bluuebunny/crossref_metadata_2025_split huggingface dataset:
Verification of the drug history given by potential blood donors: results of drug screening that combines hair and urine analysis
Authors: Mahl M.A. , Hirsch M. , Sugg U. 
Published: March 2003

BACKGROUND: Besides modern virus‐screening methods, the avoidance of transfusion transmission of viral diseases is based on the best possible selection of healthy donors. Unfortunately, most of the relevant behavior‐related risk factors are not accessible to objective verification. Drug screening can be used to validate a defined section of donor statements. It may be assumed that donors who conceal drug consumption may also conceal other relevant risk factors.STUDY DESIGN AND METHODS: Hair and urine samples from 186 young potential donors who denied having consumed drugs were investigated by gas chromatography with mass selective detection and a urine fluorescence polarization immunoassay for cannabinoids, amphetamine and amphetamine derivatives, cocaine, and opiates.RESULTS: Ten potential donors with 14 positive results on hair and urine analyses (6× cannabinoids, 4× cocaine, 1× opiates, 3× dihydrocodeine) could be identified in the population investigated.CONCLUSIONS: The donor history is not adequate for identifying potential donors with risk factors. Deliberately false statements concerning risk factors are a clear breach of trust between the blood bank and potential donors. These unreliable donors represent an incalculable risk for the transfusion recipient. Therefore, it is appropriate to validate donor statements about drug consumption by random hair and urine analyses and to exclude from the donor pool all persons revealed as drug users.
Assessment of donor T‐cell function in cellular blood components by the CD69 induction assay: effects of storage, γ radiation, and photochemical treatment
Authors: Fiebig E. , Hirschkorn D.F. , Maino V.C. , Grass J.A. , Lin L. , Busch M.P. 
Published: March 2003

BACKGROUND: Functional donor T‐lymphocytes in blood components may cause a variety of transfusion complications. A flow cytometric assay based on the measurement of induced CD69 expression may be an alternative to cell proliferation methods in determining the functional status of these cells in blood components.STUDY DESIGN AND METHODS: Seven units of whole blood, RBCs, and platelet concentrates (PCs) were stored under blood bank conditions. Half of 3 PCs each were gamma‐radiated or treated with UVA+psoralen; the other half served as controls. Samples were analyzed for phorbolester‐induced expression of CD69 as an indicator of cell responsiveness and for exclusion of propidium iodide as a measure of cell membrane integrity and viability.RESULTS: CD69 inducibility and propidium iodide exclusion decreased exponentially (half‐life, 3.3 and 8.1 days, respectively) during cold blood storage. Irradiation and UVA+psoralen treatment of PCs immediately reduced CD69 inducibility to 21 percent (controls, 82%; p = 0.004) and 12 percent (controls, 95%; p = 0.0008), respectively. The proportion of cells capable of propidium iodide exclusion was similar in treated samples and controls, but it declined faster in the treated samples during subsequent storage.CONCLUSION: Flow cytometric measurement of CD69 induction can be adapted to provide quantitative assessment of T‐cell function in blood components. Results obtained by the CD69 assay are in general agreement with those previously reported by use of proliferation methods; the assay may be useful for special applications in transfusion medicine.
Transfusion‐related sepsis due to Serratia liquefaciens in the United States
Authors: Roth V.R. , Arduino M.J. , Nobiletti J. , Holt S.C. , Carson L.A. , Wolf C.F.W. , Lenes B.A. , Allison P.M. , Jarvis W.R. 
Published: March 2003

BACKGROUND: Severe, often fatal, transfusion reactions due to bacterial contamination of blood components continue to occur. Serratia liquefaciens, an unusual human pathogen, is a recently recognized potential cause of transfusion‐related sepsis.CASE REPORTS: Five episodes of transfusion‐related sepsis and endotoxic shock due to S. liquefaciens were reported to the CDC from July 1992 through January 1999. One episode has been described. The remaining four, all fatal, are described here: three associated with RBC transfusion and one associated with transfusion of platelets. In each instance, the source of contamination could not be found. The implicated units tended to be older (mean RBC age 28 days), and visual discoloration was noted in each RBC unit, although usually in retrospect.CONCLUSION: S. liquefaciens is an increasingly recognized cause of transfusion‐related sepsis and is associated with a high mortality rate. S. liquefaciens can contaminate both RBCs and platelets, but the mechanism(s) of contamination remain unknown. Increased attention to pretransfusion visual inspection may avert the transfusion of some S. liquefaciens‐contaminated RBC units. However, more sensitive rapid diagnostic tests are needed to further reduce the risk of transfusion‐related sepsis and endotoxic shock.
Donor lymphocyte infusion to eradicate recurrent host hematopoiesis after allogeneic BMT for sickle cell disease
Authors: Baron Frederic , Dresse Marie‐Francoise , Beguin Yves 
Published: March 2003

BACKGROUND: Donor lymphocyte infusion (DLI) is currently standard therapy for relapse of malignancies after allogeneic BMT. Several observations suggest that both normal and leukemic progenitor cells of host origin constitute effective target cells for donor‐derived lymphocytes. To prevent relapse of sickle cell disease (SCD), a child with evidence of decreasing mixed chimerism received DLIs 8 months after allogeneic BMT for SCD.CASE REPORT: A 4‐year‐old child who was homozygous for SCD underwent a transplantation of bone marrow from his fully HLA‐matched sister. Routine detection of sex chromosomes in bone marrow cells evidenced decreasing mixed chimerism, which heralded a probably imminent recurrence of the disease. The patient received two DLIs in graded incremental doses on Days 234 and 267. One month later, he developed grade 2 acute GVHD that responded well to corticosteroids and cyclosporine.RESULTS: DLI resulted in complete donor chimerism within 2 months of the second infusion. Now, 2 years after the second DLI, the patient is in excellent condition, with normal Hb and excellent growth and development.CONCLUSION: This is the first report of successful use of DLI in a patient with probable imminent SCD recurrence after allogeneic BMT. It shows that DLI can displace residual host HPCs in case of recurrence of nonmalignant disease after allogeneic BMT.
Quantitative determination of anti‐K (KEL1) IgG and IgG subclasses in the serum of severely alloimmunized pregnant women by ELISA
Authors: Ahaded Abdellah , Brossard Yves , Debbia Martine , Lambin Patrick 
Published: March 2003

BACKGROUND: Severe cases of HDN occur after the immunization of the mother with K (KEL1) antigen. To date, the only means of evaluating the concentration of anti‐K in maternal serum is by titration with an indirect antiglobulin test (IAT). A more accurate estimation of the serum anti‐K concentration is needed.STUDY DESIGN AND METHODS: An ELISA technique was developed for the determination of the absolute concentration of anti‐K IgG and IgG subclasses in the sera of alloimmunized patients. In this technique, after absorption of anti‐K on K‐positive RBCs and subsequent elution at acid pH, the concentration of anti‐K in the eluate was measured with a sensitive and reproducible ELISA. This method was validated with monoclonal and polyclonal anti‐K. It was then used to assay the sera of eight pregnant women with anti‐K immunization, associated with early fetal anemia (Hct, 7‐17%) detected between the 20th and the 31st week of pregnancy. In addition, in most of these cases, the anemia was associated with fetal hydrops.RESULTS: The anti‐K IgG concentration measured by ELISA in the sera of the eight women varied from 1.0 to 4.1 μg per mL (mean, 2.2 μg/mL). Therefore, severe and early forms of fetal anemia can be observed with a relatively low concentration of anti‐K (as compared to the concentration of anti‐D in similar cases of fetal anemia due to anti‐D). The mean proportion of each IgG subclass of anti‐K in these sera was IgG1, 95.9 percent; IgG2, 2.4 percent; IgG3, 1.3 percent; and IgG4, 0.4 percent.CONCLUSION: A simple method for quantitative estimation of anti‐K in human serum has been developed. Low concentrations of anti‐K can cause fetal anemia relatively early in pregnancy. This method should lead to a better identification of pregnant women whose fetuses are at risk for severe fetal anemia due to anti‐K.
The effect of storage on the expression of platelet membrane phosphatidylserine and the subsequent impacton the coagulant function of stored platelets
Authors: Shapira Shirley , Friedman Ziva , Shapiro Hava , Presseizen Katya , Radnay Judith , Ellis Martin H. 
Published: March 2003

BACKGROUND: Platelet concentrates (PCs) derived from whole blood and stored under standard blood bank conditions undergo changes that are referred to as the platelet storage lesion. This study assesses the effect of PC preparation and storage on the distribution of phosphatidylserine (PS) in the platelet membrane and the effect that this distribution may have on the thrombogenic potential of stored PCs.STUDY DESIGN AND METHODS: Fresh platelets and PCs donated by healthy donors were obtained. PCs derived from platelet‐rich plasma were studied on Day 1, Day 3, and Day 6 of storage under blood bank conditions.RESULTS: Platelet aggregation after exposure to the platelet agonists ADP and epinephrine singly declined progressively, but, when ADP and epinephrine in combination and collagen and thrombin in combination were used as agonists, the decline in platelet aggregation was less marked. PS expression as measured by Annexin V binding (mean and SD) was 2.02 ± 0.93 percent in fresh platelet samples and increased to 5.39 ± 4.2 percent on Day 1, 22.1 ± 7.1 percent on Day 3, and 39.5 ± 12.1 percent on Day 6. Platelet prothrombinase activity (mean ± SD) as measured by thrombin generation increased from 1.49 ± 0.7 μ per mL in fresh platelet samples to 3.68 ± 1.1 μ per mL in Day 1 platelets (p<0.001), 5.15 ± 2.5 μ per mL in Day 3 platelets (p<0.001), and 4.65 ± 2.48 μ per mL in Day 6 platelets (p<0.001).CONCLUSION: These results show that PS expression increases after preparation of PCs from platelet‐rich plasma and rises progressively during platelet storage under blood bank conditions. Furthermore, the greater PS expression is associated with increased platelet‐ dependent thrombin‐generating capacity.
The capacity of different infusion fluids to lower the prooxidant activity of plasma iron: an important factor in resuscitation?
Authors: Moison Ralf M.W. , Bloemhof Fimke E. , Geerdink Janneke A.M. , De Beaufort Arnout Jan , Berger Howard M. 
Published: March 2003

BACKGROUND: Prooxidant activity of non‐protein‐bound iron (NPBI) is an important contributor to reactive oxygen species‐induced injury after the resuscitation of critically ill patients. Plasma NPBI occurs in critically ill adults, children, and newborn babies, who often require resuscitation. The ability of the resuscitation fluids to bind iron and lower the patients′ NPBI levels in vitro has not previously been studied.STUDY DESIGN AND METHODS: In an in vitro model, highly iron‐saturated cord blood plasma from 10 preterm and 10 term babies was mixed with FFP, pasteurized plasma protein solution, and 0.9‐percent saline. Plasma from 10 healthy adult volunteers was used as a control. Before and after the mixing with any resuscitation fluid, NPBI levels and ceruloplasmin iron‐oxidizing and transferrin iron‐binding antioxidant capacities were measured.RESULTS: After the in vitro mixing with FFP, the incidence and concentration of NPBI were markedly decreased and the iron‐binding antioxidant capacity was increased in the plasma of the preterm and term babies. Being mixed with pasteurized plasma protein solution and 0.9‐percent saline did not influence the iron‐binding antioxidant capacity of newborn babies′ plasma. In the control plasma, results were not changed after the mixing with any resuscitation fluid. In every group, the iron‐oxidizing antioxidant capacity was not changed after the mixing with any fluid.CONCLUSION: Iron‐induced oxidative tissue damage may be influenced by resuscitation fluids. In the ongoing debate over the choice of crystalloid or colloid resuscitation fluids, the influence of each fluid on the patient′s antioxidant capacity warrants more attention.
PEG adsorption of autoantibodies and detection of alloantibodies in warm autoimmune hemolytic anemia
Authors: Cheng Chun‐Kwok , Wong Maria L. , Lee Ala W. 
Published: March 2003

BACKGROUND: The purpose of this study was to evaluate the effectiveness of PEG in the adsorption of autoantibodies and the detection of alloantibodies in patients with warm autoimmune hemolytic anemia (WAIHA).STUDY DESIGN AND METHODS: The study was divided into three parts. First, the effectiveness of antibody removal by a conventional adsorption procedure and that by the PEG adsorption method were compared by using commercial antisera adsorbed with antigen‐positive RBCs. Second, patients′ sera with known weak alloanti‐E were used to test against screening cells after allogeneic adsorption to show nonspecific coating of antibodies and the dilution effect on the PEG adsorption procedure. Third, conventional and PEG one‐cell sample allogeneic adsorptions of WAIHA patients′ sera with and without alloantibodies were performed and compared.RESULTS: In the first part, seven of the eight polyclonal antisera gave a lower titer and score when tested against antigen‐positive RBCs in the indirect antiglobulin test; this indicated that PEG is more efficient in removing antibodies. In the second part, similar reaction patterns were observed in antibody screening tests on unadsorbed sera and on sera after the first, second, and third adsorptions, which indicated that there was no alloantibody loss, nonspecific antibody coating, or dilution effect when PEG was added in the allogeneic adsorption procedures. In the third part, a 40‐percent increase in efficiency in reducing the number of adsorptions and an 85‐percent decrease in completion time of the adsorption procedures were obtained when PEG was used for adsorbing sera from 16 patients with WAIHA. Both conventional and PEG procedures were capable of removing autoantibodies to identify the specificities of alloantibodies.CONCLUSION: The PEG adsorption method is an effective, sensitive, and efficient method of enhancing auto‐ antibody adsorption and alloantibody detection. It can reduce the processing time and minimize the delay of urgent transfusions to patients with WAIHA and can indirectly enhance cost‐effectiveness and decrease the labor‐intensive testing required by these cases.
Counting of residual WBCs in WBC‐reduced blood components: a multicenter evaluation of a microvolume fluorimeter by the United Kingdom National Blood Service
Authors: Seghatchian Jerard , Krailadsiri Pranee , Scott Colin S. 
Published: March 2003

BACKGROUND: Implementation of universal WBC reduction of blood components means that automated analytical methods may be the only satisfactory way for production laboratories to meet increased testing requirements.STUDY DESIGN AND METHODS: A multicenter study on the performance of a microvolume fluorimeter (IMAGN 2000, Becton Dickinson) was undertaken on 519 RBC, 353 platelet, and 27 fresh plasma units.RESULTS: WBC counts for the RBC samples ranged from 0.02 to 6.94 × 106 per unit (mean, 0.57) as determined by FC and from 0.02 to 5.53 × 106 per unit (mean, 0.40) as determined by MVF with a mean FC bias of +0.15 × 106 WBCs per unit, and discrepancies outside the 95% limits of agreement were mainly associated with higher FC counts. The series of platelet samples showed means of 0.90 (range, 0.06‐19.45) and 0.66 (range, 0.01‐18.95) × 106 WBCs per unit for FC and MVF methods, respectively. FC and MVF results were in good agreement at low counts, although significant discrepancies were noted at higher counts. Overall, for the platelet units, there was a mean FC bias of +0.34 × 106 WBCs per unit. The intermethod agreement exceeded 99 percent for both types of blood component when the single (both UK and United States) decision point of 5.0 × 106 WBCs per unit was applied. The mean WBC counts for the 27 analyzed fresh plasma units were 61.8, 56.0, and 46.0 per μL by Nageotte hemocytometry, FC, and MVF, respectively.CONCLUSIONS: This evaluation found that the level of intersite consistency for FC was relatively poor compared to that for MVF. The results nevertheless validated the broad equivalence of FC and MVF results for the current Council of Europe and UK/US decision points of <1.0 and <5.0 × 106 WBCs per unit.
Transfusion‐related acute lung injury after the infusion of IVIG
Authors: Rizk André , Gorson Kenneth C. , Kenney Lawrence , Weinstein Robert 
Published: March 2003

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is a well‐characterized, serious complication of blood component therapy in hospitalized patients. The signs and symptoms are often attributed to other clinical aspects of a patient's condition, and therefore TRALI may go unrecognized. IVIG is a pooled plasma derivative commonly used in the outpatient setting. Respiratory complications of IVIG infusion have typically been attributed to volume overload or allergic and vasomotor reactions. TRALI has never been documented to occur after IVIG infusion.CASE REPORT: A 23‐year‐old man with multifocal motor neuropathy developed noncardiogenic pulmonary edema 6 hours after receiving 90 g of IVIG by a rapid‐infusion protocol. He fully recovered in 5 days with nasal oxygen and bed rest. Granulocyte‐associated IgG was detected in his blood 14 and 27 weeks after the event. The lots of IVIG that he received were found to contain a low‐titer, panreactive, granulocyte antibody, mostly IgG.CONCLUSION: This is the first documented case of TRALI after IVIG infusion. An autoimmune syndrome, including autoantibody‐coated granulocytes, may have been a priming stimulus for granulocyte interaction with pulmonary capillary endothelium. Rapid infusion of a large quantity of granulocyte antibody may have precipitated TRALI. A pooled plasma product or derivative may result in TRALI.
Donor‐derived alloantibodies and passenger lymphocyte syndrome in two of four patients who received different organs from the same donor
Authors: Seltsam Axel , Hell Anette , Heymann Guido , Salama Abdulgabar 
Published: March 2003

BACKGROUND:Reported here is the occurrence of RBC alloimmunization in two of four patients who received different organs from an immunized donor.STUDY DESIGN AND METHODS:The donor, a 58‐year‐old woman, was group O D+, K−, and Fy(a−). Initially, her serum contained only a K antibody. After blood transfusion, a second antibody (anti‐Fya) could also be identified. The liver was given to a group O D+, K−, Fy(a+) patient; the pancreas and one kidney to a group O D+, K−, Fy(a+) patient; the heart to a group A D+, K−, Fy(a−) patient; and the other kidney to a group B D+, K−, Fy(a+) patient. RBC grouping and antibody screening were performed by standard techniques. Lymphoid microchimerism in the peripheral blood of the recipients was analyzed by flow cytometry and nested PCR.RESULTS:None of the recipients had irregular RBC alloantibodies at the time of transplantation. After the transplant, anti‐K became detectable in the serum of the liver recipient, and anti‐Fyacould be eluted from the RBCs of the liver recipient and the pancreas‐kidney recipient. The latter patient also developed mild hemolysis, and his Hb dropped to 8 g per dL on posttransplant Day 9. Donor‐derived lymphocytes were detectable by flow cytometry in the peripheral blood of the liver recipient and the pancreas‐kidney recipient until Days 8 and 63, respectively, whereas no lymphoid chimerism could be demonstrated in the heart recipient. PCR chimerism analyses were positive in all three recipients over the whole observation period of 97 postoperative days.CONCLUSION:The amount of cotransplanted lymphoid tissue may correlate with the extent of peripheral lymphoid microchimerism and the antibody‐formation capacity in solid organ transplantation.
Serial granulocytapheresisunder daily administration of rHuG–CSF: effects on peripheral blood counts, collection efficiency, and yield
Authors: Worel Nina , Kurz Martin , Peters Christina , Höcker Paul 
Published: March 2003

BACKGROUND: An option for treatment of severe infections in neutropenic patients is the transfusion of granulocytes from donors stimulated with rHuG–CSF. The schedule of rHuG–CSF‐stimulated granulocyte donations and the quality of the components remain controversial. This study was done with the intention of ensuring daily granulocyte support with therapeutic cell numbers, while keeping the patients' allogeneic exposure as low as possible.STUDY DESIGN AND METHODS: Granulocyte collection with multiple consecutive leukapheresis procedures under daily rHuG–CSF administration and with hydroxyethyl starch as sedimenting agent were prospectively studied. Complete blood counts of the donors, collection yield, and efficiency were analyzed.RESULTS: Products (n = 259) from 76 donors were examined. The median peripheral blood WBC and neutrophil counts were 28.1 g per L and 24.1 g per L, respectively, and they were significantly higher on Day 5 of collections than on Days 1 to 3. Platelet counts and Hb levels decreased steadily. Collection yields increased over time from 4.9 to 6.7 × 1010 neutrophils. Side effects of cytokines and aphereses did not exceed World Health Organization grade II status.CONCLUSION: Repetitive daily rHuG–CSF administration—even under daily leukapheresis procedures—results in a continuing increase in WBC and neutrophil levels and thus leads to increased collection yields. Side effects are tolerable, although Hb and platelet levels should be monitored closely.
Repeat whole‐blood and plateletpheresis donors:unreported deferrable risks, reactive screening tests, andresponse to incentive programs
Authors: Glynn Simone A. , Smith James W. , Schreiber George B. , Kleinman Steven H. , Nass Catharie C. , Bethel James , Biswas Bipasa , Thomson Ruth A. , Williams Alan E. ,   for the Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND: Evaluating plateletpheresis (PPH) and repeat community whole‐blood (RWB) donors' responses to donation incentive programs is essential for developing effective donor retention programs.STUDY DESIGN AND METHODS: Using data from a 1998 anonymous questionnaire sent to 92,581 US blood donors, the prevalence of unreported deferrable risks, screening test reactivity, and response to incentives were compared in RWB and PPH donors by the use of weighted chi‐square tests and logistic regression analyses.RESULTS: From 52,650 respondents, 38,884 RWB and 2,028 PPH donors were identified. Levels of screening test reactivity (1%) and unreported deferrable risks (UDRs, 2‐3%) were similar in RWB and PPH donors. RWB and PPH donors were strongly encouraged or discouraged by similar incentives. Of the incentives that would encourage a higher proportion of UDR‐free RWB donors to return, cholesterol screening and earning a blood credit appealed to >50 percent. Similar results were obtained for cholesterol screening in PPH donors. Community service or education credits, premarital screening, and cash had limited appeal for PPH and RWB donors, respectively, and would be more likely to differentially encourage donors with a UDR to return.CONCLUSION: Incentives that were associated with the greatest donor appeal and that minimized the potential recruitment of more risky donors were identified.