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At least 19 recordsLinked to original sources
PubMed2002

Levels of tissue inhibitor of metalloproteinases-1 in blood transfusion components.

Blood transfusion during surgery for solid tumors may reduce patient survival because of various bioactive substances present in blood preparations. The anti-proteolytic protein tissue inhibitor of metalloproteinases-1 (TIMP-1) present in large quantities in platelets has been shown to stimulate cell growth and to inhibit apoptosis and may therefore be considered to influence tumor progression. We measured TIMP-1 levels in blood transfusion preparations. especially in platelet-containing preparations, before and after leucofiltration and at different time-points during storage. The mean TIMP-1 levels in whole blood (WB) and platelet-rich plasma (PRP) were slightly reduced by leucofiltration; WB: 41.6 microg/L versus 34.9 microg/L. PRP: 139.8 microg/L versus 127.2 microg/L. However, with prestorage leucofiltration. TIMP-1 levels in buffy-coat-derived platelet (BCP) pools were significantly reduced from 134.2 microg/L to 102.2 microg/L (p=0.0013). In saline-adenine-glucose-mannitol (SAG-M) blood preparations in which the platelet content is reduced by more than 99%,. TIMP-1 could not be detected. Extracellular TIMP-1 accumulated significantly in non-filtered WB and in aferesis platelet concentrates (APC), but TIMP-1 was at no time detectable in SAG-M blood during storage. In conclusion. TIMP-1 is present in various platelet-containing blood preparations, but not in platelet-free preparations such as SAG-M, indicating that most of the TIMP-1 measured in blood preparations originates from platelets. Furthermore, TIMP-1 levels increased during storage in preparations containing platelets. which suggests a continuous disintegration of platelets. These data imply that information on preoperative blood transfusions should be taken into account when evaluating plasma TIMP-1 levels in patients.

Blood Component Transfusion↗
PubMed1999

Soluble vascular endothelial growth factor in various blood transfusion components.

BACKGROUND: Blood transfusion may reduce survival after curative surgery for solid tumors. This may be related to extracellular content of cancer growth factors present in transfusion components. Vascular endothelial growth factor (VEGF) is a potent stimulator of angiogenesis in solid tumors. The potential content of VEGF in various blood components for transfusion was evaluated. STUDY DESIGN AND METHODS: Soluble VEGF (sVEGF, isotype 165) was determined by an enzyme-linked immunosorbent assay (EIA) in serum and plasma samples and in lysed cells from healthy volunteers. Subsequently, total content of sVEGF was determined in nonfiltered and prestorage white cell-reduced whole blood (WB), buffy coat-depleted saline-adenine-glucose-mannitol (SAGM) blood, platelet-rich plasma (PRP), and buffy coat-derived platelet (BCP) pools obtained from volunteer, healthy blood donors. As a control, total content of platelet-derived soluble plasminogen activator inhibitor type 1 (sPAI-1) was determined by an EIA in the same samples. Finally, the extracellular accumulation of sVEGF was determined in nonfiltered WB and SAGM blood during storage for 35 days and in BCP pools during storage for 7 days. RESULTS: In the healthy volunteers, median total sVEGF content was 97 (range, 20-303) pg per mL in serum and 19 (13-37) pg per mL in plasma (n = 12, p < 0.002) and 445 (280-990) pg per mL in lysed cells. Median total sPAI-1 content was 94 (64-127) ng per mL in serum, 8 (6-11) ng per mL in citrated plasma, and 95 (78-123) ng per mL in lysed cells. In SAGM blood, the median total sVEGF content was 25.3 (3.3-48.4) ng per unit in nonfiltered units and undetectable in white cell-reduced units. Median total sVEGF content was 29.2 (24.8-124.9) ng per unit in nonfiltered PRP and 28.7 (24.5-118.6) ng per unit in white cell-reduced PRP. The sVEGF accumulated significantly in WB, SAGM blood, and BCP pools, depending on the storage time. CONCLUSION: The sVEGF (isotype 165) appears to be present in various blood transfusion components, depending on storage time.

Blood Platelets↗
PubMed2004

Soluble urokinase plasminogen activator receptor in blood transfusion components.

Post-transfusion infectious complications associated with allogeneic blood components may depend on storage time and may be related to extracellular accumulation of bioactive substances during storage. The glycoprotein, soluble urokinase plasminogen activator receptor (suPAR), which is located in specific granules of neutrophils, plays a role in inflammation and remodelling of the extracellular matrix. Using enzyme-linked immunosorbent assay, suPAR was determined in serum, plasma and blood cell lysates. In addition, suPAR was measured in whole blood (WB), buffy-coat-depleted saline-adenine-glucose-mannitol (SAGM) blood, platelet-rich plasma (PRP) and buffy-coat-derived platelet (BCP) pools with and without pre-storage leucofiltration, and in non-filtered WB, SAGM blood and platelet concentrates prepared using apheresis (APC) at different time points during storage. Mean suPAR concentration was significantly higher in cell lysates, compared to that in a corresponding serum (P = 0.007) and in plasma samples (P = 0.004). Mean suPAR levels in WB, BCP and SAGM were significantly reduced using leucofiltration (WB: 3.4 versus 2.0 ng mL(-1); BCP: 1.6 versus 1.1 ng mL(-1); SAGM: 2.8 versus 0.19 ng mL(-1)), whereas no difference was observed in PRP. In non-filtered WB, SAGM and APC, extracellular suPAR accumulated significantly in a storage-time-dependent manner (WB: P < 0.01; SAGM: P < 0.001; APC: P < 0.001). The present study demonstrates that cell lysates contain significantly more suPAR, compared to both serum and plasma. This can be explained by the release of suPAR from intracellular granules during cell lysis. The amount of suPAR is significantly increased during storage of blood transfusion components, an accumulation that is reduced using pre-storage leucofiltration.

Blood Component Transfusion↗
PubMed1992

Evolution in indications for blood component transfusion.

Indications for blood components are changing but continue to be based on a combination of clinical assessment and laboratory data. In the perioperative setting, some decisions must be made before laboratory data are available. To prevent the inappropriate usage of blood components, prophylactic or expectant treatment should be limited. In red cell transfusion, physiologic indices of oxygen utilization may soon supplement hemoglobin/hematocrit levels in clinical decision making. Less progress has been made in transfusion for hemostasis. Well-designed clinical studies are needed to answer remaining questions; in the interim, nationally accepted guidelines are available to assist clinicians in their decisions.

Adult↗
PubMed1978

[Blood component transfusion in Croatia].

Blood component therapy has been wildly accepted all over the world due to the better effects achieved in treating the patients, its safety and economy. In SRH it is replacing whole blood transfusions rather slowly as can be seen through five years of production and utilisation of blood derivatives. In 1974-1978 period a number of donations in Croatia increased to 27 per 1.000 inhabitants, but it is still very far from optimal 40-60 donations per 1.000 inhabitants. In that period the production of albumin increased 5 times, of immunoglobulins 10 times and factor VIII 10 times. In 1978 per 1.000 inhabitants, 2,1 1 of plasma were fractionated, 53 gr of albumin and 23 ml of imunoglobulins were used plus additional 6.200 units per one haemophiliac. These quantities are not sufficient to cover the needs of the health service in SRH. To overcome the shortage it is necessary to increase the number of donations, to augmant the average amount of donation to 450 ml., to increase the number of plasmapheresis and to use blood component therapy on a larger scale. Only after obtaining 10-12 1 of plasma for fractionation per 1.000 inhabitants optimal quantities of derivatives can be secured.

Blood Donors↗
PubMed1999

An analysis of errors in blood component transfusion records with regard to quality improvement of data acquisition and to the performance of lookback and traceback procedures.

BACKGROUND: Quality assurance of blood transfusion covers institutions, personnel, and procedures involved in preparing, issuing, and using blood components. The accuracy of data related to blood component transfusions is a tool for quality control in the transfusion service. STUDY DESIGN AND METHODS: A study of the accuracy of data records of the transfusion service at the University Hospital of Erlangen, Germany, between June 1994 and May 1996 was carried out. All returned blood component transfusion report forms were examined for discrepancies between primary data records and clinical transfusion reports. RESULTS: Blood components (n = 49,224) from allogeneic and autologous donations, packed red cells, fresh-frozen plasma, and platelet components that had been issued for transfusion were included in this evaluation. For 27.3 percent of all components issued, no transfusion report was returned to the blood bank. For the remaining 35,786 units, errors were found in 3.8 percent of the records. For 1.24 percent of all components, discrepant information related to the recipient's identity or the component's status was found; this affected the feasibility of lookback or traceback searches. CONCLUSION: A remarkably high frequency of discrepancies exists between computerized blood bank records and the information recorded on returned blood transfusion forms. The processes of data acquisition and entry must be included in quality assurance efforts in transfusion medicine.

Blood Banks↗
PubMed1996

[Adequacy of blood component transfusion according to previously established criteria].

PURPOSE: Transfusion is not devoid of adverse effects; therefore every transfusional procedure must be indicated correctly. With this in mind in 1991 transfusion guidelines were published by our Hospital Transfusion Committee. Four years later, a retrospective audit was performed. MATERIAL AND METHODS: We have evaluated all blood component orders (order is a transfusion request) during one month, classifying them as appropriate or inappropriate according to the transfusion guidelines. The evaluation was performed 24 hours after transfusion. The results obtained were compared with the ones obtained before the published transfusion guidelines. RESULTS: 481 transfusion orders were studied. 87 percent (420/481) were considered appropriate according to the transfusion guidelines. These 481 orders referred to the transfusion of 1178 units to 293 patients. 12 percent of the transfused units was considered as inappropriate. 16 percent of the patients (48/239) had at least on inappropriate transfusion procedure. The comparison with the data obtained in 1991 showed a significant increase of the appropriate transfusion orders (74 versus 87 percent). The use of fresh frozen plasma showed the greatest incidence in inappropriate use, mainly in haemorrhagic disorders without factor deficit. The patients with haemoglobin levels between 70 and 100 g/L without signs of hypoxia were the most important cause of inappropriate use of red cell concentrates. And the patients with platelet levels > 20 x 10(9)/L were the major cause of inappropriate use of platelet concentrates. CONCLUSION: Transfusion guidelines knowledge improves the use of blood components.

Anemia↗
PubMed2001

Low level leucocyte counting: a critical variable in the validation of leucodepleted blood transfusion components as highlighted by an external quality assessment study.

Leucocyte counts of < 5 x 106 per blood transfusion product are currently recommended in the UK in order to reduce transfusion-related infections and febrile reactions. Routine leucocyte depletion, however, requires the development of reliable internal and external quality assurance (EQA) programmes. We report preliminary findings from the UK NEQAS for Low-Level Leucocyte Counting from 18 UK Transfusion Centres over a four month period. Data analysis showed that the IMAGN 2000 had the lowest CVs (range 7.5-36%, mean 16.7) for samples with counts of 5-30 cells/microl when compared to the flow cytometric (range 13.8-88%, mean 29.5) and Nageotte methods (range 20.6-117%, mean 61.8). In addition, laboratories using commercial nuclear stains (LeucoCOUNTTM) had consistently lower CVs than those using 'in-house' propidium iodide staining methods. Important differences in flow cytometric gating strategies were also identified. This study highlights the current variability in low level leucocyte counting, especially within the critical range of 5-30 cells/microl (equating to < 5 x 106/l). The acceptance of consensus protocols, including gating strategies and nuclear staining techniques, is required to reduce the observed interlaboratory variation. Finally, we demonstrate that stabilized blood preparations can be successfully used to provide a national/international low-level leucocyte EQA scheme.

Blood Component Transfusion↗
PubMed1992

Perioperative haemotherapy: I. Indications for blood component transfusion.

The practice of transfusion medicine has undergone substantial change over the last decade. Much of the impetus for the change has come from the isolation of human immunodeficiency virus (HIV) and the linkage of HIV transmission to blood transfusion. The purpose of this paper is to collate and review the literature relating to the indications for blood transfusion and provide recommendations for the appropriate utilization of blood products. Peer-reviewed and published studies and reviews relating to aspects of clinical blood transfusion were identified through computer searches and searching of the bibliographies of identified articles. Emphasis was placed on the literature published within the last decade and particularly in the years 1985-91. Material was chosen which was of proved clinical importance and in which findings were consistent among different investigators or different centres. Less emphasis was placed on material reporting new findings of uncertain clinical relevance or findings that were not consistent with majority reports. It is concluded that the only indication for red cell transfusion is to increase the oxygen carrying capacity of the blood and that an adjustment downwards in the haemoglobin concentration at which blood is transfused (transfusion trigger) from the traditional level of 100 g.L-1 is supported by the physiological and clinical data. Perioperative haemoglobin concentrations of 80 g.L-1 are acceptable in otherwise healthy young patients. The transfusion trigger should be adjusted upwards from this in medically compromised patients and in the elderly (greater than 60 yr). Fresh frozen plasma (FFP) is only indicated when there are documented deficiencies of coagulation factors. Platelet concentrates (PC) are indicated for the treatment of clinical coagulopathy resulting from thrombocytopaenia or platelet dysfunction. Routine or prophylactic administration of either FFP or PC after cardiopulmonary bypass or during resuscitation from haemorrhage is not indicated.

Blood Component Transfusion↗
PubMed1995

Quantification of thrombelastographic changes after blood component transfusion in patients with liver disease in the intensive care unit.

Thrombelastography (TEG) can be used to monitor hemostasis and guide transfusion therapy during orthotopic liver transplantation. However, data are limited regarding the type and quantity of blood components necessary for TEG-guided blood component transfusion in coagulopathic critically ill patients with liver disease. We evaluated changes in four thrombelastogram variables (reaction time, thrombin constant time, alpha angle, and maximum amplitude) in whole blood samples after 74 separate blood component transfusions in 60 critically ill patients with a coagulopathy and liver disease. Only platelets significantly improved TEG variables in patients who received a single type of blood component. Each unit of platelets decreased the reaction and thrombin constant time by 0.43 (P < 0.05) and 0.82 (P < 0.005) min, respectively, increased the alpha angle by 1.5 degrees (P < 0.005), and the maximum amplitude by 1.4 mm (P < 0.005). In patients who received multiple blood components, cryoprecipitate decreased the thrombin constant time by 0.56 min/U (P < 0.05), and each unit of platelets decreased the thrombin constant time by 0.39 min (P < 0.005), and increased the alpha angle and maximum amplitude by 0.63 degrees (P < 0.05) and 0.99 mm (P < 0.005), respectively. We conclude that platelet transfusions, alone or in combination with other blood components, are most effective for improving abnormal TEG variables in coagulopathic critically ill patients with liver disease.

Blood Coagulation Disorders↗
PubMed1989

Blood component transfusion audit: a comprehensive microcomputer program.

Blood usage review is an essential aspect of hospital quality assurance. As part of a system for reviewing transfusion practices, the American Red Cross/New Jersey Blood Services has developed a series of microcomputer programs called the Blood Component Transfusion Audit. The programs use transfusion data collected on a standardized form to produce reports of utilization and analyses of transfusion practices, including the extent to which transfusions are justified by established criteria.

Blood Transfusion↗
PubMed2002

[Immunomodulatory effect of blood components transfusions].

In this paper the authors have described basic mechanisms of immunomodulation caused by blood transfusion and its clinical consequences. Transfusions of blood and blood components can induce cell interaction changing the immunological response of a recipient. Two phenomena--immunisation and immunosuppression result from post-transfusion immunological changes. The factors causing these two phenomena are not fully known. Immunomodulation observed as a consequence of blood transfusion is probably associated with a decrease of cell mediated-immunity and at the same time an increase of humoral immunity. The observed effects of transfusion include a shift of lymphocyte subpopulations from Th1 to Th2, a reduction of natural cytotoxic cell activity, CD4/CD8 ratio and blastogenesis of lymphocytes. Animal studies suggest that the mechanisms of immunomodulation are stimulated by leukocytes present in blood components. Animal data show that pre-storage leukoreduction is more effective than post-storage leukodepletion.

Blood Component Transfusion↗