bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of past and current screening tests for syphilis in blood donors: changing from a rapid plasma reagin test to an automated specific treponemal test for screening
Authors: Aberle‐Grasse John , Orton Sharyn L. , Notari Edward , Layug Lynne P. , Cable Richard G. , Badon Stanley , Popovsky Mark A. , Grindon Alfred J. , Lenes Bruce A. , Williams Alan E. 
Published: March 2003

BACKGROUND: This study evaluated the change from a rapid plasma reagin (RPR) test to an automated specific treponemal test (PK‐TP) in screening for syphilis in blood donors.STUDY DESIGN AND METHODS: A cross‐sectional seroprevalence analysis was performed on 4,878,215 allogeneic blood donations from 19 American Red Cross Blood Services regions from May 1993 through September 1995. Positive predictive values relative to the confirmatory fluorescent treponemal antibody absorption test (FTA‐ABS) were calculated. Differences in seroprevalence were compared in RPR and PK‐TP tests for 1) unconfirmed and confirmed tests, 2) first‐time and repeat donors, and 3) “recent” versus “past” infections. Donation data from three additional Red Cross regions were evaluated for repeat donation patterns of blood donors who had a donation that was positive in a serologic screening test for syphilis. The value of RPR and PK‐TP tests as surrogate markers for HIV infection was compared.RESULTS: Reactive rates were lower but the positive predictive values was higher for the PK‐TP test than for the RPR test. Initially, donors screened by PK‐TP were more likely to be confirmed as positive than were donors screened by RPR, but these rates became comparable. It is estimated that a single HIV window‐period donation was removed by serologic testing for syphilis each year of this study period.CONCLUSIONS: The change to the PK‐TP test resulted in a lower repeatedly reactive rate, better prediction that a confirmed‐positive test for syphilis would occur in testing in the FTA‐ABS, fewer donations lost, and comparable deferral rates. Because of the high rate of reactivity to serologic testing for syphilis among donors previously confirmed positive for syphilis, indefinite deferral after a confirmed‐positive index donation may be warranted. Serologic testing for syphilis is ineffective as a marker of HIV‐infectious window‐period donations.
Kinetics of peripheral blood stem cell harvests during a single apheresis
Authors: Smolowicz Adam G. , Villman Kenneth , Berlin Gösta , Tidefelt Ulf 
Published: March 2003

BACKGROUND: The enumeration of CD34+ cells in the peripheral blood of patients before leukapheresis is commonly used to predict the outcome of stem cell harvests. The concept that an increased number of transplanted cells gives faster marrow reconstitution triggers an interest in investigating the kinetics of peripheral blood stem cells during leukapheresis. The aim of this study was to investigate the issue of recruitment of hematopoietic progenitor cells during a single leukapheresis.STUDY DESIGN AND METHODS: Nine leukapheresis procedures (in 8 patients) were investigated. In each case, 3 blood volumes were processed. Samples from peripheral blood, the collection line of apheresis equipment, and the collected component were obtained after each blood volume was processed. The enumeration of CD34+ cells was performed, and the total number of progenitors, as a sum of the number of cells in the peripheral blood and the number of cells in the collected component, was calculated.RESULTS: A mean of 13.3 L of blood was processed, and a component with a mean volume of 424 mL and a mean of 10.1 × 108 CD34+ cells per kg of body weight was collected. White cell and mononuclear cell counts in peripheral blood declined concomitantly during the procedures. The calculated total number of cells—that is, the sum of the number of cells in the collected component and the number of cells in the peripheral blood—showed a concomitant, but not equal, rise in polymorphonuclear cells, mononuclear cells, and CD34+ cells during the leukapheresis. This apparent mobilization of progenitors into the peripheral blood did not correlate with the slightly increased number of polymorphonuclear cells or with the more pronounced increase in mononuclear cells.CONCLUSION: There is a substantial recruitment of progenitor cells during a single leukapheresis.
Transfusion‐associated transmissionof babesiosis in New York State
Authors: Linden J.V. , Wong S.J. , Chu F.K. , Schmidt G.B. , Bianco C. 
Published: March 2003

BACKGROUND: Babesiosis can be life‐threatening in immunocompromised individuals. Although the disease is usually transmitted by tick bite, more than 20 cases have been reported of infection transmitted by transfusion of blood or blood components obtained from apparently healthy donors from endemic areas in the United States. This report describes several recent cases of transfusion‐transmitted babesiosis in New York State.STUDY DESIGN AND METHODS: Transfusion‐associated incidents of babesiosis infection were identified and investigated. Seroprevalence of babesiosis in healthy blood donors in a highly endemic area was ascertained.RESULTS: In three incidents, babesiosis was diagnosed in five of eight patients given infected blood: two premature infants, an elderly patient with gastrointestinal bleeding, and two patients with thalassemia. Seroprevalence in blood donors on Shelter Island (Suffolk County, eastern Long Island), a highly endemic area, was 4.3 percent in May 1998.CONCLUSIONS: Infected donors lived in endemic areas and were asymptomatic with no history of tick bite. Blood collected in January 1997 from one donor was infectious. Those transfusion recipients who were infected were neonatal, elderly, or chronically transfused patients. Babesiosis should be included in the differential diagnosis of febrile illness in immunocompromised recipients of blood transfusion, particularly in the Northeastern United States.
Evidence supporting the requirement for two proline residues for expression of c
Authors: Westhoff C.M. , Silberstein L.E. , Wylie D.E. 
Published: March 2003

BACKGROUND: In humans, c antigen expression is associated with a proline residue at amino acid position 103 in the second extracellular loop of the CE protein. Comparison of nonhuman primate Rh proteins suggested that c reactivity might actually involve two proline residues. It has been shown that the RBCs of New World capuchin monkeys (Cebus apella) react with anti‐c. To further define the amino acid residues involved in c expression, Rh cDNA from the capuchin was analyzed.STUDY DESIGN AND METHODS: Rh transcripts were amplified by reverse transcription PCR from RNA isolated from the reticulocytes of a capuchin monkey and were cloned and sequenced.RESULTS: Rh transcripts from the capuchin monkey, whose RBCs react with anti‐c, were found to encode adjacent proline residues at 102 and 103.CONCLUSION: Sequencing of Rh transcripts from the capuchin monkey supports the hypothesis that the expression of c requires two adjacent proline residues. Proline causes bends or loops in proteins, which, in this case, might form a unique, stable structure resistant to perturbations induced by changes in upstream or downstream residues. This would explain the scarcity in humans of c variants as compared to the other major Rh antigen variants, and the preservation of c reactivity despite 24‐percent divergence between the human and capuchin Rh proteins.
Blood bank conditions and RBCs: the progressive loss of metabolic modulation
Authors: Messana I. , Ferroni L. , Misiti F. , Girelli G. , Pupella S. , Castagnola M. , Zappacosta B. , Giardina B. 
Published: March 2003

BACKGROUND: Human RBC metabolism is modulated by the cell oxygenation state. Among other mechanisms, competition of deoxyhemoglobin and some glycolytic enzymes for the cytoplasmic domain of band 3 is probably involved in modulation. This metabolic modulation is connected to variations in intracellular NADPH and ATP levels as a function of the oxygenation state of the cell, and, consequently, it should have physiologic relevance. The present study investigates the effect of storage on this metabolic modulation and its relationship with the alteration of membrane protein composition.STUDY DESIGN AND METHODS: RBCs stored in CPD–saline‐adenine‐glucose‐mannitol were assayed for glucose uptake and partition between glycolysis and the pentose phosphate pathway at high and low oxygen saturation by nuclear magnetic resonance spectroscopy after 1, 14, 21, 35, and 42 days of storage. Membrane protein composition was determined by SDS‐PAGE on Days 1, 14, 35, and 42. Metabolic values and 2,3 DPG concentration were also measured after rejuvenation for 1 hour at 37°C with pyruvate‐inosine‐phosphate‐adenine solution on Day 21.RESULTS: Metabolic differences between RBCs incubated at high and low oxygen saturation decreased during storage, and, on Day 35, the two groups did not have significant differences (p = 0.111). SDS‐PAGE showed that membrane protein composition was concurrently modified. The percentage of unmodified band 3 decreased during storage, principally between Days 14 and 35. In rejuvenated RBCs, oxygen‐dependent modulation was not restored.CONCLUSIONS: RBCs stored in CPD–saline‐adenine‐glucose‐mannitol do show a progressive loss of oxygen‐dependent metabolic modulation, which is not restored after rejuvenation and which seems partly related to modifications in membrane proteins, mainly band 3.
Effects of UVB radiation on cytokine generation, cell adhesion molecules, and cell activation markers in T‐lymphocytes and peripheral blood HPCs
Authors: Lankford K.V. , Mosunjac M. , Hillyer C.D. 
Published: March 2003

BACKGROUND: Immunomodulatory effects of UV light have increasingly become a focus in transfusion medicine, BMT and transplantation immunology. In the transplant setting, the use of UVB radiation may reduce or abolish T‐cell activation without compromising either bone marrow (BM) engraftment or graft‐versus‐leukemia effect. In this study, BM and apheresis‐derived peripheral blood HPCs were used to investigate the effects of UVB on colony‐forming ability, CD34+ cell viability, and growth potential, as well as on the secretion of MNC cytokines and the expression of cell surface markers and adhesion molecules.STUDY DESIGN AND METHODS: After UVB radiation, enriched populations of T cells and antigen‐presenting cells (APCs) were treated with PHA, and the MNC response was measured, as was colony‐forming ability. CD34+ cells were quantified and their growth potential was determined in culture. Next, T‐cell activation status, cell adhesion molecule and cell surface activation marker expression, and cytokine profiles were evaluated, and cytokine mRNA was quantitated. Parallel studies were done in unirradiated control cell populations.RESULTS: Low‐dose (10 mJ/cm2) UVB mitigates MNC proliferative responses by 94 percent while maintaining 60 and 80 percent of colony‐forming ability in peripheral blood HPC and BM preparations, respectively, and >50 percent of colony‐forming ability in CD34+ cell‐enriched samples. Low‐dose UVB radiation also significantly reduces T‐cell production of TNFα, TNFα mRNA, TNFβ, IL‐2, and IL‐6 and downregulates T‐cell expression of CD28, CD25, CD69, and intercellular adhesion molecule 1.CONCLUSION: These findings have shown that a “window” of low‐dose UVB radiation (10 mJ/cm2) exists, at which BM‐ and peripheral blood‐derived MNC proliferation is inactivated, while the HPCs are relatively spared. UVB light selectively affects T cells, while APCs are resistant to low doses of UVB. UVB radiation also alters the expression of some cell surface markers and cytokines that are important in T‐cell activation pathways. Reduction of T‐cell activation without cytocidal effect may allow UVB radiation to become an immunomodu‐lating agent in BM or HPC transplantation.
Fulminant babesiosis treated with clindamycin, quinine,and whole‐blood exchange transfusion
Authors: Dorman S.E. , Cannon M.E. , Telford S.R. , Frank K.M. , Churchill W.H. 
Published: March 2003

BACKGROUND: Babesiosis is an increasingly recognized parasitic infection with manifestations that range from a subclinical or mild flu‐like illness to life‐threatening disease. Risk factors that may be associated with a more severe clinical course include immunosuppression, splenectomy, and advanced age. The most effective chemotherapeutic regimen, clindamycin plus quinine, is sometimes ineffective in cases of severe disease.CASE REPORT: A previously healthy, 58‐year‐old man was infected by Babesia microti, presumably through a tick bite. He developed fulminant disease characterized by severe hemolytic anemia, disseminated intravascular coagulation, acute renal failure, and respiratory failure. There was no history of splenectomy or immunodeficiency. He was given oral clindamycin (300 mg/4×/day) 2 days before admission. Oral quinine (650 mg/3×/day) was added upon hospitalization. There was no clinical improvement despite antibiotic therapy with clindamycin and quinine. On the second hospital day, a whole‐blood exchange transfusion was performed to simultaneously lower the parasite load and replace the patient's plasma. With an automated blood cell separator, 87 percent of the patient's total blood volume was exchanged. As replacement fluid, 6.7 L of packed RBCs reconstituted with FFP (average Hct, 33%) was used. The patient's Hct increased from 26.9 percent before the exchange to 28.3 percent after the exchange. The percentage of parasitized RBCs decreased from 13.8 percent just before exchange to 4.2 percent immediately after exchange. There was rapid clinical improvement after the whole‐blood exchange transfusion. The patient's subsequent clinical course was marked by a disappearance of the parasitemia and continued slow, general improvement. Therapy with clindamycin was continued for 14 days after the exchange transfusion and quinine for 17 days.CONCLUSION: In cases of severe babesiosis, prompt institution of whole‐blood exchange transfusion, in combination with appropriate antimicrobial therapy, can be life‐saving.
The release of unsuitable units through misinterpretation of laboratory results transmitted by facsimile
Authors: Linden J.V. 
Published: March 2003

BACKGROUND: Preventable errors in transfusion medicine that have a significant risk of adverse outcome include the erroneous administration of blood of the wrong type or blood with unsuitable laboratory test results. Mandatory reports of errors by facilities providing blood services in New York State offer the opportunity for review and analysis of common factors. The state also collects statistics on the collection, laboratory testing, distribution, and disposition of blood in these facilities.CASE REPORTS: Three serious errors in transfusion medicine occurred within 3 months as a result of the misinterpretation of laboratory test results transmitted by facsimile. Two unsuitable units of blood were erroneously released, and a unit mislabeled as to the ABO group was incorporated into the hospital inventory. One of the unsuitable units was repeatedly reactive for HIV (although negative on confirmatory testing), and the other was confirmed positive for HCV.CONCLUSIONS: The vast majority of blood collected in New York State is tested by reference laboratories. Results are often transmitted by facsimile. Facsimile results may be misinterpreted because of distortion during transmission, misreading, or failure to note a separate report of pending results. Such misinterpretation results in an increased risk of adverse outcome for transfusion recipients. Laboratory results to be transmitted by facsimile could readily—and should—be clarified.
High prevalence of TT virus infection in French blood donors revealed by the use of three PCR systems
Authors: Biagini P. , Gallian P. , Touinssi M. , Cantaloube J.F. , Zapitelli J.‐P. , De Lamballerie X. , De Micco P. 
Published: March 2003

BACKGROUND: The purpose of this study was to determine the prevalence of TT virus (TTV) infection in voluntary blood donors in Southeastern France.STUDY DESIGN AND METHODS: The sera of 289 blood donors were tested for the presence of TTV DNA by two PCR systems detecting genes located in the 5′ UTR (primer set A [Set A]) and the open reading frame (ORF2) (primer set B [Set B]) of the viral genome. A randomized sample of 40 blood donors was also tested by a nested‐PCR system in the ORF1 by use of primer set C (Set C). Donors were questioned for possible risk factors for virus transmission.RESULTS: In the entire population studied, 30.8 percent of blood donors tested positive with both Sets A and B, and 70.6 percent with at least one set. In the sample tested with three sets of primers, 27.5 percent of blood donors were positive in testing with all PCR systems and 80 percent with at least one system. The specificity of TTV DNA amplification was confirmed by sequencing 10 PCR products obtained with each set of primers. Statistical analysis revealed that the prevalence of TTV reactivity increased with age.CONCLUSION: The high prevalence of TTV reactivity and the absence of a pathologic condition or risk factors obviously associated with the infection in blood donors suggest that there is no need for systematic detection of TTV infection before blood donation. Further studies are required to determine if TTV isolates can be responsible for a pathologic condition in humans after blood transfusion.
Combined administration of G–CSF and dexamethasone for the mobilization of granulocytes in normal donors: optimization of dosing
Authors: Liles W.C. , Rodger E. , Dale D.C. 
Published: March 2003

BACKGROUND: The clinical utility of neutrophil (polymorphonuclear leukocyte, PMN) transfusion therapy has been compromised, in part, by the inability to obtain sufficient quantities of functional neutrophils from donors. Mobilization of PMNs in the peripheral blood of normal volunteers has been shown to be superior when G–CSF is administered in conjunction with dexamethasone to that when either agent is administered alone. The current study was conducted to determine the optimal dosages of G–CSF and dexamethasone to be administered to donors in a granulocyte transfusion program.STUDY DESIGN AND METHODS: Five normal subjects were randomly assigned to each of the following single‐dose regimens over five consecutive weeks: 1) subcutaneous (SC) G–CSF at 600 μg and oral (PO) dexamethasone at 8 mg; 2) SC G–CSF at 450 μg and PO dexamethasone at 8 mg; 3) SC G–CSF at 450 μg and PO dexamethasone at 12 mg; 4) SC G–CSF at 450 μg; and 5) PO dexamethasone at 12 mg. Venous blood was collected at 0, 6, 12, and 24 hours after drug administration for determination of absolute neutrophil count (ANC). Side effects of drug administration were recorded by using a standardized symptom questionnaire.RESULTS: Maximal ANC was achieved at 12 hours after administration of drugs under each regimen. All four regimens containing G–CSF caused greater than 10‐fold increases in the ANC. When administered in conjunction with dexamethasone, G–CSF resulted in statistically similar PMN mobilization at dosages of 450 μg and 600 μg. The combined single‐dose regimen of SC G–CSF at 450 μg and PO dexamethasone at 8 mg increased the mean ANC from a baseline value of 2800 per μL to 37,900 per μL at 12 hours after administration. This regimen was well tolerated by the normal volunteers.CONCLUSION: In a single‐dose format designed for clinical granulocyte transfusion programs, optimal PMN mobilization can be achieved in normal donors with a combined regimen of SC G–CSF at 450 μg, and PO dexamethasone at 8 μg.
GB Virus type C/HGV markers in HCV RNA‐positive French blood donors: correlation with HCV genotypes and risk factors
Authors: Bouchardeau F. , Laperche S. , Pillonel J. , Elghouzzi M.H. , Maisonneuve P. , Tirtaine C. , Boiret E. , Razer A. , Girault A. , Beaulieu M.J. , Couroucé A.M. 
Published: March 2003

BACKGROUND: Exposure to GB virus type C/HGV (GBV‐C/HGV) could be determined by detection either of RNA by RT‐PCR or of antibodies of the envelope protein E2.STUDY DESIGN AND METHODS: The aim of the study was to determine the proportion of the GBV‐C/HGV markers of infection in a blood donor population infected with HCV and to identify GBV‐C/HGV routes of transmission that are associated with HCV genotypes and risk factors.RESULTS: Among 306 HCV RNA‐positive blood donors, the proportion of GBV‐C/HGV RNA‐positive donors and anti‐E2‐positive donors was 19.3 percent (95% CI = 15.0‐24.2%) and 42.1 percent (95% CI = 36.6‐47.9%), respectively. Exposure to GBV‐C/HGV (RNA or anti‐E2) was significantly associated with the risk factor of IV drug use. There was a trend toward association with HCV subtypes 1a and 3a, probably because these HCV subtypes are the most frequent in IV drug users. No correlation was observed between ALT elevation and the presence of GBV‐C/HGV RNA.CONCLUSION: In persons with HCV infection, IV drug use seems to be a major route of GBV‐C/HGV transmission. Precautions taken to avoid HCV infection will probably also decrease GBV‐C/HGV transmission.
Infusible platelet membranes improve hemostasis in thrombocytopenic blood: experimental studies under flow conditions
Authors: Galán Ana‐Maria , Bozzo Jordi , Hernández Maria‐Rosa , Pino Marcos , Reverter Juan‐Carlos , Mazzara Roberto , Escolar Ginés , Ordinas Antonio 
Published: March 2003

BACKGROUND : The potential hemostatic effect of infusible platelet membranes (IPM; Cyplex, Cypress Bioscience) prepared from outdated human platelets is investigated.STUDY DESIGN AND METHODS: Increasing concentrations of IPM were added to blood samples anticoagulated with low‐molecular‐weight heparin, in which platelets and WBC counts had been experimentally reduced by a filtration procedure. Thrombocytopenic blood with IPM was circulated in a perfusion chamber at various shear rates (300, 600, and 1200/sec–1), and platelet and fibrin deposition on the surface of a damaged vessel was measured. Prothrombin fragments 1 and 2 (F1+2) levels were also monitored.RESULTS: Under conditions of severe thrombocytopenia (<6000 platelets/μL) IPM did not increase platelet deposition. However, a dose‐dependent increase in fibrin deposition was observed with concentrations of IPM ranging from 0.5 to 2 mg per kg in perfusions at 300 and 600 per sec–1 (p<0.05 vs. thrombocytopenic blood). Experimental studies performed under conditions of moderate thrombocytopenia and higher shear rates (25,000‐30,000 platelets/μL; at 600 and 1200/sec–1) showed that IPM concentrations equivalent to 0.5 or 1 mg per kg improved fibrin deposition (33.5 ± 9.5% and 37.7 ± 12.8%, respectively, vs. 22.7 ± 5.2% in controls) and also promoted a moderate increase in platelet deposition, with a concomitant significant increase in the size of platelet aggregates (p<0.05). Exposure of thrombocytopenic blood to a damaged vessel resulted in an increase of F1+2 levels from 0.8 ± 0.15 to 1.7 ± 0.22 nM at 300 per sec–1 and 1.94 ± 0.46 nM at 600 per sec–1. Postperfusion levels of F1+2 after the addition of IPM were always similar to levels in untreated controls.CONCLUSION: IPM promotes local procoagulant activity at sites of vascular damage under conditions of severe and moderate thrombocytopenia. IPM also appears to facilitate platelet cohesive functions under conditions of moderate thrombocytopenia.