were determined in the collected plasma. Results: In 2 collection cycles, an average of 456±52 ml (mean ± SD; n =20) of heparinized plasma was collected, and 504±57 ml (n=2; donors with a high hemoglobin level) when 3 cycles were performed. The leukocyte and platelet contamination in the plasma (n =2) was 1.11±0.92×106 and 0.05±0.22×109 per unit, respectively, which conformed to national specifications. Sodium levels were normal, but due to dilution of the plasma with heparin solution, potassium and calcium levels were about 20% lower than the serum levels in the donors. The donor APTT values were slightly longer after the procedure than before, but remained all within normal values. Conclusion: For the collection of heparinized plasma, apheresis has the advantage that (1) high‐quality heparinized plasma can be harvested; (2) no blood components need to be discarded; (3) more plasma can be harvested with each donation, and (4) these procedures can be performed more often than whole blood donations.
Typing for the Human Lewis Blood Group System by Quantitative Fluorescence‐Activated Flow Cytometry: Large Differences in Antigen Presentation on Erythrocytes between A1, A2, B, O Phenotypes
Authors: Larson Göran , Svensson Lola , Hynsjö Lars , Elmgren Anders , Rydberg Lennart 
Published: December 2004

Abstract
Background:
Lewis phenotyping by hemagglutination is an unreliable routine method for Lewis antigen designation. Now genomic typing of the Lewis gene is available. Additionally, flow cytometry has been used for typing. We wanted to compare the results of Lewis typing in healthy individuals using the three methods. Materials and Methods: Ninety‐three randomly selected plasma donors were genotyped for inactivating Secretor (FUT2) G428A and Lewis (FUT3) T59G, T202C, C314T, G508A and T1067A point mutations: All Le(a+b−) individuals (nonsecretors) were homozygous for the FUT2 G428A mutation and all Le(a−b−) individuals had inactivating mutations on both FUT3 alleles. Fixed erythrocytes were analyzed by fluorescence‐activated flow cytometry and the results were compared with hemagglutionation and genotypic data. Antigen availability was expressed as median fluorescence intensity and as percentage positive cells with fluorescence intensities ≥ 102. Results: Using an anti‐Lea reagent a mean of 99% of erythrocytes from Le(a+b−) individuals and 1% of erythrocytes from Le(a−b−) or Le(a−b+) individuals were stained positive. Using an anti‐Leb reagent, a mean of 71% of erythrocytes from A1, 95% from B and 99% from O and A2 Le(a−b+) individuals and less than 10% of erythrocytes from Le(a−b−) or Le(a+b−) individuals were stained positive. After papain treatment 100% of the erythrocytes from A1 and A1B Le(a−b+) individuals stained positive without increase in background staining. The flow cytometric technique revealed large differences in staining intensities, within each ABO Le(a−b+) subgroup which was not directly correlated to plasma donation frequencies nor to Secretor or Lewis genotypes. Conclusion: Flow cytometry may prove valuable as a Lewis blood group typing technique but also as a research tool when investigating Lewis phenotypes of human erythrocytes.
Extracorporeal Plateletpheresis Induces the Interaction of Activated Platelets with White Blood Cells
Authors: Gutensohn K. , Alisch A. , Krueger W. , Kroeger N. , Kuehnl P. 
Published: December 2004

Abstract
Background and Objectives:
In this study we investigated whether platelet activation during apheresis results in the binding of platelets to white blood cells. Material and Methods: Analysis of platelet–leukocyte interaction was performed using multiparameter, three–color flow cytometry. Results: Over the duration of the procedure, there was an increase in the surface expression of CD62p (P–selectin) and CD63 (p<0.05), and also in the binding of platelets to monocytes (p<0.05), neutrophilic granulocytes (p<0.05) and to CD3+ cells (initially to a low degree; p<0.05). Platelet binding to CD19+ cells did not change significantly. Conclusion: This study demonstrates that platelets become activated during apheresis and that following this process, interaction with monocytes and neutrophilic granulocytes occurs.
Therapeutic Immunoadsorption Increases the Level of Circulating Soluble HLA Molecules
Authors: Poehlau D. , Kiltz U. , Rieks M. , Hoffmann V. , Rebmann V. , Schimrigk S. , Grosse–Wilde H. , Przuntek H. 
Published: December 2004

Abstract
Background and Objectives:
Immunoadsorption (IA) is an established procedure to remove Igs and immune complexes from peripheral blood. Since Igs reportedly bind to human leucocyte antigen (HLA) molecules, we were interested to know whether removal of Ig will also influence the plasma concentration of soluble HLA (sHLA). Patients and Methods: Nine patients suffering from severe autoimmune disease and undergoing 17 single courses of IA treatment were monitored for their sHLA class I (sHLA–I) and sHLA–DR plasma levels. Plasma was separated by a hollow–fiber–type separator. Plasma samples were taken before therapy, after 15 min of recirculation (without operating the adsorber), after 1 and 2 liters of plasma adsorption, and 24 and 48 h after the end of IA. Results: Before treatment the mean levels of sHLA–I and sHLA–DR were 0.37 (±0.06 SEM) and 0.32±0.05 μg/ml, respectively. After 2 liters of plasma filtration, an increase in sHLA–DR (0.80±0.10 μg/ml) was observed (p<0.001), whereas sHLA–I was only slightly affected (mean: 0.45±0.06 μg/ml). sHLA concentrations returned to initial levels after 24 h. Conclusion: The significant increase in sHLA–DR may contribute to the immunomodulatory effect of IA.
Photochemical Inactivation of Bacteria and HIV in Buffy‐Coat‐Derived Platelet Concentrates under Conditions That Preserve in vitro Platelet Function
Authors: Knutson Folke , Alfonso Ryan , Dupuis Kent , Mayaudon Véronique , Lin Lily , Corash Laurence , Högman Claes F. 
Published: December 2004

Abstract
Background and Objectives:
A photochemical process has been tested for the inactivation of viruses and bacteria in buffy‐coat derived platelet concentrates (BC PCs). Materials and Methods: BC PCs in 35% CPD plasma and 65% platelet‐additive solution (PAS III) were exposed to photochemical treatment (PCT) with 150 μM of the psoralen S‐59 and a 3 J/cm2 treatment with longwavelength ultraviolet light (UVA, 320–400 nm). Platelet function was evaluated following PCT using a panel of in vitro assays. Results: This PCT process was highly effective at inactivating gram‐positive bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis) and gram‐negative bacteria (Enterobacter aerogenes, Pseudomonas aeruginosa, Serratia marcescens). No viable bacteria were detected following PCT and 7 days of platelet storage while bacterial growth was detected in paired untreated control BC PCs. Complete inactivation of the gram‐positive Bacillus cereus was achieved only in one of two replicate experiments with BC PCs. PCT was also highly effective for inactivation of human immunodeficiency virus HIV‐1 in BC PCs inoculated with approximately 106 tissue culture infectious doses per milliliter (TCID5n/ml) of cell‐associated HIV‐1. Rapid inactivation was observed with increasing UVA doses: with 150 μM S‐59 and a 1 J/cm2 treatment of UVA, a reduction of 5:6±0.5 log TCID50/ml was achieved, and a reduction of >6.4 log TCID50/ml was achieved with 150 μM S‐59 and a 3 J/cm2 treatment of UVA. No physiologically relevant differences in platelet functions were found between the test and the control BC PCs during 7 days of storage. Conclusion: PCT with 150 μM S‐59 and a 3 J/cm2 UVA treatment does not adversely affect in vitro properties of BC PCs stored at 22°C for 7 days. The PCT process inactivated bacteria and HIV‐1 inoculated into the BC PCs. These results extend the earlier reported efficacy of PCT apheresis PCs to BC PCs.
An Extended Lymphocytotoxicity Test for Patients Treated with Lymphocytotoxic Antibodies
Authors: Moldenhauer A. , Kohlhaus R. , Salama A. 
Published: December 2004

AbstractBackground and Objectives:After organ transplantation, HLA antibodies (HLA‐Ab) stimulated by transplant or transfusion are usually indistinguishable from passive therapeutic lymphocytotoxic antibodies (LyAb), e.g. antilymphocyte globulin (ALG), antithymocyte globulin (ATG) and OKT3, by standard lymphocytotoxicity tests (LCTs). Herein, an extended technique capable of distinguishing between these two types of antibodies is described.Materials and Methods:Serum samples from 11 patients who received therapeutic antibodies were screened for HLA‐Ab by LCTs. The administered LyAb were murine OKT3 (n = 2), equine ALG (n = 3), rabbit ATG (n = 2), and combinations of ALG and OKT3 (n = 1), ATG and ALG (n = 1), and ATG and OKT3 (n = 2). To discriminate between therapeutically applied antibodies and active HLA alloimmunization, the sera were preincubated with species‐specific anti‐Fc lgG, thus blocking the therapeutic antibodies.Results:The sera of all patients treated showed strong positive lymphocytotoxic reactions [panel reactive antibodies (PRA) 50–100%]. After incubation with the corresponding Fc antibodies, in 9 of the 11 samples the amount of PRA decreased to the level present before transplantation (0–18%). In the remaining cases, new‐onset alloimmunization was detected.Conclusion:This extended LCT allows the screening of serum samples for active HLA‐Ab even in the presence of therapeutic LyAb.
Confirmation of the Assignment of the Dombrock Blood Group Locus (DO) to Chromosome 12p: Narrowing the Boundaries to 12p 12.3‐p13.2
Authors: Mauthe Jill , Coghlan Gail , Zelinski Teresa 
Published: December 2004

Abstract
Background and Objectives
: Antigens belonging to the Dombrock blood group system have been well characterized serologically. Despite being reasonably polymorphic, chromosomal localization of the gene controlling Dombrock expression (DO) has proved difficult. In the past, DO had been provisionally assigned to chromosomes 1 and 4; more recently, DO was provisionally assigned to chromosome 12. The current study was undertaken in an attempt to confirm or refute this latest assignment. Materials and Methods: DNA from a series of families segregating for DO was amplified by polymerase chain reaction and analyzed for trinucleotide or tetranucleotide repeat polymorphisms of four anonymous DNA markers (D12S1042, D12S373, D12S391, D12S372) and of the von Willebrand factor gene (VWF). Lods for or against linkage were determined between DO and each marker. Results: DO is linked to all five markers. The closest linkage was established between DO and D12S373, and DO and D12S391, with peak lods for combined paternal and maternal meioses of 7.16 at peak recombination fraction (

) = 0.08 and 7.69 at

= 0.08, respectively. Conclusions: We have confirmed the assignment of the Dombrock blood group locus to chromosome 12p and have refined its regional localization to 12p 12.3–p 13.2.
Low Leukocyte Contamination without Filtration by Preparation of Platelet Concentrates in Cylindrical Bags with the Buffy‐Coat Method
Authors: Kostelijk E.H. , Loos J.A. , Veldman H.A. , de Korte D. 
Published: December 2004

Abstract
Background and Objectives:
The buffy‐coat (BC) method for platelet concentrate (PC) preparation was modified in order to obtain leukodepleted PCs from single BCs without filtration. Materials and Methods: BCs were centrifuged in cylindrical BC bags and the optimal centrifugation conditions and optimal hematocrit were determined. Results: With optimal conditions, a tenfold lower leukocyte contamination was obtained compared with the conventionally shaped, wide BC bag (0.3 ± 0.19 versus 3.0 ± 1.71 × 106 leukocytes per unit; 85‐ml BCs). The platelet yield obtained with the cylindrical bag did not differ significantly from the yield obtained with the conventional bag (56 ± 16.4 versus 61 ± 15 × 109 platelets per PC). Furthermore, when PCs were prepared from 100‐ml BCs in cylindrical bags, a leukocyte contamination of 0.2 ± 0.11 × 106 and a platelet content of 6 ± 13.5 × 109 per PC were obtained. Conclusion: The use of cylindrical BC bags reduced the leukocyte contamination in PCs to a level required for leuko‐depletion without affecting platelet recovery.
Automated Collection of Peripheral Blood Stem Cells with the COBE Spectra for Autotransplantation
Authors: Heuft H.G. , Dubiel M. , Kingreen D. , Oertel J. , De Reys S. , Rick O. , Serke S. , Schwella N. 
Published: December 2004

Abstract
Background:
A convenient, effective and safe peripheral blood stem cell (PBSC) apheresis procedure is desirable to cope with the increasing requirements for PBSC collections. We performed PBSC harvesting with the novel COBE Spectra Auto PBSC™ system using the default software configuration recommended by the manufacturer. We analyzed collection parameters and clinical efficiency of harvested autografts following high‐dose chemotherapy (HDCT). Patients and Methods: Eighty‐one patients underwent 102 harvests after standard chemotherapy plus filgrastim (5–10 ug/kg/day) to obtain a target of ≥2.5 × 106 CD34+ cells/kg for autologous blood stem cell transplantation. Conventional‐volume leukaphereses (median: 11 leters) were performed using the manufacturer's standard software default regarding inlet flow, harvest/chase volume (3/7 ml) and number of collection cycles. The ratio of ACD‐A to whole blood was initially set at 1:12 (56 collections), later at 1:10 (46 aphereses). Results: With respect to preapheresis counts of 93 (9–876) CD34+ cells/μl, 69 patients (85.2%) achieved ≥2.5 × 106 CD34+ cells/kg by the first apheresis. PBSC products contained medians of 5.0 × 106 (0.7–77.3) CD34+cells/kg and 13.8 × 104 (2.3–105.0) CFU‐GM/kg. A preapheresis count of ≥40 CD34+ cells/μl predicted a single‐apheresis yield of ≥2.5 × 106 CD34+ cells/kg. Apheresis products showed a high mononuclear cell (MNC) purity of ≥89%. The median overal collection efficiency of CD34+ cells (CD34‐CE) was 42.6% (12.2–87.4). The CD34‐CE decreased significantly with increasing numbers of circulating CD34+ cells: 52.5% at CD34+ cells <40/μl versus 41.0% at CD34+ cells ≥40/μl (p ≤ 0.002). Coagulation problems occurred in 3 of 56 procedures at an ACD‐A to whole blood ratio of 1:12, but in no case at 1:10. Patients who underwent HDCT and autologous blood stem cell transplantation (n=40) engrafted in a median time of 9 (8–13) days for absolute neutrophil counts ≥ 0.5 × 103/μl, 10 (8–13) days for WBC > 1.0 × 103/μl and 11 (8–17) days for platelets > 20 × 103/μl. Conclusions: As a result of efficient PBSC mobilization, a single conventional‐volume leukapheresis with the COBE Spectra Auto PBSC system resulted in hematopoietic autografts with ≥ 2.5 × 106 CD34+ cells/kg in 85% of patients. Following the standard PBSC apheresis recommendations of the manufacturer, the Auto PBSC system assures PBSC products with a high MNC purity and a moderate CD34‐CE that declines significantly at increasing levels of circulating CD34+ cells. Leukaphereses performed at an ACD‐A to whole blood ratio of 1:10 should run without coagulation problems.
A UK Survey of Virological Testing of Cadaver Tissue Donors
Authors: Stanworth S.J. , Warwick R.M. , Ferguson M. , Barbara J.A. ,   Microbiology Working Group of the NIBSC steering group on Tissue/Cell Banking and Engineering
Published: December 2004

AbstractObjectives:To analyse information about virological testing of cadaveric tissue donors, including the kits used and the rates of test reactivity.Materials and Methods:Retrospective data were collected using a standardised questionnaire sent to 16 tissue banks in the UK. The rates of repeat reactive screen tests and confirmed positive results for the markers HBsAg, anti‐HCV, anti‐HIV were analysed in 1,833 cadaver tissue donors tested at 12 tissue banks over one year up to March 1998.Results:There was a wide range of kits in use for virological screen testing of cadaver donors. The rates of repeat reactivity in the screen tests varied from 0 to 42%.Conclusion:The findings have implications for policies based on discard of tissues from donors with repeat reactive results, and raise important safety issues with regards to cadaveric virological testing, as the test systems in use have not been validated for cadaver blood samples.