bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfusion‐transmitted infectious diseases in Argentina, 1995 through 1997
Authors: Schmuñis Gabriel A. , Zicker Fabio , Segura Elsa L. , Del Pozo Ana E. 
Published: March 2003

BACKGROUND: Assessment of the safety of the blood supply, the quality of screening procedures, and the risk of transfusion transmission of infectious diseases in any country can be estimated by reviewing the records of blood donations and screening procedures and the prevalence of serologic markers of infectious diseases.STUDY DESIGN AND METHODS: Information on blood donors, particularly the number of screened donors, and on the prevalence of serologic markers of infectious diseases was available from Argentina for 1995 through 1997. This information permitted the estimation of the risks and costs of preventing transfusion transmission of infectious diseases within the country during this period.RESULTS: Screening coverage was higher in the private sector. The proportion of donors screened for HIV increased from 84.52 percent in 1995 to 97.97 percent in 1997; in the same period, serologic screening for HbsAg increased from 83.71 percent to 98.48 percent; that for HCV from 69.92 percent to 97.83 percent; and that for syphilis from 87.94 percent to 98.71 percent. One hundred percent of donors were screened for Trypanosoma cruzi throughout the period. The overall prevalence of HIV per year varied from 2.42 to 3.36 per 1,000 donors; that of HBV, from 5.80 to 9.76 per 1,000; of HCV, from 7.39 to 16.61 per 1,000; and of syphilis, from 5.25 to 7.65 per 1,000. The overall prevalence of antibodies to T. cruzi ranged from 36.53 to 49.20 per 1,000 donors. The overall index of the spread of infectious viral disease through blood transfusion decreased from 47.74 per 10,000 donations in 1995 to 4.75 per 10,000 in 1997. The ratio of acquired infections to donations improved from 1:209 to 1:2,102 during the same period. The risk of T. cruzi infection from 1995 through 1997 was, in theory, nil, given the 100‐percent screening. The greatest threat to the quality of the blood supply throughout the period studied was HCV.CONCLUSION: The status of the blood supply in Argentina improved steadily from 1995 to 1997, as shown by the increase in screening coverage.
A randomized trial comparing acute normovolemic hemodilution and preoperative autologous blood donation in total hip arthroplasty
Authors: Goodnough Lawrence T. , Despotis George J. , Merkel Kurt , Monk Terri G. 
Published: March 2003

BACKGROUND: The value of acute normovolemic hemodilution (ANH) as compared to preoperative autologous blood donation (PABD) in orthopedic surgery is unknown. Therefore, a prospective, randomized study was conducted to compare these techniques in patients undergoing primary total hip arthroplasty.STUDY DESIGN AND METHODS: ANH patients underwent phlebotomy for up to 3 units, or to a target Hct level of 28 percent after induction of anesthesia. PABD patients were asked to donate up to 3 units before admission.RESULTS: Mean baseline Hct levels were not different in ANH and PABD patients (39.7 ± 4.5 vs. 41.8 ± 3.8%, p = 0.09). No difference was found in allogeneic blood exposure among ANH and PABD cohorts: 4 (17%) of 23 ANH patients received a total of 9 allogeneic blood units, compared to no allogeneic transfusions in the PABD cohort (p = 0.30). Total blood costs associated with ANH were significantly (p<0.05) lower than blood costs associated with PABD ($151 ± 154 vs. $680 ± 253, respectively).CONCLUSION: In patients undergoing total hip arthroplasty, ANH is safe, can be considered equivalent to PABD in effectively reducing exposure to allogeneic RBCs, and is less costly than PABD.
Serum supplement, inoculum cell density, and accessory cell effects are dependent on the cytokine combination selected to expand human HPCs ex vivo
Authors: Xu Ruiling , Medchill Michael , Reems Jo Anna 
Published: March 2003

BACKGROUND: The prolonged periods of pancytopenia associated with cord blood transplants suggest that in some cases cell numbers may be limiting. The possibility that limiting cell numbers may be overcome and prolonged periods of pancytopenia abrogated by the transplantation of human umbilical cord blood cells expanded ex vivo has led to efforts to define optimal culture conditions for these cells.STUDY DESIGN AND METHODS: Cord blood CD34+ cells were cultured with three cytokine combinations: SCF+G–CSF+GM–CSF+MGDF (SGGM); IL‐6+ SCF+MGDF+Flt3‐ligand (6SMF); and IL‐1+IL‐3+IL‐6+G–CSF+GM–CSF+SCF+Epo (GFmix). Serum effects, inoculum concentration (cells/mL) seeding density (cell/cm2) and accessory cell effects on the expansion of CD34+ cells were determined.RESULTS: Cellular outputs were significantly higher with fetal calf serum (FCS) than with cord blood serum (CBS) or adult group AB serum (ABS) in the presence of 6SMF, however, CBS was as effective as FCS. The best seeding concentrations varied for each of the cytokine combinations, and inoculum densities exceeding 1000 cells per cm2 proved detrimental for cultures containing GFmix and SGGM. Accessory cell studies indicated that populations expressing the CD33 antigen inhibited the expansion of purified CD34+ cells in the presence of GFmix or SGGM, but not in the presence of 6SMF.CONCLUSION: Serum supplement, inoculum cell concentration, seeding densities, and accessory cell effects are dependent upon the cytokine combination selected to expand cord blood HPCs ex vivo. Thus, each of these measures should be assessed to establish reproducible and reliable conditions for the selection of different cytokine combinations to culture cord blood HPCs.
Automation of nucleic acid extraction for NAT screening of individual blood units
Authors: Lee Dong‐Hun , Prince Alfred M. 
Published: March 2003

BACKGROUND: Automation of NAT for single units of blood is currently hampered by the labor‐intensive steps involved in the extraction of nucleic acids from samples before the amplification procedures. A new method has been developed for the automation of these steps using hydrophilic polyvinylidene fluoride (PVDF) filter plates.STUDY DESIGN AND METHODS: Quantitative nucleic acid recoveries from sera containing HCV, HIV, HBV, HAV, and human parvovirus B19 and from 3H‐labeled HCV RNA were determined in parallel by the semi‐automated PVDF method and a single‐column method (Qiagen). Quantitative PCR was performed.RESULTS: Similar recoveries of HCV, HIV, and HBV (with silica beads) were observed with the PVDF method and with the Qiagen single‐column method. The sensitivity of the PVDF‐based PCR assay for HCV, HIV, and HBV in serially diluted serum samples was always within two serial dilutions of that obtained when the Qiagen single‐column method was used in the same assays. With the use of 3H‐labeled HCV RNA, recoveries of approximately 70 percent were found by both methods.CONCLUSION: The PVDF method will permit full automation of the simultaneous extraction of nucleic acid from sera containing HCV, HIV, and HBV. This procedure will permit NAT screening of individual units of blood, will replace the current screening of pools, and will achieve improved blood safety with reduced labor and costs.
A possible role for maternal HLA antibodyin a case of alloimmune neonatal neutropenia
Authors: Hagimoto Rokuro , Koike Kenichi , Sakashita Kazuo , Ishida Takefumi , Nakazawa Yozo , Kurokawa Yumi , Kamijo Takehiko , Saito Satoshi , Hiraoka Asako , Kobayashi Masao , Komiyama Atsushi 
Published: March 2003

BACKGROUND: Alloimmune neonatal neutropenia (ANN) is caused by a reaction of maternal alloantibodies with paternally inherited antigens on the fetal neutrophils. While human neutrophil antigens (HNA) antibodies are found in half of ANN cases, specific antibodies have not been defined in the remaining cases.STUDY DESIGN AND METHODS: Reported here is a neonate with omphalitis due to neutropenia. To elucidate the cause of ANN, flow cytometric and PCR analyses were used. Reactions of the patient's and mother's sera with neutrophils, lymphocytes, and platelets were examined by lymphocytotoxicity test (LCT), anti‐human immunoglobulin‐LCT, and mixed passive hemagglutination test.RESULTS: The maternal sera reacted with neutrophils, lymphocytes, and platelets of the patient and father. The platelet adsorption eliminated the reaction of the maternal serum with the patient's neutrophils. The HLA typing of the family and an LCT using a panel of lymphocytes of 20 HLA‐typed donors showed HLA‐A2 antigen as a target of antibodies in the maternal serum. According to anti‐human immunoglobulin‐LCT, the anti‐HLA‐A2 was present in the neonatal serum. On the other hand, HNA antibodies were not detectable in the patient's or the mother's serum.CONCLUSION: These results suggest that the transplacental passage of the maternal HLA antibody caused neutropenia in this patient.
Donor WBCs can persist and transiently mediateimmunologic function in a murine transfusion model:effects of irradiation, storage, and histocompatibility
Authors: Lee Tzong‐Hae , Reed William , Mangawang‐Montalvo Leilani , Watson Jessica , Busch Michael P. 
Published: March 2003

BACKGROUND: Donor WBCs are responsible for numerous transfusion complications, but little is known concerning the natural history of their clearance following transfusion or of their function in the recipient's circulation. A murine transfusion model was developed to investigate the effects of blood component characteristics and histocompatibility on donor WBC survival kinetics and function.STUDY DESIGN AND METHODS: To investigate the effects of storage and irradiation, fresh whole blood and blood stored for 1, 2, and 6 weeks at 4°C, all from male C57b (H2Kb) mice, was transfused to female Balb/c (H2Kd) mice. To study the effect of histocompatibility, blood was also transfused from C57b mice to Balb/c, FVB, C3H, and SW (outbred) mice. To investigate the xenogeneic setting, blood from humans, rats, and rabbits was transfused to Balb/c mice. Samples were collected weekly after transfusion, and the donor WBCs were analyzed, targeting the Y‐chromosome with quantitative PCR. To investigate donor WBC function, dinitrochlorobenzene (DNCB) sensitivity was induced in donor and recipient mice, and the transfusion recipients were observed for hypersensitivity to DNCB.RESULTS: Donor WBCs had reduced in vivo survival equivalent to their period of storage ex vivo at 4°C. Irradiation of donor blood produced no observable difference in donor WBC survival. Allogeneic male donor WBCs persisted (100‐<1 cell/μL) in female Balb/c recipient mice blood over 6 weeks. Donor WBC survival kinetics displayed an early MHC‐dependent phase, which was followed by a more rapid phase that was not influenced by donor‐recipient MHC differences. All donor WBCs were cleared within 24 to 48 hours. DNCB sensitivity was passed through transfusion, where it was transiently expressed in naive recipients.CONCLUSION: The clearance of donor WBCs in the murine transfusion model is much slower than that in humans. Allogeneic donor WBC clearance may be biphasic, involving MHC‐dependent as well as MHC‐independent mechanisms. DNCB sensitivity can be transferred transiently to a naive recipient.
Absence of risk factors for false‐positive test results inblood donors with a reactive test result inan automated treponemal test (PK‐TP) for syphilis
Authors: Orton Sharyn L. , Dodd Roger Y. , Williams Alan E. ,   for the ARCNET Epidemiology Group
Published: March 2003

BACKGROUND: Screening and confirmatory serologic tests for syphilis are known to generate false‐positive results in low‐risk populations, which include blood donors. This study assessed whether conditions previously reported to cause biological false‐positive (BFP) test results for syphilis are relevant to contemporary syphilis testing of blood donors and the extent to which seropositive donors report a history of syphilis.STUDY DESIGN AND METHODS: A history of conditions reported to be associated with BFP syphilis tests or a history of syphilis infection was assessed by a case‐control study of donors with reactive and nonreactive automated treponemal test results, using an anonymous mail survey. Analysis of cases was stratified by fluorescent treponemal antibody absorption (FTA‐ABS) result.RESULTS: Adjusted ORs (95% CIs) for reported BFP‐associated conditions were 1.3 (0.8‐2.1) for FTA‐ABS‐positive cases and 0.8 (0.3‐1.9) for FTA‐ABS‐negative cases. Among responding blood donors, syphilis history was reported in 78 (51%) of 153 FTA‐ABS‐positive cases, 0 of 142 FTA‐ABS‐negative cases, and 3 (0.4%) of 716 automated treponemal test (PK‐TP)‐negative controls.CONCLUSION: Approximately half of donors with FTA‐ABS‐positive test results reported a syphilis history. There was no difference between reported BFP conditions for FTA‐ABS‐positive or FTA‐ABS‐negative cases and controls. This information may be useful when providing donors with better predonation or post‐test counseling information about syphilis testing.
Frozen‐stored granulocytes can be used for an immunofluorescence test to detect granulocyte antibodies
Authors: Nishimura Motoko , Mitsunaga Shigeki , Juji Takeo 
Published: March 2003

BACKGROUND: Donor‐ and/or recipient‐derived granulocyte antibodies are considered to be the main cause of transfusion‐related acute lung injury (TRALI), neutropenia, and febrile transfusion reactions. Several types of tests are performed to detect antibodies in donated blood and/or the serum of a transfusion recipient. Because granulocytes cannot endure the freezing‐thawing process, they cannot be stored in liquid nitrogen (LN2). Therefore, testing is time‐consuming, because freshly prepared granulocytes are needed for each testing. An attempt has been made to develop a method that uses granulocytes stored in LN2 for the granulocyte immunofluorescence test (GIFT).STUDY DESIGN AND METHODS: Freshly prepared granulocytes were suspended in a solution of 90‐percent fetal bovine serum (FBS) plus 10‐percent DMSO and then frozen and stored in LN2. In the case of GIFT, frozen‐stored granulocytes were rapidly thawed, washed, and fixed with 1‐percent paraformaldehyde (PFA) and then treated with MoAbs or serum containing antibodies that were reactive to granulocytes. After staining of granulocytes with FITC or PE, FACS analysis was performed.RESULTS: A comparison of FACS profiles of freshly prepared granulocytes stained with MoAbs or serum with FACS profiles of frozen‐thawed‐fixed granulocytes showed that the surface antigen expression was restored. Comparable results from FACS profiles of freshly prepared and frozen‐thawed‐fixed granulocytes were obtained.CONCLUSION: By being fixed with 1‐percent PFA, frozen‐stored‐thawed granulocytes can be used in the GIFT. With this method, the testing time can be shortened. Moreover, because representative panel granulocytes can be stored in several aliquots, uniform granulocytes can be used as panel cells for each testing.
Recurrent transfusion‐related acute lung injury
Authors: Win Nay , Montgomery Julia , Sage Deborah , Street Martin , Duncan John , Lucas Geoff 
Published: March 2003

BACKGROUND:Transfusion‐related acute lung injury (TRALI) is a rare condition that is commonly associated with the transfusion of donor plasma containing WBC antibodies. Biologically active lipids that accumulate during storage of RBCs and platelets may also cause TRALI. There has been only one previously reported case of recurrent TRALI.CASE REPORT:A patient received a transfusion 2 days after undergoing hysterectomy; she developed TRALI after receiving the transfusion. The patient recovered after being on ventilation for 6 days but received an additional transfusion and had a second episode of TRALI, which required further ventilation.RESULTS:Laboratory investigation of the first episode of TRALI suggested the presence of HLA‐A2 (N = 1) and granulocyte‐specific IgM antibodies (N = 2) in the sera from three of the donors. All three sera reacted in crossmatch studies with the patient's granulocytes and lymphocytes. Lymphocyte‐specific IgG antibodies were detected in the patient's serum. There was no evidence to suggest the involvement of WBC antibodies in the second episode of TRALI. Antibody screening of the donors' samples and both forward and reverse crossmatch studies were negative.CONCLUSION:The first episode of TRALI seems to be due to the action of HLA‐A2 and granulocyte‐specific IgM antibodies. The second episode may have been due to the action of lipid neutrophil‐priming agents in the donors' units in association with the patient's underlying pulmonary condition (i.e., recovering from lung injury). TRALI can recur if a patient requires further transfusion support shortly after an initial episode of TRALI.
The effect of the transfusion of stored RBCs on intestinal microvascular oxygenation in the rat
Authors: Van Bommel Jasper , De Korte Dirk , Lind Albert , Siegemund Martin , Trouwborst Adrianus , Verhoeven Arthur J. , Ince Can , Henny Christiaan P. 
Published: March 2003

BACKGROUND: Although it is known that the transfusion of stored RBCs does not always improve tissue O2 consumption under conditions of limited tissue oxygenation, the efficiency of O2 delivery to the microcirculation by stored RBCs has never been determined.STUDY DESIGN AND METHODS: In a rat hemorrhagic shock model, the effects of resuscitation with fresh or 28‐day‐old RBCs stored in CPD plasma, saline‐adenine‐glucose‐mannitol, and CPDA‐1 plasma were investigated. Systemic hemodynamic and intestinal oxygenation measures were monitored. Intestinal microvascular PO2 was determined with the O2‐dependent quenching of palladium‐porphyrin phosphorescence, and the RBC deformability was measured with a Laser‐assisted optic rotational cell analyzer.RESULTS: Hemodynamic and oxygenation measures were significantly decreased during hemorrhagic shock. Intestinal oxygen consumption and mesenteric venous pO2 were restored with the transfusion of both fresh and stored RBCs, except for CPD‐stored RBCs. The intestinal microvascular pO2 improved only with the transfusion of fresh RBCs. Deformability of the stored RBCs was significantly decreased.CONCLUSION: In contrast to that of fresh RBCs, the transfusion of stored RBCs did not restore the microcirculatory oxygenation, possibly because of impaired O2 unloading, but, except for CPD‐stored RBCs, the storage‐induced changes were not enough to impair intestinal VO2 and mesenteric venous pO2.
Rapid down modulation of P‐selectin glycoprotein ligand‐1 (PSGL‐1, CD162) by G–CSF in humans
Authors: Jilma Bernd , Hergovich Nicole , Homoncik Monika , Marsik Claudia , Kreuzer Claudia , Jilma‐Stohlawetz Petra 
Published: March 2003

BACKGROUND: In vitro and animal studies suggest a critical role for P‐selectin glycoprotein ligand‐1 (PSGL‐1) in the regulation of WBC adhesion and neutrophil counts. As WBC activation decreases PSGL‐1 expression on WBCs in vitro, the effects of G–CSF on PSGL‐1 expression were examined. STUDY DESIGN AND METHODS: Two different G–CSF doses (1 and 5 μg/kg IV) were compared with high‐dose dexamethasone (1 mg/kg twice daily) and placebo in a randomized, double‐blind, four‐way crossover trial in eight healthy volunteers. Surface expression of WBC adhesion molecules was quantified by flow cytometry. RESULTS: Both G–CSF and dexamethasone led to a delayed down regulation of L‐selectin. In contrast, G–CSF rapidly down regulated PSGL‐1 expression on neutrophils within 90 minutes, whereas neither dexamethasone nor placebo had an effect. Similarly, incubation of WBCs with clinically relevant G–CSF concentrations (60 μg/L) for 90 minutes down modulated PSGL‐1 expression on neutrophils and enhanced CD11b expression, compatible with a direct PSGL‐1 down regulation by G–CSF‐induced neutrophil activation. Similar to G–CSF, GM–CSF down regulated PSGL‐1 in vitro. Both drugs induced shedding of soluble PSGL‐1, supporting the concept that proteolytic cleavage is a potential mechanism of PSGL‐1 down regulation on neutrophils. CONCLUSION: G–CSF, but not dexamethasone, down regulates PSGL‐1 expression on the surface of neutrophils in humans. This could also partly explain the synergistic effects when both drugs are combined for optimal mobilization of neutrophils for clinical granulocyte transfusion programs.
Point mutations causing the McLeod phenotype
Authors: Russo David C.W. , Lee Soohee , Reid Marion E. , Redman Colvin M. 
Published: March 2003

BACKGROUND: The McLeod phenotype is defined by absence of Kx, weakening of Kell system antigens, and acanthocytosis. Individuals with the McLeod phenotype usually develop late‐onset neuromuscular abnormalities. Gene deletions, insertions, and point mutations that affect RNA splicing or that lead to premature stop codons have been reported to cause the McLeod phenotype. The McLeod phenotype may also be caused by mutations at a different splice site and by a novel mutation encoding an amino acid substitution that prevents transport to the cell surface. STUDY DESIGN AND METHODS: The coding and flanking intron regions of XK from four male, unrelated individuals with the McLeod phenotype and nonchronic granulomatous disease were sequenced and compared with the wild type sequence. Genomic DNA was amplified by PCR, and the products were sequenced. In one case, the mutant cDNA was expressed in a heterologous cell, and cell surface expression was determined. RESULTS: Three individuals with the McLeod phenotype had mutations that disrupted conserved GT sequences present at RNA splice sites. Two of them had G>C mutations at the 5′ splice site of intron 1, and one had a G>A mutation at the 5′ splice site of intron 2. One person with the McLeod phenotype had a 746C>G mutation in exon 3 encoding an R222G substitution. In a transfected cell, the expressed protein from the latter mutant did not travel to the cell surface. CONCLUSION: The McLeod phenotype may be caused by several different mutations.
Investigation of transfusion transmission of a WA1‐type babesial parasite to a premature infant in California
Authors: Kjemtrup Anne M. , Lee Brian , Fritz Curtis L. , Evans Cherie , Chervenak Michael , Conrad Patricia A. 
Published: March 2003

BACKGROUND: A premature infant in California developed respiratory distress associated with infection with a protozoal parasite, Babesia. The infant had received two blood transfusions, one from the father and one from an anonymous donor (Donor A). This study describes the follow‐up required to identify the source and species of Babesia that infected the infant. STUDY DESIGN AND METHODS: At the time of the infant's illness, whole blood from the infant, father, and mother was evaluated for Babesia infection. Similar evaluation of whole blood from Donor A was performed 2 months after the suspected donation to the infant. Samples were tested using blood smear examination, serology, PCR, and hamster inoculation. Identity of the recovered Babesia parasites was confirmed by DNA amplification by PCR, genetic sequencing of the 18S gene, and phylogenetic analysis. RESULTS: WA1‐type Babesia was recovered from the infant. Neither parent was the source of infection. Serology and hamster inoculation confirmed WA1‐type Babesia infection in Donor A. DNA sequences of the 18S gene from the infant and donor isolates were 100% identical. CONCLUSION: WA1‐type Babesia infections may be difficult to detect among blood donors because such infections can be subclinical. This is the second WA1‐type Babesia transmission via blood transfusion and the first in an infant. Physicians in the western United States should consider Babesia as a possible cause of nonspecific febrile illness after a blood transfusion.