Biomedical subjects

T Schulzki

Publications and source records attributed to T Schulzki.

11 recordsLinked to original sources

PubMed1996

IVBT-documented platelet function correlates with flow cytometric data.

Thrombocytopenic patients with identical platelet counts often show different bleeding tendencies owing to significant differences in the platelet function. This could be demonstrated by the in vitro bleeding test (IVBT). Using flow cytometry, we tried to find characteristics of platelet antigen expression in order to explain these differences in function. Thirty patients with bone marrow hypoplasia receiving 65 platelet transfusions (mainly from a cell separator) were observed for 3 to 29 days. Size, granulation and fluorescence of platelet-rich plasma (n = 522 samples) were evaluated using monoclonal antibodies against GP IIIb (collagen receptor), GP IIb/IIIa (fibrinogen receptor) and GP Ib (thrombin receptor). We defined separate gates for each antibody using the results from 50 normals and by laying an orthograde cross over the gate to divide the gate into four equal quadrants. The platelet populations were divided into four different groups according to the occlusion time (OT) of the IVBT and the Simplate time (ST). The thrombocytes with the most impaired function (OT > or = 485 s/ST > 30 min) had significantly less platelet fluorescence when marked with antibodies against GP IIIb and GP Ib than those with short OT and ST (OT < 100 s/ST < 15 min). Similar results were obtained when evaluating the data relative to the bone marrow status: patients with < 1000 WBC/microliters showed significantly less platelet fluorescence when marked with anti-GP IIIb and anti-GP Ib than thrombocytopenic patients, who had a spontaneous platelet rise beyond 30,000 platelets/microliters a few days later. One day after platelet transfusion, significantly more platelets with high GP IIIb and Ib expression could be found. We were also able to document better transfusion efficacy of platelet concentrates with high GP IIIb and Ib expression. Finally, patients with high bleeding scores showed less GP Ib expression on the platelets than patients with low bleeding scores. In summary, the IVBT-documented platelet function clearly corresponded to an increased expression of the collagen receptor and the thrombin receptor of platelets.

Bleeding Time↗

PubMed1995

Thrombocytopenia-adapted in vitro bleeding test assesses platelet function in thrombocytopenic patients.

Platelet counts do not always reflect the true bleeding risk in chronically thrombocytopenic patients, and the posttransfusion platelet increments do not necessarily demonstrate that therapeutic efficacy. There are no easy and reliable tests yet permitting the determination of platelet function in thrombocytopenic patients. The in-vitro bleeding test (IVBT) with the Thrombostat 4000 proved to be a very sensitive and specific test for the detection of platelet disorders. In order to become suitable for the investigation of thrombocytopenic blood with platelet count between 5 x 10(9)/L and 50 x 10(9)/L, special modifications were necessary. We report on the evaluation of two thrombocytopenia-adapted modifications (TP-IVBT 150/120), first with blood of healthy donors made thrombocytopenic (three experiments with six blood samples each of different platelet concentrations and identical hematocrit) and then in a clinical study on 77 thrombocytopenic patients (69 with bone marrow hypoplasia, eight with autoimmune thrombocytopenia) receiving 267 platelet transfusions. The patients were followed over 15 days on average (1-67 days) by daily examinations (total 1,285 observation days). Most TP-IVBT measurements were carried out in triplicate, using the modification with the 120-microns filter (TP-IVBT 120) because it proved to be superior to the other modification. Additionally, cell counts, hematocrit, body temperature, platelet volume, platelet distribution width, expression of CD 36, 41a, 42b on platelets, Simplate bleeding time, and detailed analysis of bleeding signs were performed for the calculation of a bleeding score. There was a close correlation between TP-IVBT and platelet counts with thrombocytopenic normal blood (r2 = 0.81-0.94). This indicated the suitability of this test modification to examine platelet function in thrombocytopenic patients. The clinical study showed that the TP-IVBT helped at least to determine the platelet-related bleeding risk in thrombocytopenic patients. It allowed differentiation between hypoplastic and autoimmune thrombocytopenia in most cases. In addition, significant differences in platelet function of various diseases and of different bone marrow regeneration could be demonstrated. The TP-IVBT is well-suited for the control of platelet transfusion efficacy and may replace the in-vivo bleeding time in most cases. On the other hand, the test still shows too much of a variation and involves too much labor and cost for routine application.

Bleeding Time↗

PubMed1994

A contribution to the indications for platelet transfusion and determination of its therapeutic efficacy.

The platelet count does not really reflect the true bleeding risk in chronically thrombocytopenic patients. Recently, we reported on two modifications of an in vitro bleeding test (IVBT) which appeared to be suitable for the evaluation of primary non-vascular hemostatis in thrombocytopenic and anemic patients (platelets 10-50,000/microL, hct 16-30 L/L). We report on the clinical study conducted with the IVBT modification which proved to be superior. Fifty thrombocytopenic patients, 42 with bone marrow hypoplasia and 8 with autoimmune thrombocytopenia, were followed up for a total of 686 days and received 161 platelet transfusions (mainly from cell separator). The IVBT was carried out with the Thrombostat 4000 in triplicate using 120 microns filters and evaluating the occlusion time (OT). Additionally, cell count, hematocrit, body temperature, platelet volume, platelet distribution width, Simplate time and a detailed analysis of bleeding signs for the calculation of a bleeding score were performed. The IVBT modification used allowed the determination of platelet-related bleeding risk in thrombocytopenic patients. With the IVBT, significant differences in platelet function in different patients could be demonstrated which primarily reflected the underlying disease. In addition, bone marrow regeneration correlated with platelet function. From the findings of this study, the authors formulate criteria for the indication of platelet transfusion which includes platelet function as well as the platelet count. Increased individual bleeding risk factors have to be considered too. But before generalization these criteria have to be verified by a controlled prospective study.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation Tests↗

PubMed1994

Determination of bleeding risk in thrombocytopenic patients with platelet transfusion therapy.

In a clinical study (50 thrombocytopenic patients) we determined the bleeding risk and the platelet transfusion efficacy by a special modification of the in vitro bleeding test (IVBT, Thrombostat 4000). Additionally, cell count, hematocrit, body temperature, platelet volume and distribution width, Simplate bleeding time and a bleeding score were investigated. The use of the modified IVBT proved to be promising to find a clearer indication of platelet transfusion and to estimate its efficacy.

Bleeding Time↗

PubMed1994

[Risk assessment and diminution in preoperative autologous blood donation].

Preoperative autologous blood donation is only indicated if a positive balance between benefit and risk can be struck. In this contribution the different aspects to be considered are described and valued. By a mathematical formula we try to correlate the different aspects somewhat more objectively. In addition, we define 4 risk groups by the state of health of the patients which allow to estimate the risk of the patient by blood donation more easily and help to reduce it by selection of the appropriate donation procedure.

Blood Donors↗

PubMed1994

[Comparison of thrombocyte concentrates from buffy coats after 3 and 16 hours of storage].

Since extended storage of the buffy coat (BC) might be disadvantageous for the platelet function because of granulocyte proteases we investigated platelet concentrates (PC) prepared from BC which rested either for 3 h (n = 18) or 16 h (n = 41) before further preparation. We found significant differences especially in the morphology score, pH and lactate in favour of the PC from 3-hour-BC. The differences decreased during the 5-day storage. PC of unacceptable quality (n = 4) only derived from 16-hour-BC. Therefore, the use of PC from BC stored for more than 4 h at least requires an adequate quality control before delivery.

Blood Platelets↗

PubMed1994

[Evaluation of a noninvasive method for storage control of platelet concentrates].

We evaluated a system for storage of platelet concentrates (PC) which is thought to monitor the platelet function during storage by measuring the light transmission (Plateguard). Platelet function, morphology and metabolism altered during storage as usually. But the alterations did not correlate to light transmission. Only PC with very strong changes and final pH lower than 6.0 (4 of 59) showed different light transmission (exponential curves). Nevertheless the Plateguard can detect these unsuitable PCs if the software would be modified as proposed. In addition, several technical improvements are necessary before routine use.

Blood Platelets↗

PubMed1992

New polyolefin foil for 5-day storage of platelet concentrates (PC) collected by apheresis.

In a paired study 12 platelet concentrates (PC) of Fresenius AS-104 cell separator were stored in new polyolefin bags of Fresenius (LE2) and Fenwal PL-732 bags. On day 0 and after 3 and 5 days of storage pH, pO2, pCO2, cell counts, platelet morphology and aggregability, plasma glucose, lactate, LDH and beta TG were determined. The overall changes fell within the expected range. No relevant differences between the two bags could be detected, although a few parameters (pH, pCO2) are slightly but statistically/significantly different. It can be concluded that the new polyolefin bag is well suited for 5-day storage of PC's from the AS-104.

Blood Preservation↗

PubMed1992

Superiority of gel centrifugation in antibody screening and identification.

We report on the direct comparison of gel centrifugation technique and tube testing for antibody screening (ABS) under controlled routine conditions. 3,000 blood samples were screened for antibodies (AB) by gel centrifugation (ID-System, bromelin 37 degrees C and room temperature, indirect antiglobulin test with LISS) and a sensitive tube test (TT; bromelin two-phase test, 37 degrees C and room temperature, and indirect antiglobulin test with 22% bovine albumin) in parallel. By ID significantly more relevant and potentially hemolytic AB (51 vs. 35 AB/1.7 vs. 1.2%) could be detected: anti-E 4, -C 1, -D 4, -CW 2, -c 2, -Jk(a) 2, -Jk(b) 1. Eleven of these even remained negative in TT when retested with increased sensitivity and taking additional (homozygous) test cells. In addition, naturally occurring but rarely hemolytic AB (35 vs. 23 AB/1.2 vs. 0.8%) were more frequently detectable by ID: anti-Le(a) 6, -Le(b) 2, -P1 6. In contrast, only two AB were only positive in TT: anti-Le(a) 1, -Le(a, b) 1. The main disadvantage of the ID was its frequent positivity (7.7 vs. 4.3%) due to irrelevant cold AB (anti-I, -HI, -H) and unspecific factors. This can be partly reduced by omission of the bromelin test at room temperature (ID 3.0%, TT 1.5%) as the detection of relevant AB is not affected. The frequency of naturally occurring AB was still the same as in TT (0.7%) when bromelin at room temperature was omitted in both techniques. Further advantages of the ID are simplicity, small volumes of sera and reagents, and easy evaluation.

Blood Grouping and Crossmatching↗

PubMed1992

[Production of rejuvenated and stable, leukocyte depleted erythrocyte concentrates using the heated centrifugation method].

We report on an alternative to filtration for the preparation of leukocyte-poor red cell concentrates (LP-RCC). It is based on the method of Schneider. Using RCC with buffy coat it is comparably effective in leukocyte reduction [98.3 +/- 1.0%, (3.7 +/- 2.6) x 10(6) leukocytes] and more effective in platelet reduction (96.9 +/- 2.5%). Addition of PAGGS-M before heating (30 min, 37 degrees C) as well as after preparation significantly reduces hemolysis (free hemoglobin, LDH, HBDH) and improves the quality of the LP-RCC (ATP, 2,3-DPG) during storage for 24 h after preparation. LP-RCCs prepared with PAGGS-M after 6-day storage show still better quality than before preparation and about the same quality as LP-RCCs 24 h after conventional preparation with saline solution. In conclusion, by use of PAGGS-M and sterile docking LP-RCCs of adequate quality for 6-day storage can be prepared, improving the supply of the patients concerned.

Adenine↗

PubMed1992

[Superiority of the gel centrifugation method (ID System) in detection of erythrocyte antibodies].

We report on the direct comparison of gel centrifugation technique and tube testing for antibody (AB) screening (ABS) under controlled routine conditions. 3,000 blood samples were screened for AB by gel centrifugation (ID-System, bromelin 37 degrees C and room temperature, indirect antiglobulin test with LISS) and a sensitive tube test (T; bromelin two-phase test 37 degrees C/room temperature and indirect antiglobulin test with 22% bovine albumin) in parallel. By ID significantly more relevant and potentially hemolytic AB (51 vs. 35 AB/1.7 vs. 1.2%) could be detected: anti-E 4, anti-C 1, anti-D 4, anti-CW 2, anti-C 2, anti-Jk (a) 2, anti-Jk (b) 1. 11 of these even remained negative in tube test when retested with increased sensitivity and taking additional (homozygous) test cells. In addition, naturally occurring but rarely hemolytic AB (35 vs. 23 AB/1.2 vs. 0.8%) were also more frequently detectable by ID: anti-Le (a) 6, anti-Le (b) 2, anti-P1 6. In contrast, only two AB were only positive in T: anti-Le (a) 1, anti-Le (ab) 1. The main disadvantage of ID was its frequent positivity (7.7 vs. 4.3%) due to irrelevant cold AB (anti-I, anti-HI, anti-H) and unspecific factors. This can be partly reduced by omission of the bromelin test at room temperature (ID 3.0%, T 1.5%) as the detection of relevant AB is not affected. The frequency of naturally occurring AB was still the same as in T (0.7%) when bromelin at room temperature was omitted in both techniques. Further advantages of ID are simplicity, small volumes of sera and reagents and easy evaluability.

Blood Group Antigens↗