bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the efficacy of blood and polyethylene glycol‐hemoglobin in recovery of newborn piglets from hemorrhagic hypotension: effect on blood pressure, cortical oxygen, and extracellular dopamine in the brain
Authors: Song D. , Olano M. , Wilson D. F. , Pastuszko A. , Tammela O. , Nho K. , Shorr R.G.L. 
Published: March 2003

BACKGROUND: Successful blood substitutes, when infused in place of an equal volume of whole blood, provide similar delivery of oxygen to the tissues without introducing abnormalities in cellular metabolism.STUDY DESIGN AND METHODS: Equal volumes of whole blood (control), polyethylene glycol‐hemoglobin solution at 6 g per dL, dextran solution, and physiologic saline were compared for their ability to reverse the effects of hemorrhagic hypotension on oxygenation and dopamine metabolism in the brain of newborn piglets. The decrease in mean arterial blood pressure was used as a measure of the hemorrhagic insult. Cerebral oxygen pressure was determined optically by the oxygen‐ dependent quenching of phosphorescence, and the extracellular level of dopamine in the corpus striatum was determined by in vivo microdialysis.RESULTS: Following a 2‐hour stabilization after implantation of the microdialysis probe in the corpus striatum, the mean arterial blood pressure was decreased from 88 +/− 7 torr (control) to 42 +/− 5 torr by the removal of blood in a stepwise manner, over a period of 60 minutes. Decrease in mean arterial blood pressure caused a progressive stepwise decrease in cortical oxygen pressure from 48 +/− 5 torr to 16 +/− 4 torr at the end of bleeding. As a consequence of the decrease in oxygen pressure, extracellular dopamine increased progressively to about 2300 percent of the control value. When a volume of blood equal to that removed was returned and bicarbonate was injected to help correct arterial pH, blood pressure, cortical oxygen pressure, and extracellular dopamine all returned within the 20‐ to 30‐ minute recovery period to values not significantly different from control values. An equal volume of polyethylene glycol‐hemoglobin solution, even with significantly lower hemoglobin content than whole blood, gave results comparable to those with whole blood.CONCLUSION: Polyethylene glycol‐hemoglobin solution, like whole blood but in contrast to physiologic saline or dextran solution, was capable of returning the mean arterial blood pressure, cortical oxygen pressures, and extracellular dopamine nearly to control levels after acute blood loss in newborn piglets.
Analysis of the priming activity of lipids generated during routine storage of platelet concentrates
Authors: Silliman C. C. , Dickey W. O. , Paterson A. J. , Thurman G. W. , Clay K. L. , Johnson C. A. , Ambruso D. R. 
Published: March 2003

BACKGROUND: Compounds generated during the routine storage of platelet concentrates may have deleterious effects on the transfusion recipient.STUDY DESIGN and METHODS: Daily plasma samples from platelet concentrates, both apheresis platelets and those separated from whole blood, were obtained serially during routine storage. These plasma samples were assayed for their ability to prime the NADPH oxidase in isolated human neutrophils. Quantitative and qualitative analysis of the priming agents was completed by lipid extraction, high‐pressure liquid chromatography separation, and gas chromatography/mass spectroscopy.RESULTS: Compounds were generated in both apheresis and whole‐blood platelets that significantly primed the NADPH oxidase after 24 and 48 hours of storage, respectively. The priming activity was maximal by component outdate: 2.6‐fold that of the buffer‐treated control neutrophils (apheresis) and 3.9‐fold that of the buffer‐treated control neutrophils (whole blood). These agents were generated by cellular constituents, as stored plasma did not demonstrate such priming activity. Inhibition of this priming activity by WEB 2170, a specific platelet‐activating factor receptor antagonist, suggested that the observed priming involved the platelet‐activating factor receptor. A portion of the priming activity from platelet concentrates was organically extractable: 69 percent of that from apheresis platelets and 46 percent of that from whole‐blood platelets. Further purification of the lipid's priming activity by normal‐phase high‐pressure liquid chromatography demonstrated a single peak of priming activity at the retention time of lysophosphatidylcholines. Because 46 percent of the priming activity from whole‐blood platelets was chloroform insoluble and because it has been reported that interleukin 8 is generated during routine storage of whole‐blood platelets, the effects of interleukin 8 on the NADPH oxidase were examined. Recombinant monocyte interleukin 8 rapidly primed the oxidase but was not inhibited by WEB 2170.CONCLUSION: Lipids were generated during the routine storage of platelet concentrates that prime the NADPH oxidase, and they may play a role in the severe complications of transfusion therapy. Other non‐ lipid compounds, such as interleukin 8, that are generated in whole‐ blood platelets may also contribute to the observed priming activity of plasma.
Unexplained hepatitis C virus antibody seroconversion in established blood donors
Authors: Atrah H.I. , Ala F.A. , Ahmed M.M. , Hutchinson F. , Cough D. , Baker K. 
Published: March 2003

Background: Understanding of the epidemiology and natural history of hepatitis C virus (HCV) infection is incomplete without reference to the early phase of infection. The prevalence of HCV infection is well documented in numerous reports. The seroconversion pattern in previously antibody‐negative blood donors provides a model for the study of the incidence and transmission of HCV infection.Study Design and Methods: Records of HCV antibody tests at the West Midlands Blood Transfusion Centre were reviewed to determine the seroconversion rate in 1994 among previously anti‐HCV‐negative blood donors. Seroconverting donors were counseled to investigate the possible routes of infection.Results: In 1994, blood donations (n = 256,935) were collected from 149,370 donors; 24 donors (0.016%; 1/6224) were positive in the screening enzyme‐linked immunosorbent assay (ELISA) and the third‐ generation recombinant immunoblot assay (RIBA‐3). Two donors previously negative for HCV antibody in ELISA were positive in both tests in 1994. Four donors positive in ELISA and indeterminate in RIBA‐3 in 1993 reacted positively in both tests in 1994. One donor negative for HCV antibody on previous screening reacted positively in ELISA and was indeterminate in RIBA‐3 in 1994 and has become positive in both tests in 1995. A further 43 donors negative for HCV antibody on previous screening reacted positively in ELISA and were indeterminate in RIBA‐3 in 1994.Conclusion: Documented seroconversion can take place in the absence of exposure to recognizable risk factors for the infection. The index donation or the donation immediately preceding seroconversion may be positive for HCV RNA in the polymerase chain reaction.
Infection by hepatitis C virus through contaminated intravenous immune globulin: results of a prospective national inquiry in France
Authors: Lefrere J.J. , Loiseau P. , Martinot‐Peignoux M. , Mariotti M. , Ravera N. , Thauvin M. , Marcellin P. , Janot C. 
Published: March 2003

BACKGROUND: A recent hepatitis C virus (HCV) outbreak has been suspected of being caused by an infusion of intravenous immune globulin.STUDY DESIGN AND METHODS: Three laboratories were mandated by the French regulatory agency to prospectively screen on a national scale those persons having received suspected batches: 233 exposed patients were recalled and tested for HCV antibody and for HCV RNA.RESULTS: Nineteen patients (8.1%) were found positive for HCV RNA; 7 of these 19 were positive for the HCV antibody.CONCLUSION: The link between HCV infection and intravenous immune globulin was reinforced by the overrepresentation of the 2b genotype (58%), which contrasts with the low prevalence of this genotype in France (1%).
Frequency of immediate adverse effects associated with apheresis donation
Authors: McLeod B. C. , Price T. H. , Owen H. , Ciavarella D. , Sniecinski I. , Randels M. J. , Smith J. W. 
Published: March 2003

BACKGROUND: Apheresis donation is considered safe, but the incidence of adverse effects has not been determined in a large multicenter series of donations with modern instruments.STUDY DESIGN AND METHODS: The Hemapheresis Committee of the American Association of Blood Banks devised a uniform questionnaire that asked about 32 specific adverse effects. Transient paresthesia and mild vasovagal events were excluded. A survey was conducted in 1995; 17 centers returned 19,611 responses concerning 250 to 2,000 consecutive apheresis donations per center.RESULTS: Six hundred adverse effects were reported in 428 donations (2.18% of donations). Pain or hematoma at a venipuncture site was the most common response (1.15% of donations); only 203 donations had other (nonvenipuncture) adverse effects (1.04%). Total and nonvenipuncture rates were, respectively, 4.84 and 2.92 percent for 2,295 first donations and 1.78 and 0.77 percent for 17,303 repeat donations (p < 0.001). Rates of nonvenipuncture symptoms in first and repeat donations were, respectively, citrate‐induced nausea and/or vomiting, 0.87 and 0.27 percent; tetany, 0.09 and 0.04 percent; pallor and/or diaphoresis, 1.87 and 0.32 percent; vasovagal nausea and/or vomiting, 0.87 and 0.13 percent; syncope and/or seizure, 0.39 and 0.04 percent; and chills and/or rigors, 0.31 and 0.01 percent. The overall rate of donor unconsciousness was 0.08 percent. Hemolysis was reported twice. Clotting or leakage occurred in 0.08 percent of donations, and inability to return blood occurred in 0.16 percent. No life‐threatening adverse effects were reported. Procedure‐specific nonvenipuncture rates were 1.05 percent of 17,584 platelet donations, 0.67 percent of 594 white cell donations, and 0.37 percent of 1,354 plasma donations. Center‐specific rates varied from 0.32 to 6.81 percent of donations for total adverse effects and from 0.11 to 2.92 percent of donations for nonvenipuncture events.CONCLUSION: Apheresis donation is a safe undertaking, suitable for voluntary blood donors, with a very low risk of serious adverse effects. The risk of unconsciousness is lower than that found in many studies of whole‐blood donation.
RHD genotyping in weak D phenotypes by multiple polymerase chain reactions
Authors: Legler T.J. , Maas J.H. , Blaschke V. , Malekan M. , Ohto H. , Lynen R. , Bustami N. , Schwartz D.W.M. , Mayr W.R. , Kohler M. , Panzer S. 
Published: March 2003

BACKGROUND: Weak D phenotypes involve a quantitative variation of D. The genomic basis in weak D has been disputed, however.STUDY DESIGN AND METHODS: Five sequence‐specific polymerase chain reactions (SSP‐ PCRs) on exons 2, 5, and 7 of the RHD gene were evaluated in 248 white and 98 Japanese blood donors and compared with the results obtained by amplification of intron 4 and serology. All methods and SSP‐PCR testing on the 3′ non‐coding region of the RHD gene were applied to the genotyping of 94 DNA samples derived from individuals expressing weak D phenotypes.RESULTS: Concordant results were obtained with all genotyping and phenotyping methods in testing 201 D‐positive and 145 D‐ negative donors. Four of 94 weak D samples were typed as D‐negative by amplification of intron 4 and SSP‐PCR on exon 5. Phenotyping with monoclonal antibodies revealed a DVI category in one of these cases and DFR phenotype in three of these cases. One weak D sample, which reacted like normal D‐positive cells with all applied monoclonal antibodies, was typed falsely negative by SSP‐PCR on exon 5 because of a point mutation at nucleotide 667 (T–>G) that resulted in a Phe223Val amino acid substitution. In this individual, heterozygosity was found at two other amino acid positions (Glu233Gln and Val238Met) by restriction fragment length polymorphism analysis.CONCLUSION: Genetic diversity in weak D phenotypes is rare. Only 1 of 90 true weak D phenotypes (1.1%) had a genetic variation in testing on seven gene regions of the RHD gene.
A recombinant peptide antigen line immunoassay optimized for the confirmation of Chagas' disease
Authors: Oelemann W.M.R. , Vanderborght B.O.M. , Verissimo Da Costa G.C. , Teixeira M.G.M. , Borges‐Pereira J. , De Castro J.A.F. , Coura J.R. , Stoops E. , Hulstaert F. , Zrein M. , Peralta J.M. 
Published: March 2003

BACKGROUND: The transfusion of contaminated blood has become the major route of transmission for Chagas' disease in Brazil. Current screening tests are insensitive and yield conflicting results, while confirmatory assays do not exist. A line immunoassay (INNO‐LIA Chagas Ab [INNO‐LIA]) combining relevant, immunodominant recombinant and synthetic antigens on a single nylon membrane strip was evaluated for the serologic confirmation of Chagas' disease.STUDY DESIGN AND METHODS: Sera from 1062 patients and healthy residents of four Brazilian regions endemic for Chagas' disease were used for test optimization. The established confirmation algorithm was evaluated with an independent set of positive (n = 75) and negative (n = 148) samples.RESULTS: In the optimization phase, without an established comparative gold standard, the results with the INNO‐LIA were compared with those obtained in four other screening assays. In the validation phase, the INNO‐LIA showed a sensitivity of 100 percent (95% CI, 95.21‐100) and a specificity of 99.32 percent (95% CI, 96.29‐99.98) for well‐characterized sera. Moreover, its specificity reached 100 percent with a set of 40 sera obtained from patients with documented leishmaniasis. The interpretation criteria defined in this study indicated that the INNO‐LIA accurately detected the presence of antibodies to various specific antigens of Trypanosoma cruzi.CONCLUSION: The INNO‐LIA Chagas Ab assay may become the first commercial assay to reliably confirm the presence of antibodies to T. cruzi.
Inhibition of a secondary human alloimmune response via the soluble active component of CD154 (CD40L) in severe combined immune‐deficient mice engrafted with human lymphocytes
Authors: Lazarus A.H. , Crow A.R , Freedman J. , Blanchette V. , Hannach B. 
Published: March 2003

BACKGROUND: Alloimmunization requires a process known as co‐stimulation. An important co‐stimulatory pathway for most immune responses is mediated by the interaction of CD40 on antigen‐presenting cells with CD154 (CD40L) on host T cells. Blockade of this co‐stimulatory pathway simultaneous with exposure to challenge with HLA‐incompatible cells is hypothesized to inhibit alloimmunization.STUDY DESIGN AND METHODS: Severe combined immune‐deficient (SCID) mice were reconstituted with human peripheral blood lymphocytes (Hu‐PBL‐SCID mice) from a subject primed to HLA antigens and challenged with HLA‐incompatible lymphocytes. Mice were challenged in the presence or absence of an 18‐kDa soluble recombinant active form of human CD154 (18‐kDa CD154). Human IgG production, alloimmunization, and in vitro T‐cell responsiveness were assessed.RESULTS: There was no significant effect of 18‐kDa CD154 on human IgG levels in these mice, but it inhibited the development of HLA‐specific alloantibody in this model to five subsequent untreated white cell challenges. In vitro T‐cell proliferation in a mixed lymphocyte culture was also prevented by 18‐kDa CD154.CONCLUSION: The recombinant protein 18‐kDa CD154 inhibited the ability of the Hu‐PBL‐SCID mice to mount a secondary immune response to allostimulation. This implies that transfusion‐induced alloimmunization utilizes CD40‐CD154 co‐stimulation and that blockade of this pathway can inhibit T‐cell function and interfere with the development of alloimmunization.
Analysis of donor return behavior
Authors: Ownby H.E. , Kong F. , Watanabe K. , Tu Y. , Nass C.C. ,   for the Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND:Efforts to provide a safe, adequate blood supply have been inhibited by persistent shortages attributed to a lack of motivation on the part of the general public and inefficiency in recruiting processes. This study examined whether frequency of donations and/or timing of subsequent donations by first‐time donors related to donor demographics.STUDY DESIGN AND METHODS:Characteristics of 879,816 first‐time donors making at least one whole‐blood donation were analyzed. Cox proportional‐hazards regression models evaluated the first 10 return times separately, and a recurrent‐event Cox model was applied to simultaneously evaluate the first five returns.RESULTS:The shorter the donation interval between the first two donations, the more likely the donor was to make subsequent donations. The proportion of repeat donors increased with education level. Rate of donation increased with age and education. The recurrent‐event Cox regression model showed that Rh‐negative donors, older donors, and donors who had completed college had higher donation return rates.CONCLUSION:Time to return for second donation was associated with total number of donations made and with return rate for subsequent returns. Age was the strongest predictor of high donation frequency and early‐return rate. Relationships between interdonation interval and the number of future donations may prove useful in understanding return behavior and developing donor recruitment and retention strategies.
Direct HIV testing in blood donations: variation of the yield with detection threshold and pool size
Authors: Le Corfec E. , Le Pont F. , Tuckwell H.C. , Rouzioux C. , Costagliola D. 
Published: March 2003

BACKGROUND: This study was designed to evaluate the potential yield of introducing nucleic acid amplification testing (NAT) in blood donation, according to the detection threshold and the pool size.STUDY DESIGN AND METHODS: A mathematical model of early HIV‐1 population dynamics in blood has been developed and is used to predict the window period for NAT, according to the detection threshold and the pool size. The corresponding number of undetected, infected blood donations and the residual risk are estimated by using a previously published simulation model for the United States (9.96 million blood donations from regular donors, and an observed rate of HIV antibody‐positive blood donations of 3.18/100,000) and for France (2.32 million blood donations, and a rate of antibody‐positive donations of 0.9/100,000).RESULTS: The average window period from infection predicted by the mathematical model for NAT ranges from 8.4 to 15.6 days, according to the detection threshold and the pool size. The maximum yield of adding NAT to the current antibody tests is estimated at 14 donations for the United States and 2 for France. The maximum yield of adding NAT to the newly developed combined HIV antibody and p24 antigen tests is 7 donations for the United States and 1 for France.CONCLUSION: NAT at blood donation could reduce the HIV‐1 window period to a minimal value of 8 days without pooling the blood samples, but the yield of NAT would be close to that of combined HIV antibody and p24 antigen tests for high values of the detection threshold and the pool size.
Transfusion‐acquired hepatitis C: the Danish lookback experience
Authors: Christensen Peer B. , Groenbæk Karin , Krarup Henrik B. , Gaub Johannes , Møller Axel , Skinhøj Peter , Ring‐Larsen Helmer , Groenbæk Karin , Krarup Henrik B. , Dickmeiss Dickmeiss , Wantzin Per S. 
Published: March 2003

BACKGROUND: In 1996, the Danish National Board of Health recommended hepatitis C virus (HCV) lookback to identify recipients of blood components from donors found to be positive since the implementation of anti‐HCV screening in 1991.STUDY DESIGN AND METHODS: The aim was to accumulate results of the lookback at a national level and to describe the morbidity of the infected recipients. Records of transfusion were identified for at least 10 years back, and recipients still alive were tested for hepatitis C. Those with positive results were referred for clinical evaluation.RESULTS: A total of 150 anti‐HCV‐positive Danish donors had donated blood to 1018 transfusion recipients, of whom 288 (29%) were still alive. Because of age, malignancy, or other severe diseases, 118 (41 %) of these were not contacted. Of 157 recipients screened for HCV, 128 (82%) were anti‐HCV positive on enzyme‐linked immunosorbent assay, and 88 (56%) were HCV RNA positive. Among the HCV RNA‐positive recipients, symptoms were present in 38 percent (25/66 reported), elevated alanine aminotransferase was found in 53 percent (41/77 tested), and cirrhosis was found in 11 percent (6/54 biopsied). Treatment with interferon α was initiated in 23 patients, corresponding to 26 percent of HCV RNA positive recipients.CONCLUSION: Among tested recipients in the Danish HCV lookback, most were anti‐HCV positive and more than half were still viremic. The morbidity was considerable, and one‐fourth of viremic recipients entered treatment.
Targeted hepatitis C lookback: Quebec, Canada
Authors: Long Anne , Spurll Gwendoline , Demers H. , Goldman Mindy 
Published: March 2003

BACKGROUND: Since March 1990, all blood donations in Canada are screened for antibodies to hepatitis C virus (HCV). Because HCV may cause chronic asymptomatic hepatitis, in February 1995, the Canadian Red Cross began targeted HCV lookback studies.STUDY DESIGN AND METHODS: From March 1990 to March 1997, the Quebec Center of the Canadian Red Cross collected 1,750,846 donations, and there were 561 anti‐HCV‐positive repeat donors, from whom 3,196 blood components had been issued to the hospitals. Hospital blood bank directors were asked to test recipients and return results to the Quebec Center. One hundred nine hospitals were surveyed to determine methods and resources involved in lookback. The transfusion medicine service at the Royal Victoria Hospital (RVH) developed a standard operating procedure for performing lookbacks and analyzed the costs and outcomes of lookbacks.RESULTS: As of April 1998, information has been received on 2329 (73%) of components; 1020 patients had died of unrelated causes, 590 were untraceable, and 353 were tested. Of those tested, 215 (61%) were anti‐HCV positive; their average age was 47, and at least 53 percent were already aware of their HCV status. Few hospitals had received any additional resources to perform lookbacks. At the RVH, lookback on 182 components resulted in the identification of nine seropositive recipients, average age 70, who did not previously know their HCV status; four of these patients had abnormal alanine aminotransferase levels. The cost of lookback per newly diagnosed case of HCV was estimated at $2727 (US) for the Quebec Center and $6014 (US) for the RVH.CONCLUSION: Targeted lookback in the province of Quebec on 3196 components has resulted in the identification of 101 seropositive recipients who did not previously know their HCV status.