bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐Dib as a red cell autoantibody
Authors: Issitt P.D. , Combs M.R. , Allen J. , Melroy‐Carawan H. 
Published: March 2003

Background: It is known that some “warm”‐reactive autoantibodies are directed against epitopes on the red cell anion exchanger, protein band 3. Some such antibodies (but not all) recognize Wrb. It is also known that Dia and Dib represent an amino acid polymorphism of band 3. Study Design and Methods: Autoantibodies from 119 patients were tested against Di(b‐) red cells. Seventy‐four of these autoantibodies were subsequently absorbed with Di(b‐) red cells. Results: All 119 autoantibodies initially reacted with the Di(b‐) red cells, which showed that none contained only anti‐Dib. Among the 74 adsorbed with Di(b‐) red cells, two were found to contain an unadsorbed anti‐Dib component. Conclusion: No example of autoanti‐Dib as the only autoantibody present was found among the 119 samples tested. However, 2 (2.7%) of 74 autoantibodies subjected to adsorption with Di(b‐) red cells were seen to contain an anti‐Dib component. This low incidence of autoanti‐Dib is in marked contrast to the high incidence of autoanti‐Wrb, although both antibodies define epitopes associated with the red cell anion exchanger, band 3.
Gene frequencies of human platelet antigens on glycoprotein IIIa in Japanese
Authors: Tanaka S. , Ohnoki S. , Shibata H. , Okubo Y. , Yamaguchi H. , Shibata Y. 
Published: March 2003

Background: Polymorphism of glycoprotein IIIa on human platelets is one of the factors in alloimmunization that causes neonatal alloimmune thrombocytopenia and refractoriness to platelet transfusion. Study Design and Methods: DNA typing methods were originally developed to determine the genotypes of five human platelet antigen (HPA) systems located on glycoprotein IIIa: HPA‐1, HPA‐4, HPA‐6W, HPA‐7W and HPA‐8W. The gene frequencies of these platelet antigens were determined by DNA typing of 331 unrelated Japanese donors. Results: The gene frequencies of the low‐frequency antigens were 0.002, 0.011, and 0.027 for HPA‐1b, HPA‐4b, and HPA‐6W(b), respectively. All 331 Japanese donors tested were HPA‐7W(a/a) and HPA‐8W(a/a). Moreover, in the present study, none of the donors tested had two or more of these low‐frequency antigens. Conclusion: The risk of neonatal alloimmune thrombocytopenia and refractoriness to platelet transfusion induced by the antigens of the HPA‐1, HPA‐7W, and HPA‐8W systems was extremely rare in Japanese. However, attention must be paid to the involvement of the HPA‐4 and HPA‐6W systems in these clinical disorders.
Evaluation of donor skin disinfection methods
Authors: Goldman M. , Roy G. , Fréchette N. , Décary F. , Massicotte L. , Delage G. 
Published: March 2003

BACKGROUND: Because most bacteria isolated from contaminated platelet concentrates are thought to originate from the donor's skin, the efficacy of four methods of skin disinfection was compared.STUDY DESIGN AND METHODS: Contact plates were used for antecubital skin cultures after they were demonstrated to be easier to use and at least as sensitive as a swab system. One antecubital fossa of each subject was disinfected by a standard method, the use of a povidone‐iodine swabstick containing 0.75‐percent available iodine followed by the use of a povidone‐iodine swabstick containing 1‐percent available iodine. The other arm was disinfected with either a 70‐percent isopropyl alcohol scrub followed by an ampoule of 2‐percent iodine tincture (Group 1; n = 126); a green‐soap sponge followed by a 70‐percent isopropyl alcohol swab, used for donors who are allergic to iodine (Group 2; n = 30); or a 0.5‐percent chlorhexidine gluconate and 70‐percent isopropyl alcohol sponge followed by an ampoule of 0.5‐percent chlorhexidine gluconate and 70‐percent isopropyl alcohol (Group 3; n = 40). Contact plate cultures were done before and after disinfection, and colonies counted after a 48‐hour 37°C incubation period.RESULTS: Similar numbers of bacteria grew from both antecubital fossae of the same subject before disinfection (p = 0.71). Compared to the standard povidoneiodine method, isopropyl alcohol and tincture of iodine resulted in significantly less bacterial growth (p<0.001), the green soap and isopropyl alcohol method resulted in significantly more bacterial growth (p<0.001), and the chlorhexidine gluconate and isopropyl alcohol method resulted in similar amounts of bacterial growth (p>0.3).CONCLUSION: Isopropyl alcohol scrub followed by iodine tincture is more efficacious than povidone‐iodine as measured by contact plate cultures. For donors who are allergic to iodine, chlorhexidine gluconate and isopropyl alcohol is more efficacious than green soap and isopropyl alcohol.
Retention of “safe” blood donors. The Retrovirus Epidemiology Donor Study
Authors: Thomson R. A. , Bethel J. , Lo A. Y. , Ownby H. E. , Nass C. C. , Williams A. E. ,   Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND: There are obvious advantages to increasing donor retention. However, for reasons of blood safety, certain donors may, in fact, be more desirable to retain than others. “Safe” donors are defined as those who provided a blood donation that was negative on all laboratory screening tests and who subsequently reported no behavioral risks in response to an anonymous survey. This study identifies the most important factors affecting the intention of “safe” donors to provide another donation.STUDY DESIGN AND METHODS: An anonymous survey asking about donation history, sexual history, injecting drug use, and recent donation experience was mailed to 50,162 randomly selected allogeneic donors (including directed donors) who gave blood from April through July or from October through December 1993 at one of the five United States blood centers participating in the Retrovirus Epidemiology Donor Study. Before mailing, questionnaires were coded to designate donors with nonreactive laboratory screening tests at their most recent donation.RESULTS: A total of 34,726 donors (69%) responded, with substantially higher response among repeat donors. According to reported intentions only, the vast majority of “safe” donors indicated a high likelihood of donating again within the next 12 months. Only 3.4 percent reported a low likelihood of donating again. A comparison of those likely to return and those unlikely to return reveals significant differences in demographics and in ratings of the donation experience. A higher proportion of those unlikely to return were first‐time donors, minority‐group donors, and donors with less education. The highest projected loss among “safe” donors was seen for those who gave a fair to poor assessment of their treatment by blood center staff or of their physical well‐being during or after donating.CONCLUSION: These data suggest that efforts to improve donors' perceptions of their donation experience, as well as attention to the physical effects of blood donation, may aid in the retention of both repeat and first‐time donors.
Quality control of white cell‐reduced red cells: white cell preservation and simplified counting
Authors: Tran K. , Nakajo S. , Kapoor K. , Chen M. , Stromberg R.R. 
Published: March 2003

BACKGROUND: White cell (WBC) degradation restricts the interval between the filtration process and the assay for residual WBCs. Maintaining WBC integrity would permit extended sample storage for batching and/or shipment to centralized laboratories. The usual quality control assay for WBC‐reduced red cell units requires determining the number of WBCs in the entire counting area of a Nageotte hemocytometer, which consists of 40 rows. Reducing the counting area would simplify the quality control procedure.STUDY DESIGN AND METHODS: Adsol red cell units were prepared either on the day of collection (Day 0) or on Day 1 and WBC reduced by filtration on the same day. By using prefiltration and postfiltration red cells, samples containing WBC concentrations of 15, 10, and 3 WBCs per microL were prepared by serial dilution. Identical samples were treated with glutaraldehyde and stored at either 20 to 24 degrees C or 1 to 6 degrees C. All samples were assayed on the day of component preparation and on Days 7 and 14. The numbers of WBCs corresponding to 10‐ and 40‐row areas of the Nageotte hemocytometer were determined.RESULTS: For the conditions and WBC concentration range studied, no significant changes in WBC concentrations were observed through Day 14 for glutaraldehyde‐treated samples stored at either temperature, although there were substantial decreases in untreated samples. A 10‐row measurement was determined to be sufficient for identifying WBC‐reduced red cell units passing the present limit of 5 × 10(6) residual WBCs.CONCLUSION: Glutaraldehyde treatment can preserve WBCs in red cell samples at least up to Day 14, which provides increased efficiency in quality control for laboratories. Current red cell WBC‐reduction filters produce components that, when assayed, contain fewer than 10 WBCs per full counting area. The simplified procedure would allow reduction of the counting area by 75 percent.
False‐positive eluate reactivity due to the low‐ionic wash solution used with commercial acid‐elution kits
Authors: Leger R. M. , Arndt P. A. , Ciesielski D. J. , Garratty G. 
Published: March 2003

BACKGROUND: During the use of commercial red cell (RBC) acid‐elution kits for adsorption and elution (adsorption/elution) studies with anti‐ D, unexpected reactive eluates (anti‐D) were obtained from D‐ RBCs. Such results were not obtained with a parallel xylene method or, historically, with heat and ether methods.STUDY DESIGN AND METHODS: Single‐donor and commercial polyclonal anti‐D samples were incubated with D+ and D‐ RBCs. Acid eluates were prepared by the manufacturers' directions. Variations in the wash step of the eluate preparation included the use of commercial kit wash solution versus phosphate‐ buffered saline versus solutions of various ionic strengths.RESULTS: Anti‐D was eluted from 20 of 22 samples of D‐ RBCs after incubation with commercial polyclonal anti‐D (titer 512) and from 2 of 3 samples of D‐ RBCs incubated with single‐donor anti‐D (titer 256). With a low‐ titer (16) single‐donor anti‐D, 0 of 4 eluates from D‐ RBCs reacted. When phosphate‐buffered saline was substituted for the commercial wash solution, 0 of 11 D‐ RBC eluates reacted, as compared with 9 of 11 D‐ RBCs that yielded positive 1+(‐)2+ eluates with the commercial wash solution. If the recommended initial phosphate‐buffered saline wash was omitted before the use of the commercial wash solution, the eluate reactivity was stronger (2+(‐)3+). When low‐ionic‐strength (< 0.03 M) saline was substituted, anti‐D was eluted from D‐ RBCs. All last washes were nonreactive. Antiglobulin tests on all adsorbing D‐ were negative.CONCLUSION: Commercial wash solutions used for acid elution are at low ionic strength and commonly yield superior eluates, but in the presence of high‐titer antibodies, false‐positive eluates can result. It is our belief that the low‐ionic‐strength wash solution caused aggregation of IgG and nonspecific attachment of IgG on RBCs. Aggregates will contain IgG serum antibodies in proportion to the titer of the antibody. It is this nonspecifically bound antibody that is eluted from antigen‐ negative RBCs.
Perceptions and preferences of autologous blood donors
Authors: Lee S.J. , Liljas B. , Churchill W.H. , Popovsky M.A. , Stowell C.P. , Cannon M.E. , Johannesson M. 
Published: March 2003

BACKGROUND:The public's perception of autologous blood donation and transfusion as a worthwhile alternative to allogeneic blood transfusion increased dramatically with discovery of the human immunodeficiency virus. However, new concerns are being raised about the health outcomes and cost‐effectiveness of the procedure. As more restrictive guidelines for autologous blood donation evolve, opposition from patients concerned about exposure to allogeneic blood may arise. Physicians' ability to reassure patients and garner their support for more restrictive policies requires an understanding of patients' concerns. The motivations, perceptions, and preferences of patients currently participating in autologous blood donation programs were investigated in this study.STUDY DESIGN AND METHODS:Results from two questionnaire studies of 647 autologous blood donors are presented. The questionnaires assessed demographics, risk perceptions, preferences, willingness to pay, and reactions to different interventions designed to decrease patient preference for autologous blood donation.RESULTS:Patients expressed a strong preference for the availability of autologous blood and indicated that they would be willing to pay substantial amounts of money even if the procedure were not covered by insurance. Despite education about the low risks of complications from allogeneic transfusions, an aversion to allogeneic transfusion and a willingness to pay for autologous blood donation persisted. Patients were not reassured by information on better infectious disease testing or physician recommendation against autologous blood donation. CONCLUSION: Patients currently participating in autologous blood donor programs strongly prefer continued access to this procedure, primarily because they remain concerned about the complications of allogeneic transfusions. They may not be significantly reassured despite increasingly rigorous and costly improvements in donor and component screening.
High prevalence in Central Africa of blood donors who are potentially infectious for human herpesvirus 8
Authors: Bélec L. , Cancré N. , Hallouin M.‐C. , Morvan J. , Mohamed A. Si , Grésenguet G. 
Published: March 2003

BACKGROUND: In western countries, the transmission of human herpesvirus 8 (HHV‐8) via blood transfusion has been recently postulated. In sub‐ Saharan African, the incidence of HHV‐8‐associated Kaposi's sarcoma and the seroprevalence for HHV‐8 in autochthonous populations are high.STUDY DESIGN AND METHODS:The aim of this study was to estimate the prevalence of blood donations potentially infectious for HHV‐8 in the general adult population of Central Africa. Forty‐nine blood donors at the Centre de Transfusion Sanguine in Bangui, the capital of the Central African Republic, were selected. Forty‐five inpatients of Broussais Hospital, Paris, France, who were known to be seronegative for HIV and hepatitis B and C viruses and who had not received heart or kidney transplants, were chosen as a European “control” group for comparison. HHV‐8 DNA sequences were detected in peripheral blood mononuclear cells by nested polymerase chain reaction using primer sets located in the HHV‐8 open reading frame 26.RESULTS:Eleven (22.5%; 95% CI: 12%‐37%) of 49 blood donors were positive for HHV‐8. Three (6%) were HIV‐1 seropositive. Two (67%) of the 3 HIV‐infected blood donors were also positive for HHV‐8. All blood donors were apparently healthy; none was known to suffer from Kaposi's sarcoma. Only one (2.2%) control was carrying HHV‐8 DNA on the peripheral blood mononuclear cells. The prevalence of HHV‐8 was higher in blood donors from Bangui than in patients from Broussais Hospital.CONCLUSIONS:HHV‐8 infection is highly prevalent in an apparently healthy adult population from Central Africa, which raises concerns about HHV‐8 transmission through transfusion in this setting.
Anti‐G in a pregnant patient
Authors: Cash K. , Brown T. , Strupp A. , Uehlinger J. 
Published: March 2003

BACKGROUND: Anti‐G is a red cell (RBC) antibody of the Rh system. It has been described in pregnant women only in association with anti‐D or anti‐C; therefore, the ability of this antibody alone to cause hemolytic disease of the newborn is uncertain. One case in which this antibody caused no clinical sequelae is reported.CASE REPORT: The patient was a 35‐year‐old primigravida with type O, Dñ, Cñ, Eñ, c+ RBCs who was given 4 units of type O, Dñ allogeneic RBCs and 2 units of autologous RBCs 2 years antepartum. She was found to have anti‐D and anti‐C by an outside laboratory as part of a routine prenatal work‐up. Further evaluation by our laboratory revealed the presence of anti‐G and possible anti‐C without anti‐D. Titers at 22 weeksí gestation were 64 against r′r RBCs and 16 against R2R2 RBCs; these remained unchanged throughout the pregnancy. Amniocentesis performed at Weeks 28 and 32 showed no evidence of hemolytic disease of the newborn. A healthy 3.3‐kg infant was delivered at 36 weeksí gestation. Prophylactic Rh immune globulin was administered antepartum and postpartum. The infantís RBCs were type O, D+, c+ Cñ, Eñ, and the direct antiglobulin test was positive. An acid eluate prepared from the babyís RBCs revealed anti‐G. The total bilirubin was 5.5 mg per dL at birth, and the hematocrit was 66 percent. Total bilirubin peaked on Day 5 at 11.9 mg per dL, and no therapeutic intervention was required.CONCLUSIONS: Anti‐G alone caused little if any fetal or neonatal hemolysis in this case. Although further study is needed, invasive fetal monitoring may be unnecessary if anti‐G is the sole cause of fetomaternal RBC incompatibility.
Delayed massive immune hemolysis mediated by minor ABO incompatibility after allogeneic peripheral blood progenitor cell transplantation
Authors: Salmon J.‐P. , Michaux S. , Hermanne J.‐P. , Baudoux E. , Gérard C. , Sontag‐Thull D. , Fillet G. , Beguin Y. 
Published: March 2003

BACKGROUND: Bone marrow transplantation with minor ABO incompatibility may be followed by moderate delayed hemolysis of the recipient's red cells by donor‐derived ABO antibodies. This reaction may be more severe after transplantation of peripheral blood progenitor cells (PBPCs).CASE REPORT: A 16‐year‐old boy underwent an allogeneic PBPC transplant from his HLA‐mismatched mother as treatment for acute myeloblastic leukemia that had proved resistant to induction chemotherapy. Transfusion of the unmanipulated PBPCs proceeded without any complication, despite the difference in ABO blood group (donor, O Rh‐positive; recipient, A Rh‐positive). On Day 7, a rapid drop in hemoglobin to 4 g per dL was observed, which was attributed to a massive hemolysis. All the recipient's group A red cells were destroyed within 36 hours. This delayed and rapidly progressive hemolytic anemia was not associated with the transfusion of the donor's plasma. Rather, the anti‐A titer increased in parallel with marrow recovery, which suggested an active synthesis of these antibodies by immunocompetent cells from the donor against the recipient's red cells. The mother's anti‐A titer was retrospectively found to be 2048. Her unusually high titer is probably due to prior sensitization during pregnancies. On Day 12, the patient developed grade IV graft‐versus‐host disease, which proved resistant to all treatments instituted and led to his death on Day 35.CONCLUSION: PBPC transplantation with minor ABO incompatibility may be associated with significant risk of massive delayed hemolysis.
First two cases of immune hemolytic anemia associated with ceftizoxime
Authors: Shammo J.M. , Calhoun B. , Mauer A.M. , Hoffman P.C. , Baron J.M. , Baron B.W. 
Published: March 2003

BACKGROUND: Second‐ and third‐generation cephalosporins have been associated with immune‐mediated hemolytic reactions. This report discusses two patients who developed clinically significant extravascular hemolysis while receiving the third‐generation cephalosporin ceftizoxime (Ceftizox). This is believed to be the first time hemolysis has been described in patients receiving this drug.STUDY DESIGN AND METHODS: Immunologic workup of drug‐dependent antibodies was performed on blood samples using drug‐coated and immune complex methodologies. Antibody classes and titers were analyzed.RESULTS: Both the patients' sera contained anti‐ceftizoxime that reacted with red cells only when ceftizoxime was added to the sera (“immune complex” method). The patients recovered without complications following discontinuation of the drug. Each patient had IgM and IgG drug‐dependent antibodies. The drug‐induced antibodies from each patient cross‐reacted with cefotaxime, which is structurally similar to ceftizoxime, but cross‐reacted either weakly or not at all with ceftriaxone, which has a more complex side chain.CONCLUSION: This report describes the first cases of immune hemolytic anemia associated with ceftizoxime. In drug‐induced hemolytic reactions, prompt recognition and discontinuation of the drug may be important factors in reducing the chance of serious sequelae.
Improved removal of white cells with minimal platelet loss by filtration of apheresis platelets during collection
Authors: Holme Stein , Andres Mark , Goermar Nancy B. , Giordano Gerald F. 
Published: March 2003

BACKGROUND: Filtration of apheresis platelets to remove white cells (WBCs) requires operator intervention after the collection procedure (postcollection filtration), which may cause variable and unsatisfactory filter performance (WBC removal and platelet loss). The MCS+ LN9000 apheresis system filters platelets through a WBC‐reduction filter during each collection cycle (continuous filtration) at a flow rate of 15 to 25 mL per minute. Apheresis platelets obtained by continuous filtration were evaluated in terms of platelet loss, WBC removal, and platelet storage properties and then were compared to unfiltered apheresis platelets and to apheresis platelets that underwent postcollection filtration. Two WBC‐reduction filters were tested (LRF6 and LRFXL).STUDY DESIGN AND METHODS: In 70 apheresis platelets, postcollection filtration was performed by using the LRF6 at flow rates of 80 mL per minute (n = 30) and 50 mL per minute (n = 30) and the LRFXL at 50 mL per minute (n = 10). One hundred fifty‐eight apheresis platelets underwent continuous filtration through the LRF6 (n = 58) or the LRFXL (n = 100). Unfiltered apheresis platelets (controls) (n = 30) were obtained by the same collection protocol.RESULTS: Estimated platelet loss with continuous filtration was 7 percent for the LRFXL and 3 percent for the LRF6. A reduction in the filtration flow rate from 80 to 50 mL per minute with postcollection filtration through the LRF6 resulted in markedly lower WBC levels, with 10 percent versus 57 percent of the apheresis platelets having WBC counts <1 × 105, respectively. Additional improvements in WBC removal were found with continuous filtration; 85 percent of the apheresis platelets filtered with the LRF6 and 100 percent of the apheresis platelets filtered with the LRFXL had WBC counts <1 × 105.CONCLUSIONS: Continuous or postcollection filtration of freshly collected apheresis platelets resulted in minimal platelet loss. Better WBC removal from apheresis platelets was obtained with continuous filtration than with postcollection filtration, likely because of the slower flow rate. Platelet storage quality was not affected by filtration.