| 41. |
- Ledent, Elisabeth, et al.
(författare)
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Factors influencing white cell removal from red cell concentrates by filtration
- 1996
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 36:8, s. 714-718
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The preparation of blood components by hard centrifugation results in red cell concentrates with a small amount of plasma. The influence of various plasma factors, temperature, and storage time on white cell reduction by filtration was studied. STUDYDESIGN AND METHODS: Red cell concentrates were suspended in 100 mL of saline- adenine-glucose-mannitol (SAGMAN) solution or in SAGMAN solution in which 5 or 10 mL had been replaced with an equal amount of fresh plasma, albumin (4%), or heat-inactivated plasma. After overnight storage at 4 degrees C, filtration at a slow flow rate (2 hours) was performed. The effect of temperature was studied by filtration at 4 degrees C and 37 degrees C. To study the influence of storage time, red cell concentrates were stored for 4 to 8 hours or 14 to 20 hours at 4 degrees C and filtered through another model of filter. The number of white cells was counted microscopically or by flow cytometry.RESULTS: When 5 or 10 mL of plasma was added, a significantly smaller number of white cells were found after filtration than were found in the SAGMAN control (the median difference between pairs: 23.6 × 10(6) for 5 mL [p = 0.006] and 14.9 × 10(6) for 10 mL [p = 0.003]). The number of white cells was significantly higher with 10 mL of albumin than with 10 mL of plasma (difference, 15.0 × 10(6); p = 0.006). When heat-inactivated plasma was used, the number of white cells was significantly lower than when fresh plasma was used (difference, 0.3 × 10(6); p = 0.009). Filtration at 37 degrees C resulted in a 64-percent reduction in white cells and that at 4 degrees C led to a 99.7-percent reduction (p = 0.006). When the second filter was used, a slight but significantly lower number of white cells was found in the red cell concentrate stored for 14 to 20 hours than in that stored for 4 to 8 hours (difference, 0.03 × 10(6); p < 0.001).CONCLUSION: The amount of plasma in the red cell concentrate and the storage time and temperature are important factors in the outcome of white cell reduction by filtration. The effect of plasma does not seem to be due to a general influence of protein or to the activity of complement or fibrinogen.
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| 42. |
- Ledent, Elisabeth, et al.
(författare)
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Inadequate white cell reduction by bedside filtration of red cell concentrates
- 1994
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 34:9, s. 765-768
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Tidskriftsartikel (refereegranskat)abstract
- Background: White cell filtration of red cell concentrates is often performed at the bedside, in the ward, with the filter inserted in the blood administration line. The aim of this study was to evaluate the efficiency of this filtration method and compare it to filtration in the blood bank.Study Design and Methods: One-day-old, buffy coat-reduced, hard-packed red cell concentrates in saline-adenine-glucose-mannitol solution were filtered through different filters designed for bedside or laboratory use. With filters designed for bedside use, filtration of red cells was performed under laboratory conditions at fast flow (10 min) or under bedside conditions at slow flow (2 hours). The remaining white cells were counted microscopically. Filters designed for laboratory use were evaluated at fast flow, and the number of contaminating white cells was counted by flow cytometry.Results: With bedside fllters, a significantly higher contamination of white cells was found In the units filtered at slow flow than at fast flow, regardless of the filter used. The number of units with >5 x 106 white cells was 52 (78%) of 67 filtered at slow flow compared to 11 (23%) of 47 at fast flow, all filters taken together. This difference in white cell contamination was mainly due to an increase of polymorphonuclear cells in the red cell concentrates filtered at slow flow. With filters designed for laboratory use, 0 to 2 percent of units (n = 1448) were contaminated with >5 x 106 white cells.Conclusion: Bedside filtration for white cell reduction at slow flow is inefficient for 1-day-old, buffy coat-reduced red cell concentrates.
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| 43. |
- Lee, Samuel, et al.
(författare)
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Perceptions and preferences of autologous blood donors
- 1998
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Ingår i: Transfusion (Philadelphia, Pa.). - : Blackwell Publishing. - 1537-2995 .- 0041-1132. ; 38:8, s. 757-763
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The public's perception of autologous blood donation and transfusion as a worthwhile alternative to allogeneic blood transfusion increased dramatically with discovery of the human immunodeficiency virus. However, new concerns are being raised about the health outcomes and cost-effectiveness of the procedure. As more restrictive guidelines for autologous blood donation evolve, opposition from patients concerned about exposure to allogeneic blood may arise. Physicians' ability to reassure patients and garner their support for more restrictive policies requires an understanding of patients' concerns. The motivations, perceptions, and preferences of patients currently participating in autologous blood donation programs were investigated in this study. STUDY DESIGN AND METHODS: Results from two questionnaire studies of 647 autologous blood donors are presented. The questionnaires assessed demographics, risk perceptions, preferences, willingness to pay, and reactions to different interventions designed to decrease patient preference for autologous blood donation. RESULTS: Patients expressed a strong preference for the availability of autologous blood and indicated that they would be willing to pay substantial amounts of money even ii the procedure were not covered by insurance. Despite education about the low risks of complications from allogeneic transfusions, an aversion to allogeneic transfusion and a willingness to pay for autologous blood donation persisted. Patients were not reassured by information on better infectious disease testing or physician recommendation against autologous blood donation. CONCLUSION: Patients currently participating in autologous blood donor programs strongly prefer continued access to this procedure, primarily because they remain concerned about the complications of allogeneic transfusions. They may not be significantly reassured despite increasingly rigorous and costly improvements in donor and component screening.
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| 44. |
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| 45. |
- Lindberg, L, et al.
(författare)
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Is there a clinical need for a diagnostic test allowing detection of chain type-specific anti-A and anti-B?
- 2011
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Ingår i: Transfusion. - : Wiley. - 1537-2995 .- 0041-1132. ; 51:3, s. 494-503
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hemagglutination for detection and semiquantification of ABO antibodies is associated with large center-to-center variations and poor reproducibility. Because acceptance for transplantation and diagnosis of rejection in ABO-incompatible transplantation rely on the levels and specificity of ABO antibodies, reproducible tests that allow their detection and specificity determination are required. STUDY DESIGN AND METHODS: The level of chain type-specific anti-A and anti-B were analyzed in the sera of 44 healthy individuals of known ABO blood group using an enzyme-linked immunosorbent assay (ELISA) with polyacrylamide (PAA) conjugates of blood group A and B trisaccharides or Type 2 chain A and B tetrasaccharides. Selected sera were further analyzed by hemagglutination and in an ELISA with Types 1 to 4 chain A or B neoglycolipids (NGL) as antigens. RESULTS: Immunoglobulin (Ig)G anti-A and anti-B levels were higher (p≤0.05) in blood group O than in B and A individuals. More IgM anti-A and anti-B cross-reactivity was detected in AB serum on PAA-conjugated A and B trisaccharides than on the tetrasaccharides. One of 11 blood group B and two of 12 A individuals had IgG antibodies binding the tetrasaccharide despite lack of, or very low reactivity with, the trisaccharides. IgG antibodies preferring the A and B Type 2 tetrasaccharides were of the IgG2 subclass. The NGL ELISA further supported the presence of chain type-specific anti-A and -B antibodies among nonsensitized, healthy individuals. CONCLUSION: An ELISA with structurally defined ABH antigens will allow the antibody class and fine specificity of ABO antibodies to be determined, which may improve risk assessment in ABO-incompatible transplantation.
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| 46. |
- Palfi, Miodrag, 1954-, et al.
(författare)
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A randomized controlled trial of transfusion-related acute lung injury : Is plasma from multiparous blood donors dangerous?
- 2001
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 41:3, s. 317-322
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Transfusion-related acute lung injury (TRALI) and other posttransfusion reactions may be caused by granulocyte and/or HLA antibodies, which are often present in blood from multiparous donors. The purpose of this study was to compare the effects of plasma from multiparous donors with those of plasma from donors with no history of transfusion or pregnancy (control plasma) in a prospective, randomized, double-blind, crossover study. STUDY DESIGN AND METHODS: Intensive care patients, judged to need at least 2 units of plasma, were randomly assigned to receive a unit of control plasma and, 4 hours later, a plasma unit from a multiparous donor (=3 live births) or to receive the plasma units in opposite order. The patients were closely monitored, and body temperature, blood pressure, and heart rate were recorded. Blood samples for analysis of blood gases, TNFa, IL-1 receptor antagonist, soluble E selectin, and C3d complement factor were collected at least on four occasions (before and after the transfusion of each unit). RESULTS: Transfusion of plasma from multiparous donors was associated with significantly lower oxygen saturation and higher TNFa concentrations than transfusion of control plasma. The mean arterial pressure increased significantly after the transfusion of control plasma, whereas plasma from multiparous donors had no effect on it. Five posttransfusion reactions were observed in 100 patients, in four cases after the transfusion of plasma from multiparous donors. CONCLUSION: Plasma from multiparous blood donors may impair pulmonary function in intensive care unit patients.
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| 47. |
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| 48. |
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