| 1. |
- Forsberg, B, et al.
(författare)
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The platelet-specific alloantigen PlA1 (HPA-1a): a comparison of flow cytometric immunophenotyping and genotyping using polymerase chain reaction and restriction fragment length polymorphism in a Swedish blood donor population.
- 1995
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Ingår i: Transfusion. - 0041-1132. ; 35:3, s. 241-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is an increasing interest in the development of rapid and reliable techniques for platelet alloantigen typing. STUDY DESIGN AND METHODS: By use of standardized flow cytometry and a specific human alloantiserum, 236 Swedish blood donors were immunophenotyped for the platelet-specific alloantigen, PlA1 (HPA-1a). RESULTS: Ten individuals (4.2%) had low fluorescence intensities and were considered PlA1-negative (HPA-1a-negative); all of them also demonstrated a PlA2/PlA2 (HPA-1b/1b) genotype in a polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) assay of the underlying DNA polymorphism. The remaining population had clear positive fluorescence and was regarded as PlA1-positive (HPA-1a-positive). The fluorescence distribution histogram among PlA1-positive (HPA-1a-positive) individuals was dome-shaped, and those individuals who were homozygous for PlA1 (HPA-1a) could not be distinguished from those who were heterozygous. This finding was further substantiated by PCR-RFLP analysis of the PlA1/PlA2 (HPA-1a/1b) genotype; a heterozygous genotype was found among those having a medium fluorescence intensity as well as among those having a strong fluorescence intensity. CONCLUSION: Flow cytometry is a valuable tool for large-scale detection of PlA1 (HPA-1a). However, flow cytometry based on only one antiserum cannot distinguish between homozygous and heterozygous carriers of PlA1 (HPA-1a). For zygosity testing and when platelets are difficult to obtain, the PCR-RFLP technique is the assay of choice.
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| 2. |
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| 3. |
- Frändberg, Sofia, 1972, et al.
(författare)
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The aldehyde dehydrogenase cord blood potency assay excludes early apoptotic cells
- 2018
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 58:6, s. 1452-1457
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDCord blood units (CBUs) are processed, frozen, and thawed before use in hematopoietic stem cell (HSC) transplantation. The manipulations affect HSC functionality, that is, induce apoptosis and reduce viability. HSC content, commonly expressed as CBU potency, that is, the expected ability of a CBU to restore hematopoiesis, is traditionally approximated through viable CD34+ cells and the colony-forming unit (CFU) cell cultivation assay. Alternative approaches, for example, the aldehyde dehydrogenase (ALDH) enzyme-based assay, are also forthcoming. We hypothesized that the ALDH assay might exclude apoptotic cells since it is based on enzyme activity. To investigate this, we designed a protocol for simultaneous staining of viable and apoptotic CD34+ and ALDH+ cells using 7-aminoactinomycin (7-AAD) and annexin V, in frozen-thawed CBUs. Results were correlated with results from the colony-forming unit-granulocyte/macrophage (CFU-GM) assay. STUDY DESIGN AND METHODSSamples from 57 CBUs were thawed and simultaneously analyzed for CD34+ cells, ALDH+ cells, viability (7-AAD), and apoptosis (annexin V) using flow cytometry. Enumeration of CFUs was also performed. RESULTSNo nonviable and few apoptotic cells (mean 0.7%) were identified in the ALDH+ population compared to the viable CD34+ population (mean 3.6%). The total number of ALDH+ cells correlated better than viable CD34+ cells (r=0. 72 vs. r=0.66; p<0.0001) with the results of the CFU assay. CONCLUSIONThe ALDH assay excludes nonviable and apoptotic cells, and therefore correlates better with CFU enumeration compared to the number of viable CD34+ cells. We propose that the ALDH assay might replace the CFU-GM method in CBU potency measurements.
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| 4. |
- Holmqvist, Jacob, et al.
(författare)
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No evidence of transfusion transmitted sporadic Creutzfeldt-Jakob disease: results from a bi-national cohort study
- 2020
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 60:4, s. 694-697
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Creutzfeldt-Jakob disease (CJD) is an uncommon, invariably fatal, neurodegenerative disorder that presents as progressive dementia with concurrent motor symptoms and myoclonia. The pathophysiology involves prion protein misfolding and spreading in a self-catalyzed manner. It has been shown to be transmissible through tissue transplants. Variant CJD (vCJD), a subtype of the disease is also transmissible through transfusion of blood products. This study aims to corroborate the scarce data that suggest that sporadic CJD (sCJD) is not transmitted via blood transfusion. METHODS AND STUDY DESIGN A retrospective cohort study was performed, using data from the bi-national Scandinavian Donations and Transfusions (SCANDAT2) database containing data on blood donors, donations, transfusions, and transfused patients in Sweden and Denmark since 1968 and 1982, respectively. Mortality and medical data were collected from nationwide health care and population registries. Donors with subsequent CJD were identified, as well as recipients of blood products from these donors. A second analysis was performed, screening for clustering of CJD cases from donors without a CJD diagnosis. RESULTS We identified 39 donors with a subsequent diagnosis of sCJD. No cases of CJD occurred among the 883 recipients of blood products from these donors. A total of 89 CJD cases were identified among recipients of transfusions. No clustering of cases from the same donor occurred. DISCUSSION Using data from a large, bi-national database of transfused patients, we find no evidence of sCJD transmission. Our data adds to the growing body of evidence indicating that sCJD is not transfusion transmitted.
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| 5. |
- Holmqvist, Jacob, et al.
(författare)
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Patterns and determinants of blood transfusion in intensive care in Sweden between 2010 and 2018: A nationwide, retrospective cohort study
- 2022
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 62:6, s. 1188-1198
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Tidskriftsartikel (refereegranskat)abstract
- Background Intensive care unit (ICU) patients are transfused with blood products for a number of reasons, from massive ongoing hemorrhage, to mild anemia following blood sampling, combined with bone marrow depression due to critical illness. There's a paucity of data on transfusions in ICUs and most studies are based on audits or surveys. The aim of this study was to provide a complete picture of ICU-related transfusions in Sweden. Methods We conducted a register based retrospective cohort study with data on all adult patient admissions from 82 of 84 Swedish ICUs between 2010 and 2018, as recorded in the Swedish Intensive Care Register. Transfusions were obtained from the SCANDAT-3 database. Descriptive statistics were computed, characterizing transfused and nontransfused patients. The distribution of blood use comparing different ICUs was investigated by computing the observed proportion of ICU stays with a transfusion, as well as the expected proportion. Results In 330,938 ICU episodes analyzed, at least one transfusion was administered for 106,062 (32%). For both red-cell units and plasma, the fraction of patients who were transfused decreased during the study period from 31.3% in 2010 to 24.6% in 2018 for red-cells, and from 16.6% in 2010 to 9.4% in 2018 for plasma. After adjusting for a range of factors, substantial variation in transfusion frequency remained, especially for plasma units. Conclusion Despite continuous decreases in utilization, transfusions remain common among Swedish ICU patients. There is considerable unexplained variation in transfusion rates. More research is needed to establish stronger critiera for when to transfuse ICU patients.
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| 6. |
- Karlsson, Martin, 1978, et al.
(författare)
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Plasma fibrinogen level, bleeding and transfusion after on-pump coronary artery bypass grafting surgery: a prospective observational study
- 2008
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Ingår i: Transfusion. - : Wiley. - 1537-2995 .- 0041-1132. ; 48:10, s. 2152-2158
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Early identification of patients with increased risk of excessive bleeding and transfusion after cardiac surgery offers the possibility to initiate countermeasures. Fibrinogen is a key protein in the coagulation cascade and thus a potential biomarker for bleeding. We investigated the relationship between preoperative fibrinogen plasma concentration and postoperative bleeding and transfusion after coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS: A total of 170 patients (mean age, 67 ± 9 years; 75% men) undergoing isolated CABG were included in a prospective observational study. Patient variables (age, sex, operation time, anticoagulation therapy), preoperative laboratory variables (platelet [PLT] count, activated partial thromboplastin time, prothrombin time, and fibrinogen), postoperative bleeding volume, and transfusions during hospital stay were registered. Independent predictors of bleeding volume and transfusion were identified with multiple regression models. RESULTS: Postoperative bleeding volume correlated univariately with preoperative fibrinogen concentration (r = −0.53, p < 0.001) and PLT count (r = −0.26, p = 0.001) but only preoperative fibrinogen concentration was an independent predictor of postoperative bleeding volume. Twenty-nine of the 170 patients (17%) received transfusions with blood products. Independent predictors of transfusion were preoperative fibrinogen concentration (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1-3.7 per 1-unit decrease; p = 0.027), female sex (OR, 5.0; 95% CI, 1.8-14.7; p = 0.002), and aortic cross-clamp time (OR, 1.03; 95% CI, 1.01-1.06 per minute; p = 0.013). CONCLUSION: The results indicate that preoperative fibrinogen concentration (even within the normal range) is a limiting factor for postoperative hemostasis. Preoperative measurement of fibrinogen concentration provides information about bleeding volume and transfusion requirements after CABG.
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| 7. |
- Lindberg, Linda, et al.
(författare)
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Adsorption of chain type-specific ABO antibodies on Sepharose-linked A and B tetrasaccharides
- 2012
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Ingår i: Transfusion. - : Wiley. - 0041-1132. ; 52:11, s. 2356-2367
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Antigen-specific removal of anti-A and anti-B on immunoadsorption columns carrying the blood group A and B trisaccharides is one important component of some protocols used in ABO-incompatible organ transplantation. Because ABO antibodies exist requiring parts of the core saccharide chain for binding, the anti-A and -Bbinding capacity of individual and combined, Sepharose-linked Types 1 through 4 A and B tetrasaccharides with that of the A and B trisaccharides was compared. STUDY DESIGN AND METHODS: Sepharose-linked A and B tri- and tetrasaccharides were used to adsorb anti-A and -B from pooled blood group O serum. Remaining chain typespecific anti-A and -B were detected and quantified in enzyme-linked immunosorbent assays using wells coated with neoglycoproteins or recombinant mucins carrying A and B determinants on defined core saccharide chains. RESULTS: Significantly more anti-A Type 3- and 4-specific immunoglobulin (Ig)G remained after adsorption on the A trisaccharide and the A Type 1 and A Type 2 tetrasaccharide than after adsorption on the A Types 3 and 4 tetrasaccharides. Selective adsorption of chain typespecific IgG anti-B was detected on Sepharose-linked B tetrasaccharides. In contrast, there were no chain typespecific IgM anti-A or -B. A combination of the A or B tetrasaccharides adsorbed a larger fraction of the IgG anti-A and -B repertoires than the corresponding trisaccharides. CONCLUSION: There are chain typespecific anti-A and anti-B IgG, and an adsorber based on a combination of Types 1 through 4 A or B tetrasaccharides will be a more efficient adsorber than an adsorber based on the A or B trisaccharides.
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| 8. |
- 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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| 9. |
- Rydberg, Lennart, 1944, et al.
(författare)
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Antibody response in an ABO-incompatible blood transfusion. Antigen specificity and immunoglobulin class.
- 1988
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Ingår i: Transfusion. - 0041-1132. ; 28:5, s. 483-8
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Tidskriftsartikel (refereegranskat)abstract
- The anti-A response in a group B patient accidentally given 1 unit transfusion of A1 blood is described. The antibody response is characterized both with conventional agglutination techniques and with radioimmunoassay using pure group A antigens with different core saccharide structures (type 1, 2, and 4 chains) and class-specific second antibodies. The anti-A titer rose to a maximum Days 11 to 14 after the incompatible transfusion. The antibodies involved were mainly of the IgG and IgA types, while the IgM response was moderate. The IgA antibodies seemed to be nonselective with respect to group A antigen type, while the IgG antibodies showed a specificity against type 2 chain group A antigens.
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| 10. |
- Svensson, Lola, 1948, et al.
(författare)
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Secretor genotyping for A385T, G428A, C571T, C628T, 685delTGG, G849A, and other mutations from a single PCR.
- 2000
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Ingår i: Transfusion. - 0041-1132. ; 40:7, s. 856-60
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The secretor status of an individual is important for disease relationship studies, because it determines the presence of ABH blood group antigens in the gastrointestinal tract and bodily secretions. Routine serologic methods for determining secretor status are unreliable. Current strategies based on PCR for genotyping require relatively large amounts of DNA and have to be done as several separate experiments. STUDY DESIGN AND METHODS: A single, multiplex PCR technique followed by RFLP digestion with four restriction enzymes produced unique genotype profiles for most known secretor (FUT2) mutations. RESULTS: Samples from a range of individuals with common and rare secretor genotypes were analyzed. Each gave unique patterns that allowed secretor genotypes to be determined. CONCLUSION: By using the method described here and genomic DNA, a secretor genotype based on the FUT2 mutations A385T, G428A, C571T, C628T, 685delTGG, and G849A could be accurately determined.
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