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At least 19 recordsLinked to original sources
PubMed1992

Apheresis for severe malaria complicated by cerebral malaria, acute respiratory distress syndrome, acute renal failure, and disseminated intravascular coagulation.

Malaria has become a very uncommon disease in Italy. Recently a variety of circumstances, such as travel to tropical countries as well as immigration from Asia and Africa, have combined to increase the number of malaria cases recorded annually. In this report we describe the use of red cell exchange transfusion and plasma exchange in the treatment of a patient with hyperparasitemic malaria (51% erythrocytes or more parasitized). When first observed the patient was in shock and had signs of cerebral malaria, disseminated intravascular coagulation, and acute respiratory distress syndrome, which in the following 2 days were complicated by acute renal failure. After mefloquine therapy combined with 3 red blood cell exchanges, 2 plasma exchanges, and 10 dialysis sessions over 14 days, the patient recovered completely. This case of severe malaria with multiple complications, treated with mefloquine in conjunction with both exchange transfusion and plasmapheresis, had a successful outcome and lends further support to the possible beneficial role of exchange transfusion in complicated malaria.

Acute Disease↗
PubMed1991

Hematopoietic stem cell processing and storage.

The techniques to collect, process, and store HSC in anticipation of transplantation are now widely available. Important unresolved issues revolve around the as yet imperfect identification and classification of totipotential progenitors. However, much progress has been and will continue to be made despite this limitation. Research priorities of present and future stem cell processing laboratories should include: 1. Optimization of liquid (nonfrozen) storage techniques. This will permit more complex cell-specific manipulations, such as T-lymphocyte subset selection, isolation of CD34+ populations, treatment in vitro with growth factors, gene transfer experiments, and long-range transport of HSC, to be performed while preserving HSC integrity. 2. A better understanding of the regulation and kinetics of peripheral blood and umbilical cord HSC, to allow optimum collection procedures that do not require marrow harvesting. 3. An intensive study into the optimum conditions of collection, processing, and storage of megakaryocytic progenitors to decrease the long platelet-transfusion dependency of the myeloablated patient. 4. A search for a simple in vitro correlate of engraftment potential of a stem cell preparation. This will greatly improve the quality control functions of the laboratory as well as contribute to better patient selection for transplantation.

Animals↗
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↗
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↗
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↗
PubMed1992

Limiting homologous blood exposure.

Successful limitation of homologous blood transfusion may necessitate multiple strategies and advance planning. Preoperative and intraoperative autologous blood collection may have to be supplemented with hemostatic pharmacologic agents. The use of cytokines is increasing. More efficient use of directed donors can have an important role in blood use. As these expensive and time-consuming techniques become available, a major challenge will be to determine which patients may benefit from or really need them.

Blood Component Removal↗
PubMed1992

[Autologous blood transfusions in interventions of the pelvis using the cell saver].

From July 1990 to September 1991 we used the cell-saver for autologous intraoperative retransfusion in 8 radical prostatectomies, 5 cystectomies and one adenomenucleation. Postoperatively we tolerated a hemoglobin fall up to 10 g/100 ml. Doing it without heterologous blood was possible in 7 out of 14 patients. In all of them the preoperative hemoglobin was higher than 13 g/100 ml and the blood loss did not exceed 3000 ml.

Aged↗
PubMed1992

Preparation of blood components.

The processing of blood into various components and the knowledge of component usage enables veterinarians to support and beneficially treat more animals. Blood products include packed red blood cells; fresh frozen, fresh, and modified plasma; cryoprecipitate; platelets; and concentrates. Some methods of preparation of blood products and storage are presented.

Animals↗