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At least 73 records · Page 4Linked to original sources
PubMed2005

Premedication with acetaminophen or diphenhydramine for transfusion with leucoreduced blood products in children.

Febrile non-haemolytic or allergic reactions occur in 0.1-30% of transfusions; physicians often premedicate patients with acetaminophen or diphenhydramine to prevent these reactions. The effectiveness of this practice has not been demonstrated. In this retrospective review of all transfusions at our institution during 2002, 385 patients received 7900 evaluable leucoreduced, irradiated blood products (4280 single-donor apheresis platelets and 3620 packed red blood cells). Febrile reactions occurred in 0.95% of 4108 transfusions with, and 0.53% of 3792 transfusions without, acetaminophen premedication. Allergic reactions occurred in 0.90% of 4315 transfusions with, and 0.56% of 3585 transfusions without, diphenhydramine premedication. In a multivariate analysis that adjusted for age, patient category, transfusion location, product, transfusion history, and reaction history, premedication with acetaminophen was associated with a statistically non-significant increase in the odds of a febrile reaction (odds ratio 1.74; 95% confidence interval 0.71-4.23; P = 0.22), and diphenhydramine with a non-significant increase in allergic reactions (odds ratio 1.74; 95% confidence interval 0.99-3.06; P = 0.054). Reactions occurred in only 1.3% of the 518 transfusions to patients with a history of two or more prior reactions. Febrile and allergic transfusion reactions were rare in paediatric patients transfused with leucoreduced, irradiated blood products, whether premedication was used or not.

Acetaminophen↗
PubMed2005

Low propidium iodide intensity in flow cytometric white blood cell counting as a marker of cell destruction?

BACKGROUND: Residual white blood cells (WBC) in filtered blood products were investigated with flow cytometry. Frequently two distinct populations with different propidium iodide (PI) intensities can be found. The aim of this study was to specify a population with low PI intensity and discuss it as a marker of ongoing cell destruction and their possible impact on cytomegalovirus safety. STUDY DESIGN AND METHODS: Buffy coat-depleted red blood cells were filtered with an in-line filtration set (LCR5, MacoPharma) after 4 hours (LCR5/4 hr) and 16 hours (LCR5/16 hr) of storage, and whole blood was filtered with a whole-blood filtration set (LST1, MacoPharma [LST1/4 hr]). The population with low PI intensity was sorted with a flow cytometer and prepared for transmission electron microscopy. RESULTS: The absolute count obtained in the low-PI-intensity area before filtration was significantly different comparing LCR5/4 hr (11.5 x 10(6) +/- 6.84 x 10(6) and 0.12 x 10(6) +/- 0.1 x 10(6)/unit) and LCR5/16 hr (69.3 +/- 42.12 and 0.06 +/- 0.05; p < 0.002). By use of LST1/4 hr no difference was found compared to LCR5/4 hr after filtration (0.12 +/- 0.09 vs. 0.12 +/- 0.1), but a significant difference was found when comparing the results before filtration (1.25 +/- 0.41 vs. 11.5 +/- 6.84; p < 0.02). Electron microscopy revealed that the sorted population consisted of predominantly cell and nuclear fragments. CONCLUSIONS: Events found in the low-PI-intensity area are not WBCs but partially degraded DNA coming from ongoing cell destruction during extended storage. Our results provide evidence that the absolute count of events found in the low-PI-intensity area can be used as a semiquantitative marker of WBC destruction.

Biomarkers↗
PubMed1992

Erythrocyte apheresis as a method for autologous blood transfusion--a case study in a patient with Vel-antibodies.

A 60-year old man was suffering from angina and a percutaneous transluminal coronary angioplasty (PTCA) had to be done. In the preoperative screening procedure antibodies anti-Vel were identified. The patients blood group is 0, rr. The prevalence of the blood group 0, rr, Vel(-) is 1:60,000. Compatible blood groups were not found in the patients family. The only alternative method to give this patient his necessary units of blood was an autologous transfusion procedure, however, because of the patients clinical condition it was necessary to use an erythrocyte apheresis procedure without changing his blood volume. We performed erythrocyte apheresis, using the Fenwal CS-3000. 920 ml blood was collected, Ht 0.67 l/l, enough for three units packed cells compared with random donor blood. The erythrocyte apheresis procedure was performed without any problem. The PTCA was done without complications and transfusions. The units of blood are stored in liquid nitrogen in the central laboratory of blood transfusion, Amsterdam.

Angioplasty, Balloon, Coronary↗
PubMed1992

Filtration of buffy coat free red cell concentrates in additive solution.

Leukocyte poor RCC's (LP-RCC) are indicated in chronically transfused patients in order to prevent non-hemolytic transfusion reactions and HLA alloimmunization. In this study buffy coat free red cell concentrates (BCF-RCC) in additive solution (SAG-M) stored for four weeks were leukocyte depleted by filtration with three different filter systems (Erypur Optima (E), Sepacell R500 B (S) and, Pall RC, 50 TM (P)). The BCF-RCC's were prepared using 'bottom and top (BAT)' systems and automatic separation containing about 20% leukocytes and 5% platelets of fresh whole blood. The leukocyte concentration could be reduced to less than 5 x 10(6) per RCC with all filter systems equally: Leukocytes/RCC's: E .58 +/- .94, S .36 +/- .55, P .55 +/- .69 x 10(6). The leukocyte depletion was even in case of filtering two RCC's through one filter (double filtration) efficient enough in order to keep leukocyte contamination below the 'critical immunogenic load for leukocytes (CILL)'. But significant differences concerning the damage of red cells (free hemoglobin, LDH, HBDH) were measured which were even considerable: free hemoglobin E = 3.69 +/- 2.28, S = 1.31 +/- 1.24, P = 3.58 +/- 2.34 g/l. Double filtration was only performed with filter system S showing the best blood compatibility. But the second BCF-RCC also showed considerable hemolysis. Therefore, double filtration of RCC's only seems to be indicated under optimal conditions with blood compatible filters for selected patients. Bed side filtration cannot be recommended because of the risk of hemolysis that makes quality control necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Component Removal↗
PubMed1993

Current problems with autologous blood supply.

OBJECTIVE: The purpose of the present study consists in an updated review of recent progress in the field of autologous blood supply. At different medical centers, autologous blood products are collected by quite different procedures, which may be applied during pre-, intra- and/or postoperative periods according the technical possibilities of the local blood supply systems. The products are very different, consisting in whole blood, red cell concentrates, platelet concentrates, fresh-frozen plasma (from whole blood and from plasmapheresis), as well as in wound and drainage fluid and in washed red cell concentrates. Iron therapy against autologous blood donation--or against surgical bleeding-induced anemia--is now well established, but it is unclear whether it should be given perorally or intravenously. In addition, erythropoietin substitution may be necessary for some but not all patients. DATA SOURCES: For our review we have used as sources, beyond our own published reports, studies devoted to clinical experience as well as to pathophysiological aspects of blood donation. RESULTS AND CONCLUSIONS: It becomes apparent that the practice of autologous blood supply has now reached peripheral hospitals not affiliated with bigger medical centers. Smaller hospitals may share expensive equipment necessary for autologous blood collection. Such progress contrasts with persistent uncertainties regarding iron and erythropoietin substitution.

Blood Component Removal↗
PubMed2004

Breaking dogmata to help patients: non-myeloablative haematopoietic stem cell transplantation.

Various dogmata have been broken as a consequence of the evolution of knowledge in the area of allogeneic haematopoietic stem cell (HSC) transplantation. The following is now clear: for the successful engraftment of allogeneic HSC, bone marrow ablation of the recipient is not required; HSCs create their own space through graft-versus-host reactions; several malignancies can be eradicated by the graft-versus-tumour effect; HSC allografting can be conducted on an out-patient basis; HSC allografting can be done in aged or debilitated individuals; HSC allografting can be achieved without transfusion of blood products; and the costs of the allografting procedures can be substantially diminished. Despite the fact that HSC allografting with reduced intensity conditioning may be related to several disadvantages, such as mixed chimaerism and relapse of the malignancy, breaking these dogmata has resulted in availability of HSC allografting to a larger number of individuals worldwide, thus offering true curative therapeutic options to patients who otherwise would not qualify to be given these opportunities.

Animals↗
PubMed1991

Leukocyte-poor blood components: issues and indications.

Leukocyte-poor blood components (LPBC) have now become part of the armamentarium of available transfusable blood components. Indications for the use of LPBC vary in accordance with the underlying clinical condition, as well as the intended objectives of the transfusion therapy. Technological advances have made it possible to prepare LPBC using rather simple procedures. However, any manipulation of blood components and the additional use of filters, washing, rinsing solutions, etc. inevitably result in additional costs to the patient, the health-care institution, or third-party payers. Requests for LPBC involve the preparation of RBC or platelets, leuko-depleted by at least one log. Transfusion of LPBC must be done in a logical fashion that meets the needs of the patient. Currently, LPBC is indicated for patients with a history of nonhemolytic febrile transfusion reactions to delay alloimmunization to HLA antigens and avoidance of cytomegalovirus (CMV) infection.

Blood Component Removal↗
PubMedDate not supplied

[Blood transfusion therapy at the Military Medicine Academy--present possibilities].

Blood component therapy refers to the transfusion of the specific part of blood that a patient needs, as opposed to the routine transfusion of whole blood (WB) in the past. This not only maintains blood resources, but also provides the optimal method of transfusing patients who require large amounts of a specific blood component. Since this concept have been accepted, the Institute of Transfusiology of Military Medical Academy (MMA) possess appropriate equipment for blood collection and processing of WB in components. Mainly, all kind (except frozen) of packed red cells (RBCs), platelet concentrates (random-donor buffy coat or apheresis donation), single-donor (apheresis) or random-donor (buffy coats) granulocytes, fresh frozen plasma (FFP), single-donor cryoprecipitate are prepared. Recently, fibrin glue (obtained by recycled cryoprecipitation from single-donor or autologous plasma), and some of new generation of blood components: hematopoietic stem and progenitor cells (fresh or cryopreserved), collected from bone marrow or harvested from peripheral blood after mobilization and donor-specific mononuclear cells for cell therapy, i.e. immunomodulation during relapse of leukemia after bone marrow transplantation, have become the routine. Analysis of blood component therapy done at the MMA during the past 11 years (1989-1999) showed that: a) participation of WB transfusion in the group of surgical clinics was permanently decreased (from 59.60% in 1989 to 0.37% in 1999); b) WB transfusion (in the last few years) practically was not used in the group of internal medicine clinics (0.82% in 1993 and 0.45% in 1999); c) overall WB transfusion in MMA is extremely rare (0.37%).

Blood Component Removal↗
PubMed2001

['Variant of Creutzfeldt-Jacob disease and blood transfusion'; report of the Dutch Health Council].

The new variant form of Creutzfeldt-Jakob Disease (vCJD), which has been diagnosed in about 100 patients--mostly in the United Kingdom (UK)--is considered to be associated with the consumption of beef contaminated with the agent bovine spongi-form encephalopathy (BSE). Although no cases of vCJD have been reported until now in the Netherlands, large quantities of beef have been imported from the UK in previous years; furthermore about 17 cattle with BSE have been detected in the Netherlands. Concern about the possible transmission of vCJD via blood and blood-products has led to a number of countries taking precautionary measures. Following questions raised by the Minister of Health, Welfare and Sport, the Health Council of the Netherlands issued a report to address the need for certain precautionary measures such as the leukodepletion of blood and the exclusion of donors at risk for vCJD. The Health Council recommends the routine leukodepletion of cellular blood components. The exclusion of donors who have resided in the UK for six or more months during the period 1980-1996, was considered to be insufficient to contribute to risk reduction. The Minister has recently decided to follow these two recommendations. However, she is of the opinion that the Health Council's recommendation to exclude all donors who have previously been transfused with cellular blood components is unnecessary. A common European position regarding such precautionary measures is deemed to be necessary. This would allow the exchange of blood components between countries and would also prevent donors, patients and the public at large from being confused or uncertain about the safety of blood components.

Animals↗
PubMed2001

[Labile blood products and their preparation].

Licensed labile blood components are put down on a regulatory list by the French Health Authority. They are prepared by the French National Blood Service and controlled according to regulatory and validated procedures. Depending on the origin of the blood, labile blood components are either homologous (donors) or autologous (from patients). Blood components (red cell concentrates, platelet concentrates and fresh frozen plasma) are processed within sterile closed disposable systems using either post-donation processing of whole blood or apheresis technology. All homologous blood components are leuco-reduced. Depending on specific settings, blood components could be washed, gamma irradiated or cryopreserved. Fresh frozen plasma is either "donor retested" after quarantine or viro-attenuated by solvent detergent treatment. Release is only allowed after a full conformity control of each blood component unit.

Adult↗
PubMed1992

[Reduction of leukocytes and loss of erythrocytes in production of erythrocyte concentrates using the "top and bottom" principle, a comparison between the equipment combinations Biopack-U/Biotrans Separator and Optipac/Optipress].

Using four different centrifugation methods, we compared the combinations of top and bottom bags and blood component separators made by Biotrans and Baxter. Compared with the cell counts of the donated blood, there remained 25% of the leukocytes and 88% of the red blood cells in the red cell preparations following application of the Biotrans system; the respective values for the Baxter system were 20% leukocytes and 85% red cells. The results were not influenced by the centrifugation method used. Thus, febrile nonhemolytic transfusion reactions and immunization against leukocyte antigens can be avoided by neither system.

Blood Component Removal↗
PubMed1992

Improvement of the separation of blood by modification of separators Optipress and Biotrans Separator.

UNLABELLED: By use of the new top-and-bottom bag system and automatic separators the quality of red cell concentrates (RCC) and fresh frozen plasma (FFP) could be markedly improved. Simultaneous preparation of storable single-donor platelet concentrates (PC) resulted, however, in too high losses of red cells and plasma. Through modification of the pressure plate of the separators and variation of the residual buffy coat (BC) volumes we tried to optimize the separation in this respect. In a second study we tried to establish the preparation of platelet-rich plasma (PRP) using top-and-bottom bag systems and automatic separators. MATERIALS AND METHODS: 1st study: 149 whole-blood units (Biopack U, quadruple systems) were separated into components either with Optipress (Opt, n = 58) or with Biotrans Separator (Bio, n = 91). To Optipress additional plates, 3-6 mm thick, were attached and the residual BC volume was varied by different adjustments of the distance screw. The Biotrans Separator was used with a plane pressure plate as well as with a modified plate having a transverse groove; the residual BC volume was adjusted to 50-120 ml. 2nd study: 15 whole-blood units were separated into PRP and RCC either using the Optipress (standard version, n = 5) or the Biotrans Separator (alternating opening of clamps, standard plate, n = 10). RESULTS AND CONCLUSIONS: 1st study: Both separations could be improved. The loss of red cells was significantly lower in case of the Biotrans Separator: Bio 15.6%, Opt 25.9%, p < 0.001. Other separation parameters showed no relevant difference between both separators. 2nd study: By use of the Biotrans Separator significantly less platelets could be separated (Bio 75.1 x 10(9), Opt 87.0 x 10(9), p < 0.05), but the PRP clearly was contaminated with less leukocytes (Bio 51.0 x 10(6), Opt 458.9 x 10(6), p < 0.01). The contamination of the RCC with leukocytes (about 20%) was markedly improved in both methods when compared with conventional preparations. The mean loss of red cells was 12.8% in both methods.

Blood Component Removal↗
PubMed1992

[Procedure for production of leukocyte depleted erythrocyte and thrombocyte concentrates (PRP method) using top and bottom bags, Optipress automated separators and a computer controlled Cryofuge 6000].

PRP methods for production of WBC-poor red blood cell (RBCC) and platelet concentrates (PC) are investigated using top-and-bottom bags and Optipress separators. A standard centrifugation method (profile A) and 2 methods (profiles B and C) for a computer run centrifugation using 21 (profile B) or 19 (profile C) varying time segments and g numbers. An MS-DOS-compatible personal computer runs a Cryofuge 6000. 500 ml fresh whole blood are collected in triple and/or quadruple top-and-bottom blood bags. Samples of 163 blood donors, 163 RBCCs and 161 PCs are analyzed by a Coulter Counter T 540. Blood smears of 5 RBCCs made by profile B are evaluated. Mean WBC contamination of RBCCs produced by profiles A, B and C is found to be lower than 5 x 10(8)/RBCC. None of the 5 blood smears can be counted out completely. The full number of 100 WBCs is not detected. All WBCs found are polymorphous nuclear cells. Mononuclear cells (MNC) are not evident. PCs produced by profile B contain a mean platelet yield of (76.4 +/- 21.2) x 10(9)/PC and a WBC contamination of (1.2 +/- 0.7) x 10(7)/PC. The PCs of profile B differ significantly (p < 0.001) from those of profile A and profile C. The results show a high quality of RBCC and PC produced by PRP methods using top-and-bottom blood bags and Optipress separators. Employing a computer run centrifuge, PC and RBCC contain a similar WBC contamination compared with concentrates produced by buffy coat methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Component Removal↗
PubMed1992

[Combination of a simple hollow fiber system with leukocyte filter for production of leukocyte depleted erythrocyte concentrates and plasma].

Leukocyte-depleted red cell concentrate (RCC) and plasma were separated by a hollow fiber filter system combined with a leukocyte filter without any additional devices. The RCC with 100 ml additive solution had a weight of 329 g; hematocrit was 0.55, free hemoglobin 16 mg/dl; leukocytes were (0.6 +/- 0.6) x 10(9)/l. The plasma (268 g) contained 5.4 g/dl of total protein, and only a few blood cells; clotting factor VIII activity 75%, all satisfying the guidelines.

Blood Component Removal↗