bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of difference in cytomegalovirus transmission via the transfusion of filtered‐irradiated and nonfiltered‐irradiated blood to newborn infants in an endemic area
Authors: Ohto Hitoshi , Ujiie N. , Hirai K. 
Published: March 2003

BACKGROUND: It is accepted that white cells contained in blood components are the most significant source of cytomegalovirus (CMV) infection in immunocompromised and immunodeficient recipients.STUDY DESIGN AND METHODS: To determine whether white cell filtration of blood would be effective in preventing infection among newborn transfusion recipients in a hyperendemic area, a randomized study was performed. All donor blood units were irradiated before issue to prevent posttransfusion graft‐versus‐host disease. Recipients were monitored for CMV infection by seroconversion (development of IgM anti‐CMV) and CMV‐DNA isolation.RESULTS: Three (9%) of 33 infants who received filtered blood and 1 (5%) of 19 infants given nonfiltered blood were infected with CMV, as determined by the presence of IgM anti‐CMV and/or CMV DNA isolation. There was no significant difference in the rate of CMV infection in the two groups.CONCLUSION: The CMV infection observed in the study may come from other routes such as breastfeeding, rather than from transfusion. Our findings suggest that the routine use of white cell‐reduction filtration to reduce the risk of transmitting CMV is unwarranted for neonates in endemic regions.
An analysis of errors in blood component transfusion records with regard to quality improvement of data acquisition and to the performance of lookback and traceback procedures
Authors: Zimmermann Robert Zimmermann , Linhardt Christian , Weisbach Volker , Büscher Marcus , Zingsem Jürgen , Eckstein Reinhold 
Published: March 2003

BACKGROUND: Quality assurance of blood transfusion covers institutions, personnel, and procedures involved in preparing, issuing, and using blood components. The accuracy of data related to blood component transfusions is a tool for quality control in the transfusion service.STUDY DESIGN AND METHODS: A study of the accuracy of data records of the transfusion service at the University Hospital of Erlangen, Germany, between June 1994 and May 1996 was carried out. All returned blood component transfusion report forms were examined for discrepancies between primary data records and clinical transfusion reports.RESULSTS: Blood components (n = 49,224) from allogeneic and autologous donations, packed red cells, fresh‐frozen plasma, and platelet components that had been issued for transfusion were included in this evaluation. For 27.3 percent of all components issued, no transfusion report was returned to the blood bank. For the remaining 35,786 units, errors were found in 3.8 percent of the records. For 1.24 percent of all components, discrepant information related to the recipient's identity or the component's status was found; this affected the feasibility of lookback or traceback searches.CONCLUSION: A remarkably high frequency of discrepancies exists between computerized blood bank records and the information recorded on returned blood transfusion forms. The processes of data acquisition and entry must be included in quality assurance efforts in transfusion medicine.
Successful mobilization of peripheral blood HPCs with G–CSF alone in patients failing to achieve sufficient numbers of CD34+ cells and/or CFU–GM with chemotherapy and G–CSF
Authors: Fraipont V. , Sautois B. , Baudoux E. , Pereira M. , Fassotte M.‐F. , Hermanne J.‐P. , Jérusalem G. , Longrée L. , Schaaf‐Lafontaine N. , Fillet G. , Beguin Y. 
Published: March 2003

BACKGROUND: Mobilization with chemotherapy and G–CSF may result in poor peripheral blood HPC collection, yielding <2 × 106 CD34+ cells per kg or <10 × 104 CFU–GM per kg in leukapheresis procedures. The best mobilization strategy for oncology patients remains unclear.STUDY DESIGN AND METHODS: In 27 patients who met either the CD34 (n = 3) or CFU–GM (n = 2) criteria or both (n = 22), the results obtained with two successive strategies—that is, chemotherapy and G–CSF at 10 μg per kg (Group 1, n = 7) and G–CSF at 10 μg per kg alone (Group 2, n = 20) used for a second mobilization course—were retrospectively analyzed. The patients had non‐Hodgkin's lymphoma (5), Hodgkin's disease (3), multiple myeloma (5), chronic myeloid leukemia (1), acute myeloid leukemia (1), breast cancer (6), or other solid tumors (6). Previous therapy consisted of 10 (1‐31) cycles of chemotherapy with additional chlorambucil (n = 3), interferon (n = 3), and radiotherapy (n = 7).RESULTS: The second collection was undertaken a median of 35 days after the first one. In Group 1, the results of the two mobilizations were identical. In Group 2, the number of CD34+ cells per kg per apheresis (0.17 [0.02‐0.45] vs. 0.44 [0.11‐0.45], p = 0.00002), as well as the number of CFU–GM (0.88 [0.00‐13.37] vs. 4.19 [0.96‐21.61], p = 0.00003), BFU–E (0.83 [0.00‐12.72] vs. 8.81 [1.38‐32.51], p = 0.00001), and CFU‐MIX (0.10 [0.00‐1.70] vs. 0.56 [0.00‐2.64], p = 0.001134) were significantly higher in the second peripheral blood HPC collection. However, yields per apheresis during the second collection did not significantly differ in the two groups. Six patients in Group 1 and 18 in Group 2 underwent transplantation, and all but one achieved engraftment, with a median of 15 versus 12 days to 1,000 neutrophils (NS), 22 versus 16 days to 1 percent reticulocytes (NS), and 26 versus 26 days to 20,000 platelets (NS), respectively. However, platelet engraftment was particularly delayed in many patients.CONCLUSION: G–CSF at 10 μg per kg alone may constitute a valid alternative to chemotherapy and G–CSF to obtain adequate numbers of peripheral blood HPCs in patients who previously failed to achieve mobilization with chemotherapy and G–CSF. This strategy should be tested in prospective randomized trials.
Transfusion errors in New York State: an analysis of 10 years' experience
Authors: Linden Jeanne V. , Wagner Kathleen , Voytovich Anthony E. , Sheehan Joseph 
Published: March 2003

BACKGROUND: While public focus is on the risk of infectious disease from the blood supply, transfusion errors also contribute significantly to adverse outcomes. This study characterizes such errors.STUDY DESIGN AND METHODS: The New York State Department of Health mandates the reporting of transfusion errors by the approximately 256 transfusion services licensed to operate in the state. Each incident from 1990 through 1998 that resulted in administration of blood to other than the intended patient or the issuance of blood of incorrect ABO or Rh group for transfusion was analyzed.RESULTS: Erroneous administration was observed for 1 of 19,000 RBC units administered. Half of these events occurred outside the blood bank (administration to the wrong recipient, 38%; phlebotomy errors, 13%). Isolated blood bank errors, including testing of the wrong specimen, transcription errors, and issuance of the wrong unit, were responsible for 29 percent of events. Many events (15%) involved multiple errors; the most common was failure to detect at the bedside that an incorrect unit had been issued.CONCLUSION: Transfusion error continues to be a significant risk. Most errors result from human actions and thus may be preventable. The majority of events occur outside the blood bank, which suggests that hospitalwide efforts at prevention may be required.
Preoperative predictors of the need for allogeneic blood transfusion in lung cancer surgery
Authors: Cirasino Lorenzo , Barosi Giovanni , Torre Massimo , Crespi Stefano , Colombo Paola , Belloni Pier Angelo 
Published: March 2003

BACKGROUND: The use of blood‐saving techniques in elective surgery can produce a favorable cost‐benefit ratio only when there is a reasonable likelihood that transfusion will be required. To apply a targeted blood‐sparing technique in lung cancer surgery, the patient's preoperative characteristics that predict the use of allogeneic blood transfusion (ABT) in this practice were investigated.STUDY DESIGN AND METHODS: One hundred seventy‐three consecutive patients who underwent primary lung cancer surgery were included in this retrospective study. Clinical and epidemiologic variables, lung tumor extension (TNM staging), and surgery type were analyzed by logistic regression to discover the preoperative predictors of ABT.RESULTS: Thirty patients, 17.3 percent of all who underwent surgery and 19.9 percent of those who underwent resolvent surgery, received ABT. Excluding a patient who needed 18 units of RBCs, the number of ABT units required by transfused patients was 1.93 ± 0.88 (mean ± SD). Extensive surgery, patient's age (≤64 years), and elevated erythrocyte sedimentation rate (>45 mm/hour) were the preoperative variables that influenced the need for ABT. The definitive predictive model was able to recognize 82.3 percent of patients who received ABT and 95.6 percent of those who did not.CONCLUSION: A predictive model can preoperatively identify patients at risk for needing ABT in lung cancer surgery. The model could be utilized to tailor blood‐sparing intervention programs.
Completely converting a blood service region to the use of safer plasma
Authors: McCarthy Leo J. , Danielson Constance F.M. , Rothenberger Sandra S. , Parker Carol , Weidner John , Miraglia Charles , Matus Deborah , Waxman Dan 
Published: March 2003

BACKGROUND: Three types of plasma are widely available for transfusion. Two plasma components, FFP donor retested (FFP‐DR), and solvent/detergent‐treated plasma (SDP), are now considered to be safer from infectious complications than FFP.STUDY DESIGN AND METHODS: A large regional blood center attempted to provide FFP‐DR exclusively to all its 42 hospitals. Significant planning, increases in computer capabilities, and expansion of component storage areas were completed before initiation of this program.RESULTS: During the first 6 months of the FFP‐DR program, the blood center was not able to supply the entire region exclusively with FFP‐DR. Consequently, SDP was utilized to supplement the program and to successfully and completely convert the region's 42 hospitals to the use of safer plasma.CONCLUSION: Two new plasma components were utilized to completely convert a blood service region to the use of safer plasma.
Donor neutrophil function after plateletpheresis
Authors: Western Karoline H. , Videm Vibeke 
Published: March 2003

BACKGROUND: Neutrophils are important mediators of inflammation and may be activated by foreign surfaces in apheresis systems. Because most of the WBCs are returned to the donor, it was investigated whether artificial activation leads to altered donor neutrophil function.STUDY DESIGN AND METHODS: Three apheresis systems (Amicus, Autopheresis‐C, and CS‐3000; all: Baxter Fenwal) were investigated. Preapheresis and postapheresis blood samples were drawn from 10 volunteer donors, with all three apheresis systems used in random order for each donor. Changes in neutrophil phagocytic ability, oxidative burst, and expression of l‐selectin and CD11b were measured by flow cytometry, and plasma concentrations of myeloperoxidase and lactoferrin were measured by EIA. Complement activation was evaluated by quantification of C3bc and the terminal complement complex by EIA.RESULTS: Neutrophil expression of l‐selectin increased after apheresis (p = 0.02), and the production of oxygen radicals was reduced (p = 0.01). This effect was possibly a result of priming. Complement was not activated. There were no significant differences in neutrophil function after apheresis with any of the three apheresis systems.CONCLUSIONS: Neutrophil function was altered after apheresis, although to a very small extent, and contact between neutrophils and the foreign surface in the apheresis systems is found to be a biotolerant procedure.
Detecting failed WBC‐reduction processes:a quality assurance program introduced in a blood center
Authors: Adams Melanie R. , Hirschler Nora V. , Papenfus Linda , Heaton William A. 
Published: March 2003

BACKGROUND: Pragmatic yet statistically valid quality assurance (QA) programs are necessary so that blood centers can select, validate, and monitor their WBC‐reduction processes. A QA system for WBC‐reduction processes based on the practical application of statistical theory within a large blood center was developed. The system identifies parameters for procedure and component evaluation and provides sample size and formatting suggestions.STUDY DESIGN AND METHODS: Analyses of both procedure and component performance were undertaken during the purchase, validation, and control of filtration and apheresis WBC‐reduction processes at Blood Centers of the Pacific from 1997 through 1999. QA analysis was categorized on the basis of whether the process was new to the organization or was a modification of a previously validated system. The numbers of samples necessary to consistently detect failure in platelet yield, unit volume, pH, and WBC count was statistically determined by parametric and nonparametric techniques.RESULTS: Parametric analysis (power analysis) of the mean ± SD of smaller numbers of samples was highly sensitive to shifted distributions, but only if the shift was normally distributed. Nonparametric analysis, necessary when the nature of the underlying distribution is unknown, suggested a minimal sample of 40 was required to achieve high confidence that significant bimodal failure (a secondary population with WBCs 5% above the cutoff) would be detected.CONCLUSION: A QA system, developed for the evaluation of new or revised WBC‐reduction processes, was based on statistical analysis of normally and non‐normally distributed process failure. The number of samples was determined that allowed the achievement of confidence and tolerance levels considered appropriate within the blood center. Suggestions for outlier evaluation and a format for performance documentation have also been developed. To better define blood center quality goals, further research is necessary on donor and component biologic variability and the most significant modes of WBC‐reduction process failure.
Autoimmune hemolytic anemia caused by IgG λ‐monotypic cold agglutinins of anti‐Pr specificity after rubella infection
Authors: König Andreas L. , Schabel Angela , Sugg Udo , Brand Ulrich , Roelcke Dieter 
Published: March 2003

BACKGROUND: In postinfection cold agglutinin (CA) disease, a relation between CA specificity and the underlying infectious agent has been observed. The induction of anti‐I by Mycoplasma pneumoniae and that of anti‐i by EBV are well‐established examples.CASE REPORT: A 5‐year‐old boy developed severe hemolytic anemia after serologically ascertained rubella infection. Hemolysis was caused by high‐titer CAs, which were analyzed by absorption and elution with sialidase‐treated RBCs and hemagglutination‐inhibition experiments.RESULTS: After elimination of normal anti‐I and anti‐T, the predominant CA was found to be an IgGλ autoantibody with anti‐Pr1 specificity.CONCLUSION: This case seems to be of interest because it is the first report of severe CA‐induced hemolysis after rubella infection, it is the first description of an IgGλ‐monotypic CA, and, along with previous case reports (three established and three suspected cases), it indicates a relationship between rubella infection and the CA specificity anti‐Pr.
Comprehensive analysis of citrate effects during plateletpheresis in normal donors
Authors: Bolan Charles D. , Greer Sarah E. , Cecco Stacey A. , Oblitas Jaime M. , Rehak Nadja N. , Leitman Susan F. 
Published: March 2003

BACKGROUND: Although plateletpheresis procedures are generally well tolerated, the clinical and metabolic consequences associated with rapid infusion of up to 10 g of citrate are underappreciated, and a comprehensive description of these events is not available.STUDY DESIGN AND METHODS: Clinical and laboratory changes were studied in seven healthy donors undergoing three 90‐minute plateletpheresis procedures each, at continuous, fixed citrate infusion rates of 1.1, 1.4, and 1.6 mg per kg per minute.RESULTS: Serum citrate levels increased markedly with increasing citrate infusion rates and did not achieve a stable plateau. As citrate infusion rates increased, the total volume processed and platelet yields also increased, but donor symptoms became more severe. Ionized calcium (iCa) and ionized magnesium (iMg) concentrations decreased markedly, by 33 and 39 percent below baseline, respectively, at a citrate rate of 1.6 mg per kg per minute. Intact parathyroid hormone levels were higher at 30 minutes than at later time points, despite progressive decreases in iCa and iMg. Urine citrate, calcium, magnesium, sodium, and potassium concentrations and urine pH values increased markedly during all procedures.CONCLUSION: Marked, progressive increases in serum citrate levels occur during plateletpheresis, accompanied by symptomatic decreases in iCa and iMg, with significantly increased renal excretion of calcium, magnesium, and citrate.
Confidence in the safety of blood for transfusion: the effect of message framing
Authors: Farrell Kathleen , Ferguson Eamonn , James Virge , Lowe Kenneth C. 
Published: March 2003

BACKGROUND: Blood transfusion is a universally used, life‐saving medical intervention. However, there are increasing concerns among patients about blood safety. This study investigates the effect of message framing, a means of presenting information, on confidence in blood transfusion safety.STUDY DESIGN AND METHODS: The same factual information regarding the safety of blood for transfusion was presented to a sample of 254 adult students (donors and nondonors) as either a gain frame (lives saved), a loss frame (lives lost), or a combined frame (a loss frame expressed in a positive context). This provided a basic two‐way, between‐subjects design with 1) blood donation history (donors vs. nondonors) and 2) message frame (gain, loss, and combined) functioning as the between‐groups factors. It was hypothesized that participants would consider blood safer if information was presented as a gain frame. The role of stress appraisals as potential mediators of the framing effect was also explored.RESULTS: As predicted, participants receiving the gain‐frame information were significantly more confident of the safety of blood for transfusion than those receiving loss‐frame information or both. This was unaffected by donation history or appraisals of stress associated with transfusion. The extent to which blood was considered safe was negatively associated, independently of framing effects, with perceptions that transfusion was threatening.CONCLUSION: Information about transfusion should be conveyed to patients in a form focusing on the positive, rather than the negative, known facts about the safety of blood.
Peripheral blood progenitor cell grafts contain high levels of platelet‐secreted mediators
Authors: Foss Brynjar , Abrahamsen Jenny Foss , Bruserud Øystein 
Published: March 2003

BACKGROUND: The cytokine network in peripheral blood progenitor cell (PBPC) grafts may affect hematopoietic reconstitution or the risk of postransplant relapse of malignant disorders through effects on normal progenitor cells or contaminating malignant cells. Whether thrombopoietin (TPO), SCF, and platelet‐secreted mediators are parts of this network was investigated.STUDY DESIGN AND METHODS: Peripheral blood and PBPC plasma samples were collected consecutively from patients with malignant disorders who underwent PBPC harvest. Blood samples were collected immediately before and after apheresis. Patients underwent mobilization by chemotherapy plus G–CSF, except for one patient who received only G‐CSF. Plasma levels were also determined for healthy controls.RESULTS: PBPC grafts had greater levels of platelet‐secreted platelet factor 4 (PF4), β‐thromboglobulin, and platelet‐derived growth factor isoform AB, as compared with venous levels in patients and controls. Although platelet and PF4 levels in autografts were significantly correlated, the graft:blood ratio was higher for PF4 than for platelets. In both the patients' blood and the autografts, TPO levels were increased from the levels in normal controls. Blood and graft levels of SCF were within the normal range.CONCLUSION: The cytokine network of PBPC autografts includes increased levels of TPO and several platelet‐derived mediators.
High‐titer screening PCR: a successful strategy for reducing the parvovirus B19 load in plasma pools for fractionation
Authors: Weimer Thomas , Streichert Sigrid , Watson Charles , Gröner Albrecht 
Published: March 2003

BACKGROUND: Human parvovirus B19 (B19) is regarded as a potential risk factor for certain patient populations receiving plasma components.STUDY DESIGN AND METHODS: The prevalence of B19 was determined in a limited plasma donor population. Conditions for high‐titer screening PCR were designed to allow the removal of plasma donations in the acute phase of infection with virus loads ≥107 genome equivalents per milliliter before manufacturing. Antithrombin III lots originating from screened plasma were compared to lots originating from untested plasma with respect to their B19 DNA load by a sensitive PCR assay.RESULTS: B19 was shown to have a prevalence of about 1 per 800 plasma donations. Only a minority (1/8000) of occurrences were in the acute phase of infection. Removing plasma units with high virus load as determined by high‐titer screening PCR significantly decreased peak virus loads of plasma pools for fractionation. Together with a virus‐removal capacity of 10.4 log10 of the manufacturing process, this screening resulted in a final antithrombin III product that was nonreactive for B19 on PCR.CONCLUSION: Combining the strategy of high‐titer screening PCR with the virus reduction capacity of the manufacturing process considerably increased the margin of B19 virus safety of antithrombin III. This strategy should have positive impact on other plasma components as well.
Three‐base deletion and one‐base insertion of the α(1,4)galactosyltransferase gene responsible for the p phenotype
Authors: Koda Yoshiro , Soejima Mikiko , Sato Hiroyuki , Maeda Yoshiaki , Kimura Hiroshi 
Published: March 2003

BACKGROUND: Recently, an α(1,4)galactosyltransferase gene that is responsible for synthesis of Pk (Gb3) was isolated. The p individuals who did not express the Pk, P, and P1 antigens on RBC membranes were shown to lack the Pk (Gb3) synthase activity because of multiple distinct mutations in the α(1,4)galactosyltransferase gene. STUDY DESIGN AND METHODS: DNA sequences of the Pk (Gb3) synthase gene in three Japanese individuals with the p phenotype were analyzed. RESULTS: One individual was found to be homozygous for an allele containing a three‐base deletion of CTTCTTC to CTTC from bases 237 through 243 in the coding region. The other two individuals were found to be homozygous for an allele containing a single cytosine insertion in a cytosine repeat at positions 1026 through 1029, resulting in a reading frame shift. CONCLUSION: The p blood group phenotype is due to several distinct nonfunctional alleles without any predominant allele.