bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful storage of RBCs for 10 weeks in a new additive solution
Authors: Hess J.R. , Rugg N. , Knapp A.D. , Gormas J.F. , Silberstein E.B. , Greenwalt T.J. 
Published: March 2003

BACKGROUND: The effect of storing packed RBCs suspended in 300 mL of an alkaline, experimental additive solution (EAS 64) was explored.STUDY DESIGN AND METHODS: RBC units prepared from blood collected from healthy donors into CPD were WBC reduced and stored for 10 weeks under blood bank conditions after the addition of 300 mL of EAS 64 (adenine, 2 mM; dextrose, 50 mM; mannitol, 20 mM; NaCl, 75 mM; Na2HPO4, 9 mM). For comparison, non‐WBC‐reduced units from the same donors were stored in a different additive solution (AS‐1, Baxter Healthcare) for 6 weeks. Standard methods were used for the in vitro assays. The 24‐hour in vivo recoveries were measured by using 51Cr‐ and 99mTc‐labeled RBCs.RESULTS: Mean recovery in the EAS 64 units after 10 weeks was 84 ± 8 percent, the same as in the AS‐1 units stored for 6 weeks. For EAS 64 and AS‐1 units, respectively, the ATP of the RBCs was 85 percent and 64 percent of the initial value, hemolysis was 0.43 percent and 0.63 percent, supernatant potassium was 24 mEq per L and 44 mEq per L, and the morphologic index was 98 and 71.CONCLUSION: RBCs suspended in 300 mL of EAS 64 can be stored satisfactorily for 10 weeks. Longer RBC storage should reduce outdating, increase availability of transfusions in remote locations, and improve the efficiency of autologous donor programs.
Survival of Ehrlichia chaffeensis in refrigerated, ADSOL‐treated RBCs
Authors: McKechnie Don B. , Slater Kimetha S. , Childs James E. , Massung Robert F. , Paddock Christopher D. 
Published: March 2003

BACKGROUND: The purpose of this study was to investigate the persistence of viable Ehrlichia chaffeensis in ADSOL‐treated RBCs stored at 4 to 6°C.STUDY DESIGN AND METHODS: The continuous monocytic cell lines THP‐1 and DH82 were infected with E. chaffeensis (St. Vincent isolate). Packed RBC units were inoculated in separate experiments with E. chaffeensis‐infected cells as final concentrations of 8.02 × 104 (DH82) and 1.43 × 104 (THP‐1) infected cells per mL. Aliquots were stored at 4 to 6°C for 1 to 42 days. At selected intervals, nucleated cells from the RBC aliquots were obtained by using a ficoll‐isopaque separation procedure. Uninfected DH82 cell cultures were inoculated with the harvested nucleated cells or supernatant. The cell cultures were evaluated for infection by weekly examination of Wright's (Diff‐Quik) stained cytocentrifuged slides. PCR amplification was also used to test the harvested nucleated cells or supernatant for the presence of E. chaffeensis DNA.RESULTS: In both types of infected cell lines, E. chaffeensis was reisolated in DH82 cells for as long as 11 days from the cellular fraction and for up to 5 days from the supernatant fraction. PCR results were positive throughout the 42‐day testing period.CONCLUSION: Cell‐associated E. chaffeensis remains viable in ADSOL‐treated RBCs stored at 4 to 6°C for at least 11 days. These data suggest that transfusion‐acquired infection is possible. Successful reisolation was achieved from the supernatant fraction, which suggests that RBC products treated with a WBC‐reduction procedure may still present a risk for transfusion transmission. No correlation between PCR positivity and viability of bacteria was noted.
An amino acid substitution in the putative second extracellular loop of RBC band 3 accounts for the Froese blood group polymorphism
Authors: McManus Kirk , Lupe Krystine , Coghlan Gail , Zelinski Teresa 
Published: March 2003

BACKGROUND: The low incidence RBC antigen Fra has been excluded from 17 of the 25 established blood group systems. Previous genetic analysis assigned the gene controlling Fra expression to the same chromosomal region as the solute carrier family 4, anion exchanger member 1 gene (SLC4A1). Because SLC4A1 encodes RBC band 3 and controls the expression of Diego blood group system antigens, the possible relationship of Fra to the Diego blood group system was investigated by molecular analysis of SLC4A1.STUDY DESIGN AND METHODS: Blood samples were obtained from the members of two unrelated Mennonite kindreds segregating for Fra. DNA was extracted, amplified by PCR using intronic primer sets flanking exons 11‐20 of SLC4A1, and screened by single‐strand conformation polymorphism (SSCP) analysis. Those exons displaying SSCPs were subjected to DNA sequence analysis.RESULTS: An exon 13 SSCP mobility shift was observed in the DNA from all Fr(a+) persons that was not seen in the DNA from Fr(a‐) family members or control subjects. Linkage between the exon 13 SSCP and Fra was established, with peak lods = 3.62 at θ = 0.00 for combined paternal and maternal meioses. DNA sequencing revealed a GAG → AAG mutation that underlies a Glu480Lys substitution in RBC band 3.CONCLUSIONS: A point mutation in exon 13 of SLC4A1 accounting for a Glu480Lys substitution in band 3 controls Fra expression. On the basis of these our results, the International Society of Blood Transfusion Working Party on Terminology for Red Cell Surface Antigens has assigned Fra to the Diego blood group system, with the designation DI20.
Validation of selected donor‐screening questions: structure, content, and comprehension
Authors: Orton Sharyn L. , Virvos Victoria J. , Williams Alan E. 
Published: March 2003

BACKGROUND: Donor questioning is an integral component of blood safety, designed to identify and interdict donors considered to be at elevated risk of transfusion‐transmissible infection. Questions are frequently added to this screening procedure, but they are rarely evaluated for comprehension.STUDY DESIGN AND METHODS: Seven American Red Cross blood donor history questions were selected for evaluation. Focus groups were conducted using individuals from high school/college, church, business, and other sources, who had never donated blood. Both sexes and various age and racial groups were represented. The donation process and regulatory requirements or guidelines were explained. Participants were asked to consider 1) content, 2) clarity 3) likelihood of asking for more information, 4) suggestions for improvement, and 5) how a need for clarifying information would best be met.RESULTS: Constructive, helpful, and consistent comments obtained might be utilized in revising questions.CONCLUSION: Focus group discussions can be useful in providing guidance for developing screening questions that can be easily understood.
CD34+ cell mobilization for allogeneic progenitor cell transplantation: efficacy of a short course of G–CSF
Authors: De Fabritiis Paolo , Iori Anna Paola , Mengarelli Andrea , Gozzer Maria , Ferrazza Giancarlo , De Propris Maria Stefania , Romano Atelda , Arcese William 
Published: March 2003

BACKGROUND: G–CSF‐mobilized PBPCs are considered the richest source of HPCs for both autologous and allogeneic transplantation, but, despite their wide use, the best dose and schedule for G–CSF administration have not been definitively established.STUDY DESIGN AND METHODS: With a target of collecting from the peripheral blood ≥4 × 106 CD34+ cells per kg of body weight of the recipient, the short‐course administration of glycosylated G–CSF (gly‐G–CSF) in 30 healthy donors for an allogeneic transplantation was investigated. Gly‐G–CSF was given subcutaneously at a dose of 10 μg per kg per day in two divided doses over 3 days and was followed by a leukapheresis (on the 4th day) 12 hours after the last dose.RESULTS: A median of 53.5 circulating CD34+ cells per μL (range, 19‐190) was found in the 30 donors on the day of first leukapheresis, which allowed a median CD34+ cell collection of 6.0 × 106 per kg of body weight of the donor and 6.5 × 106 per kg of body weight of the recipient. In 25 (83%) of 30 donors, a single procedure was sufficient to collect the target CD34+ cells, while in the other 5, two leukapheresis procedures were required. Hematologic reconstitution was observed in all patients at a median of 14 days (range, 10‐23) for neutrophils and 14.5 days (range, 11‐46) for platelets. With a median infusion of 3.9 × 108 CD3+ T‐lymphocytes per kg of body weight of the recipient (range, 1.3‐7.8), acute and chronic GVHD occurred in 13 (43%) of 30 and 15 (60%) of 25 evaluable patients, respectively. After a median follow‐up of 337 days from transplant, 22 (73%) of 30 patients are alive in complete remission.CONCLUSION: A schedule consisting of 3‐day administration of gly‐G–CSF followed by a single leukapheresis can be proposed and widely accepted by healthy donors, as 84 percent of them reach the target in the estimated time with a reduced drug exposure. The cost of the procedure is reduced, in terms of both the growth factor administration and the number of leukapheresis procedures. The search for the optimum methods of donor management may improve the acceptability of this procedure and increase the number of allogeneic transplantations from PBPCs.
Platelet storage lesion of WBC‐reduced, pooled, buffy coat‐derived platelet concentrates prepared in three in‐process filter/storage bag combinations
Authors: Krailadsiri Pranee , Seghatchian Jerard , Williamson Lorna M. 
Published: March 2003

BACKGROUND: With the implementation of universal WBC reduction in the United Kingdom, in‐process WBC‐reduction filters for pooled buffy coat (BC)‐derived platelet concentrates (PCs) are used in routine production. The effects of three filter/storage bag combinations on platelet activation and mi‐crovesiculation and on the activation of coagulation were investigated.STUDY DESIGN AND METHODS: Using pooled BCs from the same donors, three filter/storage bag combinations (Autostop BC/CLX, Pall Biomedical; Sepacell PLX5/PL2410, Asahi Medical; and Imugard III‐PL 4P/Teruflex, Terumo) were compared with unfiltered controls for their effects on microvesiculation and other storage‐induced changes in platelets. Process efficiency was measured by platelet yield and residual WBC count. The storage changes were assessed: pH, activation of platelets measured by CD62P on the platelet surface and in supernatant plasma, quantitation of platelet‐derived and RBC‐derived microvesicles, cellular injury measured by annexin V in the supernatant plasma, and activation of the coagulation system measured by kallikrein‐like and thrombin‐like activities, prothrombin fragment 1+2, and thrombin‐antithrombin complex.RESULTS: All three filters were comparable in terms of platelet recovery and WBC removal, and none induced immediate platelet activation or microvesiculation. With storage, platelet activation or microvesiculation increased in platelets prepared by all three filters and in unfiltered controls, but these effects were significantly less in the Imugard PCs than in controls. These findings were consistent with those for annexin V in the supernatant plasma, which were lower in Imugard PCs than in other products. Sepacell and Imugard filters reduced RBC‐derived microvesicles to 50 percent of control levels, but the Autostop filter had no effect. On storage, levels of RBC‐derived microvesicles in filtered products remained static, but levels in the unfiltered control doubled. Kallikrein‐ and thrombin‐like activities were generated only by the Autostop filter without any further increment on storage.CONCLUSION: WBC‐reduced pooled BC‐PCs prepared by various filter/bag combinations were equivalent on Day 1 but differed during storage in terms of platelet activation or microvesiculation.
The low‐incidence MNS antigens Mv, sD, and Mit arise from single amino acid substitutions on GPB
Authors: Storry Jill R. , Reid Marion E. , MacLennan Sheila , Lubenko Anatole , Nortman Peter 
Published: March 2003

BACKGROUND: GPB carries ‘N’ at its N‐terminus and S and s, determined by a polymorphism at amino acid position 29 (Met29Thr). The low‐incidence antigens Mv, sD, and Mit are associated with weakened expression of S and/or s, and the purpose of this study was to define their molecular bases.METHODS: The GPB gene (GYPB) was sequenced after RT‐PCR of RNA from four samples: two Mv+, one sD+, and one Mit+. The point mutations observed were confirmed by sequencing of genomic DNA from these and other examples of sD+ and Mit+ samples.RESULTS: A point mutation of 65C>G observed in the Mv+ samples predicted a change of Thr3Ser. A mutation of C>G at nucleotide 173 of the GYPB coding sequence, observed in two sD+ samples, predicted a change of Pro39Arg. Three Mit+ samples showed a nucleotide substitution of 161G>A, which predicted a change of Arg35His. Altered expression of S or s was confirmed by serologic tests.CONCLUSION: These results confirm that Arg35 is important for full expression of S. Pro39 and, surprisingly, Thr3 are also important for full expression of s. Furthermore, Thr3 must be essential for expression of ‘N,’ as Mv+ RBCs lack ‘N.’
Routine HCV PCR screening of blood donations to identify early HCV infection in blood donors lacking antibodies to HCV
Authors: Hitzler Walter E. , Runkel Stefan 
Published: March 2003

BACKGROUND: Detection of early hepatitis C infection of blood donors is still a major problem for blood transfusion. Common anti‐HCV screening assays show differences in sensitivity and specificity. The often mild symptoms of acute hepatitis C also cause difficulties in the identification of early HCV infection. The feasibility and efficacy of routine screening of blood donations for HCV RNA were investigated.STUDY DESIGN AND METHODS: Blood donations (n = 251,737) were screened for HCV RNA over 4 years. RNA extraction, amplification, and detection were done by two commercial HCV PCR kits (HCV Cobas Amplicor and HCV Cobas Amplicor 2.0, Roche Diagnostics). Screening was done by pool testing with a maximum pool size of 40 serum samples.RESULTS: Three donations out of 251,737 were HCV RNA positive and anti‐HCV negative. ALT levels of these donations were 271, 32, and 10 U per L. The HCV infection of a fourth HCV RNA‐positive donor could not be identified by routine, second‐generation HCV EIA (Abbott Diagnostika). In this case, two previous donations were also HCV RNA positive, and three second‐generation test systems (Abbott) could not detect anti‐HCV, whereas third‐generation anti‐HCV screening assays detected antibody with different sensitivity. The first HCV RNA‐positive donation was identified only by the HCV ELISA 3.0 (Ortho Diagnostic Systems). The results of confirmatory assays like RIBA HCV 3.0 (Ortho) and Matrix (Abbott) indicate a restricted immune response to NS3 only.CONCLUSION: HCV RNA detection by PCR can be carried out routinely in blood donor screening without significant delay of release of the components. The residual risk of transmission can be reduced by identification of early infection, which can lead to an improved safety of blood components. RNA screening can also be advantageous in cases of incomplete or lack of antibody response to HCV.
Virus inactivation of plasma‐derived proteins by pasteurization in the presence of guanidine hydrochloride
Authors: Schlegel Andreas , Immelmann Andreas , Kempf Christoph 
Published: March 2003

BACKGROUND: Viruses, among them parvovirus B19 and other small, nonenveloped viruses, may be present in human blood and may contaminate plasma‐derived therapeutics. Efficient inactivation or removal of such viruses, especially parvoviruses, represents a current problem and corresponding technologies are under investigation. In this report, such a technology is described.STUDY DESIGN AND METHODS: A recently developed pasteurization of human apolipoprotein A‐I (apoA‐I), which is performed at 60°C for 10 hours in the presence of guanidine hydrochloride (GdnHCl), was validated by using a series of model viruses, including members of the families parvoviridae and picornaviridae. The model viruses were spiked into the apoA‐I‐ and GdnHCl‐containing solutions, and virus inactivation was evaluated by infectivity assays in cell cultures. The mechanism of virus inactivation was studied by virus sedimentation analysis using the picornavirus model.RESULTS: All viruses tested were inactivated to levels below the limit of detection, although different inactivation kinetics were obtained for the different viruses. The mechanism of virus inactivation by this pasteurization was disassembly of the virus particles into single proteins or small noninfectious viral subunits.CONCLUSION: The pasteurization validated in this report has the potential to inactivate a wide range of transfusion‐relevant viruses including parvoviruses and picornaviruses.
Immunochemical determination of cellular prion proteinin plasma from healthy subjects and patients withsporadic CJD or other neurologic diseases
Authors: Völkel Dirk , Zimmermann Klaus , Zerr Inga , Bodemer Monica , Lindner Thomas , Turecek Peter L. , Poser Sigrid , Schwarz Hans P. 
Published: March 2003

BACKGROUND: Creutzfeldt‐Jakob disease is thought to be caused by conversion of cellular prion protein (PrP) from its soluble form (PrPsen) to a pathologic form (PrPres). The occurrence of a new variant of CJD has increased the demand for a rapid assay capable of detecting a theoretical risk of transmission of the disease by blood or plasma.STUDY DESIGN AND METHODS: A quantitative sandwich ELISA for routine screening was developed for analysis of PrP levels in plasma. The time‐resolved dissociation‐enhanced fluorescence technology allowed a detection limit in plasma samples of approximately 50 pg/mL. Levels of PrPsen were tested in plasma from 31 patients with CJD, from 11 patients with other neurodegenerative diseases, and from a control group of 200 healthy subjects.RESULTS: The assay recognized both PrPsen and pathologic PrPres, but did not differentiate between the two isoforms. PrPsen levels were higher in plasma from both patient groups than in plasma from the control group: 27 of the 31 (87%) CJD patients and all patients with other neurodegenerative diseases had higher levels than the highest concentration found in the control group. No correlation was found between age and PrP level. No signal could be detected in the CJD samples after protease K digestion, indicating that all detected PrP was protease‐sensitive and therefore not pathologic.CONCLUSION: These data suggest that soluble PrPsen in plasma samples might be useful as a surrogate marker for a broad spectrum of neurologic diseases as well as for CJD.
Platelet‐reactive HLA antibodies associated with low posttransfusion platelet increments:a comparison between the monoclonal antibody‐specific immobilization of platelet antigens assay and the lymphocytotoxicity test
Authors: Kurz Martin , Knöbl Paul , Kalhs Peter , Greinix Hildegard T. , Höcker Paul , Panzer Simon 
Published: March 2003

BACKGROUND: Platelet‐reactive HLA antibodies are a major reason for low posttransfusion platelet increments. The clinical importance and value of the test systems for their in vitro determination is still controversial.STUDY DESIGN AND METHODS: A prospective analysis of HLA antibodies was performed in sera obtained once a week for at least 4 consecutive weeks from 55 patients (female/male, 28/27; age: median, 49 years; range, 18‐69) undergoing intensive chemotherapy and in need of prophylactic platelet transfusions. All sera (n = 330) were analyzed by the monoclonal antibody‐specific immobilization of platelet antigens (MAIPA) assay and by the standard lymphocytotoxicity test (LCT).RESULTS: In the MAIPA, 24.5 percent of sera (81/330) obtained from 22 patients contained HLA antibodies. These were detected significantly more often by the MAIPA assay than by the LCT (24.5% vs. 8.2%). Fifty‐five sera (20 patients) were positive in the MAIPA assay only. In 15 patients, HLA antibodies were transient. In 3 patients, HLA antibodies were detected earlier by the MAIPA assay than by the LCT. Significantly more sera obtained at the time of low posttransfusion platelet increments were positive in MAIPA alone, rather than in both MAIPA and the LCT (44% vs. 17%).CONCLUSION: The MAIPA assay is more sensitive than the standard LCT in detecting platelet‐reactive HLA antibodies. These MAIPA‐positive/LCT‐negative HLA antibodies affect the posttransfusion platelet increment.
Single‐donor platelets reduce the risk of septic platelet transfusion reactions
Authors: Ness Paul , Braine Hayden , King Karen , Barrasso Christine , Kickler Thomas , Fuller Alice , Blades Natalie 
Published: March 2003

BACKGROUND: Septic platelet transfusion reactions (SPTRs) are the most common, serious risk of transfusion. Because SPTRs result from donor skin flora or asymptomatic bacteremia, the use of single‐donor platelets (SDPs) has been proposed to reduce the risk of SPTRs from the risks with pools of platelet concentrates (PCs).STUDY DESIGN AND METHODS: Beginning in 1986, all febrile transfusion reactions were evaluated by culture of the platelet bag. Confirmed SPTRs were identified by isolation of the same bacteria from the bag and the patient's blood or by positive Gram's stain of the bag that confirmed a positive platelet culture. In 1987, a program to minimize PC use in favor of SDP use was initiated as a means of reducing SPTRs.RESULTS: In 12 years, the use of SDPs increased from 51.7 percent to 99.4 percent of all platelet transfusions at one institution. SPTRs fell from three events in 1 year to the current rate of one event per year. The incidence of SPTRs decreased from 1 in 4,818 transfusions to 1 in 15,098 transfusions. The rate of SPTRs due to PCs was 5.39 times higher than that of SPTRs due to SDPs (95% CI, 1.89,12.9).CONCLUSION: The use of SDPs is a simple means of reducing SPTRs. Other measures such as sterilization will be required to eliminate all SPTRs.
Role of oral versus IV iron supplementation in the erythropoietic response to rHuEPO: a randomized, placebo‐controlled trial
Authors: Olijhoek Ger , Megens Johannes G.N. , Musto Paulo , Nogarin Livio , Gassmann‐Mayer Christiana , Vercammen Els , Hayes‐Licitra Sandra A. 
Published: March 2003

BACKGROUND: Preoperative treatment with rHuEPO (epoetin alfa: EPREX, Janssen‐Cilag; or PROCRIT, Ortho Biotech) in conjunction with iron supplementation increases the erythropoietic response in elective orthopedic surgery patients, but it is not known whether the magnitude of this response is dependent on the route of iron administration.STUDY DESIGN and METHODS: Non‐iron‐deficient patients undergoing elective orthopedic surgery (N = 110) with baseline Hb ≥10 to ≤13 g per dL were randomly assigned to receive either epoetin alfa (600 IU/kg) plus IV iron (n = 29) or oral iron (n = 29) or placebo plus IV iron (n = 25) or oral iron (n = 27) in this 14‐day study. RBC production, Hb, Hct, reticulocytes, iron status, and adverse events were monitored throughout the study.RESULTS: Epoetin alfa treatment plus either oral or IV iron supplementation significantly increased total RBC production, Hb, Hct, and reticulocytes over the values seen with the respective placebo treatments (p = 0.0001). There were no differences between the epoetin alfa treatment groups. Placebo treatment plus oral or IV iron supplementation was not associated with increases in hematologic values. There were no differences in the incidence of adverse events among the treatment groups.CONCLUSION: There was a comparable erythropoietic response to epoetin alfa, irrespective of the route of iron administration. The route of iron administration, therefore, does not modulate the erythropoietic response to epoetin alfa in patients who are not iron deficient. Safety and convenience benefits may be gained by adopting oral iron supplementation in this patient subset.