bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significant numbers of apheresis‐derived group O platelet units have “high‐titer” anti‐A/A,B: implications for transfusion policy
Authors: Josephson C.D. , Mullis N.C. , Van Demark C. , Hillyer C.D. 
Published: May 2004

Transfusion of group O single‐donor apheresis PLTs (SDP) to group A recipients has resulted in intravascular hemolysis and mortality. Owing to low availability of type‐specific SDPs, transfusion services sometimes issue ABO‐mismatched PLTs. After observing two cases of acute hemolysis following infusion of O SDPs to group A patients, where both recipient eluates revealed anti‐A specificity, a prospective study to determine the prevalence of “high‐titer” anti‐A/A,B in group O SDPs was commenced.One hundred group O SDP samples were tested. Titers of at least 64 and/or 256 from either buffered (generally reflective of IgM antibodies) or anti‐IgG gel cards, respectively, were considered critically high. Twenty‐eight and 39 percent of samples revealed critically high anti‐A/A,B IgM and IgG titers, respectively. IgM titers were at 1:64 (18%), 128 (6%), and 256 (4%), whereas IgG titers were at 1:256 (28%), 512 (7%), 1024 (2%), and 2048 (2%).The prevalence of critical anti‐A/A,B titers in group O SDPs is relatively high. Thus, the risk of minor side ABO mismatch and potential intravascular hemolysis during group O SDP transfusion to group A recipients may be significant. Based on these data, a policy was instituted to test anti‐A/A,B titers in O SDPs prior to “out‐of‐group” transfusion.
Transfusion‐transmitted hepatitis E caused by apparently indigenous hepatitis E virus strain in Hokkaido, Japan
Authors: Matsubayashi Keiji , Nagaoka Yasuhiro , Sakata Hidekatsu , Sato Shinichiro , Fukai Kanji , Kato Toshiaki , Takahashi Kazuaki , Mishiro Shunji , Imai Mitsunobu , Takeda Naokazu , Ikeda Hisami 
Published: May 2004

BACKGROUND:  In industrialized countries, sporadic cases of hepatitis E have been reported in individuals who have never been in an endemic area. Hepatitis E virus (HEV) infection commonly occurs via the fecal‐oral route but a potential risk of transfusion transmission route has been suggested.STUDY DESIGN AND METHODS:  A 67‐year‐old Japanese male patient who had never been abroad received a transfusion of blood from 23 voluntary donors and developed acute hepatitis with unknown etiology after transfusion. His blood samples were tested for viral markers of hepatitis viruses.RESULTS:  HAV, HBV, HCV, CMV, and EBV were ruled out as causative agents in this case. The patient's blood sample in the acute phase contained HEV RNA as well as IgM and IgG anti‐HEV. HEV RNA was also detected in one of the FFP units transfused. The donor had no history of traveling abroad and had a normal ALT level at the time of donation. The PCR products from the patient and the donor showed complete identity for two distinct regions of HEV within open reading frame 1.CONCLUSION:  The patient was infected with HEV via transfused blood from a volunteer donor. A potential risk of posttransfusion hepatitis E should be considered even in nonendemic countries.
Collection of white blood cell‐reduced plasma by apheresis
Authors: Vrielink Hans , Van Der Meer Pieter F. 
Published: May 2004

BACKGROUND:  WBC reduction of cellular blood components has been introduced in many countries. Owing to concerns of residual WBCs in plasma, a new method to collect WBC‐reduced plasma by apheresis was studied.STUDY DESIGN AND METHODS:  An apheresis machine (PCS2, Haemonetics) was used, in combination with the “high‐separation” core (HSC) bowl, a redesigned version of the blow‐molded (BM) bowl. With the BM bowl collections as control group, various software settings were investigated applying the HSC bowl. The optimized program was validated for routine application. Results are expressed as means ± SD.RESULTS:  Plasma collected in the control group with the BM bowl (n = 25) had a volume of 622 ± 7 mL and contained 5.3 ± 4.6 × 106 WBCs per L, 11 ± 5 × 109 PLTs per L, and 0.063 ± 0.051 × 109 RBCs per L. The collection efficiency was 17.8 ± 2.8 mL per minute, and the total procedure time was 36.1 ± 6.3 minutes. The HSC bowl produced plasma that had a volume of 623 ± 9 mL and contained 0.01 ± 0.02 × 106 WBCs per L, 2 ± 2 × 109 PLTs per L, and 0.00040 ± 0.0016 × 109 RBCs per L (n = 134, all p < 0.001). The collection efficiency was 15.8 ± 2.2 mL per minute, and the collection time was 40.3 ± 6.3 minutes (both p < 0.001).CONCLUSION:  The HSC bowl with the new software reliably produces WBC‐reduced apheresis plasma, with a slight elongation of the procedure time.
RH locus contraction in a novel Dc‐/D‐‐ genotype resulting from separate genetic recombination events
Authors: Huang C.‐H. , Peng J. , Chen H.C. , Chen Y.X. , Lin D.‐T. , Lin S.W‐S. , Reid M.E. , Powell V.I. 
Published: May 2004

BACKGROUND:  The rare phenotypes Dc‐ and D‐‐ lack the expression of E/e and CcEe antigens, respectively; their cotransmission in a single family has not been reported.STUDY DESIGN AND METHODS:  Six members of a Chinese family with two exhibiting the Dc‐ phenotype were studied using standard serologic methods. Rh genotypes were analyzed by Southern blot, and RH loci, by exon PCR. Rh transcripts were characterized by gene‐specific RT‐PCR and sequencing.RESULTS:  Although Rh typing detected two members as Dc‐ homozygotes, RFLP analysis and exon PCR showed them to be Dc‐ heterozygotes with a partial deletion of RHCE. cDNA sequencing showed the expression in the family of normal RHD and RHCe as well as hybrid transcripts, RHD(1‐9)/RHCE(10) and RHCE(1‐3)/RHD(4‐10). Thus, the Dc‐ members had the genotype of Dc‐/ D‐‐ and expressed both hybrid genes that were inherited from their parents, respectively.DISCUSSION:  This is the first demonstration in a family that the Dc‐ and D‐‐ complexes neither are linked with a normal RHD or RHCE gene. The segregation of these two different hybrid genes with single break points sug‐gests their independent genetic origin and provides molecular insights into the dynamic nature of genomic rearrangements leading to RH locus contraction.
Effect of thrombopoietin alone and a combination of cytochalasin B and ethylene glycol bis(β‐aminoethyl ether) N,N′‐tetraacetic acid‐AM on the survival and function of autologous baboon platelets stored at 4°C for as long as 5 days
Authors: Valeri C. Robert , Ragno Gina , Marks Peter W. , Kuter David J. , Rosenberg Robert D. , Stossel Thomas P. 
Published: May 2004

BACKGROUND:  PLTs stored at 22°C have the potential for bacterial contamination, a problem that could be reduced by 4°C storage. Nevertheless, PLTs stored at 4°C exhibit a significantly reduced life span. This study was performed to determine whether treatment of PLTs with thrombopoietin or cytochalasin B plus ethylene glycol bis(β‐aminoethyl ether) N,N′‐tetraacetic acid (EGTA)‐AM could prevent exponential loss of PLTs stored at 4°C.STUDY DESIGN AND METHODS:  Autologous baboon PLTs were stored at 22 or 4°C. The 4°C stored PLTs were treated with 1.5 ng per mL thrombopoietin, with 1 µmol per L cytochalasin B, and 80 µmol per L EGTA‐AM (cyto‐EGTA) or not treated and labeled with 111In‐oxine to study their in vivo recovery and life span. PLT function was assessed by correction of an aspirin‐induced prolonged bleeding time. Aggregation responses and morphology were also assessed.RESULTS:  PLTs stored at 22°C had normal in vivo recovery and linear survival. PLTs stored at 4°C, whether or not they were treated with thrombopoietin, had normal recovery and exponential survival. Aggregation of cyto‐EGTA‐treated PLTs was similar for PLTs stored at 4°C and fresh PLTs, but decreased in PLTs stored at 22°C for 5 days. The addition of cyto‐EGTA to PLTs before 4°C storage inhibited morphologic changes that occurred in PLTs stored at 22°C and cold‐induced PLT clumping, but did not prevent exponential disappearance of the PLTs.CONCLUSION:  Addition of thrombopoietin or cyto‐chalasin B and EGTA‐AM to PLTs before 4°C storage did not prevent exponential loss of PLTs.
Analysis of ABO discrepancies occurring in 35 French hospitals
Authors: Chiaroni J. , Legrand D. , Dettori I. , Ferrera V. 
Published: May 2004

BACKGROUND:  The risk of immunohemolytic reaction owing to ABO‐mismatched mistransfusion is 100 to 1000 times higher than the risk of viral infection. Like analysis of incident reports, evaluation of near‐miss events can provide useful insight into hazardous situations for mis‐matched blood transfusion. The aim of this prospective study was to assess the incidence and root causes of all ABO discrepancies, detected by a central hematology laboratory, in blood samples referred from 35 district hospitals.STUDY DESIGN AND METHODS:  ABO discrepancies were detected by comparing either two current blood specimens or a current and historical specimen collected over a 5‐year study period. Discrepancies were investi‐gated by retyping new samples, checking sample identifi‐cation, and reviewing previous hospital records.RESULTS:  A total of 118 ABO discrepancies were discovered in a series of 407,769 tests carried out during the study period. The incidence of ABO discrepancies was 1 per 3,400. This figure was 10 times higher than the incidence of ABO‐mismatched transfusions. Most of these ABO discrepancies were due to phlebotomy errors, that is, collection from wrong patient. The second most common cause involved clerical errors during patient registration or identification.CONCLUSION:  ABO discrepancies can result from errors made not only by the medical staff during phlebotomy but also to by the clerical staff during registration and identification. These findings emphasize the need to standardize data transmission between health care personnel.
Photochemical inactivation of selected viruses and bacteria in platelet concentrates using riboflavin and light
Authors: Ruane Patrick H. , Edrich Richard , Gampp Deanna , Keil Shawn D. , Leonard R. Lynne , Goodrich Raymond P. 
Published: May 2004

BACKGROUND:  A medical device is being developed for the reduction of pathogens in PLT concentrates (PCs). The device uses broadband UV light and the compound riboflavin (vitamin B2).STUDY DESIGN AND METHODS:  Pathogens were added to single‐donor PLTs. After treatment, the infectivity of each pathogen was measured using established biologic assays. In vitro PLT performance was evaluated after treatment and after 5 days of storage using a panel of 10 in‐vitro cell quality assays.RESULTS:   In studies with viral pathogens, the Pathogen Reduction Technology (PRT) system provided average log reduction factors of 4.46 ± 0.39 for intracellular HIV, 5.93 ± 0.20 for cells associated HIV, and 5.19 ± 0.50 for West Nile virus. For the nonenveloped porcine parvovirus, a reduction factor greater than 5.0 log was observed. Staphylococcus epidermidis and Escherichia coli bacteria were also tested with observed reduction factors to the limits of detection of 4.0 log or greater. PLT cell quality was adequately maintained after treatment and during storage. Although P‐selectin expression, glucose consumption, and lactate production increased relative to controls, this was not beyond accepted levels. The pH of treated PCs also decreased slightly relative to control PLTs on Days 1 and 5.CONCLUSION:  The data indicate that the device successfully reduced the number of selected pathogens in PCs. Despite the fact that significant differences exist between treated and control in‐vitro variables, it is speculated that the clinical effectiveness of both products will not be significantly different, based on comparison to historical data for products in routine clinical use today.
Anemia and its treatment and outcomes in persons infected with human immunodeficiency virus
Authors: Buskin Susan E. , Sullivan Patrick S. 
Published: May 2004

BACKGROUND:  Anemia is a common comorbidity with HIV. Before the highly active antiretroviral therapy (HAART) era, anemia was found to be associated with decreased survival. This study examined the prevalence of anemia since HAART's availability and the associations between anemia treatments and survival.STUDY DESIGN AND METHODS:  Anemia prevalence in a cohort of HIV‐infected persons was described. In a smaller cohort of HIV‐infected anemic patients, survival was modeled with a time‐dependent proportional hazards regression model adjusting for CD4+ T‐lymphocyte count, plasma HIV RNA concentration load, hemoglobin (Hb) level, and other factors.RESULTS:  Anemia (Hb level < 10.5 g/dL, or physician diagnosis) decreased from 13 to 5 percent (p < 0.05) in 1996 through 2001. Anemia prevalence was highest (24‐35%) and did not decrease among patients with CD4 count less than 100 cells per mL. In total, 216 severely anemic HIV‐infected individuals (mean Hb level, 8.1 g/dL) followed for a median of 13 months had a 37‐percent mortality rate. Of these, 22 percent were untreated (13% mortality rate), 42 percent received transfusion alone (52% mortality), 12 percent received epoetin alfa alone (19% mortality), and 24 percent received both (47% mortality). Transfusion was associated with a threefold excess mortality risk, but epoetin alfa prescription was not associated with mortality.CONCLUSION:  The prevalence of anemia decreased in the HAART era, and transfusion was positively associated with risk of death, suggesting limiting use of transfusions in nonemergency situations.
Persistence of cefotetan on red blood cells
Authors: Davenport Robertson D. , Judd W. John , Dake Louann R. 
Published: May 2004

BACKGROUND:  Cefotetan can cause severe immune hemolytic anemia that may persist long after the drug is discontinued. To study the binding of cefotetan to RBCs, patients who received cefotetan were followed and tested for the presence of antibody to cefotetan.STUDY DESIGN AND METHODS:  Patients receiving cefotetan were identified from pharmacy and nursing records. Blood samples obtained for routine hematology tests were analyzed. Cefotetan binding to patients’ RBCs was tested using a previously characterized high‐titer anticefotetan serum by gel technique. To determine the minimum amount of drug necessary for binding to occur, RBCs were incubated with serial dilutions of cefotetan at pH 7.4.RESULTS:  Sixty patients receiving 1 to 25 g IV (median, 2 g) of cefotetan were followed for 1 to 123 days (median, 18 days). All were initially positive, for cefotetan on RBCs. Positivity persisted for up to 98 days after the last dose of drug. Fifteen patients became negative during follow‐up. The first negative sample occurred at Day 30 to 123. Using the midpoint between the last positive and first negative to estimate of the duration of positivity, we estimate that cefotetan remains RBC‐bound for 16.5 to 92 days (median, 67.5 days). During the follow‐up period, five patients developed anticefotetan detectable in the serum. Twenty patients receiving other cephalosporin antibiotics showed no specific reactivity of their RBCs with anticefotetan. In vitro studies showed a minimum necessary drug concentration of 1 µmol/L at physiologic pH, which was not significantly altered by RBC pretreatment with ficin, sialydase, or DTT.CONCLUSIONS:  Cefotetan is tightly bound to RBCs after intravenous administration and remains detectable for weeks after the last dose. Antibodies to cefotetan may occur in about 8 percent of patients receiving the drug. The minimum necessary concentration for RBC binding is low compared to an estimated plasma concentration of 240 µmol/L from a single IV dose of 1 g.
Incidence and specificity of HLA antibodies in multitransfused patients with acquired aplastic anemia
Authors: Laundy G.J. , Bradley B.A. , Rees B.M. , Younie M. , Hows J.M. 
Published: May 2004

BACKGROUND:  This study aimed to establish the prevalence and characteristics of anti‐HLA in antibody acquired aplastic anemia patients following cessation of antithymocyte globulin therapy and to characterize antibody in terms of epitope specificity.STUDY DESIGN AND METHODS:  One hundred and fifty multitransfused, untransplanted patients from eight European centers were investigated by serologic methods.RESULTS:  Sixty‐two percent were antibody positive. Eighteen HLA‐Class‐I‐specific antibodies (15 IgG, 3 IgM) were identified in 13 patients; 13 antibodies were specific for HLA‐A epitopes and 5 for HLA‐B. Epitope analysis identified significant correlation between serum reactivity and amino acid substitutions associated with HLA‐Class‐I epitopes. An excess of antibodies to HLA‐A1‐associated cross‐reactive groups was identified. There was no significant difference in antibody frequency in patients taking cyclosporine compared to those who were not.CONCLUSION:  Data suggested a contribution from B cell memory of alloantigens introduced during pregnancy. In some cases, antibody production continued many years after the last transfusion, and although the target varied between individual patients, the antibody to HLA was focused on a few specific Class I epitopes, the majority of which mapped to the HLA‐A molecule.
Posttransfusion 24‐hour recovery and subsequent survival of allogeneic red blood cells in the bloodstream of newborn infants
Authors: Strauss Ronald G. , Mock Donald M. , Widness John A. , Johnson Karen , Cress Gretchen , Schmidt Robert L. 
Published: May 2004

BACKGROUND:  The feasibility, efficacy, and safety of transfusing stored allogeneic RBCs has been demon‐strated for small‐volume transfusions given to infants. We measured the posttransfusion recovery and intravascular survival of allogeneic RBCs stored up to 42 days to further elucidate their efficacy.STUDY DESIGN AND METHODS:  Preterm infants were transfused with 1.0 mL of biotinylated RBCs plus 15 mL per kg of unlabeled allogeneic RBCs. Posttran‐sfusion infant blood samples obtained at 10 minutes, and at 1, 2, 4, 7, 10, 14, and 21 days were used to determine the 24‐hour posttransfusion recovery (PTR24), mean potential life span (MPL), and time to disappearance of 50 percent of biotinylated RBCs (T50).RESULTS:  No significant differences were found between allogeneic RBCs stored 1 to 21 days versus 22 to 42 days for PTR24, MPL, or T50, indicating comparable posttransfusion circulation, regardless of storage age. Although MPL and T50 values in infants using biotinylated RBCs were short, compared to those expected using chromium‐labeled RBCs in adults, they agreed with results reported by others using biotinylated RBCs.CONCLUSIONS:  Satisfactory posttransfusion RBC recovery and survival, measured with biotinylated RBCs, support earlier clinical trials that established the efficacy and safety of stored allogeneic RBCs for small‐volume transfusions given to infants. The relatively short MPL and T50 values in some infants may underestimate true survival due to ongoing erythropoiesis and infant growth with commensurate increase in blood volume during the time of RBC survival studies. Because values in infants differ from those expected using chromium‐labeled RBCs in adults, and the number of posttransfusion determinations was few, additional studies are needed to define the mechanisms involved.
Blood transfusion rates in the care of acute trauma
Authors: Como John J. , Dutton Richard P. , Scalea Thomas M. , Edelman Bennett B. , Hess John R. 
Published: May 2004

BACKGROUND:  Ten to 15 percent of all RBCs are used in the care of injury. Understanding patterns of RBC use is important. Routine resource allocation, planning for mass casualty situations, designing research, and optimizing triage all can be usefully informed.STUDY DESIGN AND METHODS:  Blood Bank and Trauma Registry records were linked to produce a transfused blood product list for each patient directly admitted from the scene of injury to a large Level 1 trauma center in calendar year 2000. Categorical associations between demographic data, Injury Severity Score, transfused products, and outcome were sought. Special attention was paid to the groups receiving uncross‐matched RBCs and more than 10 units of RBCs.RESULTS:  Eight percent (479/5645) of acute trauma patients received RBCs, using 5219 units and sustaining an overall mortality of 27 percent. Sixty‐two percent of RBCs were given in the first 24 hours of care. Three percent of patients (147 injured) received more than 10 units and received 71 percent of all RBCs given. Mortality in this cohort was 39 percent. Ninety percent of the patients who received more than 10 units of RBCs received plasma, and 71 percent received PLTs.CONCLUSIONS:  A small number of patients receives most of the blood products used in the treatment of injury. Transfusion of more than 10 units of RBCs identifies a subgroup where most patients received plasma and PLTs to treat actual or anticipated dilutional coagulopathy. There is no clear threshold beyond which blood use is futile.
West Nile virus in plasma is highly sensitive to methylene blue–light treatment
Authors: Mohr Harald , Knüver‐Hopf Joseph , Gravemann Ute , Redecker‐Klein Anette , Müller Thomas H. 
Published: May 2004

BACKGROUND: The epidemic of West Nile virus (WNV) in the US resulted in cases of transfusion‐transmitted WNV. Effective pathogen reduction methods could have removed this infectious agent from the blood supply We have evaluated the efficacy of photodynamic treatment of fresh frozen plasma (FFP) with methylene blue (MB), a decontamination method applied in several European countries.STUDY DESIGN AND METHODS: FFP units (300 ml each) were spiked with WNV. MB was added, and the units were illuminated with white or monochromatic yellow light. WNV infectivity was determined by bioassay. WNV‐RNA was quantitated by real‐time PCR. The inactivation of WNV was investigated under standard and under suboptimal conditions, respectively. In addition, rechallenge experiments with multiple addition of WNV at maximal load (approx. 105 CFU/ml) and repeated illumination without replenishing MB were performed.RESULTS: Complete inactivation of WNV was achieved by MB (0.8‐1 mmol/l) and illumination with white light (30,000‐45,000 Lux) within 2 min. White yellow light 20‐40 J/cm2(2.5‐5 min) were sufficient for inactivation by 5.75 log10‐steps. The rechallenge experiments revealed the substantial reserve capacity of the procedure to inactivate WNV. Quantitative PCR indicated that the viral RNA was rapidly destroyed.CONCLUSION: All experimental data demonstrate the enormous potency of phototreatment with MB to inactivate WNV in plasma.
Predonation water ingestion attenuates negative reactions to blood donation
Authors: Hanson Sarah A. , France Christopher R. 
Published: May 2004

BACKGROUND:  Novice blood donors are at increased risk for unpleasant blood donation‐related symptoms (e.g., dizziness, weakness, and lightheadedness), and the experience of such symptoms can contribute to a decreased likelihood of repeat donation. Recent laboratory studies suggest that water ingestion produces hemodynamic effects that may be sufficient to reduce risk of syncope and related reactions during blood donation.STUDY DESIGN AND METHODS:  Male and female volunteers were randomly assigned to ingest either 500 or 0 mL of water 30 minutes before donating blood for the first time. In addition, bioimpedance analysis was used to assess predonation chronic hydration levels in all donors. Immediately after donation, participants completed the Blood Donation Reactions Inventory to assess subjective experience of negative physiologic reactions.RESULTS:  Analysis of Blood Donation Reactions Inventory scores revealed that predonation water ingestion was associated with a 47‐percent reduction of total donation‐related symptoms (F [1,79]= 11.81, p = 0.001). Chronic hydration status was not related to reported reactions.CONCLUSION:  Novice blood donors responded positively to predonation water consumption, and they were able to consume 500 mL in less than 5 minutes. Results of the present study suggests that predonation water ingestion may be a simple and cost‐effective strategy to enhance the donation experience and possibly increase donor retention.