bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of a computer program to exclude additional unexpected antibodies
Authors: Rondeel J.M.M. , van Opdorp A.H.B. , Dinkelaar R.B. 
Published: March 2003

BACKGROUND: When a patient has produced red cell (RBC) antibodies in the past, he or she is at risk of producing additional antibodies after antigen challenge. The presence of these antibodies should be excluded before each transfusion. The following criteria are applied when using commercial test RBCs: RBCs should not express the antigen against which the previously documented antibody is directed. For other clinically significant antigens, at least one RBC sample should be from a donor who is homozygous for the encoding gene. The manual selection of such RBCs is tedious and requires experience.STUDY DESIGN AND METHODS: A computer program has been developed that generates exclusion panels (EPs) by selecting a minimum number of RBCs from commercial test panels complying with current criteria. When RBCs from a donor who is homozygous for the encoding gene are absent, the program selects, as a second‐best option, RBCs from a donor who is heterozygous for that gene. The computer program developed for this study investigated the usefulness of commercially available panels from separate manufacturers in excluding the presence of additional antibodies. A list of 488 antibodies detected by a regional blood bank in 1994 was used as cases of antibodies documented in the past.RESULTS: In 61 percent of the cases, successful EPs (i.e., those complying with the criteria), consisting of three to four different phenotypes, were selected. In the remaining 39 percent of cases, it was impossible to generate successful EPs: 1 to 2 additional antibodies could not be excluded or could be excluded only by using RBCs from heterozygotes. Commercial panels differed only slightly in their efficiency in providing suitable RBCs. None of the commercial panels could provide suitable RBCs to exclude all additional antibodies in the presence of anti‐c, anti‐e, or anti‐M. Increasing the number of RBCs from which to select EPs only slightly increased the percentage of success.CONCLUSION: Computer‐aided construction of EPs quickly shows whether strict criteria can be met or whether alternative techniques should be used. It leads to a significant reduction in the number of RBC suspensions necessary to exclude additional antibodies. Results with various commercial panels differed only slightly.
Collection and transfusion of blood and blood components in the United States, 1994
Authors: Wallace E.L. , Churchill W.H. , Surgenor D.M. , Cho G.S. , McGurk S. 
Published: March 2003

BACKGROUND:Collections and transfusions of blood in the United States in 1994 were measured and compared with those in 1992.STUDY DESIGN AND METHODS:Completed survey questionnaires were returned by all 147 regional blood centers, 1340 American Association of Blood Banks (AABB) member hospitals, and 523 non‐AABB hospitals. Statistical tests verified the representativeness of the sample.RESULTS:The United States domestic blood supply in 1994 (13,340,000 units) was 3.3 percent less than in 1992. It included allogeneic blood (11,773,000 units), autologous blood (1,013,000 units), and directed donations (334,000 units). Of these, 432,000 units were rejected on testing, 11,107,000 units were transfused to 3,398,000 patients, and 1,801,000 units were discarded or unaccounted for. Platelet transfusions amounted to 7,866,000 units. Compared with the totals for 1992, transfusions of single‐donor platelets (714,000 packs or 4,284,000 units) increased by 17.6 percent, while transfusions of platelet concentrates (3,582,000 units) fell by 23.6 percent. Fresh‐frozen plasma transfusions (2,621,000 units) increased by 16.2 percent over the number for 1992.CONCLUSIONS:The US blood collection rate in 1994 was 74.6 units per 1000 population of donor age, the lowest recorded level since 1971. The US RBC transfusion rate in 1994 was 42.8 units per 1000 population, about the same as 1979. Transfusions of single‐donor platelets, 16.5 units per 1000 population, exceeded transfusions of platelet concentrate (13.8/1000) for the first time. Plasma transfusions were 10.1 units per 1000 population. The US blood supply in 1994 was adequate to meet patient demands.
Validation of a new immunoblot assay (LiaTek HIV III) for confirmation of human immunodeficiency virus infection
Authors: Zaaijer H.L. , van Rixel G.A.C.M. , Kromosoeto J.N.R. , Balgobind‐Ramdas D.R. , Cuypers H.T.M. , Lelie P.N. 
Published: March 2003

BACKGROUND: Used as a supplemental assay, new anti‐human immunodeficiency virus (HIV) immunoblots, employing recombinant and synthetic antigens, appeared to resolve the majority of samples with false‐reactive Western blot results. Would it be possible to completely replace the Western blot by an immunoblot for confirmation and exclusion of HIV infection?STUDY DESIGN AND METHODS:The sensitivity of the new LiaTek HIV III immunoblot assay (Organon Teknika, Turnhout, Belgium) was tested on 416 Western‐blot positive samples (386 HIV‐1, 22 HIV‐2, 1 HIV‐1/2, and 7 HIV‐O) and on 45 HIV‐1 seroconversion samples. The specificity was tested on 146 samples from noninfected donors with false‐positive results on a HIV screening test.RESULTS:All Western‐ blot‐positive samples tested positive in the immunoblot (sensitivity: 100%). The immunoblot could not discriminate between HIV‐1 and HIV‐2 infection in 22 of 416 (5%) samples. The LiaTek assay showed reactivity in 28 of 45 seroconversion samples, whereas the Western blot reacted in 30 of 45 seroconversion samples. With false‐positive donor samples, the immunoblot was indeterminate in 10 of 146 samples (specificity: 93%), and the Western blot was indeterminate in 44 of 146 samples (specificity: 70%). CONCLUSION: Like the Western blot, the immunoblot runs the risk of missing samples that are reactive by enzyme immunoassay during the early stage of HIV infection. Nevertheless, considering its superior specificity on false‐positive donor samples, it appears that the immunoblot offers a cost‐effective alternative to the Western blot assay for confirmation and exclusion of HIV infection.
Human T‐lymphotropic virus type I among blood donors from Guadeloupe: donation, demographic, and biologic characteristics
Authors: Rouet F. , Foucher C. , Rabier M. , Gawronski I. , Taverne D. , Chancerel B. , Casman O. , Strobel M. 
Published: March 2003

BACKGROUND: Epidemiologic data on human T‐lymphotropic virus type I (HTLV‐I) in Guadeloupe (French West Indies) are scant.STUDY DESIGN AND METHODS: From January 1989 to December 1996, 59,426 blood donors were screened by enzyme immunoassay for antibodies to HTLV‐I. All repeatedly reactive samples were confirmed by Western blot. Temporal trends in HTLV‐I seropositivity rates were examined during the study period. A multivariate analysis of donation, demographic, and biologic characteristics was performed.RESULTS: Of the screened blood donors, 195 were confirmed as seropositive, for an overall prevalence of 0.33 percent (95% CI 0.28‐0.38). A marked decrease in overall HTLV‐I prevalence with time (from 0.47% in 1989 to 0.13% in 1996) was observed, which can be explained mainly by the decreasing percentage of recruited new donors during the study period. Four independent risk factors for HTLV‐I were identified: new donor status (odds ratio [OR] 12.5), female sex (OR 1.7), increasing age (30‐39 years: OR, 2.4; 40‐49 years: OR, 3.7; >50 years: OR 6.6), and positive antibodies to hepatitis B virus core antigen (OR, 1.7). Selection of specific locations for blood collection was inversely associated with HTLV‐I (OR 0.5).CONCLUSION: New donor status, advancing age, female sex, and positivity for hepatitis B virus core antibodies were the major factors associated with HTLV‐I infection in Guadeloupe.
A survey of phlebotomy among persons with hemochromatosis
Authors: McDonnell S.M. , Grindon A.J. , Preston B.L. , Barton J.C. , Edwards C.Q. , Adams P.C. 
Published: March 2003

BACKGROUND: One in 10 whites in the United States is a carrier for hemochromatosis and an estimated 1 in 200 is clinically affected. Early treatment with therapeutic phlebotomy to remove excess iron can prevent associated chronic diseases. However, little information is available on the amount of blood withdrawn or the rates of withdrawal from hemochromatosis patients. The patterns of therapeutic phlebotomy and the magnitude of charges in persons with hemochromatosis were surveyed.STUDY DESIGN AND METHODS: Surveys were mailed to persons with hemochromatosis identified by health care providers, blood centers, patient advocacy groups, and the Internet. There were 2362 respondents to the survey from the United States.RESULTS: Thirty‐seven percent of respondents reported being voluntary blood donors prior to diagnosis. The mean rate of therapeutic phlebotomy for iron depletion was 2.6 units per month (mean duration, 13 months). The mean rate of maintenance phlebotomy was 0.5 units per month. Therapeutic phlebotomy rates varied by sex, age, reason for diagnosis, and severity of symptoms. Seventy‐six percent of respondents reported full or partial insurance coverage of therapeutic phlebotomy charges. Seventy‐six percent received therapeutic phlebotomy services in a hospital or physician's office and 30 percent in a blood center. Charges for therapeutic phlebotomy varied by site, with a mean cost of $90 in hospitals and $52 in blood centers. Fifty‐four percent of respondents attempted to donate blood after their diagnosis but were excluded.CONCLUSION: The amount of blood withdrawn from persons with hemochromatosis is substantial. The location where patients received phlebotomy services appears to be influenced by charges and time since diagnosis.
A study of an educational intervention to decrease inappropriate preoperative autologous blood donation: its effectiveness and the effect on subsequent transfusion rates in elective hysterectomy
Authors: Kanter M.H. , Van Maanen D. , Anders K.H. , Castro F. , Mya W. Win , Clark K. 
Published: March 2003

BACKGROUND: Decreasing the overcollection of preoperative autologous blood is difficult to achieve. The purpose of this study was to determine whether an educational intervention designed to outline the risks of preoperative autologous collection can decrease such donations and, if so, to determine how this decrease will affect subsequent transfusion rates.STUDY DESIGN AND METHODS: An educational intervention consisting of a didactic presentation to the Department of Gynecology staff about the risks and benefits of autologous blood was implemented. Written material with similar information was given to patients. Subsequently, the percentage of patients donating autologous blood, the number of autologous units donated, and the rates of transfusion in patients eligible for autologous donation who were admitted for elective abdominal or vaginal hysterectomy were measured. These rates were compared to those in similar patients admitted in the 2 years before the educational intervention.RESULTS: After an educational intervention, the proportion of patients donating autologous blood decreased from 53 percent to 26 percent (p<0.01), and the number of units collected per patient decreased from 0.86 to 0.31 (p<0.01); this resulted in a savings of 80 autologous donations per year. Despite no difference in estimated blood loss (p = 0.46), the overall transfusion rate decreased from 10 percent to 3.7 percent (p = 0.03), while the allogeneic transfusion rate demonstrated no significant change (1.1% vs. 2.2%; p = 0.40).CONCLUSIONS: Unnecessary preoperative autologous donations by elective hysterectomy patients can be decreased by educating physicians and patients about the risks of preoperative autologous blood donation. Decreasing such unnecessary donations can decrease the subsequent autologous transfusion rate, with its attendant risks, without increasing the risk of allogeneic transfusion.
Antibodies provoked by the transfusion of biotin‐labeled red cells
Authors: Cordle D.G. , Strauss R.G. , Lankford G. , Mock D.M. 
Published: March 2003

BACKGROUND: Biotin‐labeled (biotinylated) red cells (B‐RBCs) offer a technique by which to study RBC volume and circulating kinetics without in vivo radiation. The immunogenicity of B‐RBCs is undefined.STUDY DESIGN AND METHODS: To determine if biotinylation renders RBCs immunogenic, autologous B‐RBCs were transfused to 20 healthy subjects, and plasma samples were obtained before transfusion and serially for up to 6 months after transfusion. These serial samples, plus plasma from 20 normal control subjects not given B‐RBCs, were screened for antibodies to B‐RBCs by use of an antiglobulin technique against aliquots of group O RBCs from a single donor—one aliquot biotinylated and one aliquot not biotinylated (i.e., test and control RBCs). Posttransfusion recovery and survival of B‐RBCs were also determined.RESULTS: Plasma from none of 20 normal nontransfused subjects reacted with B‐RBCs. Similarly, none of the 20 subjects given autologous B‐RBC transfusions exhibited antibodies before transfusion. However, 3 of the 20 subjects transiently produced antibodies to B‐RBCs after transfusion. Antibodies disappeared within 6 months in 2 of these 3 subjects and within 12 months in the third. Antibody reactivity was not reduced by dithiothreitol, but in 2 of the 3 subjects, B‐RBC antibodies were neutralized by incubation with biotin solution. Circulating RBC kinetics were not altered in the 3 subjects with antibody. The significance of these observations is unclear, because antibodies were just beginning to emerge during the studies.CONCLUSIONS: Biotinylation does not render RBCs reactive with normal human plasma (i.e., presumably does not evoke neoantigens). Transfused B‐RBCs occasionally provoke IgG antibodies in healthy subjects. Because the biologic effects of B‐RBC antibodies currently are unknown, testing for them is recommended when multiple B‐RBC transfusions are given to study RBC volume or circulating kinetics.
Collection of peripheral blood progenitor cells with an automated leukapheresis system
Authors: Rowley S.D. , Prather K. , Bui K.T. , Appel M. , Felt T. , Bensinger W.I. 
Published: March 2003

BACKGROUND: Apheresis devices designed for the collection of mature blood elements are being used for the collection of peripheral blood progenitor cells (PBPCs). The collection of PBPCs differs from that of other cells in the rarity of the target cell and in the fact that donors may undergo several days of collection. A consequence of this process may be a depletion of blood cells such as platelets from the blood. The disposable set and operating software for an apheresis device (Spectra, COBE BCT) was modified by the manufacturer to automate the collection of PBPCs and reduce the collection of unwanted blood cells.STUDY DESIGN AND METHODS: A study was initiated to compare the collection of PBPCs with the new device, the AutoPBSC (version [V]6.0 with AutoPBSC tubing set), and that with the MNC (mononuclear cell) procedure (V4.7 with white cell tubing set), for patients and healthy donors.RESULTS: Patients whose blood was processed by either the V6.0 or V4.7 procedure achieved the target dose of 5 × 106 CD34+ cells per kg of patient weight in similar numbers of procedures, even though the calculated collection efficiency for CD34+ cells using the automated V6.0 procedure was significantly less than that with the V4.7 procedure for both allogeneic donors and patients donating PBPCs. The collection efficiency for platelets was lower with the V6.0 procedure, and components collected in this manner contained fewer platelets. Apheresis by the V6.0 procedure required 30 to 60 more minutes per procedure than apheresis by the V4.7 procedure. Review of engraftment kinetics after transplantation did not reveal any effect of the collection procedure on recipients of either allogeneic or autologous transplants.CONCLUSION: The collection efficiencies of the V6.0 procedure for both CD34+ cells and mature blood cells are lower than those of the V4.7 procedure. The lower collection efficiency for platelets results in a smaller drop in peripheral blood platelet count after the procedure. The automated features of the V6.0 procedure may simplify PBPC collection, but this procedure requires a longer apheresis.
Evidence for a separate genetic origin of the partial D phenotype DBT in a Japanese family
Authors: Huang C.H. , Chen Y. , Reid M.E. , Okubo Y. 
Published: March 2003

BACKGROUND: In a Moroccan family, the partial D phenotype DBT is defined by an RHD‐CE‐D gene in which exons 5 to 7 of RHD were replaced by those of RHCE. In this study, the molecular basis and inheritance of DBT in a Japanese family are described.STUDY DESIGN AND METHODS: A Japanese proposita exhibiting the DBT phenotype was analyzed by serologic methods and molecular techniques. The RH transcripts of the proposita were sequenced and compared with those of normal donors. The inheritance and structure of the RH genes in the family were determined by Southern blot analysis and exon‐specific polymerase chain reaction.RESULTS: The proposita typed weak D and C+c+E+e+Rh:32. Family data indicated a cotransmission of Rh32 with DBT and a linkage of C and e with DBT. Southern blot testing of the proposita's genomic DNA indicated a partial and a total absence of RHD on the respective homologous chromosomes. Sequencing of her cDNA showed expression of Ce, cE, and RHD‐CE‐D transcripts but not D. The RHD‐CE‐D hybrid was characterized by a conversion of five RHD exons into RHCE exons (exons 5‐9). The 5′ and 3′ breakpoints in the fusion gene were localized to the intron 4/exon 5 region and intron 9.CONCLUSION: The new RHD‐CE‐D gene defines a separate genetic origin of DBT in the Japanese family. The proximal sequence encoded by RHD exon 4 and RHCE exon 5, together with the distal RHCE sequence, may involve the cotransmission of Rh32 and DBT, which behave as codominant and recessive characters, respectively.
Improved collection of mobilized CD34+ hematopoietic progenitor cells by a novel automated leukapheresis system
Authors: Ravagnani Fernando , Siena Salvatore , De Reys Stefan , Di Nicola Massimo , Notti Paola , Giardini Roberto , Bregni Marco , Matteucci Paola , Gianni Alessandro M. , Pellegris Giuseppe 
Published: March 2003

BACKGROUND: For simplification of blood cell transplantation, an automated apheresis system that exploits a dual‐stage channel device for mononuclear cell (MNC) collection (Au‐toPBSC, designed for the COBE Spectra) was studied.STUDY DESIGN AND METHODS: The automated default software (AutoPBSC‐Default) and three software modifications of the harvest frequency during leukapheresis, referred to as Au‐toPBSC‐1.25, AutoPBSC‐1.75, and AutoPBSC‐2.75, were evaluated in comparison with the semiautomated Version 4.7 (V4.7) apheresis system in 119 leukapheresis procedures performed in 90 cancer patients treated with chemotherapy plus granulocyte–colony‐stimulating factor. CD34+ cell and platelet collection efficiency (CE); volume and cell composition of the leukapheresis components; and patient platelet and red cell (RBC) loss during leukapheresis were measured.RESULTS: The majority of collection measures evaluated with the AutoPBSC compared favorably to those obtained with the V4.7. CD34+ cell CE increased from 55 percent with V4.7 to 68 percent with the AutoPBSC‐Default (p = 0.05). The AutoPBSC provided lower platelet contamination in the collected component (1.18 × 1011 vs. 2.26 × 10′′ with the V4.7;p< 0.001). The volume of the AutoPBSC‐Default component was significantly lower (67 vs. 180 mL with the V4.7; p<0.001). The MNC purity of the AutoPBSC component was greater (52 vs. 28% with the V4.7; p<0.001), and the RBC contamination lower (AutoPBSC, 0.53 × 1011 vs. 1.04 × 1011 with the V4.7; p<0.001). Modifications of the AutoPBSC to increase the harvest frequency by 1.25‐, 1.75‐, and 2.75‐fold resulted in increased CD34+ cell CE (77%, 75%, and 83%, respectively; p<0.001 in all cases), but also in reduced numbers of circulating platelets, higher platelet contamination of the component, and lower MNC purity than were seen with the AutoPBSC‐Default.CONCLUSION: The AutoPBSC offers the following advantages over the V4.7 system: a) better CE of CD34+ cells; b) reduced collection of platelets; c) reduced contamination of the leukapheresis component with granulocytes, platelets, and RBCs; d) reduced component volume; and e) automation.
Long‐term storage at −80°C of hematopoietic progenitor cells with 5‐percent dimethyl sulfoxide as the sole cryoprotectant
Authors: Galmés Antonio , Besalduch Judy , Bargay Judy , Novo Andres , Morey Miguel , Guerra José M. , Duran Maria A. 
Published: March 2003

BACKGROUND: Hematopoietic progenitor cells (HPCs) can be cryopreserved and stored below −120°C in liquid nitrogen or at −80°C in mechanical freezers.STUDY DESIGN AND METHODS: The feasibility of long‐term storage of HPCs at −80°C was investigated. The studies included a comparison of 5‐ and 10‐percent dimethyl sulfoxide (DMSO) as cryoprotectant at various lengths of storage time. Mononuclear cell (MNC) recovery and viability and colony‐forming unit‐granulocytemacrophage (CFU–GM) and burst‐forming unit–erythroid (BFU‐E) recovery assays were performed. The peripheral blood HPCs of 24 consecutive patients included in the program of autologous transplantation were studied.RESULTS: The MNC viability decreased progressively with the length of time from cryopreservation, reaching 32 percent after 31 months of storage. The recovery rates of CFU–GM and BFU–E also decreased progressively with the duration of frozen storage, to 50 and 43.5 percent, respectively, after 12 months and to 0 percent (both) after 24 months. At 6 months of storage, MNC viability was 80 percent, and CFU–GM and BFU–E recovery was 63.5 and 80.5 percent, respectively. There were no differences between MNCs cryopreserved with 5‐ or 10‐percent DMSO in terms of cell viability. There were no differences between CFU–GM recovery or BFU–E recovery from HPCs cryopreserved in 5‐ or 10‐percent DMSO. Patients given HPCs stored in these conditions for periods ranging between 123 and 202 days showed a complete and rapid hematologic recovery.CONCLUSION: HPCs can be cryopreserved at −80°C with 5‐percent DMSO and stored at −80°C no longer than 6 months. A 5‐percent DMSO concentration is comparable to a with 10‐percent concentration in terms of recovery and MNC viability.