bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfusion of washed and centrifuged shed RBCs during maxillofacial surgery affects cytokine concentrations
Authors: Rohling Roman G. , Zimmermann Axel P. , Zellweger René , Schanz Urs 
Published: March 2003

BACKGROUND: In patients undergoing elective maxillofacial surgery, hyperthermic reactions have been observed after the transfusion of autologous washed and centrifuged shed blood. It was the aim of this study to correlate the clinical features with changes in cytokine levels.STUDY DESIGN AND METHODS: In 24 consecutive patients, TNFα, IL‐1, and IL‐6 levels were determined in washed and centrifuged shed RBCs (CS RBCs) and in the patient's serum before, as well as 15 and 120 minutes after transfusion. At the same time, blood was drawn for culture. Patients in whom whole blood was saved through the use of acute normovolemic hemodilution served as a control group (n = 6).RESULTS: After the transfusion of CS RBCs, patients had not only elevated cytokine levels but also transient bacteremia involving the pathogens previously detected in CS RBCs. No rise in body temperature occurred.CONCLUSION: In the light of these results, the use of CS RBCs in patients undergoing maxillofacial surgery should be restricted to those patients with no primary bacterial contamination.
Allelic polymorphisms of human Fcγ receptor IIa and Fcγ receptor IIIb among distinct groups in Brazil
Authors: Kuwano Sachie T. , Bordin José O. , Chiba Akemi K. , Mello Adriana B. , Figueiredo Maria S. , Vieira‐Filho João P.B. , Fabron Antonio , Kerbauy José 
Published: March 2003

BACKGROUND: The FcγRIIA gene is expressed in two polymorphic forms, R131 and H131, which differ by the replacement of histidine by arginine at position 131. The FCGR3B (FcγRIIIB) gene exists in two allelic isoforms, known as FCGR3B1 (FcγRIIIB‐NA1) and FCGR3B2 (FcγRIIIB‐NA2), which differ in nucleotides 141, 147, 227, 277, and 349. An additional polymorphism is the SH antigen that is associated with the FCGR3B3 (FcγRIIIB‐SH) allele.STUDY DESIGN AND METHODS: By use of a PCR with allele‐specific primers, the allelic polymorphisms of FcγRIIA and FcγRIIIB were determined among 263 unrelated Brazilian subjects, including Amazon Indians (n = 92), blood donors (n = 85), and patients with sickle cell disease (SCD) (n = 86).RESULTS: Amazon Indians had a significantly higher frequency of the R131 allele than did blood donors and SCD patients (0.91 vs. 0.55 vs. 0.55; p<0.001). NA1 and NA2 gene frequencies were found to be 0.67 and 0.21 for Amazon Indians, 0.58 and 0.42 for blood donors, and 0.61 and 0.39 for SCD patients, respectively. The FcγRIIIB‐SH allele was absent from the Amazon Indians, but 9 (10.6%) blood donors and 10 (11.6%) SCD patients expressed this allele.CONCLUSION: Overall, the data indicate that the distribution of the FcγRIIIB alleles is significantly different in Amazon Indians from the distribution in Brazilian blood donors or African Brazilian patients with SCD, but that it is similar to the distributions reported in Asian populations. Moreover, the distribution of the FcγRIIA and FcγRIIIB alleles among Brazilian blood donors and SCD patients is comparable to the distributions reported in whites from the United States and Europe.
Potassium‐adsorption filter for RBC transfusion: a Phase III clinical trial
Authors: Inaba Shoichi , Nibu Keiko , Takano Hisayo , Maeda Yoshiaki , Uehara Kouichi , Oshige Takaaki , Yuasa Takeshi , Nakashima Hitoshi 
Published: March 2003

BACKGROUND: Within the past 2 years, three cases of cardiac arrest just after rapid transfusion of RBCs preserved for over 7 days after 15‐Gy irradiation were found. This severe complication caused transient hyperkalemia. To prevent potassium (K+) overload by RBC transfusion at the bedside, a K+‐adsorption filter made of sodium polystyrene sulfonate was developed.STUDY DESIGN AND METHODS: After in vitro and animal safety and efficacy tests, a Phase III clinical trial was conducted with 65 patients given transfusions via the newly developed filter (filter group) and 37 patients in whom the filter was not used (control group) and transfusions were given at twice the usual flow rate (20 mL/min).RESULTS: More than 85‐percent (94.4 ± 3.8%) removal of K+ in RBCs in mannitol‐adenine‐phosphate (MAP) that had been preserved for more than 14 days or that were used 3 days after 15‐Gy irradiation (calculated K+: 3.8 ± 1.3 mEq/bag) was achieved in 82 of 83 bags of MAP RBCs in the filter group, with 79.6 percent removed in the other, even in rapid transfusions. RBC recovery 1 day after transfusion, determined by increments in RBCs, Hb, and Hct, were 24 and 0.4 × 104 per μL, 0.7 and 0.3 g per dL, and 1.6 and 0 percent, respectively, in the filter and control groups. No adverse transfusion reactions, such as hypotension, anaphylactoid reactions, or asthma‐like attacks, were observed, except for one case of urticaria in the filter group. Mild fever (within 1°C) after transfusion was observed in both groups. Serologic markers of hemolysis rose slightly in both groups, but there was no significant difference between the two groups.CONCLUSION: The newly developed K+‐adsorption filter is useful, especially in a rapid transfusion setting.
A MAR‐like antibody in a DCWe/DCWe person
Authors: O'Shea Kathleen P. , Øyen Ragnhild , Sausais Laima , Stephens Vivian A. , Stillwell Gail F. , Bisgard Leslie A. , Martin Judy , Reid Marion E. 
Published: March 2003

BACKGROUND: MAR (RH51), a high‐incidence antigen in the Rh blood group system, is absent from RBCs with a double dose of CW or CX or a single dose each of CW and CX antigens, as well as from rare Rh phenotypes including D–– and Rhnull. The MAR antigen is associated with the presence of Ala36 and Gln41 on the RhCe protein. The original example of anti‐MAR, described in 1994, was made by a DCWe/DCXe woman. It was possible that the antibody directed against a high‐incidence antigen in the Rh system made by a DCXe/DCXe woman (CM) in 1983 was anti‐MAR.CASE REPORT: A 52‐year‐old, multiply transfused, white woman (CJ) with pre‐existing anti‐c, ‐E, and ‐Jka presented for preoperative work‐up for her fifth open heart procedure. The strength of the reaction of her RBCs with anti‐CW suggested a double dose of CW antigen. Her serum, which unexpectedly was strongly reactive with c–, E–, Jk(a–) RBCs by PEG indirect antiglobulin test, was incubated with E–c–, Jk(a–) RBCs, and an eluate was prepared. This eluate reacted 3+ with E–c–, Jk(a–) RBCs but did not react with Rhnull (n = 5), –– (3), DCW– (2), Dc– (1), or DCWe/DCWe (1) RBCs. Two related DCXe/DCXe and two unrelated DCWe/DCXe RBC samples were weakly agglutinated. The patient's RBCs were negative with the original anti‐MAR but reacted as strongly as the positive control RBCs with the antibody made by the DCXe/DCXe person.CONCLUSION: This is the first example of a MAR‐like antibody made by a DCWe/DCWe woman. The specificity cannot be called anti‐MAR, because some MAR‐negative samples react, albeit weakly. The original anti‐MAR, made by a DCWe/DCXe woman, did not react with DCWe/DCWe, DCWe/DCXe, or DCXe/DCXe RBCs. It is apparent that the specificity of “anti‐MAR” differs slightly, depending on the CW/CX status of the antibody maker.
Severity of iron overload in hemochromatosis: effect of volunteer blood donation before diagnosis
Authors: Barton James C. , Preston Benjamin L. , McDonnell Sharon M. , Rothenberg Barry E. 
Published: March 2003

BACKGROUND: An effort was made to determine if volunteer blood donation before diagnosis decreases the severity of iron overload at diagnosis in persons with hemochromatosis.STUDY DESIGN AND METHODS: A study was performed in 1089 persons in the United States with hemochromatosis who responded to a convenience sample survey and in 124 C282Y/C282Y hemochromatosis probands diagnosed during routine medical care.RESULTS: Less than half of questionnaire respondents (46.2%) and probands (35.5%) reported that they had been volunteer blood donors; 5.4 percent and 4.0 percent, respectively, had donated >20 units of blood. In either subject group, there were no significant differences according to age in the mean numbers of units that needed to be removed by therapeutic phlebotomy to induce iron depletion in subgroups of men and women, respectively. Similarly, there was no significant correlation of units of voluntary blood donation or of therapeutic phlebotomy index (= therapeutic phlebotomy units ÷ age in years) with the number of therapeutic phlebotomy units needed to induce iron depletion. When questionnaire respondents were stratified by sex, there was no significant correlation of units of blood donation with the number of therapeutic phlebotomy units needed to induce iron depletion or with the therapeutic phlebotomy index.CONCLUSION: Routine blood donation does not, on average, decrease the severity of iron overload in persons with hemochromatosis. These findings have implications for the understanding of the severity of iron overload and its complications in hemochromatosis, for advising persons with hemochromatosis about treatment, and for considering persons with hemochromatosis as possible blood donors.
Platelet transfusions in the neonatal intensive care unit:factors predicting which patients will require multiple transfusions
Authors: Del Vecchio Antonio , Sola Martha C. , Theriaque Douglas W. , Hutson Alan D. , Kao K.J. , Wright Dale , Garcia Maria G. , Pollock Brad H. , Christensen Robert D. 
Published: March 2003

BACKGROUND:Previous studies suggest that recombinant thrombopoietin (rTPO) will increase platelet production in thrombocytopenic neonates. However, the target populations of neonates most likely to benefit should be defined. Studies suggest that rTPO will not elevate the platelet count until 5 days after the start of treatment. Therefore, the neonates who might benefit from rTPO are those who will require multiple platelet transfusions for more than 5 days. This study was designed to find means of prospectively identifying these patients.STUDY DESIGN AND METHODS:A historic cohort study of all patients in the neonatal intensive care unit (NICU) at the University of Florida who received platelet transfusions from January 1, 1997, through December 31, 1998, was conducted.RESULTS:Of the 1389 patients admitted to the NICU during the study period, 131 (9.4%) received platelet transfusions. Seventeen were treated with extracorporeal membrane oxygenation and were excluded from further analysis. Of the remaining 114 patients, 55 (48%) received one transfusion and 59 (52%) received more than one transfusion (21 had >4). None of the demographic factors examined predicted multiple platelet transfusions. However, two clinical conditions did; liver disease and renal insufficiency. Neonates who received one platelet transfusion had a relative risk of death 10.4 times that in neonates who received none (p = 0.0001). Neonates who received >4 platelet transfusions had a risk of death 29.9 times that in those who received no transfusions (p = 0.0001).CONCLUSION:NICU patients with liver disease or renal insufficiency who receive one platelet transfusion are likely to receive additional transfusions. Therefore, these patients constitute a possible study population for a Phase I/II rTPO trial.
Seroprevalence of human herpes virus 8 antibody in populations at high or low risk of transfusion, graft, or sexual transmission of viruses
Authors: Challine Dominique , Roudot‐Thoraval Françoise , Sarah Turiaf , Laperche Liliane , Boisson Bruno , Mauberquez Stéphanie , Dubernet Fabienne , Rigot Pïerrette , Lefrère François , Mercier Bernard , Brossard Yvon , Rouet François , Girot Robert , Loiseau Pascale , Girard Danièle , Claquin Jacky , Loty Bernard , Lerable Joëlle , Mariotti Martine , Pawlotsky Jean‐Michel , Lefrère Jean‐Jacques 
Published: March 2003

BACKGROUND: The routes of transmission of human herpes virus 8 (HHV‐8) remain unclear. In particular, HHV‐8 transmission by blood components and organ transplantation is still debated and raises public health issues. The objective of this study was to determine the prevalence of anti‐HHV‐8 in selected populations of persons or patients with or without risk factors for the transmission of viral infections, in order to determine the routes of HHV‐8 transmission.STUDY DESIGN AND METHODS: A total of 1431 persons or patients at low or high risk of sexually, blood‐, or graft‐transmitted viral infections were tested by means of a standardized immunofluorescence serologic assay detecting anti‐HHV‐8.RESULTS: The persons or patients could be classified into three distinct groups according to anti‐HHV‐8 prevalence: a low prevalence group (0.0% to 5.0%), including healthy blood donors, healthy pregnant women, multiply transfused patients with thalassemia major, and IV drug users; an intermediate prevalence group (5.0% to 20.0%), including organ donors, kidney transplant recipients, and multiply transfused patients with sickle cell disease; a high prevalence group (>20.0%), including HIV‐negative persons at high risk of sexually‐transmitted viral infections, and HIV‐infected homosexual men and heterosexuals.CONCLUSION: The sexual route appears to be the main route of HHV‐8 transmission; bloodborne transmission of HHV‐8, if it exists, is rare. In contrast, organ transplantation recipients might be exposed to HHV‐8 transmission by the transplanted organ, which raises the issue of systematic screening of organ donors.
Autologous blood transfusion in the United States: clinical and nonclinical determinants of use
Authors: Segal Jodi B. , Guallar Eliseo , Powe Neil R. 
Published: March 2003

BACKGROUND : Preoperative donation of blood lowers the risk of allogeneic RBC transfusion. The use of autologous blood is not well quantified. This study aimed at identifying the frequency and determinants of use of autologous transfusion in the United States.STUDY DESIGN AND METHODS: This national cross‐sectional study, using the Nationwide Inpatient Sample, included all patients admitted to 900 hospitals in 19 states in 1996. Logistic regression with weighting yielded nationally representative results for the independent effects of clinical and nonclinical patient characteristics on autologous blood use.RESULTS: Autologous transfusion was used in 19 of 1000 hospitalizations. The procedures using autologous blood most frequently were knee arthroplasty, hip replacement, prostatectomy, spinal fusion, and hysterectomy. Blacks and Hispanics were less likely to receive autologous transfusion than were whites (OR, 0. 64; 95% CI, 0.45‐0.83); patients with Medicaid were less likely than the privately insured to receive autologous transfusions (OR, 0.29; 95% CI, 0.20‐0.43), with racial differences greatest among the privately insured. Women received autologous blood for cardiovascular surgeries much less often than men (OR, 0.32; 95% CI, 0.20‐0.49).CONCLUSION: Ethnic minorities, women, and patients with Medicaid appear to receive fewer autologous blood transfusions than the rest of the population. Although this could reflect either better or worse quality of care, nonclinical determinants of transfusion practice warrant attention and further investigation.
Detection and removal of fat particles from postoperative salvaged blood in orthopedic surgery
Authors: Ramírez Gemma , Romero Adolfo , García‐Vallejo Juan Jesús , Muñoz Manuel 
Published: March 2003

BACKGROUND: Although transfusion or return of salvaged shed blood has become popular in major orthopedic procedures, this blood‐saving method is still controversial because shed blood may be contaminated with chemical and tissular debris, such as fat particles, which may increase the risk of fat embolism after bone surgery. STUDY DESIGN AND METHODS: In an effort to find an easy, reliable method for determination of both fat particle content and removal from shed blood, analyses of perioperative blood samples were performed with a cell counter (Technicon H3 [H3]) in orthopedic patients undergoing spinal fusion in which postoperative shed blood was collected and returned with a blood collection canister. A screen or surface filter was intercalated in the return line to eliminate microaggregates, fat particles, and/or WBCs. RESULTS: Fat particles in shed blood are clearly detected as a condensed, sigmoidal‐shaped area at the right‐hand side of the PMN zone in the channel in which the H3 measures particles according to their degree of lobularity. This signal can be reproduced by the addition of animal or vegetable fat to venous blood, but not by the addition of activated platelets or RBC membranes. Fat particles, together with WBCs and microaggregates, in shed blood were effectively removed by surface filters, whereas screen filters were not effective. CONCLUSION: The use of the TH3 seems to be an easy, reliable, and low‐cost approach for monitoring fat particle content and removal from postoperative salvaged shed blood in orthopedic procedures.
Production of pathogen‐inactivated RBC concentrates using PEN110 chemistry: a Phase I clinical study
Authors: AuBuchon James P. , Pickard Constance A. , Herschel Louise H. , Roger Jill C. , Tracy James E. , Purmal Andrei , Chapman John , Ackerman Samuel , Beach Kathleen J. 
Published: March 2003

BACKGROUND: Despite extensive reductions in risk, donor selection and testing cannot eliminate pathogen transmission. The objective of this study was to evaluate clinically the viability of pathogen‐inactivated RBCs. STUDY DESIGN AND METHODS: Twelve healthy subjects each donated two units of blood that were handled as additive system control units or were inactivated using the PEN110 process (INACTINE, V.I. Technologies) in randomized order. PEN110, which inactivates pathogens by reacting with nucleic acid bases, was incubated with RBCs for 6 hours, followed by washing and quenching with sodium thiosulfate. Radiolabeled RBC recovery and survival determinations were undertaken after 28 days of storage; biochemical and hematologic variables were assessed over 42 days. RESULTS: After 28 days, treated units had a 24‐hour double‐label (51Cr/99mTc) recovery (85.0 ± 5.0%) that was indistinguishable from control units (85.9 ± 2.7%); the times required for reduction of radioactivity of labeled cells to half the Day 1 activity (T50) were similar for both groups (treated, 31.9 ± 8.2 days; control, 32.9 ± 3.3 days). No deleterious effects of PEN110 treatment were found on RBC antigens tested. Treatment reduced 2,3‐DPG levels by half and slightly lowered pH levels. Throughout the 42‐day storage period, treated RBCs had a lower level of lactate production and a trend toward lower glucose consumption. Hemolysis remained below 1 percent; supernatant potassium and ATP levels were lower than those seen in control RBCs. CONCLUSION: PEN110‐treated RBCs stored for 28 days meet all critical requirements for therapeutically useful units.
Absence of anti‐D alloimmunization in hematologic patients after D‐incompatible platelet transfusions
Authors: Cid Joan , Ortin Xavier , Elies Enric , Castellà Dolors , Panadés Marta , Martín‐Vega Carmen 
Published: March 2003

BACKGROUND: Rh antigens are not present on the platelet surface. However, platelet concentrates may contain enough RBCs to elicit an anti‐D response. Thus, D status must be considered in platelet transfusion. In immunosuppressed patients, frequencies of D alloimmunization of up to 19 percent have been previously reported. STUDY DESIGN AND METHODS: Here a prospective study is reported in which 22 D– patients with hematologic disease received D+ platelet transfusions. Platelet concentrates were prepared from whole‐blood donations according to the buffy coat method and were pooled before administration. The antibody screen test to detect anti‐D was performed by LISS‐ IAT using the gel test. RESULTS: Our series comprises 22 immunosuppressed D+ patients with a median age of 56 years (range, 23–79). The patients received 121 D‐incompatible pooled platelet transfusions. The mean ± SD of RBC content was 4.17 ± 1.74 mL. None of the 22 patients developed detectable anti‐D after a median follow‐up of 8 weeks (range, 1–37). CONCLUSION: The risk of D alloimmunization is low in patients with hematologic disease after D‐incompatible platelet transfusions using platelet concentrates prepared by the buffy coat method.
Comparative analysis of normal prion protein expression on human, rodent, and ruminant blood cells by using a panel of prion antibodies
Authors: Barclay G. Robin , Houston E. Fiona , Halliday Sue I. , Farquhar Christine F. , Turner Marc L. 
Published: March 2003

BACKGROUND: It is not known whether variant CJD can be transmitted within the human population by blood transfusion. The expression of normal cellular prion protein (PrPC) by different blood cell types may permit selective uptake and dissemination of infectivity.STUDY DESIGN AND METHODS: The normal distribution of PrPCon the major blood cell types of species known to be susceptible to natural or experimental transmissible spongiform encephalopathies was studied. Blood from healthy humans, mice, hamsters, cattle, and sheep was examined by flow cytometry by using a large panel of antibodies with different prion protein (PrP) epitope specificities to maximize the detection of PrP variants across species and cell type.RESULTS: PrP was detected on all major human blood cells types except eosinophils, but was not detected as ubiquitously or uniformly on major blood cell types of different animal species.CONCLUSION: Different animal species have unique patterns of expression of PrPCon blood cell types, with none equivalent to the human pattern. This needs to be considered when extrapolating from animal models of blood‐borne transmissible spongiform encephalopathy infectivity, particularly in regard to the risk assessment of potential variant CJD spread within the human population. The relationship between PrP distribution and infectivity distribution in blood needs further investigation.
WBC filtration of whole blood after prolonged storage at ambient temperature by use of an in‐line filter collection system
Authors: Shinar Eilat , Prober Galina , Yahalom Vered , Michlin Hedva 
Published: March 2003

BACKGROUND : Before‐storage WBC reduction by filtration appears to be an effective way to prevent transfusion‐associated complications. It also has superiority over WBC reduction at the time of transfusion (bedside), due to the many variables associated with such practice and the difficulty in performing adequate quality control. To determine the adaptability of collection systems containing in‐line filters to the current blood collection strategy, the feasibility, efficiency, and quality of before‐storage WBC reduction of whole blood (WB) units were evaluated, following their prolonged storage at ambient temperature prior to component preparation, by use of an integral in‐line filter. STUDY DESIGN AND METHODS : Blood was collected from random donors into quadruple blood pack units with an integral in‐line filter and divided into three groups, according to storage conditions. WBC reduction was performed at room temperature, on WB units after storage at ambient temperature either for less than 8 or up to 18 hours on 1,4‐butanediol cooling trays or for 18 hours in the cold. RESULTS
: All the filtration procedures met the AABB threshold of less than 5 × 10
6
residual WBCs per unit and the European requirements for WBC counts of less than 1 × 10
6 WBCs per unit. The average filtration time was less than 22 minutes in all units studied. Filtration time and blood flow rate were both significantly longer, and RBC loss was significantly higher in WB units that were filtered after prolonged storage in the cold. CONCLUSIONS : Adequate before‐storage WBC reduction can be achieved when performed on WB units, which were stored at ambient temperature for 18 hours, by use of an in‐line filtration system. The procedure, performed under relatively simple logistics, results in good‐quality, standard components, which require no further modifications when supplied to the transfusion services.