bluuebunny/crossref_metadata_2025_split huggingface dataset:
An undetectable source of technical error that could lead to false negative results in enzyme linked immunosorbent assay of antibodies to HIV‐1
Authors: WILTBANK T.B. , MCCARROLL D.R. , WARTICK M.G. 
Published: March 2003

ABSTRACTSince the institution of routine testing for antibodies to Human Immunodeficiency Virus (HIV) using the enzyme‐linked immunosorbent assay (ELISA), the specificity and sensitivity of this assay system has received significant scrutiny. During previous use of this methodology, we have quantified rates of false biological positive results using commercial kit assays in a normal donor population. In this study, we have identified a potential source for false negative results. Using multiple lots of two different commercial ELISA kits, the absorbance readings at the test end point could not differentiate between normal non‐reactive donor samples and blanks containing no sample. These results occur using normal donor samples, even though the assays could distinguish between blank wells and the manufacturers' “normal controls”, provided with the assay. Our findings suggest that a technical pipetting error is presently undetectable, either visually or by statistical methods, and could permit an untested, potentially HIV‐1 positive, unit to be released into the transfusable blood supply. A possible solution is suggested.
Effect on platelet properties of exposure to temperatures below 20°C for short periods during storage at 20 to 24°C
Authors: Moroff G. , Holme S. , George V.M. , Heaton W.A. 
Published: March 2003

Background: When platelet concentrates (PCs) are shipped over long distances, it is not always possible to ensure that their temperature is maintained at 20 to 24°C. In addition, PCs are not agitated as during routine storage.Study Design and Methods: Studies have been conducted to evaluate how exposure to temperatures below 20°C in the absence of agitation influences properties of platelets. In initial studies, exposure to 4°C for 3 or 5 hours or to 12°C for 5 or 17 hours on Day 2 of a 5‐ to 6‐day storage period was associated with a loss of discoid shape. This was reflected by slightly lower but statistically different morphology scores after storage compared to those observed with control platelets that were stored only at 20 to 24°C. In addition, a qualitative difference in morphology was noted in controls and PCs held at 16°C for 17 hours. In more detailed studies, both the in vivo viability and in vitro properties of platelets exposed between Day 1 and Day 2 to either 12°C or 16°C for 17 hours were evaluated. The protocol involved a paired study design (n = 4 for each exposure temperature) with the simultaneous storage of two identical PCs, one exposed to 12 or 16°C and the other one maintained at 20 to 24°C throughout the 5‐day storage.Results: Exposure to 12°C significantly reduced (p < 0.05 by paired t test) the in vivo recovery to 37.6 ± 13.8 percent (mean ± 1 SD) from 47.8 ± 11.5 percent and the survival time to 2.0 ± 0.3 days from 6.5 ± 1.4 days. On exposure to 16°C, the differences in viability from those of control units were much less but still significant. The in vivo recovery was 42.7 ± 3.8 percent compared to 49.2 ± 3.0 percent and the survival time was 3.5 ± 1.2 days compared to 6.6 ± 0.3 days. The loss of in vivo viability of the test platelets was associated with a loss of discoid shape, as reflected by morphology scores, extent of shape change, and mean platelet volume. In addition, platelet metabolism also appeared to be affected, as suggested by increased lactate production. All of the in vitro properties except for total ATP and residual glucose that were statistically different from those of controls on exposure to 12°C were also significantly different on exposure to 16°C.Conclusion: These findings demonstrate that platelets undergo substantial changes in in vivo viability and in vitro properties when they are exposed to temperatures below 20°C for short periods.
In vitro characteristics of white cell‐reduced single‐unit platelet concentrates stored in syringes
Authors: Pisciotto P.T. , Snyder E.L. , Snyder J.A. , Frattaroli S. , Hopfer S.M. , Rinder H.M. , Smith B.R. 
Published: March 2003

BACKGROUND: Platelet concentrates (PCs) for premature infants may be subjected to filtration, centrifugation, and various storage conditions before transfusion.STUDY DESIGN AND METHODS: As there are few data on the cumulative effect of these procedures on PCs, platelet properties (including biochemical and functional in vitro assays) were evaluated after the processing of single units of PCs through a 1‐unit‐capacity high‐efficiency white cell (WBC)‐reduction filter followed by syringe storage at either 22 or 37 degrees C for 6 hours. Two‐ and 5‐day‐old PCs, volume‐reduced PCs, and prestorage WBC‐reduced PCs were evaluated.RESULTS: WBC filtration consistently resulted in a 3 to 4 log10 reduction in WBCs, with less than 15‐percent platelet loss. No adverse effects of platelet function or evidence of increased platelet activation as determined by the percentage of P‐selectin positivity were noted. A decrease in pH associated with increased lactate production and consumption of glucose was observed following syringe storage under all conditions tested. Such changes were most pronounced, however, with volume‐reduced PCs stored at 37 degrees C (pH 6.31 ± 0.15, lactate 23.0 ± 3.06 mmol/L). All pH levels at the end of storage were above the minimum Food and Drug Administration requirement (pH 6.0).CONCLUSION: The in vitro data suggest that single units of PCs can undergo WBC filtration followed by syringe storage for up to 6 hours and still maintain acceptable storage characteristics. The practice of maintaining volume‐reduced PCs in syringes for 6 hours at 37 degrees C in isolettes during transfusion should, however, be avoided.
Storage of apheresis platelets after gamma radiation
Authors: SWEENEY J.D. , HOLME S. , MOROFF G. 
Published: March 2003

BACKGROUND: There are conflicting data on the effect of irradiation and subsequent storage on the quality of platelet components.STUDY DESIGN AND METHODS: The retention of platelet properties during storage of gamma‐irradiated apheresis suspensions was studied in 22 apheresis components obtained on a cell separator with a specialized centrifugation chamber. Immediately after collection, each suspension was divided equally into two 1‐L polyolefin containers. On Day 1 (n = 12) and Day 3 (n = 10) one of each pair of suspension containers was gamma radiated with 2500 cGy. All platelet suspensions were stored for 5 days at 20 to 24 degrees C. Samples were drawn on Day 5 from each of the 22 pairs of containers for evaluation of an array of in vitro properties. Samples were taken from 10 pairs of containers for platelet labeling with either 51Cr or 111In for subsequent transfusion and concurrent in vivo measurement of recovery and survival. Posttransfusion samples were drawn after 24 hours for ex vivo whole blood aggregation.RESULTS: Comparable in vitro and in vivo properties were measured in irradiated and control platelets, whether irradiation was performed on Day 1 or Day 3. The mean +/− 1 SD in vivo recovery and survival time for controls and platelets irradiated on Day 1 was 52 +/− 14 percent and 146 +/− 34 hours and 51 +/− 7 percent and 147 +/− 36 hours, respectively. For Day 3 irradiation, the values were 46 +/− 12 percent and 150 +/− 60 hours and 47 +/− 9 percent and 151 +/− 53 hours, respectively. A small, but measurable adverse effect of irradiation on ex vivo platelet aggregation was present.CONCLUSION: These data indicate that storage of apheresis platelets after gamma radiation is without clinically significant, demonstrably adverse effects on platelet quality.
Identification of variant glycophorins of human red cells by lectinoblotting: application to the Mi.III variant that is relatively frequent in the Taiwanese population
Authors: Wu A. M. , Duk M. , Lin M. , Broadberry R. E. , Lisowska E. 
Published: March 2003

BACKGROUND: Detection of normal and variant glycophorin electrophoretic bands with T‐ and Tn‐specific lectins is based on the possibility of glycophorin transformation into T or Tn antigens by simple chemical modifications in the blot.STUDY DESIGN AND METHODS: Human red cell membrane proteins were fractionated by sodium dodecyl sulfate‐ polyacrylamide gel electrophoresis and blotted onto nitrocellulose. The blots were submitted to mild acid hydrolysis (desialylation of glycophorins exposing T antigens) and then to Smith degradation (degalactosylation of asialo‐glycophorins exposing Tn antigens). The modified glycophorin bands were detected with biotinylated lectins and horseradish peroxidase‐conjugated avidin.RESULTS: The lectins from Artocarpus integrifolia (jacalin, anti‐T/Tn), Amaranthus hybridus (anti‐ T), Salvia sclarea (anti‐Tn), and Vicia villosa (anti‐Tn) were used. The lectins detected normal glycophorin bands in control and variant red cells and characteristic additional bands in Mi.III (GP.Mur) red cells. The sensitivity of the method is comparable to that obtained by immunoblotting with glycophorin monoclonal antibodies. Comparison of the electrophoretic mobility of normal and variant bands is helpful in the classification of glycophorin variants.CONCLUSION: Lectinoblotting, based on carbohydrate recognition, enables the detection in a red cell sample, with high sensitivity, of all normal and variant glycophorin bands. The method can be also applied to other purposes, such as the identification of poly‐O‐glycosylated glycoproteins in other cells or the characterization of glycosylation of glycophorins and other poly‐O‐glycosylated proteins.
Platelet membrane glycoproteins and microvesicles in blood from postoperative salvage: a study in cardiac bypass patients
Authors: Sloand E. , Alyono D. , Yu M. , Klein H. 
Published: March 2003

BACKGROUND: Transfusion of blood collected by intraoperative and postoperative salvage systems has been linked to the development of thrombocytopenia and disseminated intravascular coagulation. Although functional defects have been reported in platelets from unwashed salvaged blood, platelet membrane glycoprotein (GP) composition, a potentially important determinant of function and survival, has not been studied.STUDY DESIGN AND METHODS: Platelets from 22 patients whose blood was salvaged at the completion of surgery were analyzed and compared to platelets obtained from the venous blood from the same patient. Platelet membranes were stained with fluorescein isothiocyanate‐conjugated CD41a monoclonal antibody (anti‐GPIIb/IIIa) to identify platelets, a phycoerythrin‐conjugated monoclonal antibody, CD62 (anti‐P‐selectin) to identify activated platelets, and CD42b (anti‐ GPIb) or anti‐GPIb/IX to assess GPIb. Samples were analyzed with a flow cytometer using software.RESULTS: Platelets obtained from salvaged blood demonstrated lower GPIb expression (CD42b and GPIb/IX monoclonal antibody binding), higher P‐selectin expression, and greater numbers of platelet‐derived microvesicles.CONCLUSION: The clinical significance of transfusing blood containing activated platelets and microvesicles merits investigation.
Characterization of reactions after transfusion of cellular blood components that are white cell reduced before storage
Authors: Federowicz I. , Barrett B. B. , Andersen J. W. , Urashima M. , Popovsky M. A. , Anderson K. C. 
Published: March 2003

Background: During the storage of cellular components before transfusion, cytokines that may mediate transfusion reactions are released from white cells (WBCs). Adverse effects of transfused cellular blood components therefore depend not only on the number of residual WBCs in blood components, but also on the timing of WBC reduction.Study Design and Methods: Febrile nonhemolytic transfusion reactions (FNHTRs), allergic reactions, and other reactions were characterized in recipients of 4728 units of red cells (RBCs) and 3405 bags of single‐donor apheresis platelets (SDAPs), all of which underwent prestorage WBC reduction. To delineate the impact of prestorage versus poststorage WBC reduction of RBCs on transfusion reactions, these results were compared with reactions occurring after the transfusion to similar recipients of 6447 bags of RBCs that underwent poststorage WBC reduction by bedside filtration and 5197 units of SDAPs that underwent prestorage WBC reduction. The levels of interleukin (IL) 1 beta, IL‐6, IL‐8, and tumor necrosis factor‐alpha (TNF‐alpha) were measured in a subset of 20 implicated cellular blood components at the time of transfusion reactions and correlated with the duration of storage before transfusion.Results: The incidence of reactions was greater after transfusions of SDAPs (5.49%) than of RBCs (1.63%). The incidence of FNHTRs after transfusion of RBCs that were WBC reduced before storage (1.1%) was significantly lower (p = 0.0045) than that after transfusion of RBCs that were WBC reduced after storage (2.15%). Although allergic reactions to RBCs that were WBC reduced before storage were also less common (0.41%) than those to RBCs that were WBC reduced after storage (0.51%), the difference was not significant (p = 0.067). At the time of reactions to RBCs and SDAPs that were reduced before storage, the level of IL‐6 was negatively correlated (r = ‐0.54, p = 0.014) with the duration of storage before transfusion, and there was no correlation between the level of either IL‐1 beta or IL‐8 and the interval before transfusion. TNF‐alpha was not detectable in any implicated component.Conclusion: FNHTRs, but not allergic reactions, were less common after transfusion of RBCs that were WBC reduced before storage than after the transfusion of those WBC reduced after storage at the bedside by filtration. The level of IL‐6 in implicated cellular blood components that were WBC reduced before storage was inversely correlated with the length of storage before transfusion. Further studies are needed to determine whether the transfusion of cellular blood components that were WBC reduced before storage can both diminish the incidence of adverse reactions and improve outcome.
The predictors of red cell transfusions in total hip arthroplasties
Authors: Nuttall G. A. , Santrach P. J. , Oliver W. C. , Horlocker T. T. , Shaughnessy W. J. , Cabanela M. E. , Bryant S. 
Published: March 2003

BACKGROUND: Most blood crossmatched in a hospital blood bank is for surgical patients, and the majority is never transfused. The maximal standard blood order schedule is used to promote efficient ordering practices for surgical patients.STUDY DESIGN and METHODS: To ascertain the predictors of red cell transfusions for patients undergoing total hip arthroplasty, the charts of 299 adult patients undergoing primary and revision total hip arthroplasty were reviewed. A surgical blood order equation was developed for calculating the number of units of red cells that should be ordered. Stepwise regression analysis was used to determine which patient‐and‐case‐related variables should be considered in the surgical blood order equation.RESULTS: The significant indicators for allogeneic red cell transfusion to patients on the day of total hip arthroplasty were preoperative hemoglobin concentration, weight, age, estimated blood loss, and aspirin use. The surgical blood order equation would result in a lower crossmatch‐to‐transfusion ratio than would the maximal standard blood order schedule (1.23 vs. 3.14). Costs were also lower with the surgical blood order equation.CONCLUSION: Incorporation of patient factors resulted in increased efficiency of blood‐ordering practices in total hip arthroplasty.
Complement activation during storage of whole blood, red cells, plasma, and buffy coat
Authors: Hyllner M. , Arnestad J.P. , Bengtson J.P. , Rydberg L. , Bengtsson A. 
Published: March 2003

BACKGROUND: The process of separating whole blood into components and the storage of blood components may cause the release of toxic metabolites from the complement cascade. The aim of this study was to determine whether the storage of blood components leads to the activation of the complement cascade and the release of anaphylatoxins.STUDY DESIGN AND METHODS: Blood from 12 healthy volunteers was collected and stored either as whole blood or as components: red cells in saline‐adenine‐glucose‐mannitol solution, plasma, and buffy coat. The concentrations of anaphylatoxins and other complement proteins in the various blood components were intermittently analyzed during a 5‐week storage period.RESULTS: Increasing levels of anaphylatoxins were demonstrated during the storage of whole blood and plasma. Elevated concentrations of the anaphylatoxins C3a and C5a were observed during the storage of whole blood. Increased C5a levels were observed after 7 days of storage. High concentrations of C3a were found in plasma after 14 days of storage. Low or non‐detectable levels of C3a, C5a, and other complement components were found in red cells stored in saline‐adenine‐glucose‐mannitol solution.CONCLUSION: The study demonstrated activation of complement during the storage of whole blood and plasma but not in red cells in storage solution. The transfusion of larger volumes of stored whole blood or plasma may contribute to the risk of development of organ dysfunction. Therefore, it is advisable to use red cells in storage solution.
Antibodies to hepatitis E virus among several populations in Greece: increased prevalence in an hemodialysis unit
Authors: Dalekos G. N. , Zervou E. , Elisaf M. , Germanos N. , Galanakis E. , Bourantas K. , Siamopoulos K. C. , Tsianos E. V. 
Published: March 2003

BACKGROUND: Hepatitis E virus (HEV) has been found to be the causative agent of enterically transmitted non‐A, non‐B hepatitis in tropical and subtropical countries. Several investigators, however, have indicated that HEV could be endemic in Europe, albeit at a low prevalence.STUDY DESIGN AND METHODS: The purpose of this study was to estimate the prevalence of anti‐HEV in various populations in northwestern Greece (Epirus region). Healthy blood donors (2636), refugees from southern Albania (350), children (165), injecting drug users (IDUs) (65), multiply transfused patients (62), patients with chronic viral hepatitis (75), and chronic hemodialysis patients (149) were investigated for anti‐HEV by enzyme immunoassay and confirmatory Western blot assay. In addition, 380 consecutive healthy blood donors and 62 hemodialysis patients from a neighboring area (Agrinion, Greece) were investigated.RESULTS: A very low presence of anti‐HEV antibody was found among healthy blood donors from Epirus (0.23%) and Agrinion (0.53%). Anti‐HEV was not detected in children, IDUs, or multiply transfused patients. In contrast, a low but significant prevalence of anti‐HEV was found among refugees (4.85%), patients with chronic viral hepatitis (5.3%), and hemodialysis patients from Epirus (1.34%), as compared with healthy blood donors from Epirus: p < 0.0001, p < 0.00001, and p < 0.10, respectively. A high prevalence (9.7%) of anti‐ HEV was revealed in patients at the hemodialysis unit of the General Hospital of Agrinion (p < 0.00005, compared to healthy blood donors from Agrinion). No significant association was found between anti‐HEV positivity and the age or sex of donors, the duration of hemodialysis, positivity for hepatitis B or C virus infection markers, history of hepatitis, increased alanine aminotransferase, renal transplantation, a history of transfusion, or the number of units transfused.CONCLUSION: This study demonstrated a high prevalence of anti‐HEV in a separate hemodialysis unit, without an association with the known routes of transmission of blood‐borne viruses. This observation suggests that a still‐undefined intra‐unit factor or other factors are associated with HEV transmission.
Changing transfusion practices in hip and knee arthroplasty
Authors: Warner D.O. , Warner M.A. , Schroeder D.R. , Offord KP. , Maxson P. , Santrach P. 
Published: March 2003

BACKGROUND: This study was designed to examine changes in perioperative transfusion practices after the introduction of autologous blood conservation strategies into routine clinical practice.STUDY DESIGN AND METHODS:The existing medical records of all patients undergoing total hip or knee arthroplasty at Mayo Clinic in Rochester, MN, who resided in Olmsted County, were reviewed over three periods: 1981–82 (232 procedures), 1987–88 (269 procedures), and 1993–94 (398 procedures).RESULTS:The proportion of patients receiving any perioperative red cell (RBC) units significantly decreased (from 85% in 1981–82 to 65% in 1993–94). The timing of transfusion also changed; the proportion of RBC units transfused in the preoperative or intraoperative periods decreased from 68 percent in 1981–82 to 38 percent in 1993–94, with the balance of RBC units transfused in the postoperative period. Although the number of RBC units utilized per procedure in the intraoperative period significantly decreased, the number of RBC units transfused in the postoperative period significantly increased (from 0.6 +/− 1.0 to 1.1 +/− 1.4 units per procedure in 1981–82 and 1993–94, respectively, p < 0.05). CONCLUSION: Although blood conservation strategies have been successful in reducing RBC transfusion intraoperatively, avoidance of intraoperative transfusion may in some cases postpone, rather than prevent, transfusion.
Oral or intravenous iron as an adjuvant to autologous blood donation in elective surgery: a randomized, controlled study
Authors: Weisbach V. , Skoda P. , Rippel R. , Lauer G. , Glaser A. , Zingsem J. , Zimmermann R. , Eckstein R. 
Published: March 2003

BACKGROUND: This study was performed to evaluate the capacity of oral and intravenous (IV) iron administration during autologous blood donation (ABD) to improve the efficacy of ABD and to prevent the need for allogeneic blood transfusion in patients without iron deficiency who are undergoing major elective surgery for which a minimum of 3 autologous units have been ordered.STUDY DESIGN AND METHODS: One hundred twenty‐three patients were enrolled in an open‐labeled, randomized, controlled trial and assigned to three treatment groups: patients in Group 1 received 3 × 100 mg of Fe2+ per day given orally for 5 weeks before operation; patients in Group 2 received 200 mg of Fe3+ given intravenously after each donation combined with initial IV iron supplementation in patients with hemoglobin under 15 g per dL; and patients in Group 3 were in the control group that received no iron medication. A modest ABD program involving weekly phlebotomy and threshold hemoglobin values for donation of 11.5 g per dL in women and 12.0 g per dL in men was performed.RESULTS: Ninety patients, 15 women and 15 men in each of the three groups, completed the study. The mean net red cell production during ABD was no higher (p>0.2) in the iron‐treated groups (Group 1: 473 ± 178 mL; Group 2: 436 ± 170 mL; Group 3 (controls): 397 ± 174 mL). The mean number of autologous units donated per patient did not differ (p>0.7) among the groups (Group 1: 3.1 ± 0.6; Group 2: 2.9 ± 0.7; Group 3: 3.0 ± 0.7). The proportion of patients who needed allogeneic blood transfusion showed no significant (p>0.4) advantage for iron treatment, (Group 1: 7%; Group 2: 20%; Group 3: 10%).CONCLUSION: In non‐iron‐deficient patients undergoing modest ABD without erythropoietin therapy, neither oral nor IV application of iron during the preoperative period enhances the success of preoperative ABD.