bluuebunny/crossref_metadata_2025_split huggingface dataset:
A pilot randomized trial comparing symptomatic vs. hemoglobin‐level‐ driven red blood cell transfusions following hip fracture
Authors: Carson J. L. , Terrin M. L. , Barton F. B. , Aaron R. , Greenburg A. G. , Heck D. A. , Magaziner J. , Merlino F. E. , Bunce G. , McClelland B. , Duff A. , Noveck H. 
Published: March 2003

BACKGROUND: The indications for transfusion have never been evaluated in an adequately sized clinical trial. A pilot study was conducted to plan larger clinical trials.STUDY DESIGN AND METHODS: Hip fracture patients undergoing surgical repair who had postoperative hemoglobin levels less than 10 g per dL were randomly assigned to receive 1) symptomatic transfusion: that is, transfusion for symptoms of anemia or for a hemoglobin level that dropped below 8 g per dL or 2) threshold transfusion: that is, patients receive 1 unit of packed RBCs at the time of random assignment and as much blood as necessary to keep the hemoglobin level above 10 g per dL. Outcomes were 60‐day mortality, morbidity, functional status, and place of residence.RESULTS: Among 84 eligible patients enrolled, mean (± SD) prerandomization hemoglobin was 9.1 (± 0.6) g/ dL. The median number of units transfused in the threshold transfusion group was 2 (interquartile range, = 1–2), and that in the symptomatic transfusion group was 0 (6; interquartile range, = 0–2) (p < 0.001). Mean hemoglobin levels were approximately 1 g per dL higher in the threshold group than in the symptomatic group: for example, on Day 2, 10.3 (± 0.9) g per dL versus 9.3 (± 1.2) g per dL, respectively (p < 0.001). At 60 days, death or inability to walk across the room without assistance occurred in 16 (39.0%) of the symptomatic transfusion group and 19 (45.2%) of the threshold transfusion group. Death occurred by 60 days in 5 (11.9%) of the symptomatic transfusion group and 2 (4.8%) in the threshold transfusion group (relative risk = 2.5; 95% CI, 0.5–12.2). Other outcomes were similar for the two groups.CONCLUSIONS: Symptomatic transfusion may be an effective blood‐sparing protocol associated with the transfusion of appreciably fewer units of RBCs and lower mean hemoglobin levels than are associated with the threshold transfusion policy. However, it is unknown whether these two clinical strategies have comparable mortality, morbidity, or functional status. A definitive trial is needed.
Immunologic changes after transfusion of autologous or allogeneic buffy coat‐poor versus white cell‐reduced blood to patients undergoing arthroplasty. I. Proliferative T‐cell responses and the balance of helper and suppressor T cells
Authors: Innerhofer P. , Luz G. , Spötl L. , Hobisch‐Hagen P. , Schobersberger W. , Fischer M. , Nussbaumer W. , Lochs A. , Irschick E. 
Published: March 2003

BACKGROUND: Donor white cells (WBCs) contained in red cell (RBC) transfusions are thought to provoke down‐regulation of T‐cell‐mediated immunity. This study investigated this topic in otherwise healthy patients receiving buffy coat‐depleted or WBC‐filtered RBCs and undergoing standardized perioperative management.STUDY DESIGN AND METHODS: Patients undergoing elective orthopedic surgery (primary hip and knee replacement surgery) were enrolled in a prospective study. Perioperative changes in T‐cell proliferation (stimulation with phytohemagglutinin and mixed lymphocyte culture) and T‐cell balance (T‐lymphocytes, helper T cells, and suppressor T cells) were compared after random assignment to allogeneic buffy coat‐depleted (Group 2, n = 8) or WBC‐reduced RBC (Group 3, n = 11) transfusion regimens. Recipients of autologous buffy coat‐depleted RBC transfusions (n = 15) served as controls (Group 1).RESULTS: Compared to that in autologous transfusion recipients, alloantigen‐induced T‐cell proliferation was significantly reduced in recipients of allogeneic WBC‐reduced RBCs (Day 3, p = 0.0274). After the transfusion of allogeneic buffy coat‐depleted RBCs, a weak trend toward decreased T‐cell proliferation was observed (p = 0.0933) and the numbers of CD4+ T cells were also significantly lower (Day 7, p = 0.0389). On Day 10, alloantigen‐induced T‐cell proliferation remained significantly below baseline after transfusion of WBC‐reduced RBCs (p = 0.05), the numbers of CD3+ cells decreased in allogeneic RBC recipients (Group 2, p = 0.078; Group 3, p = 0.05), and those of CD8+ cells decreased significantly after the transfusion of allogeneic buffy coat‐depleted RBCs (p = 0.0234) concomitant with an increased CD4:CD8 ratio (p = 0.0391).CONCLUSION: Results of the present study confirm the hypothesis of impaired T‐cell‐mediated immunity after allogeneic transfusion.
Seroindeterminate patterns and seroconversions to human T‐lymphotropic virus type I positivity in blood donors from Martinique, French West Indies
Authors: Cèsaire R. , Bera O. , Maier H. , Lezin A. , Martial J. , Ouka M. , Kerob‐Bauchet B. , Amar A.K. Ould , Vernant J.C. 
Published: March 2003

BACKGROUND: Screening for human T‐lymphotropic virus type I (HTLV‐I) antibodies in volunteer blood donors has been systematic in the French West Indies since 1989. Western blot‐indeterminate results are commonly obtained. The significance of these indeterminate serologic patterns in HTLV‐I‐endemic areas is still unclear.STUDY DESIGN AND METHODS: During a 2‐year period, 9759 blood donors were tested for HTLV‐I antibodies. The epidemiologic features of HTLV‐I‐seropositive,‐seroindeterminate, and ‐seronegative donors were compared. A lookback investigation was performed for the HTLV‐I‐seropositive donors, and the HTLV‐I‐seroindeterminate individuals were followed up.RESULTS: Thirty‐nine donors (0.4%) were HTLV‐I seropositive and 49 (0.5%) were seroindeterminate. The age and sex ratio characteristics of the seroindetermi‐nate donors are divergent from those of the HTLV‐I‐seropositive group and are more like those of the seronegative population. However, during the study period, three cases of seroconversion after an initial seroindeterminate profile were reported. Two cases were detected through follow‐up of 38 HTLV‐I‐ seroindetermi‐nate donors over a mean of 8 months (2‐24 months). The third seroconverter belonged to the HTLV‐I‐seropositive group and was identified through lookback investigation. This case is atypical, with p19 reactivity for several months before HTLV‐I seropositivity.CONCLUSION: These findings indicate that, although HTLV‐I‐seroindeterminate donors mainly are HTLV‐I‐noninfected, the rate of seroconversion in a repeat blood donor population from an endemic region must be taken into consideration. Moreover, the case of delayed seroconversion observed in this study suggests the difficulty of counseling seroindeterminate blood donors in endemic regions.
Semi‐automated flow cytometric analysis of CD34‐expressing hematopoietic cells in peripheral blood progenitor cell apheresis products
Authors: Gutensohn K. , Carrero I. , Krueger W. , Kroeger N. , Schäfer P. , Luedemann K. , Kuehnl P. 
Published: March 2003

BACKGROUND: The measurement of CD34+ cells is the most important step in the quality control of peripheral blood progenitor cell apheresis products. For this purpose, flow cytometry is applied. Recently, a new test kit has been introduced for the enumeration of CD34‐expressing cells, in combination with software support for semi‐automation of data acquisition and analysis.STUDY DESIGN AND METHODS: This study evaluated the ProCOUNT kit. Ninety samples obtained from peripheral blood progenitor cell apheresis products from 39 patients with hemato‐oncologic diseases were analyzed. For data acquisition and analysis, ProCOUNT software was used. Data comparison was performed with parallel measurements according to the International Society for Hematotherapy and Graft Engineering (ISHAGE) guidelines and the German reference protocol for analysis of CD34‐expressing cells.RESULTS: Correlation of the German and ISHAGE techniques was excellent (r2 = 0.99). The initial correlation coefficient of ProCOUNT analysis with the German protocol was r2 = 0.89. In 21 (23.3%) of 90 ProCOUNT analyses, a warning message was encountered from the ProCOUNT software. Following manual reevaluation of these data with CellQUEST software, a correlation of r2 = 0.96 with the German protocol and r2 = 0.97 with the ISHAGE analyses was obtained. ANOVA testing revealed significant differences between ProCOUNT and ISHAGE techniques (p<0.05) and between ProCOUNT and the German protocol (p<0.05). No statistically significant difference between ISHAGE and German protocol was observed (p = 0.19).CONCLUSION: The ProCOUNT kit and software for semi‐automated data acquisition and analysis represents a further step toward standardization of CD34 cell quantitation in peripheral blood progenitor cell apheresis products. However, the occurrence of software warnings is high, and analysis or data reevaluation by experienced staff is still mandatory. Therefore, currently there is no definite advantage of the kit and software over the existing guidelines for CD34+ analysis in peripheral blood progenitor cell grafts.
Variations in the expression of granulocyte antigen NB1
Authors: Matsuo K. , Lin A. , Procter J.L. , Clement L. , Stroncek D. 
Published: March 2003

BACKGROUND: Between 87 and 97 percent of whites express NB1 alloantigen on some but not all of their granulocytes. The expression of NB1 has not been compared among large groups of adults of different sexes, ages, and ethnic groups. Previous testing of whites suggests that the expression of NB1 is variable.STUDY DESIGN AND METHODS: Serologic testing of granulocytes from 224 persons with two examples of MoAb to NB1 (1B5 and 7D8) was performed to distinguish phenotypic differences among age, sex, and ethnic groups and differences in reactivity to MoAbs. The donors were from 17 to 82 years of age, and 87 were female. They were from four ethnic backgrounds: 54 were African American (black), 10 were Asian, 9 Hispanic, and 152 white. Granulocytes were tested by flow cytometry. Parallel testing with MoAbs to CD16, CD11b, and CD45 served as controls. The size of the granulocyte population reacting with 1B5 and 7D8 and the respective mean, median, and peak cell fluorescence intensities were analyzed.RESULTS: The expression of 7D8 and 1B5 was greater on granulocytes from female donors. The expression of 7D8 fell in older women but not in men. There were no differences among the four racial groups in either the frequency of NB1 as determined by 1B5 or 7D8 or in the size of the population of granulocytes reacting with either antibody. When the fluorescence intensities of the antibody reactions were compared among groups, there were no differences in reactivity with 1B5. However, reactions with 7D8 were all greater in blacks. Comparison of the size of the antigen‐positive granulocyte population, as determined by antibody reactivity, showed that only 30 donors differed by more than 10 percent. These discordant results were more likely to occur in whites than in blacks (18% vs. 4%, p<0.02).CONCLUSIONS: NB1 is composed of at least two epitopes as determined by serologic studies. The expression of both antigens is greater in females. The 7D8‐reactive epitope appears to be more prevalent or more accessible on granulocytes of blacks. Variations in the expression of NB1 are more likely to occur in whites. The biochemical and molecular basis of these variations are not known.
Effects of three Hb‐based oxygen‐carrying solutions on neutrophil activation in vitro: quantitative measurement of the expression of adherence receptors
Authors: Toussaint Marie , Latger‐Cannard Veronique , Caron Alexis , Lecompte Thomas , Stoltz Jean‐Francois , Vigneron Claude , Menu Patrick 
Published: March 2003

BACKGROUND: Hb‐based oxygen carriers (HbOCs) are currently under investigation as RBC substitutes. These solutions have vasoactive properties and may modify the behavior of the RBC in vitro. The effects of these agents on other blood cells have not been extensively investigated. The aim of this study was to evaluate the potential effect(s) of three differently modified HbOCs on the activation of PMNs.STUDY DESIGN AND METHODS: Whole blood from humans was incubated with Hb dextran‐benzene‐tetracarboxylate, αα‐Hb, or o‐raffinose‐poly‐Hb for 15, 30, and 60 minutes. The expression of adherence receptors CD62L, CD18, and CD11b, which reflects the activation state of the neutrophils, was assessed in vitro by a direct immunofluorescence method using calibration beads measured by flow cytometry.RESULTS: The observed expression of each of the three adherence receptors for each solution at each time point was similar to that noted with the RPMI control. Decreases in CD62L and increases in CD18 expression were noted at 15 minutes of incubation but, when those values were compared to the values obtained with TNFα as the positive control of PMN activation, the profile of expression of adherence receptors obtained with HbOC solutions did not conform to the expected activation profile of PMNs.CONCLUSION: Hb solutions modified by a variety of methods, as obtained and employed in this study, did not appear to activate neutrophils in vitro.
First‐time blood donors: demographic trends
Authors: Wu Ying , Glynn Simone A. , Schreiber George B. , Wright David J. , Lo Annie , Murphy Edward L. , Kleinman Steven H. , Garratty George ,   for the Retrovirus Epidemiology Donor Study (REDS) Group
Published: March 2003

BACKGROUND: With changing demographics of the United States population and the continuous need to recruit new donors, it is important to monitor the demographic profile of first‐time donors and to evaluate changes in the donor pool to improve recruitment targeting.STUDY DESIGN AND METHODS: First‐time whole blood (n = 901,862) donors at five United States blood centers between 1991 and 1996 were analyzed.RESULTS: The total number of first‐time donors appears to be decreasing. Over the 6‐year period, there was an overall increase in the proportion of Hispanic and other minority first‐time donors and a concurrent decrease in the proportion of white donors at Retrovirus Epidemiology Donor Study centers. Other variables, including age, sex, and education, did not show a consistent trend.CONCLUSION: The demographic profile of first‐time donors is changing. These data highlight the importance for blood centers to continuously monitor the donor population. A better understanding of the donor population may help blood centers adjust their donor outreach, recruitment, and retention programs. New recruitment efforts appear needed to counter general apathy toward donating blood, and minority groups appear to be receptive to becoming blood donors.
RBC transfusion in sickle cell anemia (HbSS):experience from the Jamaican Cohort Study
Authors: Thame Jennifer R. , Hambleton Ian R. , Serjeant Graham R. 
Published: March 2003

BACKGROUND: RBC transfusion is widely advocated in the management of sickle cell anemia (SCA), but it carries potentially serious risks, especially in the setting of chronic transfusion. The Jamaican Sickle Cell Clinic is conservative in its use of transfusion, and this experience is presented to allow comparison with other centers in defining the role for transfusion in SCA.STUDY DESIGN AND METHODS : Reported here is a retrospective, descriptive study of all RBC transfusions given to 311 subjects with SCA who were followed in a cohort study from birth and are, at this writing, 16.3 to 24.7 years old.RESULTS: There were 520 transfusion episodes in 197 (63.3%) of the 311 subjects; 1 transfusion in 80 (41%) of those who received transfusion(s), 2 transfusions in 54 (27%), 3 transfusions in 21 (11%), 4 in 17 (9%), 5 in 9 (5%), and 6 or more in 16 (8%). Single transfusions were usual for acute anemia of aplastic crises or acute splenic sequestration, and multiple transfusions (up to 21 episodes) were usual in the prophylaxis of recurrent stroke. Indications were aplastic crisis (102), acute chest syndrome (90), acute splenic sequestration (75), stroke (62), septicemia (46), hypoplasia (40), hypersplenism (34), surgery (31), gastroenteritis (10), and miscellaneous (30).CONCLUSION : Despite conservative transfusion use, 70.6 percent of patients had received at least one transfusion by 20 years of age in the Jamaican Sickle Cell Clinic.
Incidence rates of viral infections among repeat donors:are frequent donors safer?
Authors: Schreiber George B. , Glynn Simone A. , Busch Michael P. , Sharma Usha K. , Wright David J. , Kleinman Steven H. ,   for the Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND: Incidence rates (IRs) for viral infections may vary with the frequency of donation among repeat, community, whole‐blood (WB) donors, with IRs thought to be lower among donors with higher frequency of donation.STUDY DESIGN AND METHODS: IRs for HIV, HTLV, HCV, and HBV infection were stratified by frequency of donation among 868,403 repeat WB donors who gave approximately 4 million donations at five United States blood centers from 1991 through 96. All donors had given at least 2 donations during those years, with the first donation being nonreactive on confirmatory testing. Frequency of donation was measured in three ways: by the number of donations per year; at the time of donation, by the number of donations given within the preceding 2‐year period; and by the number of donations given from 1991 through 1993.RESULTS: The IRs for HIV, HCV, and HBV infection did not appear to differ among donors with lower or higher numbers of donation per year. However, the IR for HTLV infection decreased as the number of donations per year increased (p = 0.0004). IRs for all viral markers remained stable, regardless of the number of donations given within the 2‐year period before the donation. Although IRs for HIV, HTLV, and HCV infection did not vary by the number of donations given in 1991 through 1993, the IR for HBV infection appeared to be lower in donors who gave more donations in that period (p = 0.01).CONCLUSION: These findings do not provide evidence of a lower IR for transfusion‐transmissible viral infections among repeat WB donors who give more frequently. Abbreviated screening histories for frequent repeat donors might not be advisable.
Effect of prophylactic transfusion of stored RBCs on oxygen reserve in response to acute isovolemic hemorrhage in a rodent model
Authors: D'Almeida Mark S. , Gray Daryl , Martin Claudio , Ellis Christopher G. , Chin‐Yee Ian H. 
Published: March 2003

BACKGROUND: The storage of RBCs results in a time‐related decline in 2,3 DPG that may reduce the ability to unload oxygen (O2) to tissue. The objective of this study was to compare the effect that transfusion of stored 2,3 DPG‐depleted rat blood (7 days in CPDA‐1) had on the O2 reserve in conscious rats, with that of the transfusion of fresh blood (<2‐hour storage).STUDY DESIGN AND METHODS: Anemic rats (Hb, 80 g/L) received either fresh packed RBCs or stored RBCs to raise Hb levels to 140 g per L. They then underwent isovolemic hemorrhage mimicking surgical blood loss to the point of O2 supply dependency (OSD). Critical O2 delivery (DO2crit), Hb concentration, and O2 extraction at OSD were measured in a metabolic chamber.RESULTS: After transfusion, RBC DPG decreased by 50 percent in the stored‐blood group, and the p50 value decreased by 5 mmHg (32.1 ± 2.5 mmHg vs. 37.5 ± 3.0). DO2crit was similar in the two groups (fresh blood: 2.79 ± 0.44 mL/min × g–1; stored blood, 2.99 ± 0.76 mL/min × g–1). The critical Hb concentration at DO2crit was higher in the stored‐blood group (44 ± 4 g/L) than in the fresh‐blood group (38 ± 5 g/L); the cardiac index and O2 extraction ratio in the two groups were not different. Under conditions of severe normovolemic anemia in rats, depletion of DPG and a decrease in p50 had only minor effects on the O2 reserve. At OSD, under these conditions, O2 consumption is not limited by diffusion.CONCLUSION: The physiologic impact of DPG depletion in transfused stored blood on oxygen availability in normal rats appears to be small and may be clinically inconsequential.
Risk behavior in Norwegian blood donors
Authors: Stigum Hein , Bosnes Vidar , Ørjasæter Harald , Heier Hans Erik , Magnus Per 
Published: March 2003

BACKGROUND: Blood banks ensure the safety of blood components by testing them for a set of known infectious agents and by careful selection of donors based on a self‐administered questionnaire and an interview. The purpose of this study is to describe the risk behavior for sexually transmitted diseases in Norwegian blood donors.STUDY DESIGN AND METHODS: A survey of the sexual habits of 5,859 blood donors in the capital of Norway was performed by using anonymous questionnaires. The results were compared with a previous survey of 10,000 randomly selected Norwegian subjects aged 18 to 60 years. The response rates were 70.3 percent and 48.4 percent, respectively.RESULTS: Blood donors had considerably more education than the general population. Their general sexual behavior was similar to that of the rest of the population, although the blood donors had later sexual debut, fewer new partners per year, and a lower frequency of intercourse. In addition, homosexual experience among males was much lower in the donor group. Blood donors were less likely to engage in risk behavior for sexually transmitted diseases than were the general population. Nevertheless, 1.5 percent of the donors reported behavior that would have led to deferral had the behavior been disclosed at the predonation interview. Deferrable donors were more likely to be male and young and to have had many partners.CONCLUSION: Anonymous questionnaires reveal information that is not given at the time of blood donation.
Transfusion‐transmitted bacterial infectionin the United States, 1998 through 2000
Authors: Kuehnert Matthew J. , Roth Virginia R. , Haley N. Rebecca , Gregory Kay R. , Elder Kathy V. , Schreiber George B. , Arduino Matthew J. , Holt Stacey C. , Carson Loretta A. , Banerjee Shailen N. , Jarvis William R. 
Published: March 2003

BACKGROUND: Bacterial contamination of blood components can result in transfusion‐transmitted infection, but the risk is not established.STUDY DESIGN AND METHODS: Suspected cases of transfusion‐transmitted bacteremia were reported to the CDC by participating blood collection facilities and transfusion services affiliated with the American Red Cross, AABB, or Department of Defense blood programs from 1998 through 2000. A case was defined as any transfusion reaction meeting clinical criteria in which the same organism species was cultured from a blood component and from recipient blood, with the organism pair confirmed as identical by molecular typing.RESULTS: There were 34 cases and 9 deaths. The rate of transfusion‐transmitted bacteremia (in events/million units) was 9.98 for single‐donor platelets, 10.64 for pooled platelets, and 0.21 for RBC units; for fatal reactions, the rates were 1.94, 2.22, and 0.13, respectively. Patients at greatest risk for death received components containing gram‐negative organisms (OR, 7.5; 95% CI, 1.3‐64.2; p = 0.009).CONCLUSION: Bacterial contamination of blood is an important cause of transfusion‐transmitted infection; infection risk from platelet transfusion is higher compared with that from RBCs, and, overall, the risk of infection from bacterial contamination now may exceed that from viral agents. Recipients of components containing gram‐negative organisms are at highest risk for transfusion‐related death. The results of this study may help direct efforts to improve transfusion‐related patient safety.