bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect on the safety of intravenous immunoglobulin of testing plasma for antibody to hepatitis C
Authors: Biswas R.M. , Nedjar S. , Wilson L.T. , Mitchell F.D. , Snoy P.J. , Finlayson J.S. , Tankersley D.L. 
Published: March 2003

Background: The safety of intravenous immunoglobulin (IGIV), manufactured from units testing negative for antibody to hepatitis C virus (anti‐HCV), was investigated.Study Design and Methods: A study involving five chimpanzees was performed to determine whether the safety of IGIV would be compromised if units of plasma that reacted for anti‐HCV were withheld from pools from which IGIV is manufactured. In the first phase of the experiment, two chimpanzees were infused with 25 mL per kg of unprocessed, pooled plasma from 2887 donors who did not react for anti‐HCV in single‐antigen (c100‐3) enzyme‐linked immunosorbent assays. In the second phase, each of three chimpanzees was infused with 1000 mg per kg of IGIV manufactured from the same plasma units. The immunoglobulin was made by seven United States‐ licensed manufacturers, each using its own approved method. Each chimpanzee received an equal dose of each manufacturer's IGIV.Results: The two chimpanzees that received anti‐c100‐3‐nonreactive, unprocessed pooled plasma became infected with HCV. The three chimpanzees infused with IGIV did not show any evidence of infection with HCV 15 months after inoculation. Two of these animals were challenged with human non‐ A,non‐B hepatitis‐infectious plasma, and both subsequently showed evidence of HCV infection.Conclusion: These studies demonstrate that, as determined by infectivity for chimpanzees, 1) the withholding of plasma units that react for anti‐c100‐3 from pools from which plasma products are manufactured does not render the source material noninfectious, and 2) the safety of IGIV manufactured from such plasma pools is not compromised by withholding the units that react for anti‐ c100‐3.
Resolution of refractory, classic thrombotic thrombocytopenic purpura after staphylococcal protein A immunoadsorption
Authors: Drew M.J 
Published: March 2003

Background: Multiple therapeutic interventions are available for treatment of thrombotic thrombocytopenic purpura. Resolution of thrombotic thrombocytopenic purpura may require use of several of these interventions.Case Report: A patient presenting with classic (non‐ cancer chemotherapy‐associated) thrombotic thrombocytopenic purpura had an initial response to intensive, daily plasma exchange with fresh‐ frozen plasma and cryosupernatant. Multiple attempts over a period of 2 months to decrease the frequency of plasma exchange resulted in exacerbations of disease activity, indicated by increased schistocytosis, decreased hematocrit, increased serum lactate dehydrogenase, and decreased platelet counts. After a total of 39 plasma exchanges, the patient was begun on immunoadsorption therapy utilizing a staphylococcal protein A immunoadsorption treatment column. After six 2000‐mL protein A immunoadsorption treatments, the patient's platelet count, lactate dehydrogenase, and peripheral smear normalized, and they have remained normal over nearly 4 months of follow‐up.Conclusion: Treatment by protein A immunoadsorption may be of benefit in patients with classic thrombotic thrombocytopenic purpura who are not achieving a sustained remission with conventional plasma exchange therapy.
Influence of Rh phenotype on the antigen density of C, c, and D: flow cytometric study using a frozen standard red cell
Authors: Wagner F.F. 
Published: March 2003

BACKGROUND: Flow cytometry is increasingly being used for the comparison of antigen density. Indirect immune fluorescence is more sensitive than direct immune fluorescence and thus allows the study of red cells (RBCs) with a weak D antigen.STUDY DESIGN AND METHODS: In indirect immune fluorescence, when the fluorescence is standardized by the use of aliquoted frozen standard RBCs, the coefficient of variation in fluorescence intensity was less than 5 percent, which allows accurate determination of minor variations of Rh antigen density. RESULTS: For D antigen, the well‐known suppressive effect of C, and the low antigen density of the weak D phenotype, was demonstrated. Use of epitope‐specific monoclonal antibodies yielded similar results and allowed the identification of a D category IV heterozygote; the relative antigen density measured with a monoclonal antibody that reacted with D(IV) was twice that measured with a monoclonal antibody that did not react with D(IV). RBCs from C and c homozygotes had significantly more antigen than those from heterozygotes. There was significant variation in antigen density, depending on Rh phenotype: for example, D+ RBCs had less C antigen than D‐ RBCs, and Rh:1,2,‐3,4,5 (CcDee) RBCs had more c antigen than Rh:1,2,3,4,5 (CcDEe) RBCs. There was no difference in D, C, and c antigen density in neonatal and adult RBCs. CONCLUSION: Flow cytometry is an excellent tool for the demonstration of minor differences in antigen density
Demonstration by the monoclonal antibody‐specific immobilization of erythrocyte antigens assay that a new red cell antigen belongs to the Kell blood group system
Authors: DANIELS G.L. , PETTY A.C. , REID M. , MOULDS M. , DEVENISH A. , HALIL O. 
Published: March 2003

BACKGROUND: The Kell blood group system comprises 21 antigens residing on a red cell membrane glycoprotein of apparent M(r) 93,000.STUDY DESIGN AND METHODS: Serologic techniques were used to identify a new red cell antigen. The monoclonal antibody‐specific immobilization of erythrocyte antigens (MAIEA) assay was used to identify the red cell membrane component carrying that antigen.RESULTS: A new high‐frequency red cell antigen was identified and provisionally named RAZ. RAZ is absent from K.o red cells and from red cells treated with 2‐amino‐ ethylisothiouronium bromide and is expressed weakly on McLeod phenotype cells. It differs from all other Kell system antigens, and no depression of other Kell system antigens on RAZ+ red cells was noticed. The RAZ antigen was shown by the MAIEA assay to be located on the Kell glycoprotein.CONCLUSION: RAZ is a new high‐frequency antigen located on the Kell glycoprotein. The MAIEA assay is a very effective method of demonstrating the membrane structure carrying a red cell antigen
Transfusion of donor buffy coat cells in the treatment of persistent or recurrent malignancy after allogeneic bone marrow transplantation
Authors: Collins R.H. , Pineiro L.A. , Nemunaitis J.J. , Jain V.K. , Waxman D. , Miller W.V. , Fay J.W. 
Published: March 2003

BACKGROUND: Patients who experience relapse after allogeneic bone marrow transplantation have a poor prognosis. However, preclinical and clinical data have strongly suggested the existence of an immune‐ mediated anti‐tumor effect of allogeneic bone marrow transplantation. This effect, termed graft‐versus‐leukemia, may be harnessed purposefully in patients with posttransplant relapses by the administration of immune cells obtained by leukapheresis of the original bone marrow donor.STUDY DESIGN AND METHODS: Thirteen patients with persistent or recurrent hematologic malignancy after HLA‐matched sibling‐donor allogeneic bone marrow transplantation were treated with transfusion of buffy coat cells collected from the original bone marrow donors. Mononuclear cell dose ranged from 1.18 to 4.28 × 10(8) per kg. Alpha‐interferon (1.5‐3 × 10(6) U/m2 3‐5x/week) was given to seven patients. Patients were observed for the development of graft‐versus‐ host disease and disease response.RESULTS: Three of five patients with chronic myelogenous leukemia had complete remissions. One of five patients with active acute leukemia attained complete remission. A sixth acute leukemia patient treated with buffy coat transfusion after the induction of remission with chemotherapy relapsed 12 months later. One patient with myeloma had a complete but transient response. A patient with Hodgkin's disease did not respond. Four patients remain in remission 4, 16, 17, and 29 months after attaining complete remission. Graft‐versus‐host disease occurred in eight patients, including all of those with a complete response. One patient developed transient pancytopenia.CONCLUSION: The transfusion of donor buffy coat cells has significant anti‐tumor activity in patients with relapsed hematologic malignancy after allogeneic bone marrow transplantation. This effect is strongly associated with graft‐versus‐host disease.
Transfusion‐transmitted human parvovirus B19 infection in a thalassemic patient
Authors: Zanella A. , Rossi F. , Cesana C. , Foresti A. , Nador F. , Binda A.S. , Lunghi G. , Cappellini M.D. , Furione M. , Sirchia G. 
Published: March 2003

BACKGROUND: Human parvovirus (HPV) B19 infection has been shown to be transmissible by clotting factor concentrates, most often resulting in asymptomatic seroconversion. So far, no case of B19 transmission due to single‐donor transfusion has been documented. CASE REPORT: A case of transfusion‐transmitted HPV B19 infection in a 22‐year‐old female thalassemia major patient is described. She presented with an aplastic crisis; this was followed 1 week later by transitory heart failure and acute tricuspid incompetence. The echocardiogram revealed a grade III tricuspid regurgitation and a floating vegetation on the atrial face of the tricuspid lateral leaflet. The tricuspid regurgitation and vegetation spontaneously disappeared within 15 days. Blood cultures for bacteria were repeatedly negative. IgM anti‐HPV B19 seroconversion was documented in the acute phase. B19 DNA was detected by polymerase chain reaction and remained detectable up to 4 months after diagnosis. High‐ titer IgM anti‐HPV and B19 DNA were also found in serum samples collected at the time of donation from one of the donors of the blood transfused before the onset of clinical symptoms.CONCLUSION: This case documents the transmission of HPV B19 by the transfusion of 1 red cell unit and the occurrence of possible transient cardiac involvement in this infectious complication.
Patterns of use of group O, Rh‐negative red cells in a large metropolitan area and an action plan to control utilization
Authors: Newman B.H. , Shafer A.W. , Saeed S.M. 
Published: March 2003

Background: In southeastern Michigan, the group O, Rh‐negative (O‐) red cell supply was below emergency levels during one‐sixth of 1994, despite 43‐percent overcollection of O‐ red cell units relative to the size of the O‐ patient population. O‐ red cell units are overutilized because of their universal ABO and Rh compatibility. This study evaluated how hospitals in a large metropolitan area utilized O‐ red cell units, so that strategies could be devised to reduce O‐ usage.Study Design and Methods: Through an O‐ red cell utilization survey, 56 hospitals were encouraged to collect three months' worth of transfusion data, either prospectively or retrospectively. O‐ usage was compared to total red cell usage and categorized into transfusions to O‐ patients, those to non‐O‐ patients, and the number of O‐ units that outdated.Results: Of 40,616 units transfused in 38 hospitals, 3,535 (8.7%) were O‐; 71 percent of the O‐ units were transfused to O‐ patients, 28 percent were transfused to non‐O‐ patients, and 1 percent outdated. Hospital transfusions to O‐ patients appeared to correlate with the racial makeup of the patient population, while hospital transfusions to non‐O‐ patients appeared to correlate with hospital size and the hospital's transfusion practices.Conclusion: O‐ red cell usage in a hospital is dependent on the racial and ethnic mix of the hospital's patient population, the amount of transfusion activity, and the hospital's transfusion practices. An understanding of the dynamics of O‐ usage allowed the development of strategies to decrease O‐ utilization.
Donation deferral criteria for human immunodeficiency virus positivity among blood donors in northern Thailand
Authors: Sawanpanyalert P. , Uthaivoravit W. , Yanai H. , Limpakarnjanarat K. , Mastro T.D. , Nelson K.E. 
Published: March 2003

Background: The purpose of this study was to develop human immunodeficiency virus (HIV) infection donation deferral criteria for blood donors in an HIV‐epidemic area of northern Thailand, where the predominant means of transmission of HIV is through heterosexual contact.Study Design and Methods: In a preliminary study, 2242 blood donors were interviewed, and their blood was tested for HIV antibodies between September 1993 and April 1994. The risk factors associated with HIV positivity were identified. Criteria to identify HIV‐positive persons on the basis of a logistic equation were developed and applied to another group of 5769 prospective blood donors.Results: A multivariate analysis showed the following odds ratios (OR) for traits that were independently associated with HIV positivity: younger age (OR = 0.93 for each additional year of age), male gender (OR = 2.41), having no more than a primary school education (OR = 2.00), being in the military (OR = 1.78), being unsure of one's own blood safety (OR = 2.00), history of injecting drug use (OR = 5.36), diagnosis of syphilis or positive syphilis serologic test in the past 12 months (OR = 2.67), and genital ulcer in the past 12 months (OR = 4.56). On the basis of the model, with a limit of <10 percent loss of uninfected donors, predicted probabilities of HIV positivity alone or of markers of infection with HIV, hepatitis B virus, or Treponema pallidum were calculated. With a cutoff of 6.5‐percent estimated probability of HIV infection, derived from the logistic equation, the donor deferral criteria have 33.6‐percent sensitivity and 8.3‐percent positive predictive value for HIV positivity and 15.5‐percent sensitivity and 18.4‐percent positive predictive value for markers of infection with one of the three pathogens.Conclusion: The proposed donor deferral system provides a more flexible, sensitive, and predictive tool for averting donation by those who, though HIV antibody‐negative, are at a higher risk of being infected with HIV.
Institutional variation in hemotherapy for solid organ transplantation
Authors: Danielson C.F. , Filo R.S. , O'Donnell J.A. , McCarthy L.J. 
Published: March 2003

Background: Solid organ allograft recipients may require large amounts of blood components. The modification of components to make them safer for iatrogenically immunosuppressed transplant patients increases workload demands on blood banks and transfusion services.Study Design and Methods: Institutions within the United States and Canada providing hemotherapy as support for transplant recipients were surveyed for their transfusion practices.Results: Responses from 25 institutions provide the data for this report. In 1991, the mean intraoperative red cell requirements ranged from <1 unit for renal allograft recipients to 17.3 units for liver transplant recipients. The latter group also required the greatest amounts of platelets, fresh‐frozen plasma, and cryoprecipitate. More than 75 percent of responding institutions provided either cytomegalovirus‐seronegative or white cell‐reduced cellular components to pediatric recipients of liver allografts and to both adult and pediatric recipients of heart, lung, and heart‐lung allografts. The use of irradiated cellular blood components, although uncommon, was greatest in heart transplant recipients. The use of pretransplantation transfusions for immunomodulation was generally limited to patients awaiting a living‐donor renal transplant.Conclusion: Transfusion practices varied among the institutions, but the majority provide cytomegalovirus‐safe cellular blood components to heart and lung allograft recipients and to pediatric transplant patients. Gamma‐radiated cellular components are not routinely provided to patients undergoing solid organ transplantation. Liver allograft recipients require the greatest amount of hemotherapeutic support.
Circulating red cells usually remain of host origin after bone marrow transplantation for severe combined immunodeficiency
Authors: Brady K.A. , Cowan M.J. , Leavitt A.D. 
Published: March 2003

Background: Patients with severe combined immunodeficiency (SCID) treated with allogeneic bone marrow transplantation often receive a milder conditioning regimen than patients who undergo transplantation for hematologic malignancy, and they regularly retain circulating white cells of host origin. The origin of circulating red cells following successful bone marrow transplantation to treat SCID is not known.Study Design and Methods: Review of the medical records identified all patients with SCID who underwent ABO‐mismatched bone marrow transplantation at the University of California, San Francisco, between 1982 and 1994. The ABO and Rh phenotype at>6 months after transplantation was determined for all successful transplants by review of the medical record or the taking of a fresh blood sample for analysis. Patient‐conditioning and donor bone marrow‐preparative regimens were reviewed to assess their possible influence on the red cell phenotype after successful bone marrow transplantation.Results: Nine of 35 SCID patients who underwent successful transplantation received marrow from ABO‐mismatched donors. Eight of the nine patients had only host red cells circulating at 6 to 84 months after transplantation, while one patient had only donor red cells circulating at 48 months after transplantation. None of the patients had circulating red cells of both host and donor origin. Conditioning regimens included cyclophosphamide and antithymocyte globulin for all nine patients; only three patients also received total body irradiation. Seven of the nine patients received related‐donor, HLA‐ mismatched bone marrow, and two patients received HLA‐identical bone marrow; eight patients received T‐cell‐depleted bone marrow. The one patient whose red cell phenotype converted to that of the donor received T‐cell‐depleted, haploidentical marrow, and the preparative regimen included chemotherapy and total body irradiation.Conclusion: SCID patients successfully treated with allogeneic bone marrow transplantation typically fail to show circulating red cells of donor phenotype; this finding is in contrast to the universal presence of circulating donor red cells following successful bone marrow transplantation to treat hematologic malignancies and other diseases. The milder conditioning regimens typically given to patients with SCID, along with T‐cell depletion and HLA mismatching, may play a role in this different outcome. It is not known whether the inability to find circulating red cells of donor origin is due to a failure to engraft donor pluripotent stem cells or a failure of engrafted donor stem cells to differentiate along the erythroid lineage.
A point score system for predicting the likelihood of blood transfusion after hip or knee arthroplasty
Authors: Larocque B. J. , Gilbert K. , Brien W. F. 
Published: March 2003

BACKGROUND: Given the high cost of autologous blood donation for elective surgery, it would be desirable to predict which patients are most likely to benefit from the procedure. The purpose of this study was to develop a point score system for predicting the likelihood of blood transfusion in hip and knee arthroplasty.STUDY DESIGN AND METHODS: A database of 599 patients undergoing elective surgery at a teaching hospital was used for the analysis. Variables were analyzed to determine their univariate association with postoperative blood transfusion. Significant factors were entered into a multiple logistic regression model, and a point score system was developed on the basis of the regression coefficients. Four strata of transfusion risk were constructed.RESULTS: Factors independently associated with blood transfusion included preoperative hemoglobin, type of arthroplasty, primary versus revision surgery, autologous donor status, and patient weight. Four factors were used to create a point score system with four strata. The likelihood of blood transfusion for patients in the four risk strata was 1.7, 11.0, 40.0, and 78.3 percent. The calculated area under the receiver operating characteristic curve was 0.86.CONCLUSION: The likelihood of a postoperative blood transfusion can be predicted by using this simple point score system. Autologous blood donation can subsequently be targeted to the high‐risk patients.
Increase in endogenous thrombopoietin in healthy donors after automated plateletpheresis
Authors: Dettke M. , Hlousek M. , Kurz M. , Leitner G. , Rosskopf K. , Stiegler G. , Stohlawetz P. , Worel N. , Hocker P. , Panzer S. 
Published: March 2003

BACKGROUND: Thrombopoietin (TPO) is a key cytokine involved in the regulation of megakaryocytopoiesis and platelet production. The aim of the present study was to test whether platelet donation is associated with changes in the serum TPO levels in healthy donors undergoing plateletpheresis.STUDY DESIGN AND METHODS: The study group consisted of 23 healthy donors undergoing single‐donor plateletpheresis for the first time. Serum TPO levels and platelet counts were determined before platelet collection, at the end of apheresis, and for 4 days thereafter. Serum TPO levels were determined by a TPO‐specific enzyme‐ linked immunosorbent assay.RESULTS: In relationship to platelet donation, serum TPO levels showed a temporary increase from baseline levels of 69.2 +/− 7.1 pg per mL to 117 +/− 6.8 pg per mL 2 days after plateletpheresis (p < 0.05). Further evaluation revealed a decline in serum TPO levels as platelet counts increased. Female donors showed a delayed normalization of circulating platelet numbers and serum TPO levels as compared to male donors. There was no significant correlation between serum TPO levels and the absolute platelet number during normalization of the donors' platelet counts after plateletpheresis.CONCLUSION: Single‐donor plateletpheresis results in a temporary increase in serum TPO levels in healthy platelet donors, which may be part of a compensatory response‐boosting megakaryocytopoiesis after platelet collection.