bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of RBC alloantibodies and autoantibodies in sickle cell patients who received transfusions
Authors: Aygun Banu , Padmanabhan Savitri , Paley Carole , Chandrasekaran Visalam 
Published: March 2003

BACKGROUND: The clinical significance of alloimmunization to RBC antigens in sickle cell patients was analyzed by a retrospective review of the records of pediatric and adult sickle cell patients who received transfusions and who were followed over a 10‐year period. STUDY DESIGN AND METHODS: Charts of pediatric and adult sickle cell patients followed at Schneider Children's Hospital (SCH) and Long Island Jewish Medical Center between 1989 and 1999 were retrieved. Patients followed at SCH were classified as pediatric, regardless of age. Data on transfusion history, alloimmunization, and transfusion reactions from 1990 were retrieved from computerized blood bank records. Transfusion history, development of alloantibodies and autoantibodies, and transfusion reactions were correlated with clinical evidence of hemolysis or other adverse reactions from the charts. All patients received ABO‐ and Rh‐compatible blood transfusions for which a partial or extended antigen match was not performed. RESULTS: Among pediatric patients, 29 percent developed clinically significant alloantibodies, and 8 percent developed autoantibodies. Seven patients developed delayed hemo‐ lytic and/or serologic transfusion reactions, two with hyperhemolysis, two with clinical evidence of hemolysis, and three with serologic evidence only. The two patients with hyperhemolysis had received extended antigen‐matched RBC transfusions to provide blood compatible with their existing antibodies. Among adult patients, 47.0 percent developed significant alloantibodies, and 9.7 percent developed autoantibodies. Five incidences of delayed hemolytic and/or serologic transfusion reactions occurred, one with hyperhemolysis and four with serologic evidence only. CONCLUSION: The alloimmunization rate is 29 percent in pediatric and 47 percent in adult sickle cell patients when partial or extended RBC antigen match is not performed. However, the delayed serologic and/or hemolytic transfusion reactions did not result in severe clinical outcome in most instances. The most important adverse event was hyperhemolysis, which may be triggered by a transfusion, but was not prevented by matching for RBC antigens. In most instances, the cause of hyperhemolysis was multifactorial.
Motivations to donate blood: demographic comparisons
Authors: Glynn Simone A. , Kleinman Steven H. , Schreiber George B. , Zuck Thomas , Mc Combs Suzanne , Bethel James , Garratty George , Williams Alan E. ,   Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND: Understanding blood donor motivations is crucial to improving effectiveness of donor recruitment and retention programs. STUDY DESIGN AND METHODS: Data from a 1998 survey of 92,581 U.S. blood donors were used to evaluate factors influencing the decision to donate in various demographic groups. Data were weighted to adjust for response and sample design. RESULTS: Of 52,650 respondents, 45,588 gave whole‐blood (WB) donations. Among all demographic groups, the major reasons to donate were altruism (75‐87%) and awareness of the need for blood (34‐43%). Except for first‐time donors and those ≤25 years old, blood drive organizers and/or recruiters were more important than family and/or peers in encouraging donors (13‐19% vs. 1‐8%). Although 59 to 63 percent of donors said they would be encouraged to donate by reminders originating from the blood bank, for some, the contact would have a negative effect and discourage donation. Discouragement would be higher if they were reminded by a telephone call (14%) rather than by a letter or e‐mail (4%) or an appeal (2%) from the blood bank. CONCLUSION: WB donations appear to be made primarily for altruistic reasons and in response to appeals for blood. Ways to build on this humanitarianism and take advantage of new communication routes, such as e‐mail, need to be developed.
High‐throughput HBV DNA and HCV RNA detection system using a nucleic acid purification robot and real‐time detection PCR: its application to analysis of posttransfusion hepatitis
Authors: Mitsunaga Shigeki , Fujimura Kayoko , Matsumoto Chieko , Shiozawa Rieko , Hirakawa Shinichi , Nakajima Kazunori , Tadokoro Kenji , Juji Takeo 
Published: March 2003

BACKGROUND: A high‐throughput detection system was developed for HBV DNA and HCV RNA. METHODS: A combination of real‐time detection PCR using an automated system (PRISM 7700, PE Biosystems, Foster City, CA) and automatic viral nucleic acid extraction (BioRobot 9604, Qiagen, Hilden, Germany) was used as the high‐throughput detection system. An internal control for HBV DNA detection was also developed. RESULTS: Testing of 96 samples for HBV and HCV was completed within 5 hours. The sensitivity of this system almost equals that of the manual method using nested PCR. The addition of an internal control for HBV detection did not affect the sensitivity of the method and confirmed the accuracy of results. It was possible to quantify HBV in HBV+ samples that contain more than 500 genome equivalents per mL. We started using this system from June 1999 for testing stored donor and patient samples to analyze cases of posttransfusion hepatitis and identified three HBV+ donations that were implicated in posttransfusion hepatitis B. CONCLUSION: The high‐throughput detection system is a useful tool for HBV DNA and HCV RNA detection because it enables rapid and reliable testing of a large number of samples.
Influence of mode of birth and collection on WBC yields of umbilical cord blood units
Authors: Sparrow Rosemary L. , Cauchi Jennifer A. , Ramadi Lanny T. , Waugh Caryll M. , Kirkland Mark A. 
Published: March 2003

BACKGROUND: The aim of this study was to determine the influence of mode of birth and umbilical cord blood (CB) collection before (in utero) or after delivery of the placenta (ex utero) on total number of WBCs and CD34+ cells in CB units. STUDY DESIGN AND METHODS: Consecutively donated, banked CB units were assessed for net volume, WBC concentration, total number of WBCs, proportion of CD34+ cells, and total number of CD34+ cells. These parameters were then correlated with the mode of birth and the mode of CB collection relative to the delivery of the placenta. RESULTS: A significantly higher CB volume was seen following cesarean section (n = 61) than following vaginal delivery (n = 157; median volume, 76 vs. 63 mL, respectively; p < 0.0001). In contrast, CB from vaginal delivery had a significantly higher WBC concentration compared with CB from cesarean section (medians, 17.1 × 109 and 13.6 × 109 WBCs/L, respectively; p < 0.0001). The mode of birth did not influence the proportion of CD34+ cells. A correlation was demonstrated between the total number of CD34+ cells and the total number of WBCs. As a consequence of the opposing effects on volume and WBC counts by cesarean section and vaginal delivery, there were no significant differences in the total number of WBCs or CD34+ cells for the CB units with mode of delivery in this study. No significant differences were found in CB with mode of CB collection (in utero [n = 58] or ex utero [n = 99]) following vaginal delivery. CONCLUSIONS: The mode of birth influences the CB WBC concentration and volume collected and should be taken into consideration for establishing any acceptance limits for CB units to be banked. There were no differences in CB with in utero or ex utero collections.
DNA‐based typing of blood groups for the management of multiply‐transfused sickle cell disease patients
Authors: Castilho Lilian , Rios Maria , Bianco Celso , Pellegrino Jordão , Alberto Fernando L. , Saad Sara T.O. , Costa Fernando F. 
Published: March 2003

BACKGROUND: The usefulness of DNA genotyping for RBC antigens as a tool for the management of multiply‐transfused patients with sickle cell disease (SCD) to overcome the limitations of hemagglutination assays was evaluated. STUDY DESIGN AND METHODS: Blood samples from 40 multiply‐transfused SCD patients were studied by hemagglutination and by PCR‐RFLP for antigens or genes in the Rh (D, C/c, E/e), Kell, Kidd, and Duffy systems. RESULTS: Discrepancies were found between hemagglutination and DNA typing test results in six patients: two were discrepant in Rh typing (one was D− by hemagglutination and RhD by DNA, and one was E+e− and RhEe by DNA), two were discrepant in Duffy typing [both were Fy(a+b−) and Fyb/Fyb by DNA], and four were discrepant in Kidd typing [Jk(a+b+) and Jkb/Jkb by DNA; two of these samples were also discrepant in Duffy]. Stored segments from blood units that had been recently transfused to these six recipients were phenotyped, confirming that the transfused RBCs were the source of the discrepancy between genotype and phenotype. CONCLUSION: DNA typing of blood groups by PCR‐RFLP in peripheral blood WBCs contributes to the management of transfusions in SCD patients by allowing a more accurate selection of donor units.
Cellular prion protein is expressed on endothelial cells and is released during apoptosis on membrane microparticles found in human plasma
Authors: Šimák Jan , Holada Karel , D'Agnillo Felice , Janota Jan , Vostal Jaroslav G. 
Published: March 2003

BACKGROUND: Blood and plasma of animals experimentally infected with transmissible spongiform encephalopathies (TSEs) can transmit TSE infection by transfusion. A conformational isoform of prion protein (PrPsc) is believed to be the TSE‐infectious agent that propagates by converting the cellular prion protein (PrPc) to additional molecules of PrPsc. In orally infected animals, PrPsc accumulates in intestinal endothelial cells. In blood, two thirds of PrPc resides in plasma, but its source is not known. STUDY DESIGN AND METHODS: The expression of PrPc in cultured human umbilical vein endothelial cells (HUVECs) was studied using flow cytometry, immunoblotting, and RT‐PCR. Flow cytometry was used to characterize endothelial membrane microparticles (MPs) in cell culture supernatants and in normal human plasma. RESULTS: HUVECs and bovine aorta endothelial cells express PrPc. The number of surface PrPc molecules per cell in HUVECs was 58,000 ± 2,800. The induction of apoptosis in HUVECs led to a marked release of membrane MPs (60,000‐80,000 MPs/103 cells) that expressed PrPc and other endothelial antigens. The presence of endothelial cell‐derived MPs expressing PrPc was demonstrated in platelet‐free human plasma. CONCLUSION: Endothelial cell apoptosis is associated with the release of PrPc‐positive MPs. These MPs contribute to the PrPc pool in plasma and may have a role in disseminating TSE infectivity in blood.
Donor anti‐Jka causing hemolysis in a liver transplant recipient
Authors: Hareuveni Mara , Merchav Hadar , Austerlitz Neomi , Rahimi‐Leveen Neomi , Ben‐Tal Ofira 
Published: March 2003

BACKGROUND: Hemolytic transfusion reactions have been observed in recipients of ABO‐ and/or D‐mismatched marrow, peripheral blood, and solid organs. Passenger lymphocyte syndrome occurs when immunocompetent donor lymphocytes transferred during transplantation produce alloantibodies against host antigens. CASE REPORT: The first case of a delayed, anti‐Jka‐mediated hemolytic reaction in a liver transplant recipient, caused by passenger donor lymphocytes, is reported here. A 43‐year‐old man underwent liver transplantation. Six weeks later, the patient underwent a second liver transplant. On Day 10 of the second transplant, clinical hemolysis ensued; anti‐Jka was detected. The patient's DAT became positive, and anti‐Jka was eluted from his RBCs. On Day 35 of the patient's second transplant, 3 weeks after the last blood transfusion, the patients' DAT was still weakly positive with anti‐Jka in the eluate. Six months later, serum antibody screening was negative, but the DAT was still weakly positive. The patient's RBCs tested Jk(a+), whereas the second donor's RBCs were Jk(a−). CONCLUSION: This is the first documentation of clinically significant hemolysis caused by anti‐Jka, produced by passenger lymphocytes transferred from the donor's liver to the transplant recipient.
Trypanosoma cruzi in Los Angeles and Miami blood donors: impact of evolving donor demographics on seroprevalence and implications for transfusion transmission
Authors: Leiby David A. , Herron Ross M. , Read Elizabeth J. , Lenes Bruce A. , Stumpf Robert J. 
Published: March 2003

BACKGROUND: Trypanosoma cruzi, the agent of Chagas' disease, continues to be a concern for blood safety, as demonstrated by recent transfusion‐transmitted cases in the United States and Canada. The chronic nature of Chagas', coupled with increasing numbers of immigrants from T. cruzi‐endemic countries, suggests that Chagas' is a long‐term public health problem. Herein, we report on a multiyear epidemiologic study of T. cruzi in Los Angeles and Miami blood donors. STUDY DESIGN AND METHODS: From May 1994 to September 1998, blood donors in Los Angeles and Miami were queried regarding birth or time spent in an endemic country. Donations of “yes” respondents were tested by EIA, confirmed by radioimmunoprecipitation assay, and if confirmed as seropositive, enrolled in look‐back investigations. RESULTS: A total of 1,104,030 Los Angeles and 181,139 Miami donors were queried regarding risk; 7.3 and 14.3 percent, respectively, responded yes. Seropositive rates were 1 in 7,500 Los Angeles and 1 in 9,000 Miami donors. In Los Angeles, seroprevalence rates increased significantly from 1996 to 1998 and were significantly higher for directed donors than nondirected donors. Look back identified 18 recipients, all of whom were seronegative for T. cruzi. CONCLUSION: Significant numbers of T. cruzi‐seropositive donors contribute to the U.S. blood supply. The incidence of seropositivity is enhanced by minority recruitment efforts necessitated by donor demographic shifts. Similarly, high rates among directed donations in Los Angeles are attributable to a disproportionate number of at‐risk directed donors. Current look‐back data likely underestimate the frequency of transfusion‐ transmitted T. cruzi. These results indicate that con‐ tinued evaluation of transfusion as a mode of T. cruzi transmission in the United States is needed.
Transfusion support with RBCs from an Mk homozygote in a case of autoimmune hemolytic anemia following diphtheria‐pertussis‐tetanus vaccination
Authors: Johnson Susan T. , McFarland Janice G. , Kelly Kevin J. , Casper James T. , Gottschall Jerome L. 
Published: March 2003

BACKGROUND: Autoimmune hemolytic anemia (AIHA) in children, although unusual, is often associated with recent infection. Several reports have identified the diphtheria‐pertussis‐tetanus (DPT) vaccination as a possible trigger for AIHA. STUDY DESIGN AND METHODS: Life‐threatening AIHA was diagnosed in a 6‐week‐old infant 5 days after receiving a DPT vaccination. The patient required daily transfusion and/or exchange transfusion for 3 weeks. RBCs from an Mk homozygote were found compatible with the patient's autoantibody. Transfusion of RBCs from an Mk homozygote and later RBCs from an individual (K.T.) with a variant glycophorin, Mi.VII, were required to sustain the patient's Hb level until autoantibody production ceased, as evidenced by a fall in antibody titer and the patient's Hct returning to normal. RESULTS: The DAT was positive (3+) with only anti‐C3 on presentation. An IgM cold reactive autoantibody with probable anti‐Pr specificity and high thermal amplitude (37°C) was identified in the serum. The DAT was no longer positive after transfusion with compatible blood. CONCLUSION: This case represents life‐threatening AIHA in an infant, temporally related to a DPT injection and responsive to a combination of immunosuppression and transfusion of rare compatible blood.
Anti‐HCV confirmatory testing of voluntary blood donors: comparison of the sensitivity of two immunoblot assays
Authors: Kiely Philip R. , Eliades Leo A. , Kebede Mekonnen , Stephenson Matthew D. , Jardine Darren K. 
Published: March 2003

BACKGROUND : In this study, the sensitivity of two commercially available anti‐HCV immunoblot assays (HCV Western blot [Wellcozyme] and RIBA 3.0 SIA [RIBA‐3, Chiron]) was compared in a voluntary blood donor population. STUDY DESIGN AND METHODS : Four groups of donor samples were retrospectively tested in this study. Groups 1 and 2 were donor samples that gave positive or indeterminate band patterns, respectively, when originally tested on the HCV Western blot between 1994 and 1998. These samples were tested on the RIBA 3.0. Donor samples in Groups 3 and 4 were originally tested on RIBA‐3 during 1998 and 1999 and gave positive or indeterminate blot results, respectively. In this study these two groups were tested on the HCV Western blot. Samples with discrepant results on the two immunoblot assays were selected for genotyping or serotyping. RESULTS : The two immunoblots showed similar sensitivity to the core and NS5 proteins. However, of 35 samples positive on Western blot or RIBA‐3, the Western blot failed to detect NS4 in 14 samples compared with only 5 for RIBA‐3. As well, the Western blot failed to detect NS3 in 6 samples compared to 2 for RIBA‐3. Five (27.8%) of 18 samples that were Western blot indeterminate due to core reactivity showed an additional NS3 band on RIBA‐3. Of the samples with additional NS3 and/or NS4 reactivity on RIBA‐3 that were genotyped or serotyped, all were HCV type 3. CONCLUSIONS : Western blot and RIBA‐3 showed similar sensitivity to the HCV core and NS5 proteins. However, RIBA‐3 showed greater sensitivity to both NS3 and NS4 compared to the Western blot. The reduced sensitivity of the Western blot to the NS3 and NS4 proteins was observed with HCV type 3 samples.
Blood collection and transfusion in the United States in 1997
Authors: Sullivan Marian T. , McCullough Jeffrey , Schreiber George B. , Wallace Edward L. 
Published: March 2003

BACKGROUND : Collections, processing, and transfusions of blood and blood components in the US in 1997 were measured and compared with 1994 and prior years. STUDY DESIGN AND METHODS : Questionnaires were returned by 2391 blood centers, AABB member hospitals, nonmember hospitals, and other facilities. Statistical procedures were used to verify that the sample was representative and to estimate national collections and utilization. RESULTS : The gross domestic blood supply in the US in 1997 was 12,602,000 units, 5.5 percent less than in 1994. It included 11,741,000 units of allogeneic community blood, 643,000 units of autologous blood, and 205,000 units of allogeneic‐directed blood. Platelet transfusions amounted to 9,037,000 platelet concentrate equivalent units, of which 62.4 percent were apheresis packs. Compared with 1994, total platelet units transfused increased by 14.9 percent and single‐donor platelet units transfused increased by 31.7 percent, whereas platelet concentrate transfusion declined by 3.8 percent. Transfusions of FFP increased by 26.6 percent compared with 1994. CONCLUSIONS : The margin of US allogeneic blood supply in excess of allogeneic transfusions in 1997 was 630,000 units, 5.4 percent of total allogeneic supply as compared with margins in prior years ranging between 9.3 and 10.9 percent. Although overall allogeneic available supply in 1994 was adequate to meet transfusion demand, the decrease in the margin between 1994 and 1997 is cause for concern. The rate of whole‐blood collections in 1997 per 1000 members of the population aged 18 to 65 years was 12.6 percent lower than 1994. The RBC transfusion rate per 1000 members of the population in 1997 remained nearly the same as in 1994. However, the rates of platelet and of plasma transfusions both increased.
Sickle Hb polymerization in RBC components from donors with sickle cell trait prevents effective WBC reduction by filtration
Authors: Stroncek David F. , Rainer Tobie , Sharon Victoria , Byrne Karen M. , Noguchi Constance T. , Klein Harvey G. , Schechter Alan N. , Leitman Susan F. 
Published: March 2003

BACKGROUND: RBC components collected from donors with sickle cell trait frequently occlude WBC‐reduction filters. In vitro, sickle trait RBCs have the potential for sickle Hb (Hb S) polymerization at low oxygen saturations and high Hb concentrations. STUDY DESIGN AND METHOD: To determine if the low pH and high osmolarity of the CP2D used in the collection contributed to filter failures, the filterability of sickle trait donor RBCs collected in CP2D was compared with RBCs from the same donors collected in heparin. RESULTS: Five of six sickle trait components collected in CP2D did not complete filtration, but all six RBC components collected in heparin filtered completely. RBC components collected in CP2D from four other sickle trait donors were divided in two, and one‐half was treated with carbon monoxide to convert Hb S to its liganded form to prevent Hb S polymerization. All four carbon monoxide‐treated components filtered within 9 minutes, but only one untreated component filtered completely. RBC components collected by apheresis contained less CP2D, and five of seven sickle trait apheresis components filtered completely; four of the five filtered rapidly (<15 min) and one filtered in 100 minutes. Hb oxygen saturation was greater in the four rapidly filtering apheresis RBC components (68 ± 9%) than in the three that filtered slowly or incompletely (37 ± 5%, p = 0.03). CONCLUSIONS: Hb S polymerization appears responsible for RBC WBC‐reduction filter failures. Citrate anticoagulant and low oxygen saturation are responsible in part for Hb S polymerization in this setting.
Pharmacokinetic study of FFP photochemically treated with amotosalen (S‐59) and UV light compared to FFP in healthy volunteers anticoagulated with warfarin
Authors: Hambleton Julie , Wages David , Radu‐Radulescu Lucian , Adams Melanie , MacKenzie Malcolm , Shafer Steven , Lee Martin , Smyers Jocelyn , Wiesehahn Gary , Corash Laurence 
Published: March 2003

BACKGROUND : To date, no clinical trials have characterized FFP infusion efficacy, and infusion still carries infectious risk. This single‐blinded crossover study compared postinfusion kinetics of FVII in photochemically treated FFP to standard FFP. STUDY DESIGN AND METHODS : Subjects donated plasma by apheresis. Half of the collected plasma was treated with the psoralen amotosalen hydrochloride (S‐59) and UVA light, and half were prepared as standard plasma. Subjects received warfarin over 4 days to lower FVII levels. On Day 4, subjects received 1 L of either treated or standard FFP. After 2 weeks, subjects underwent a regimen identical to that with the other type of FFP. RESULTS : After warfarin ingestion, the mean FVII concentration was 0.33 IU per mL. Both types of FFP exhibited comparable FVII kinetics, with a mean peak increment of 0.10 to 0.12 IU per mL occurring at the end of infusion. The effect disappeared after 8 hours. DISCUSSION : Study data of warfarin‐treated healthy volunteers demonstrate that psoralen plus UV‐treated FFP provides an equivalent in vivo coagulation response to control plasma. A 1‐L dose of FFP in adults may provide an initial increment of 0.10 IU per mL of FVII. In the absence of bleeding, FVII levels return to baseline after 8 hours.