bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of recombinant human antithrombin in patients with congenital antithrombin deficiency undergoing surgical procedures
Authors: Konkle Barbara A. , Bauer Kenneth A. , Weinstein Robert , Greist Anne , Holmes Houston E. , Bonfiglio Judith 
Published: December 2004

BACKGROUND : Hereditary antithrombin (AT) deficiency is associated with a significant risk of venous thromboembolism. Patients with this disorder frequently require long‐term anticoagulation. Discontinuation of anticoagulation for childbirth or surgery may carry a substantial thrombotic risk. For this reason, replacement with AT concentrate has been used when anticoagulation is interrupted. A new recombinant human AT concentrate, produced using transgenic technology, has recently been developed. STUDY DESIGN AND METHODS : Human recombinant AT (rhAT) was provided by GTC Biotherapeutics, Inc. on a compassionate‐use basis for five patients with hereditary AT deficiency who underwent six surgical procedures. Patients were treated perioperatively. Dosing was determined individually by the investigators with a goal of maintaining an AT activity of 80 to 150 percent. RESULTS : There was no clinical evidence of thrombosis or bleeding. Four of the five patients had postoperative duplex ultrasound studies of the lower extremities, which showed no evidence of acute thrombosis. Four patients were tested for antirecombinant rhAT antibodies postoperatively and were negative. CONCLUSION : These case reports indicate that rhAT can provide effective support for AT‐deficient patients who undergo surgery. Further study of this product is needed to define optimal dosing and further assess clinical response.
GUTI: a new antigen in the Cromer blood group system
Authors: Storry Jill R. , Sausais Laima , Hue‐Roye Kim , Mudiwa Flora , Ferrer Zennie , Blajchman Morris A. , Lublin Douglas M. , Ma Bei‐Wen , Miquel Juan F. , Nervi Flavio , Pereira Jaime , Reid Marion E. 
Published: December 2004

BACKGROUND : The Cromer blood group system consists of seven high‐incidence and three low‐incidence antigens carried on decay‐accelerating factor (DAF). This report describes the identification and characterization of a new Cromer high‐incidence antigen, named GUTI. STUDY DESIGN AND METHODS
: RT‐PCR and sequence analysis were performed on cDNA prepared from a Chilean donor whose serum contained the alloantibody (anti‐GUTI). Based on the observed point mutation, a PCR‐RFLP assay using
Mae II was developed. To map the epitope, DAF‐deletion mutants were tested by immunoblotting with anti‐GUTI. RESULTS
: Sequence analysis revealed a substitution of 719G>A in
DAF
in the proband. The proband's parents and two daughters were heterozygotes for 719G>A, one sister whose RBCs typed GUTI– was homozygous for 719A, and one sister had the wild‐type
DAF (719G). Seven additional heterozygote samples were identified among 214 Chileans. No heterozygotes were found in 197 New York donors. Analysis using DAF‐deletion mutants showed the antigenic determinant to be within short consensus repeat (SCR) 4. CONCLUSION : This study describes a novel high‐ incidence antigen (GUTI) in the Cromer blood group system characterized by the amino acid arginine at position 206 in SCR4 of DAF. The GUTI‐negative proband has a substitution mutation that predicts for histidine at this position.
Expression of human neutrophil antigen‐2a (NB1) is increased in pregnancy
Authors: Caruccio Lorraine , Bettinotti Maria , Matsuo Kazuhiko , Sharon Victoria , Stroncek David 
Published: December 2004

BACKGROUND : The expression of human neutrophil antigen‐2a (HNA‐2a) or NB1 is highly variable. This study investigated variations in neutrophil expression of HNA‐2a by comparing the expression of epitopes recognized by three HNA‐2a‐specific CD177 antibodies among healthy adults and pregnant women. STUDY DESIGN AND METHODS : Flow cytometry was used to compare the neutrophil reactions of three CD177 antibodies (MEM‐166, TAG4, and 7D8) among 52 healthy adults. Because HNA‐2a expression is greater in women than men, neutrophils were studied from 21 women early in pregnancy and 23 women late in pregnancy. RESULTS : All three CD177 antibodies reacted with two populations of neutrophils: a brightly staining population and a dimly staining population. Among the 52 healthy adults, there was no difference in the mean size of the brightly reactive population of neutrophils recognized by each antibody (46 ± 23% for MEM‐166, 49 ± 23% for TAG4, and 49 ± 23% for 7D8), and all three antibodies were specific for HNA‐2a. For all three antibodies the size of the antigen bright neutrophil population was greater on neutrophils collected both early and late in pregnancy than in healthy adults. There was no difference in the size of the antigen bright population among neutrophils tested early and late in pregnancy. CONCLUSION : HNA‐2a antigen expression increases in pregnancy. Some of the variations in neutrophil expression of HNA‐2a among individuals is likely due to differences in gene regulation or differences in post‐translational protein modifications rather than gene polymorphisms.
Use of sentinel sites for daily monitoring of the US blood supply
Authors: Nightingale Stephen , Wanamaker Virginia , Silverman Barbara , McCurdy Paul , McMurtry Lawrence , Quarles Philip , Sandler S. Gerald , Triulzi Darrell , Whitsett Carolyn , Hillyer Christopher , McCarthy Leo , Goldfinger Dennis , Satcher David 
Published: December 2004

BACKGROUND : This report describes the first year of a government‐sponsored program that uses daily reports from 29 sentinel sites to monitor the capacity of the US blood supply to meet demand. STUDY DESIGN AND METHODS : From August 15, 2001, to August 14, 2002, 29 sentinel sites provided daily reports of the number of units of RBCs in inventory, transfused, exported, and outdated by ABO and Rh, and platelets by random or apheresis donor. Days supply of each component category was calculated as the number of units in inventory reported on a day divided by the sum of units transfused, exported, and outdated on that day. Sites also provided daily responses to questions about threatened or actual shortages. RESULTS : The median of the days supply of RBCs at the 26 hospital transfusion services was 7.2 days. However, median days supply varied substantially by site and by day of the week. A+, O+, and O– units accounted for 30, 35, and 12 percent of total inventory and were maintained at a median supply of 7.4, 6.4, and 9.5 days, respectively. Reports of threatened RBC shortages peaked in early January 2002 and again in early July 2002. The July 2002 peak was about twice the January 2002 peak. Inventories at community‐based centers were similar to those at hospital transfusion services. Hospitals maintained only a 1‐day supply of platelets. Eight percent of random and 4 percent of apheresis platelets were outdated. There were 20 reports that surgery had to be postponed or canceled because platelets were unavailable. CONCLUSIONS : Inventories of RBCs maintained at the participating sites were sufficient, with only one brief exception, to meet local demand during the first year of this monitoring program. The weekly rate of threatened shortage reports was more sensitive than days inventory as a predictor of actual shortages of RBCs. Unlike RBCs, platelet days supply, reports of threatened or actual platelet shortages, and platelet outdate rates did not vary seasonally.
A simple cryopreservation method for dendritic cells and cells used in their derivation and functional assessment
Authors: Celluzzi Christina M. , Welbon Craig 
Published: December 2004

BACKGROUND: Cryopreservation and storage permitting multiple treatments with single donations is of practical importance to cellular therapies. HES and DMSO, used successfully in simple clinical procedures for freezing marrow and peripheral blood progenitor cells at –80°C, was tested on antigen‐presenting dendritic cells (DCs) and cells used in their derivation. STUDY DESIGN AND METHODS: DCs cultured in serum‐free media from adherent or CD14+ apheresis MNCs (n = 36) in the presence of GM‐CSF + IL4 ± TNFα were frozen and stored at –80°C in 6‐percent HES, 5‐percent DMSO, and 4‐percent HSA. Apheresis MNCs, CD14+ monocytes, and lymphocytes were similarly frozen and later thawed for culture. Cells were assayed for viability, DC phenotype, mixed lymphocyte reaction, and antigen presentation before and 3, 6, 9, 12 or more months after freezing. RESULTS: DCs retained viability (82 ± 2.3%) for at least 24 months. Mature and immature phenotype and function were preserved. Thawed MNCs and CD14+ cells differentiated to DCs and lymphocytes maintained high functional viability (92 ± 3%) comparable to prefreeze levels. CONCLUSION: A simple –80°C freezing and storage method that combines extracellular (HES) and intracellular (DMSO) agents is practical and preserves functional viability of DCs, MNCs, CD14+ monocytes, and lymphocytes.
Analysis of PBPC cell yields during large‐volume leukapheresis of subjects with a poor mobilization response to filgrastim
Authors: Moncada Victoria , Bolan Charles , Yau Yu Ying , Leitman Susan F. 
Published: December 2004

BACKGROUND: The circulating CD34 count is a reliable predictor of peripheral blood progenitor cell (PBPC) yields in subjects with a vigorous mobilization response to G‐CSF, however, the value of this parameter in poor mobilizers is uncharacterized. STUDY DESIGN AND METHODS: Consecutive PBPC procedures (n = 81) with preapheresis CD34 counts less than 20 per μL (poor mobilizers) were compared with an equal number of good mobilizers (preapheresis CD34 counts ≥20/μL). G‐CSF was administered at standard doses (10 μg/kg/day). RESULTS: CD34 yields correlated strongly with preapheresis CD34 counts in both good and poor mobilizers and were higher in allogeneic than autologous donors. For a standard 75‐kg recipient, a CD34 cell dose of greater than 2 × 106 per kg was never achieved in less than two 15‐L procedures if the preapheresis CD34 count was less than 8 per μL. Preapheresis WBC and MNC counts were lower in poor than in good mobilizers (28.4 vs. 43.0 and 3.25 vs. 5.01 × 103/μL, respectively, p < 0.0001). Total WBC counts correlated more strongly with preapheresis CD34 counts, total CD34 yields, and CD34 yields per L processed in good mobilizers (R = 0.50, R = 0.44, and R = 0.42, respectively) than in poor mobilizers (R = 0.22, R = 0.02, and R = 0.01, respectively), whereas total MNC counts correlated more strongly with these parameters in poor (R = 0.38, R = 0.23, and R = 0.27, respectively) than in good mobilizers (R = 0.04, R = 0.13, and R = 0.16, respectively). CONCLUSION: CD34 cell yields correlate strongly with preapheresis CD34 counts. Based on this analysis, a CD34 count greater than or equal to 8 per μL is the threshold for performing PBPC collections in our institution.
Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti‐HBc: implications for transfusion transmission and donor screening
Authors: Kleinman Steven H. , Kuhns Mary C. , Todd Deborah S. , Glynn Simone A. , McNamara Anne , DiMarco Anthony , For The Retrovirus Epidemiology Donor Study Michael P. Busch 
Published: December 2004

BACKGROUND: An estimate of the rate of HBV DNA‐positive, anti‐HBc‐positive units is important for evaluating the need for anti‐HBc donor screening, especially in the context of HBV NAT. STUDY DESIGN AND METHODS: HBsAg EIA‐nonreactive, anti‐HBc‐reactive (Corzyme, Abbott Laboratories) specimens were retrieved from a repository and were retested for anti‐HBc (with PRISM HBcore, Abbott Laboratories, currently under FDA review) and anti‐HBs (with PRISM Ausab, Abbott Laboratories, research assay). HBV DNA testing using a PCR assay with a greater than 95 percent detection rate of less than 50 copies per mL was performed on a subset of specimens that were PRISM HBcore‐reactive and were anti‐HBs‐ negative or reactive at less than 100 IU per L. RESULTS: A total of 395 of 1231 specimens eligible by our serologic criteria were tested by PCR. Four anti‐HBs‐negative specimens were PCR‐positive with estimated HBV DNA copy numbers of 10 per 30 copies per mL in two specimens and 50 to 100 copies per mL in two others. The HBV DNA detection rate in anti‐HBs‐negative specimens was 3.7 percent, and the projected rate among all Corzyme‐reactive specimens was 0.24 percent, leading to an estimated yield of 1 HBV DNA‐positive, anti‐HBc‐positive unit in 49,000 units that were otherwise eligible for transfusion (95% CI, 1 in 16,600‐1 in 152,600). CONCLUSIONS: Anti‐HBc screening detects HBsAg EIA‐negative, HBV‐infected donors at a rate comparable to the estimated residual risk for HBV window‐period infections. The low viral load in the HBV DNA‐positive samples suggests that minipool NAT will not detect most potentially infectious units from anti‐HBc‐positive donors.
The cost‐effectiveness of NAT for HIV, HCV, and HBV in whole‐blood donations
Authors: Jackson B.R. , Busch M.P. , Stramer S.L. , AuBuchon J.P. 
Published: December 2004

BACKGROUND: The risk of viral infection associated with blood transfusion is lower than ever before because of aggressive screening and testing practices. NAT technology has lowered that risk even further but at an additional cost to the health‐care system. STUDY DESIGN AND METHODS: Marginal cost‐effectiveness of NAT for HIV, HCV, and HBV in whole‐blood donations was calculated with a previously published Markov decision model. This model was updated with disease incidence data from all 2001 American Red Cross whole‐blood donations as well as window‐period data from the Retrovirus Epidemiology Donor Study (REDS). RESULTS: Whole‐blood donation NAT for HIV and HCV is expected to cost between $155 million (minipool NAT) and $428 million (single‐donation NAT) per year in the US and avert 4 to 7 HIV infections and 56 to 59 HCV infections. Adding HBV NAT would be expected to avert 9 to 37 HBV infections at an additional cost of between $39 million and $130 million per year. Overall, NAT would cost between $4.7 million and $11.2 million per quality‐adjusted life‐year saved. Discontinuing HIV p24 antigen and HBc testing would offset this somewhat. CONCLUSIONS: The cost‐effectiveness of whole‐blood NAT is poor. The testing cost would need to decrease significantly to bring the cost‐effectiveness in line with most other accepted medical practices.
Cord blood processing with an automated and functionally closed system
Authors: Zingsem Jürgen , Strasser Erwin , Weisbach Volker , Zimmermann Robert , Ringwald Jürgen , Goecke Tamme , Beckmann Matthias Wilhelm , Eckstein Reinhold 
Published: December 2004

BACKGROUND: Umbilical cord blood processing with standard centrifugation techniques is performed in open systems and results in varying cell and volume recoveries. STUDY DESIGN AND METHODS: Forty umbilical cord blood donations were randomly assigned to processing either with a microprocessor‐controlled cell separator equipped with closed disposables or with a manual separation procedure in blood bags. The collection efficiency of nucleated cells, MNCs, RBCs, and CD34+ cells and the processing time were analyzed. RESULTS: Using the cell processor, mean collection efficiencies were 78.6 ± 24.9 percent for nucleated cells, 77.4 ± 27.8 percent for MNCs, 55.5 ± 14.6 percent for RBCs, and 83.6 ± 32.5 percent for CD34+ cells, while they were 73.1 ± 13.2 percent for nucleated cells, 78.1 ± 14.9 percent for MNCs, 26.0 ± 12.2 percent for RBCs, and 77.0 ± 17.6 percent for CD34+ cells when using the standard centrifugation technique. The processing time was about 20 minutes for automated processing and 60 to 80 minutes for the standard centrifugation technique. CONCLUSION: Using the new cell processor, the collection efficiencies for nucleated cells, MNCs, and CD34+ cells are similar to those obtained by established centrifugation techniques while the RBC reduction is less effective. The main advantages of the new systems are the closed system, the more standardized processing procedure, and a significantly shorter processing time.
Retrospective targeted HCV lookback using centralized contracted notification service
Authors: Saxena Sunita , Shulman Ira A. , Pachciarz Judith , Downey Nancy , Figueroa Priscilla I. 
Published: December 2004

BACKGROUND: Mandated HCV 2.0 lookback significantly challenged the human and financial resources available to the six Los Angeles County Department of Health Services (DHS) hospital blood banks. To comply with FDA requirements, DHS developed a centralized process that utilized the services of a contract vendor for performing HCV lookback. STUDY DESIGN AND METHOD: A DHS public health nurse acted as HCV lookback coordinator and as liaison with the vendor. Cases were electronically forwarded to the vendor, who then reviewed the patient's chart to obtain information necessary for tracking the patient through commercial databases. The vendor was responsible for notifying the recipient for pretest counseling and for providing documentation of all efforts. RESULTS: In total, 411 recipients were identified, of which, 168 cases were completed by the hospitals, 243 were forwarded to the vendor, 50 percent were deceased, 21 percent were contacted, and 28 percent could not be contacted, and 1 percent could not be located on any databases. The vendor contacted 35 of 66 cases that the hospitals had unsuccessfully attempted to contact. Of the cases forwarded to the vendor, 82 percent were completed on time. Delays were attributable to the vendor in less than 2 percent of cases. The cost per case forwarded to the vendor was $322. CONCLUSION: Utilizing a professional service to conduct HCV recipient notifications is an effective strategy for meeting FDA deadlines and for freeing transfusion service staff to perform critical functions. It remains to be seen whether such strategies offer a cost savings.
Collection of MNCs and progenitor cells by two separators for PBPC transplantation: a randomized crossover trial
Authors: Ikeda Kazuhiko , Ohto Hitoshi , Nemoto Kenji , Yamamoto Go , Kato Katsuhiko , Ogata Takashi , Shichishima Tsutomu , Maruyama Yukio 
Published: December 2004

BACKGROUND: Efficient collection of progenitor cells is essential for PBPC transplantation. Two apheresis machines (Amicus, Baxter Healthcare; and Spectra, Gambro BCT, software version 4.7) were compared prospectively by a crossover trial. STUDY DESIGN AND METHODS: Apheresis collections were performed for two consecutive days on patients for autologous and donors for allogeneic PBPC transplantation. The patients and donors, receiving a G‐CSF, were randomized into two groups. In Group I, PBPCs were collected by the Amicus on the 1st day and the Spectra on the 2nd day, and the reverse order was used with Group II. A total of 60 apheresis procedures of 30 (16 in Group I and 14 in Group II) among 40 patients and donors enrolled were performed and evaluated. RESULTS: The nucleated cell counts, MNC counts, CD34+ PBPC counts, and amounts of CFU‐GM collected per procedure were similar with the Amicus and the Spectra. On the other hand, the decrease of peripheral blood platelet counts of patients and donors was more prominent from using Spectra than Amicus (p < 0.0001). Components collected by the Amicus had fewer platelets than those collected by the Spectra (p < 0.0001). The efficiencies of collecting nucleated cells, MNCs, and CD34+ PBPCs were not different between the machines (p > 0.05). However, the efficiency of collecting platelets was significantly higher with Spectra than with Amicus (p < 0.0001). The Amicus took longer than the Spectra to process the same volume (p < 0.05). CONCLUSION: Amicus is superior to Spectra in avoiding apheresis‐induced thrombocytopenia caused by platelets contaminating the collected samples. Therefore, the Amicus is useful for patients with thrombocytopenia or with a less‐than‐normal platelet count.
Barcode technology: its role in increasing the safety of blood transfusion
Authors: Turner C.L. , Casbard A.C. , Murphy M.F. 
Published: December 2004

BACKGROUND:  Incorrect blood component transfusion is the most frequent serious incident associated with transfusion. Errors responsible for these incidents frequently involve patient misidentification.STUDY DESIGN AND METHODS:  This study evaluated a barcode patient identification system involving hand‐held computers for blood sample collection for compatibility testing and the administration of blood. Audit of practice was carried out before and after its introduction.RESULTS:  The baseline audit revealed poor practice, particularly in patient identification. Significant improvements were found in the procedure for the administration of blood following the introduction of barcode patient identification, including an improvement from 11.8 to 100 percent in the correct verbal identification of patients (p ≤ 0.001). Similar significant improvements were found in matching verbally stated identification details with details on patient identification wristbands, in correct patient identification before the collection of blood samples, and in the proportion of correctly labeled samples. Staff found the barcode identification system easy to operate and preferred it to standard procedures.CONCLUSIONS:  A barcode patient identification system was found to simplify the clinical transfusion process and improve practice. These results provide support for further work on the development of such systems for transfusion and for other hospital procedures requiring patient identification.
Reversibility of severe metabolic stress in stored platelets after in vitro plasma rescue or in vivo transfusion: restoration of secretory function and maintenance of platelet survival
Authors: Rinder Henry M. , Snyder Edward L. , Tracey Jayne B. , Dincecco Dorothy , Wang Chao , Baril Laurence , Rinder Christine S. , Smith Brian R. 
Published: December 2004

BACKGROUND:  Determining reversible aspects of the platelet storage lesion may result in improved function and survival of transfused platelets.STUDY DESIGN AND METHODS:  Using a model of high‐dose (apheresis‐derived) platelet concentrates (PC), functional changes imposed by transient adverse metabolic conditions (pH < 6.0 for 1‐2 hr) that could be reversed by autologous plasma rescue followed by standard platelet storage were investigated. Whole‐blood‐derived PCs were transfused into a small number of normal volunteers to determine platelet recovery and survival.RESULTS:  Without rescue, high‐dose PCs developed severe in vitro functional derangements at the time of the pH nadir including 1) loss of resting morphology; 2) complete abrogation of osmotic recovery and platelet aggregation and glycoprotein IIb/IIIa up‐regulation to agonist; and 3) decreased α‐granule release. By contrast, spontaneous and agonist‐induced binding of annexin V were unaffected by adverse metabolic conditions. Plasma rescue to an optimal pH improved morphology scores, stabilized osmotic recovery, and completely restored platelet secretory responses, as measured by aggregation, glycoprotein IIb/IIIa up‐regulation, and α‐granule release. In a limited number of studies, plasma rescue was accompanied by preserved in vivo platelet recovery and survival after autologous transfusion after 5 days of storage.CONCLUSION:  Transient derangement of platelet metabolism, which does not increase membrane phosphatidylserine exposure, causes in vitro functional abnormalities that are fully reversed or stabilized by metabolic rescue. Preliminary data suggest that such rescued platelets may have normal posttransfusion recovery and survival.