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PubMed1975

Passive transfer of immunity into leprosy patients by transfusion of lymphocytes and by transfusion of Lawrence's transfer factor.

About 1,200 million viable lymphocytes from normal but lepromin- and tuberculin-positive human beings were transfused in four patients of lepromatous and one of tuberculoid leprosy three times at monthly intervals. Three patients of lepromatous leprosy suffered from erythema modosum, whereas the other two developed severe reaction whenever put on the smallest dose of dapsone. In one patient of lepromatous leprosy, minimal improvement or none was observed, whereas in the remaining three cases of lepromatous and one of tuberculoid leprosy, clinical, bacteriological, as well as histological improvement occurred. Two of the five patients started to tolerate the dapsone during the period of study. The present study indicates that immunotherapy might have a definite role in the management of the disease especially in cases with erythema nodosum. Lawrence factor, prepared from leucocytes of normal donors, was transfused three times into four lepromatous leprosy patients who were intolerant to anti-leprosy drugs. The donors were healthy but were tuberculin and lepromin (Mitsuda) positive. The clinical, histological, bacteriological (morphological index), and immunological assessments of the patients were performed before and 5 months after starting the immunotherapy. In two patients conversion of Mitsuda reaction occurred, but there was no appreciable improvement in the clinical, histologic, and bacteriologic status of these patients.

Adolescent↗
PubMed2005

Severe transfusion-related acute lung injury in the intensive care unit secondary to transfusion of fresh frozen plasma.

Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion of blood products. A case of severe TRALI secondary to infusion of fresh frozen plasma in the intensive care unit is discussed. Additionally, the aetiology and pathogenesis of this relatively under-diagnosed and under-reported clinical entity is reviewed. It is our conclusion that proper diagnosis and reporting is necessary for prompt and appropriate treatment of the patient and to prevent additional reactions in other patients.

Adolescent↗
PubMed2003

Neonatal transfusion malaria requiring exchange transfusion.

Transfusion-acquired malaria in a neonate is uncommon and factors such as drug resistance and concomitant G6PD deficiency can cause treatment difficulties. We report a 26-day-old premature infant with chloroquine-resistant malaria who underwent exchange transfusion. The aim was to correct anaemia, decrease parasitaemia and remove G6PD-deficient cells to allow successful use of quinine.

Anemia↗
PubMed1983

Intra-uterine transfusions to the Rhesus-immunized fetus in the Department of Obstetrics, National Hospital, Oslo 1968-1979. The fetal prognosis by intra-uterine transfusions in relation to amniotic fluid blood pigment index.

During the years 1968-79, 115 intra-uterine transfusions (IUT) were performed in 71 severely Rh-immunized pregnant women at 26-32 weeks' gestational age. Thirty-five (approx. 50%) infants survived; 28 died in utero and 9 in the neonatal period. The selection of patients and technique is described. The amount of transfused blood in cord blood at birth is presented for the majority of liveborn infants. The study emphasizes that the outcome of IUT is entirely dependent on the degree of hemolysis at the time of the initial IUT. Among 30 patients with an amniotic fluid optical density difference at 450 m mu less than 0.3, a survival rate of 83% was registered compared with 36% and 0% in groups with values 0.3-0.6 and greater than 0.6, respectively.

Amniotic Fluid↗
PubMed1991

Incidence of hepatitis and seroconversion to hepatitis C virus after open-heart surgery in transfused and non-transfused patients in Sweden.

The transmission of non-A, non-B hepatitis (NANB)/hepatitis C virus (HCV) was studied in patients undergoing open-heart surgery and related to the reception of blood products and hospitalization and surgery per se. Posttransfusion hepatitis NANB was noticed in 17/390 (4.4%) patients receiving heterologous blood and 8/16 tested became positive for anti-HCV (Ortho HCV ELISA), all within 5 months after onset of hepatitis. Among patients with normal ALAT before surgery and during follow-up, who had received heterologous blood, 1/50 seroconverted after 6 months. This patient probably had a subclinical HCV infection, or possibly a temporary non-specific anti-HCV reactivity with a maximum optical density/cut-off ratio (OD/CO) of 1.2, whereas all posttransfusion hepatitis C cases had OD/CO ratios greater than 4. No hepatitis occurred among the 92 non-transfused patients and no seroconversion was found in any of 62 non-transfused patients tested 6 months after the operation. It was concluded that (1) hospitalization and surgery per se does not seem to offer a risk of hepatitis NANB/C, and (2) seroconversion to for HCV occurs in only 50% of Swedish patients with acute posttransfusion NANB hepatitis.

Alanine Transaminase↗
PubMed1984

Hepatitis B virus antibody in blood donors and the occurrence of non-A, non-B hepatitis in transfusion recipients. An analysis of the Transfusion-Transmitted Viruses Study.

Patients who received transfusions and nontransfused control patients were followed to assess the incidence and cause of post-transfusion hepatitis and to identify donor factors that might relate to risk of hepatitis. We evaluated as risk factors in donors the presence of antibody to hepatitis B virus compared with elevated alanine aminotransferase (ALT) level. Units of blood that were positive for antibody to hepatitis B core antigen (anti-HBc) were associated with a twofold to threefold greater risk of non-A, non-B hepatitis in the recipients than were units without anti-HBc. In the absence of specific serologic tests for non-A, non-B agents, screening of donors for anti-HBc might be considered. Our data suggest that the incidence of non-A, non-B hepatitis might have been reduced by about one third by such screening. However, elevated ALT levels in donors had a similar association with non-A, non-B hepatitis in recipients but would have resulted in fewer units of blood being discarded than would screening for anti-HBc.

Alanine Transaminase↗
PubMed1979

Controlling post-transfusion hepatitis: a proposal to publicize hepatitis rates of transfusion facilities.

A federal requirement that donor blood be labelled as either "paid" or "volunteer" took effect on May 15, 1978. A major rationale for requiring such labelling is that physicians, now that they can distinguish between categories of blood, will fear liability for post-transfusion hepatitis resulting from the use of paid blood. Thus, supporters of the labelling requirement hope that it will deter the use of high-risk commercial blood. Some paid blood, however, is not commercial blood and in fact may be safer than volunteer blood. The labelling strategy for hepatitis control, therefore, has negative as well as positive attributes. This Article considers the efficacy of blood labelling as a hepatitis control measure and proposes an alternative strategy--the periodic publicizing of hepatitis rates of facilities that perform transfusions--that, if practiced responsibly, could significantly decrease hepatitis transmission rates.

Blood Banks↗
PubMed1980

[Non-A, non-B post-transfusion hepatitis. Serological survey of 85 patients with acute hepatitis following blood transfusion].

In a serological survey of 85 adult patients hospitalized for an episode of transfusion-associated hepatitis, 45 were reactive for hepatitis B surface antigen and therefore diagnosed as having hepatitis B. Forty HBsAg non reactive patients were examined for development of antibody to hepatitis A and B antigens, cytomegalovirus and Epstein-Barr virus. Three patients showed serologic evidence of hepatitis B and one for hepatitis A. None of the remaining 36 subjects developed serologic evidence of acute infection with the viruses tested during the study period, so that they were classified as having so-called NANB hepatitis. As reported in other studies, analysis of the incubation period showed that two subgroups of NANB hepatitis may be identified with short and long incubation period, so that it appears likely that at least two agents are implicated in NANB hepatitis. Our data confirm that also in our area a large proportion of transfusion-associated hepatitis is related to NANB agent(s) requiring additional measures for its prevention.

Acute Disease↗
PubMed1997

[Severe complications, adverse effects due to blood transfusion and its measures--transfusion transmitted viral infections].

Since the implementation of blood screening for HBs-Ag, HTLV-1-Ab, HIV-Ab and HCV-Ab, donor blood collected by the Japan Red Cross Blood Center has become among the safest in the world. The current incidence of HBV, HTLV-1, HIV and HCV transmission by blood transfusion are estimated to be 1/500,000, 1/50,000, 1/1,000,000 and 1/500, respectively. Even though the latest, most advanced techniques are used, it is impossible to completely prevent transmission of these viruses. HIV transmission from donor blood during the window period before the HIV-Ab reaches testable levels was reported in May 1997. Even though there has been a remarkable decrease in these notorious virus transmissions, transfusion transmissions of new viruses have become apparent. Parvovirus B19, Cytomegalovirus and Epstein-Barr virus are known to be blood born infections. Recently, HGV, HHV-8 and Borna disease virus transmission has been shown. Discussions as to how to insure safe blood products through effective screening for these new viruses must be held in the near future.

Humans↗
PubMed1994

[Transfusion-associated acute pulmonary insufficiency: a rare, but life-threatening transfusion reaction].

Two patients developed within several hours after blood transfusion severe shortness of breath which required temporary artificial ventilation. X-ray pictures of the chest showed pulmonary edema in both patients. No cardiac causes for edema were found. Detection of granulocyte antibodies in the sera of one patient and one blood donor confirmed the suspected diagnosis of transfusion-related acute lung injury.

Acute Disease↗
PubMed1998

Blood transfusion: influence of transfusion therapy on outcome.

Few studies have addressed the influence of different transfusion therapies on outcome in a convincing way. Proven adverse impact of allogeneic blood on outcome is minimal. Acute mortality has declined to about 1 : 500,000 and the rate of transfusion-transmitted infections is decreasing, too. Data on postoperative infections and non-Hodgkin's lymphoma as possible adverse effects are controversial. Evidence for an increased risk of tumour recurrences is lacking. Alternatives to allogeneic blood may have appreciable risks: perioperative blood recovery had a fatality rate of more than 1 : 40,000. Reduction of allogeneic blood exposure may not be equated with improved outcome.

Journal Article↗
PubMed2006

Residual risk of HIV, HVB and HCV transmission by blood transfusion between 2002 and 2004 at the Abidjan National Blood Transfusion Center.

The assessment of the viral residual risk from blood products is an assessment indicator of the quality management system and of the availability process of these products. Assessments of HIV, HBV and HCV viruses transmission risks through blood transfusion are calculated after the setting of a quality approach at the Abidjan NBTC. The method used estimates the risk of a donation made during a period immunologically silent. The residual risks for HIV, HBV, and HCV viruses have been estimated by multiplying the incidence rate for 100,000 people per year by the respective durations of the serological windows. The data received from the Abidjan Center's information processing system (Progesa 4.4d of MAK SYSTEM) go from 2002 to 2004 period. The residual risks are 1/5780 donations for HIV and 1/406 donations for the HCV, then 1/383 donations for the HBV. The residual risk for the HIV is almost four times reduced compared to that of 1997. The results show not only the importance of the transmission risk of HIV, HBV and HCV viruses through blood products, but also the necessity to set a quality management system in endemic countries of Sub-Saharan Africa.

Blood Transfusion↗
PubMed2004

[Informing the transfused patient of the possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion].

TRUE RISKS AND THEORETICAL RISKS: The texts ruling the obligation of the physician to inform the patient appears not to include theoretical risks in their application. In France however, the field of blood transfusions extends this obligation to the theoretical risk of potential transmission through the blood of the infectious agent responsible for Creutzfeldt-Jakob's disease. UNANSWERED QUESTIONS: From an ethical point of view, is information on the theoretical risk of transmission founded? From a formal point of view, the means used for such an extension (i.e.,a bulletin) is debatable; was this an adequate measure? THE RETURN OF COMMON SENSE: If we look at the earlier texts, the principle of an obligation to inform the patient of the theoretical risks does not appear widespread or even confirmed. Do these text simply the return of "common sense"? And if so, to what extent does it encourage the illusion of a zero risk...?

Blood Transfusion↗
PubMed1992

[Hepatitis C virus and transfusion: policy regarding the donation and the donor. Groupe "Hépatites Virales" de la Société Nationale de Transfusion Sanguine].

Hepatitis C virus (HCV) discovery and introduction of anti-HCV antibodies screening in blood transfusion imply the necessity of a good blood donations and blood donors policy. Detection of a seropositivity during the screening must be completed with a confirmatory test. The results are directly used to inform donors and define the blood products policy. Donors with positive results on confirmatory test are discarded and have physical and biological examinations in hepatology. Individuals with indeterminate or negative results must be retested for the HCV serology. Furthermore, because of a rapid improvement in the fields of technology, diagnosis and therapy of HCV, an adaptation of the policy is necessary.

Blood Donors↗
PubMed1996

Erythropoietin course in newborns with Rh hemolytic disease transfused and not transfused in utero.

This study reports the Hb, erythropoietin (Epo), and reticulocyte course at different postnatal ages (range, 8-83 d) of 56 blood samples from 30 newborns (range, one or two blood samples from each newborn) with erythroblastosis fetalis (18 intrauterine transfused (IUTd) and 12 non-IUTd). Hb, Epo, and reticulocyte values were not statistically different in IUTd and non-IUTd cases. As age increased, decreasing Hb values and increasing Epo levels were observed. The reticulocyte count was relatively low in all but six cases. There was an inverse correlation between Epo and Hb (r = -55, p < 0.001), but no correlation was found between Hb and reticulocytes or between Epo and reticulocytes. When groups were formed on the basis of Hb levels, anemic newborns showed higher serum Epo than did nonanemic patients (p < 0.02). In the present study we found a significant increase in Epo levels in anemic newborns without a rise in the reticulocyte count. These results suggest that other mechanisms, rather than low Epo production, could be involved in the pathogenesis of this anemia. Persisting anti-D antibodies, probably at a medullary level, may destroy erythrocyte precusors, leading to anemia with a low reticulocyte count.

Aging↗
PubMed1977

Blood transfusion for the patient who is difficult to transfuse.

There are two types of patients who are difficult to transfuse because of the presence of red cell antibodies, those patients who have an antibody reactive against an antigen of high incidence and those who have multiple antibodies. Possible sources of blood for the patient who has an antibody reactive against a high-incidence red cell antigen include the patient's family, rare donors lacking the high-incidence antigen, and self-donation. Possible sources of blood for those who have multiple antibodies are limited to rare donors lacking the appropriate combination of antigens or to self-donation.

Blood Donors↗
PubMed1996

Transfusion practice in a Canadian hospital. Use of a major European study of transfusion practice for comparison as a form of audit.

Blood transfusion practices in a Canadian hospital have been compared, as a form of audit, to those reported in a multi-hospital study in Europe, to identify possible deviations from desirable practice. Blood product use for four surgical procedures: laparatomic cholecystectomy, total hip replacement, coronary artery bypass graft (CABG) and abdominal aortic aneurysmectomy (AAA), was determined from this hospital's blood bank data base, and is compared to use for the same procedures in European hospitals. Blood product use here is less than in the majority of European centres, in respect of red cells for all four procedures and plasma for CABG and AAA. Platelet use in association with CABG and AAA is greater than the majority of European centres reporting data. As a consequence, platelet use here will be subjected to closer review.

Blood Transfusion↗