bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience with a transfusion recipient education program about hepatitis C
Authors: ZUCK T. F. , ROSE G. A. , DUMASWALA U. J. , GEER N. J. 
Published: March 2003

ABSTRACT: Shortly after test kits for antibodies to the hepatitis C virus (HCV) were licensed in May of 1990, our medical community undertook a public education program encouraging previous transfusion recipients to see their physicians about the wisdom of being tested for anti‐HCV. In response, 1034 samples were received for testing. All samples repeatably reactive (RR) with anti‐HCV enzyme‐linked immunoassay (EIA) were tested further with a research recombinant immunoblot assay (RIBA). Overall, 76 of the 1034 (7.4%) recipient samples were RR and 64 of these (84.2%) were reactive with RIBA. Recipients transfused prior to surrogate testing (alanine aminotransferase [ALT] and anti‐hepatitis B core [anti‐HBc]) in 1986 showed a 8.6 percent reactivity with RIBA and those transfused after surrogate testing showed a 4.8 percent reactivity, a 44 percent reduction. Of the 57 recipient samples reactive with RIBA and suitable for assay, 11 (19.3%) had an elevated ALT. Among 76 randomly selected blood donors with RR EIAs studied for comparison with recipients, 20 (26.3%) were reactive with RIBA, 9 of which had an abnormal surrogate test that would have disqualified them. ALT concentrations were abnormal in 6 (30%) of the donors who were reactive on RIBA.We conclude that an education program that encourages previous transfusion recipients to seek medical advice about anti‐HCV testing is practical from the standpoint of the blood center. We believe more widespread implementation of similar programs should be considered. The findings also suggest that, when available, supplemental testing should be offered to blood donors with RR EIAs before they are counseled about permanent deferral because of anti‐HCV testing and to transfusion recipients identified by programs such as the one described.
Transfusion and second malignancy
Authors: Ford C.D. , Gillette J.W. , Handrahan D.L. , Koehler C.S. 
Published: March 2003

BACKGROUND: Perioperative blood transfusion has been reported to cause a variety of immunosuppressive effects, including increased rates of malignancy recurrence. The effect of perioperative transfusion on second malignancy risk has not previously been investigated.STUDY DESIGN AND METHODS: Second malignancy risk was evaluated in 1053 patients previously operated upon for colon cancer, and these findings are related to perioperative transfusion history.RESULTS: Transfusion history did not relate to the probability of a patient's remaining free of second malignancy.CONCLUSION: An increased risk of total or second malignancies (with the possible exception of lung cancer) was not associated with transfusion.
Declining efficacy of AIDS case list cross‐referencing in human immunodeficiency virus look‐back: 1981 through 1992
Authors: Samson SM. , Edmiston RK. , Busch MP. , Perkins HA. 
Published: March 2003

Background: The impact of AIDS case list cross‐referencing in human immunodeficiency virus look‐back was assessed.Study Design and Methods: Post‐1977 blood donations from former donors identified by 11 collaborating health departments as having developed AIDS have been traced at Irwin Memorial Blood Centers since 1983. To assess the changing efficacy of AIDS case list cross‐referencing in identifying infected donors and recipients, trends in cases reported through December 1992 were analyzed.Results: Previous donors (n = 638) were identified from 21,917 AIDS case listings, for an overall match rate of 2.9 percent. The rate of detection of previous donors from listings of AIDS cases declined from a peak of 5.3 percent in 1985 to 1.6 percent in 1992. Overall, 86 percent (1824/2122) of donations by persons later reported on AIDS case lists were made prior to January 1983 when risk exclusion measures were initiated. Of the 212 known infected recipients linked to AIDS case list donors, 87 (41%) were previously identified by other look‐back approaches. The rate of identification of infected recipients detected exclusively through AIDS case listings declined from a mean of 21 per year from 1984 to 1987 to a mean of 3 per year from 1990 to 1992. No transmissions have been documented from donations prior to 1979.Conclusion: These findings demonstrate the declining yield of AIDS case list cross‐referencing as a trigger for human immunodeficiency virus look‐back. Continued reevaluation of look‐back programs is essential so that their various components may be curtailed when justified.
Use of recombinant human erythropoietin to assist autologous blood donation by anemic rheumatoid arthritis patients undergoing major orthopedic surgery
Authors: Mercuriali F. , Gualtieri G. , Sinigaglia L. , Inghilleri G. , Biffi E. , Vinci A. , Colotti M.T. , Barosi G. , Deliliers G. Lambertengh 
Published: March 2003

Background: In rheumatoid arthritis (RA) patients undergoing orthopedic surgery, anemia is the major factor in the use of allogeneic blood.Study Design and Methods: To determine whether recombinant human erythropoietin (rHuEPO) could allow preoperative autologous blood procurement and reduce allogeneic blood exposure, 11 RA patients who were unable preoperatively to deposit blood for autologous use because of their anemia (baseline hematocrit < 34% [0.34]) and who were scheduled for primary total hip replacement or total knee replacement were treated intravenously with 300 U per kg of rHuEPO in combination with intravenous iron saccharate (100 mg), given twice weekly for 3 weeks. The transfusion treatment was compared with that in 12 control patients with comparable baseline hematologic values who underwent the same operation.Results: Control patients could not preoperatively deposit any blood for autologous use, while all but one of the rHuEPO‐ treated patients deposited 2 or more units (mean, 2.6 ± 0.6; range, 2‐ 4) (p < 0.001). The control group received more allogeneic units (2.6 ± 1.6 vs. 0.8 ± 0.8) (p = 0.009). Moreover, 50 percent of the rHuEPO‐treated patients, as compared with 8 percent of controls, completely avoided allogeneic transfusion.Conclusion: Recombinant human erythropoietin is safe and effective in stimulating erythropoiesis, allowing preoperative donation of blood for autologous use, and reducing exposure to allogeneic blood for RA patients who are unable preoperatively to deposit blood because of anemia.
Effects of new brochures on blood donor recruitment and retention
Authors: Gimble J.G. , Kline L. , Makris N. , Muenz L.R. , Friedman L.I. 
Published: March 2003

BACKGROUND: Currently, donors may arrive at blood collection sites without prior knowledge of eligibility and deferral criteria.STUDY DESIGN AND METHODS: The effects of distributing newly developed recruitment brochures 2 weeks in advance of blood drives and the provision of brochures on temporary deferral at the taking of health history were examined in four southeastern regional blood collection centers. Twenty‐four similar pairs of worksites, with employee‐only recruitment, were randomly assigned to a control (C) or experimental (E) group. Information about sponsor recruitment strategies, worksite factors, and first‐time, repeat, and temporarily deferred donors was obtained at three collection drives per site over a 1‐year period. Drive 1 was used as a baseline. Two weeks before Drives 2 and 3, the recruitment brochures were distributed to all Group E employees, with temporary deferral brochures provided as needed when the health history was taken.RESULTS: No significant differences between groups or drives were found in the total percentage of employees recruited or returning as a result of recruitment or deferral brochure distribution (Wilcoxon's signed rank test and t test). Substantiating previous observations by donor recruiters, the study results showed decreased donations during vacation periods and busier times at the workplace. Loudspeaker announcements led to decreased donations; increased donations followed special appeals in relation to a specific patient, an accident, or a natural disaster.CONCLUSION: The brochures may have encouraged previous donors to return, but their use did not significantly increase the recruitment of new donors or the return of temporarily deferred donors.
Rare detection of hepatitis B and hepatitis C virus genomes by polymerase chain reaction in seronegative donors with elevated alanine aminotransferase
Authors: SANKARY T.M. , YANG G. , ROMEO J.M. , ULRICH P.P. , BUSCH M.P. , RAWAL B.D. , VYAS G.N. 
Published: March 2003

Background: Since screening for antibody to hepatitis C virus (HCV) was introduced in 1990, posttransfusion hepatitis has been reduced to nearly background levels. This has led to reconsideration of the value of testing donated blood for elevated alanine aminotransferase (ALT). The contribution of ALT testing in detecting seronegative infection was evaluated by the performance of polymerase chain reaction (PCR) for hepatitis B virus (HBV) or HCV in plasma from ALT‐elevated blood units.STUDY DESIGN AND METHODS: Testing was performed on 375 units of plasma, derived from an equivalent of 47,500 blood donations, with a highly sensitive hemi‐nested PCR procedure. Using a triplet of primers directed at the conserved regions of HBV DNA and 5′‐noncoding regions of HCV RNA, the hemi‐nested PCR assay can reliably amplify 10 viral molecules to levels detectable in ethidium bromide‐stained agarose gels. Pools of plasma from groups of four donors were screened with hemi‐nested PCR. For any reactive pools, the plasma from individual donors was retested twice on different aliquots.RESULTS:Two of 375 units, both with midrange ALT elevation, were repeatedly reactive in hemi‐nested PCR (one each for HBV DNA and HCV RNA). However, samples from the two suspect donors tested 9 and 5 months later revealed no seroconversion, elevated ALT, or viral genomes in hemi‐nested PCR. CONCLUSION: The lack of confirmed HBV or HCV infection in this study representing an estimated 47,500 voluntary blood donations suggests that routine ALT testing for further prevention of posttransfusion hepatitis after exclusion of HBV‐ and/or HCV‐seropositive blood may be superfluous.
The routine use of Rh‐negative reagent red cells for the identification of anti‐D and the detection of non‐D red cell antibodies
Authors: SHULMAN I.A. , CALDERON C. , NELSON J.M. , NAKAYAMA R. 
Published: March 2003

BACKGROUND: Before 1987, fewer than 50 patients per year at the authors' laboratory had a positive antibody detection test due to antepartum Rhesus immunoprophylaxis. However, after 1987, a marked increase was observed in the number of patients who had received Rh immune globulin (RhIG) during pregnancy as part of routine antepartum Rh immunoprophylaxis. In anticipation that an increased use of RhIG during pregnancy would increase the number of patients in whom anti‐D was detected by this laboratory, a protocol was developed to abbreviate the process required to identify anti‐D. Although this protocol was adopted primarily to address an anticipated increase in antenatal RhIG usage in women, it was also applied to alloimmunized Rh‐negative males.STUDY DESIGN AND METHODS: When an Rh‐negative patient (male or female) had a reactive screening test for unexpected antibodies and met certain other criteria, the patient's serum was tested with a three‐vial set of Rh‐negative reagent red cells (Rh‐negative screening RBCs), instead of with panels of typed RBCs (panel RBCs), for the identification of anti‐ D or the detection of non‐D antibodies. If the serum under test did not agglutinate or hemolyze Rh‐negative screening RBCs, anti‐D was identified and no further testing was performed. If the serum agglutinated or hemolyzed Rh‐negative screening RBCs, conventional testing with panel RBCs was done to determine the antibody specificity.RESULTS: Rh‐negative patients (n = 1174) who had reactive screening tests for unexpected antibodies were tested with Rh‐negative screening RBCs; 1079 were found to have anti‐D as a single antibody. Seven of these patients subsequently developed a non‐D alloantibody, after transfusion or pregnancy, and one patient had anti‐C that escaped detection at the time of initial testing with Rh‐negative RBCs (a false‐ negative result). Ninety‐two patients had anti‐D in combination with a non‐D antibody, and three patients had a non‐D antibody but not anti‐D. Use of the anti‐D identification protocol actually reduced the laboratory workload by 176 College of American Pathologists workload units per month, in spite of a marked increase in the number of patients in whom anti‐D was detected. No hemolytic transfusion reaction was attributed to the abbreviation of anti‐D identification. CONCLUSION: The identification of anti‐D may be abbreviated without jeopardizing patient safety. Such a protocol can reduce laboratory workload and might be particularly appealing to health care facilities that perform antibody detection testing on large numbers of Rh‐negative pregnant women, especially if antepartum RhIG is administered routinely.
Virus inactivation in red cell concentrates by photosensitization with phthalocyanines: protection of red cells but not of vesicular stomatitis virus with a water‐soluble analogue of vitamin E
Authors: Ben‐Hur E. , Rywkin S. , Rosenthal I. , Geacintov N. E. , Horowitz B. 
Published: March 2003

BACKGROUND: Photodynamic treatment of red cells (RBCs) with phthalocyanines and red light inactivates lipid‐enveloped viruses, such as vesicular stomatitis virus (VSV) and human immunodeficiency virus. To protect RBCs from photodynamic damage, type I free radical quenchers, such as mannitol, which did not affect virus inactivation, were added.STUDY DESIGN AND METHODS: Aluminum phthalocyanine tetrasulfonate (AIPcS4) was found to inactivate VSV at a rate one‐ fourth that of the silicon phthalocyanines (Pc 4 and Pc 5). However, the latter also caused more RBC damage. To protect RBCs against this photodynamic damage, Trolox, a water‐soluble vitamin E analogue, was used. RBC damage was measured as potassium leakage or hemolysis during storage after treatment. In addition, reduction in negative surface charge on RBCs was measured immediately after treatment, and the effect of Trolox on VSV inactivation in RBCs was evaluated.RESULTS: Trolox at a concentration of 5 mM was found to reduce potassium leakage during storage after Pc 4 and AIPcS4 photodynamic treatment of RBCs. Hemolysis during storage of RBC concentrates treated with Pc 4 or Pc 5 was drastically reduced by the addition of 5 mM Trolox prior to light exposure. At the same concentration, Trolox inhibited the reduction of negative surface charges on RBCs following Pc 4 and Pc 5 photodynamic treatment. Under these conditions, VSV inactivation by photodynamic treatment with all phthalocyanines was not affected by Trolox. In aqueous solution, Trolox formed a complex with AIPcS4, thus quenching the excited triplet state of AIPcS4 at a constant rate of 8.8 × 10(6) per M per second.CONCLUSION: These findings indicate that Trolox protects RBCs from phthalocyanine‐photosensitized damage without affecting virus kill. The addition of Trolox would be beneficial for improving the quality of RBCs subjected to photodynamic treatment.
False‐positive human immunodeficiency virus type 1 western blot tests in noninfected blood donors
Authors: Sayre Keith R. , Dodd Roger Y. , Tegtmeier Gary , Layug Lynne , Alexander Steve S. , Busch Michael P. 
Published: March 2003

Background: The manufacturers' criteria for a positive human immunodeficiency virus type 1 (HIV‐1) Western blot (WB) test were recently revised to require reactivity to only two of the following bands: p24, gp41, and gp120/160. In a recent report, low‐risk blood donors were identified in whom nonspecific reactivity to multiple env antigens in WB testing resulted in apparently false‐positive WBs by these criteria. The present study was conducted to verify the existence of false‐positive WBs among noninfected donors and to assess the extent of this problem.Study Design and Methods: Four donors classified as WB‐ positive on the basis of env‐only (3 cases) or p24/env‐only (1 case) patterns were investigated. Index and/or follow‐up specimens were tested by polymerase chain reaction (PCR), by overlapping recombinant env antigens and synthetic peptides in enzyme immunoassays, and by deglycosylated and denatured antigen WBs. WB records from American Red Cross blood centers were reviewed to determine the frequency of env‐ only and p24/env‐only patterns, relative to all positive WBs, from 1988 through 1993.Results: The four index‐case donors denied risk and had stable WB reactivity during follow‐up. HIV PCR was negative in all. Env reactivity was restricted to nonglycosylated gp41 epitopes; no gp120‐ specific reactivity was detected. For three of the four donors, env reactivity was mapped to a 20‐amino acid N‐terminal epitope of gp41. The rate of detecting WBs with these false‐positive patterns increased from 0.6 percent of all positive WBs from 1988 to 1990 (4/776) to 8 percent in 1991 and 1992 (52/683), and then it declined to 6 percent in 1992 and 1993 (47/783). Env‐only patterns predominated in 1991 and 1992, whereas p24/env‐only patterns were more frequent following implementation of combined anti‐HIV‐1/HIV type 2 enzyme immunoassays in 1992.Conclusion: Low‐risk blood donors can have false‐positive results on WB tests. Increased detection of env‐only and p24/env‐only WBs appears related to the enhanced sensitivity of newer enzyme immunoassays to gp41 and p24 antibodies. Donors with these patterns should undergo follow‐up testing to document the presence or absence of HIV infection.
Relationship between antibody to hepatitis B core antigen and retroviral infections in blood from volunteer donors
Authors: Korelitz J.J. , Busch M.P. , Kleinman S.H. , Williams A.E. , Zuck T.F. , Gilcher R.O. , Ownby H.E. , Chien H. Co , Nemo G.J. 
Published: March 2003

Background: The value of the test for antibody to hepatitis B core antigen (anti‐HBc) as a surrogate screening assay in the time before sensitive, virus‐specific screening tests were available has been well established. There is significant debate, however about the residual value of anti‐HBc screening after the implementation of human immunodeficiency virus (HIV)‐, human T‐lymphotrophic virus (HTLV)‐, and hepatitis C virus (HCV)‐specific assays and, in particular, about its utility as a lifestyle marker to identify persons at risk for retrovirus infections.Study Design and Methods: Screening tests for antibodies to HIV, HTLV, and HBc, as well as confirmatory or supplemental test results for anti‐HIV and anti‐HTLV, were obtained from approximately 2.8 million donations collected from 1991 through 1993 by five blood centers within the United States. The sensitivity, positive predictive value, and relative prevalence of anti‐HBc for each retrovirus were calculated and compared among demographic subgroups.Results: The overall relationship between anti‐HBc and anti‐HIV was similar to that between anti‐HBc and anti‐HTLV. When calculated from the measured endpoint of the prevalence of anti‐HIV‐positive and anti‐ HTLV‐positive donations, the sensitivities were 31.1 and 26.2 percent, the positive predictive values were 0.18 and 0.21 percent, and the relative prevalences were 30.1 and 23.8, respectively. Among 27 anti‐ HIV‐seroconverting donors and 9 anti‐HTLV‐seroconverting donors, the sensitivities were 7.4 percent (95% CI: 0.9–24.3%) and 0 percent (95% CI: 0.0–28.3%), respectively. It was estimated that for each HIV‐ infected window‐period donation detected by anti‐HBc, from 19,000 to 81,000 HIV‐noninfected donations are discarded. Similarly, more than 33,000 HTLV‐noninfected donations are likely to be discarded for each HTLV‐infected donation detected by anti‐HBc.Conclusion: Although anti‐ HBc‐reactive donations are more likely to be seropositive for a retrovirus than are anti‐HBc‐nonreactive donations, the low positive predictive value limits the test's effectiveness. If the anti‐HBc test is retained in the blood donor setting, efforts should be focused on reducing the number of false‐positive results.
Surveillance for human immunodeficiency virus type 1 group O infections in the United States
Authors: Pau C. P. , Hu D. J. , Spruill C. , Schable C. , Lackritz E. , Kai M. , GEORGEM J.R. , Rayfield M. A. , Dondero T. J. , Williams A. E. , Busch M. P. , Brown A. E. , McCutchan F. E. , Schochetman G. 
Published: March 2003

BACKGROUND: Reports that the human immunodeficiency virus type 1 (HIV‐ 1) group O variants are not reliably detected by some commercial diagnostic tests have raised concerns about the sensitivity of existing screening tests, especially with regard to blood safety. Although it is unlikely that these divergent strains are prevalent in North America, systematic, continuous surveillance is needed to monitor the potential spread of HIV variants into that region.STUDY DESIGN AND METHODS: Stored serum samples (n = 1072) from both high‐ and low‐risk population groups at several sites in the United States and Puerto Rico were tested by peptide enzyme immunoassays specific for the prototypic HIV‐1 group O strains, MVP5180 and ANT70. RESULTS: None of the 1072 samples examined had peptide reactivity that was consistent with HIV‐1 group O infection.CONCLUSION: While no evidence of specific HIV‐1 group O (MVP5180 or ANT70) infection was found in this study, the sensitivity of current tests has not been fully evaluated against the wide range of genetic variation of HIV. Therefore, it is important to continue active surveillance for HIV‐1 and HIV type 2 strains, to characterize any divergent strains, and to judiciously modify tests to correct for any deficiencies in sensitivity.
Growth of bacteria in platelet concentrates obtained from whole blood stored for 16 hours at 22°C before component preparation
Authors: Sanz C. , Pereira A. , Vila J. , Faundez A.‐I. , Gomez J. , Ordinas A. 
Published: March 2003

BACKGROUND: Previous studies have shown that cooling whole blood to 22°C immediately after collection allows it to be held for up to 16 hours before component preparation (overnight‐hold method) without a significant decrease in the quality of components obtained. A study was designed to evaluate the effect of the overnight‐hold method on the growth of bacteria in experimentally contaminated blood units.STUDY DESIGN AND METHODS: Twenty whole‐blood units were inoculated with Staphylococcus epidermidis (300 colony‐forming units [CFU]/mL; n = 10) or Escherichia coli (50 CFU/mL; n = 10) immediately after collection. Half the units of each group were fractionated 6 hours after collection and the other half after storage for 16 hours at 22°C. Twenty additional whole‐blood units were divided in two equal parts, one of which was white cell reduced before inoculation. These 40 half‐units were inoculated with S. epidermidis or E. coli and processed by the overnight‐hold method. The growth of bacteria was assessed in platelet concentrates on the second and fifth days of storage, in packed red cells on Day 35, and in fresh‐frozen plasma after 60 days.RESULTS: No bacteria growth was detected in plasma or red cell units. On the second day of storage, both bacteria strains grew more slowly in platelet concentrates obtained from blood processed by the overnight‐hold method. This difference disappeared for S. epidermidis on the fifth day. When white cell‐reduced and non‐white cell‐reduced whole‐blood units were compared, platelet concentrates from the latter showed a delayed growth of both bacterial strains on the second and fifth days of storage.CONCLUSION: Prolonged storage of whole‐blood units at 22°C before component preparation delays bacteria growth. This effect seems to be mediated by white cells.