These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Incompatible blood transfusion: Challenging yet lifesaving in the management of acute severe autoimmune hemolytic anemia  

PubMed Central

Background and Aim: Autoimmune hemolytic anemia (AIHA) is characterized by the production of autoantibodies directed against red cell antigens. Most patients of AIHA arrive in the emergency or out-patient department (OPD) with severe anemia requiring urgent blood transfusion. Here we share our experience of managing these patients with incompatible blood transfusions and suggest the minimal test required to assure patient safety. Materials and Methods: A total of 14 patients admitted with severe anemia, diagnosed with AIHA and requiring blood transfusion urgently were included in the study. A series of immunohematological investigations were performed to confirm the diagnosis and issue best match packed red blood cells (PRBC) to these patients. Results: A total of 167 PRBC units were crossmatched for 14 patients of which 46 units (28%) were found to be best match ones and 26 (56.5%) of these units were transfused. A mean turn around time of 222 min was observed in issuing the “best match” blood. Severe hemolysis was observed in all patients with a median hemoglobin increment of 0.88 g/dl after each unit PRBC transfusion. Conclusion: Decision to transfuse in AIHA should be based on the clinical condition of the patient. No critical patient should be denied blood transfusion due to serological incompatibility. Minimum investigations such as direct antiglobulin test (DAT), antibody screening and autocontrol should be performed to ensure transfusion safety in patients. All transfusion services should be capable of issuing “best match” PRBCs in AIHA. PMID:25161349

Das, Sudipta Sekhar; Zaman, Rafiq Uz; Safi, Mohammad

2014-01-01

2

Acute hemolytic transfusion reactions due to multiple alloantibodies including anti-E, anti-c and anti-Jkb.  

PubMed Central

We report a case of two consecutive episodes of acute hemolytic transfusion reactions (HTRs) due to multiple alloantibodies in a 34-yr-old man who suffered from avascular necrosis of left femoral head. He received five units of packed red blood cells (RBCs) during surgery. Then the transfusion of packed RBCs was required nine days after the surgery because of the unexplained drop in hemoglobin level. The transfusion of the first two units resulted in fever and brown-colored urine, but he received the transfusion of another packed RBCs the next day. He experienced even more severe symptoms during the transfusion of the first unit. We performed antibody screening test, and it showed positive results. Multiple alloantibodies including anti-E, anti-c and anti-Jkb were detected by antibody identification study. Acute HTRs due to multiple alloantibodies were diagnosed, and the supportive cares were done for 6 days. We suggest the antibody screening test should be included in the panel of pretransfusion tests for safer transfusion, and it is particularly mandatory for the patients with multiple transfusions, pregnant women, and preoperative patients. PMID:14676451

Park, Tae Sung; Kim, Ki Uk; Jeong, Woo Jin; Kim, Hyung Hoi; Chang, Chulhun L.; Chung, Joo Seop; Cho, Goon Jae; Lee, Eun Yup; Son, Han Chul

2003-01-01

3

Acute Hemolytic Transfusion Reaction in a Patient with Bombay Phenotype: Implications for ABO Grouping.  

PubMed

Bombay blood group is a rare phenotype that is characterized serologically by absence of H, A and B antigens on red cell surface and presence of corresponding antibodies in the serum. We report a case of 45-year old patient having Bombay blood group phenotype who experienced an acute reaction due to transfusion of mismatched blood unit. PMID:25332552

Malhotra, Sheetal; Dhawan, Hari Krishan; Jain, Ashish; Sachdev, Suchet; Marwaha, Neelam

2014-09-01

4

Initiation and Regulation of Complement during Hemolytic Transfusion Reactions  

PubMed Central

Hemolytic transfusion reactions represent one of the most common causes of transfusion-related mortality. Although many factors influence hemolytic transfusion reactions, complement activation represents one of the most common features associated with fatality. In this paper we will focus on the role of complement in initiating and regulating hemolytic transfusion reactions and will discuss potential strategies aimed at mitigating or favorably modulating complement during incompatible red blood cell transfusions. PMID:23118779

Stowell, Sean R.; Winkler, Anne M.; Maier, Cheryl L.; Arthur, C. Maridith; Smith, Nicole H.; Girard-Pierce, Kathryn R.; Cummings, Richard D.; Zimring, James C.; Hendrickson, Jeanne E.

2012-01-01

5

Investigation of whether the acute hemolysis associated with Rho(D) immune globulin intravenous (human) administration for treatment of immune thrombocytopenic purpura is consistent with the acute hemolytic transfusion reaction model  

PubMed Central

BACKGROUND Immune thrombocytopenic purpura and secondary thrombocytopenia patients treated with Rho(D) immune globulin intravenous (human; anti-D IGIV) have experienced acute hemolysis, which is inconsistent with the typical presentation of extravascular hemolysis—the presumed mechanism of action of anti-D IGIV. Although the mechanism of anti-D-IGIV–associated acute hemolysis has not been established, the onset, signs/symptoms, and complications appear consistent with the intravascular hemolysis of acute hemolytic transfusion reactions (AHTRs). In transfusion medicine, the red blood cell (RBC) antigen-antibody incompatibility(-ies) that precipitate AHTRs can be detected in vitro with compatibility testing. Under the premise that anti-D-IGIV–associated acute hemolysis results from RBC antigen-antibody–mediated complement activation, this study evaluated whether the incompatibility(-ies) could be detected in vitro with a hemolysin assay, which would support the AHTR model as the hemolytic mechanism. STUDY DESIGN AND METHODS Seven anti-D IGIV lots were tested to determine the RBC antibody identities in those lots, including four lots that had been implicated in acute hemolytic episodes. Hemolysin assays were performed that tested each of 73 RBC specimens against each lot, including the RBCs of one patient who had experienced acute hemolysis after anti-D IGIV administration. RESULTS Only two anti-D IGIV lots contained RBC antibodies beyond those expected. No hemolysis endpoint was observed in any of the hemolysin assays. CONCLUSION Although the findings did not support the AHTR model, the results are reported to contribute knowledge about the mechanism of anti-D-IGIV–associated acute hemolysis and to prompt continued investigation into cause(s), prediction, and prevention of this potentially serious adverse event. PMID:19220820

Gaines, Ann Reed; Lee-Stroka, Hallie; Byrne, Karen; Scott, Dorothy E.; Uhl, Lynne; Lazarus, Ellen; Stroncek, David F.

2012-01-01

6

Post-transfusion hypertension and seizure in congenital hemolytic anemia: a case report and literature review.  

PubMed

A rare syndrome of hypertension, seizures and intracranial bleed has been reported among patients with congenital hemolytic anemia who underwent multiple blood transfusions. We report this syndrome in a 12-year-old Malay girl with hemoglobin E-beta-thalassemia, who underwent intensive transfusion and subsequently had headache, visual loss, severe hypertension and seizures. A comprehensive literature review revealed 30 patients with this syndrome, of whom 15 had intracranial bleed and 12 among these 15 died. A less-intensive transfusion regimen among patients with chronic hemolytic anemia and prompt detection and management of hypertension may prevent this potentially fatal syndrome. PMID:24473404

Ngim, Chin Fang; Ng, Chen Siew; Lai, Nai Ming

2014-06-01

7

Acute hemorrhage and blood transfusions in horses.  

PubMed

Treatment of acute hemorrhage in the horse involves targeted medical management and also may involve surgical stabilization. This article provides an approach to the initial stabilization and information on available topical hemostats. The practice of blood collection and transfusion is also described, with attention to new information on viability of transfused equine blood, potential negative effects of blood transfusion, and methods of cell salvage. PMID:25016500

Mudge, Margaret C

2014-08-01

8

Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases  

PubMed Central

Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a fixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient’s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a “one-by-one” administration schedule. Evidence-based clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within well-constructed protocols will offer better prospects for blood conservation in selected IBD patients undergoing elective surgery. PMID:19787832

Garcia-Erce, Jose Antonio; Gomollon, Fernando; Munoz, Manuel

2009-01-01

9

Hemolytic disease of the fetus and newborn owing to anti-U, successfully treated with repeated intrauterine transfusions.  

PubMed

Hemolytic disease of the fetus and newborn (HDFN) owing to anti-U has rarely been reported. U is part of the MNS system.M and N glycoproteins are located on glycophorin A (GPA); Sand s antigens are on glycophorin B (GPB). Individuals who lack GPB are S- and s- and also lack U. The U- phenotype occurs almost exclusively in the African population and has a very low frequency (0.25%). Anti-U is of immunoglobulin G class and can cause hemolytic transfusion reaction and HDFN. In this report we present the use of a noninvasive method to detect anemia in the fetus and the subsequent use of intrauterine transfusion(IUT) with blood of a very rare phenotype. For the first time, we used deglycerolized and 3-week-old red blood cell units for IUT without signs of adverse reactions and with the expected effect on the hemoglobin value. We conclude that this transfusion strategy could be applied safely. PMID:24094236

Strindberg, Johanna; Lundahl, Joachim; Ajne, Gunilla

2013-01-01

10

Recognition, Investigation and Management of Acute Transfusion Reactions  

PubMed Central

The recognition and management of transfusion reactions (TRs) are critical to ensure patient safety during and after a blood transfusion. Transfusion reactions are classified into acute transfusion reactions (ATRs) or delayed transfusion reactions, and each category includes different subtypes. Different ATRs share common signs and symptoms which can make categorisation difficult at the beginning of the reaction. Moreover, TRs are often under-recognised and under-reported. To ensure uniform practice and safety, it is necessary to implement a national haemovigilance system and a set of national guidelines establishing policies for blood transfusion and for the detection and management of TRs. In Oman, there are currently no local TR guidelines to guide physicians and hospital blood banks. This paper summarises the available literature and provides consensus guidelines to be used in the recognition, management and reporting of ATRs. PMID:25097764

Al-Riyami, Arwa Z.; Al-Hashmi, Sabria; Al-Arimi, Zainab; Wadsworth, Louis D.; Al-Rawas, Abdulhakim; Al-Khabori, Murtadha; Daar, Shahina

2014-01-01

11

Acute nonimmune hemolytic anemia without fulminant hepatitis in Wilson disease.  

PubMed

Owing to the insidious course and variable presentation, Wilson disease is often diagnosed months to years after the initial symptoms. Although fulminant hepatitis with nonimmune hemolytic anemia is frequently reported, chronic mild hepatitis can occur with bouts of transient hemolytic anemia. We report a 16-year-old female who presented with fatigue, dizziness, and new onset jaundice. She had a hemolytic anemia, although diagnosis of Wilson disease was initially confounded by a family history of autoimmunity with a high erythrocyte sedimentation rate and only mildly elevated bilirubin and aspartate aminotransferase. Macrocytosis, poor liver synthetic function, and low serum alkaline phosphatase led to the diagnosis. PMID:21516016

Agrawal, Anurag K; Haddad, Fadi G; Matsunaga, Alison

2011-05-01

12

The hazards of blood transfusion in historical perspective.  

PubMed

The beginning of the modern era of blood transfusion coincided with World War II and the resultant need for massive blood replacement. Soon thereafter, the hazards of transfusion, particularly hepatitis and hemolytic transfusion reactions, became increasingly evident. The past half century has seen the near eradication of transfusion-associated hepatitis as well as the emergence of multiple new pathogens, most notably HIV. Specific donor screening assays and other interventions have minimized, but not eliminated, infectious disease transmission. Other transfusion hazards persist, including human error resulting in the inadvertent transfusion of incompatible blood, acute and delayed transfusion reactions, transfusion-related acute lung injury (TRALI), transfusion-associated graft-versus-host disease (TA-GVHD), and transfusion-induced immunomodulation. These infectious and noninfectious hazards are reviewed briefly in the context of their historical evolution. PMID:18809775

Alter, Harvey J; Klein, Harvey G

2008-10-01

13

Brown recluse spider (Loxosceles reclusa) envenomation leading to acute hemolytic anemia in six adolescents.  

PubMed

Loxosceles reclusa (brown recluse spider) bites often cause local envenomation reactions; however, acute hemolysis from systemic loxoscelism is rare. To highlight this important diagnostic consideration for unexplained hemolysis in areas endemic for brown recluse spiders, we report on 6 adolescents with acute hemolytic anemia from presumed L reclusa bites. PMID:20006769

McDade, Jenny; Aygun, Banu; Ware, Russell E

2010-01-01

14

Transfusion-Related Acute Lung Injury: The Work of DAMPs*  

PubMed Central

Current notions in immunology hold that not only pathogen-mediated tissue injury but any injury activates the innate immune system. In principle, this evolutionarily highly conserved, rapid first-line defense system responds to pathogen-induced injury with the creation of infectious inflammation, and non-pathogen-induced tissue injury with ‘sterile’ tissue inflammation. In this review, evidence has been collected in support of the notion that the transfusion-related acute lung injury induces a ‘sterile’ inflammation in the lung of transfused patients in terms of an acute innate inflammatory disease. The inflammatory response is mediated by the patient's innate immune cells including lung-passing neutrophils and pulmonary endothelial cells, which are equipped with pattern recognition receptors. These receptors are able to sense injury-induced, damage-associated molecular patterns (DAMPs) generated during collection, processing, and storage of blood/blood components. The recognition process leads to activation of these innate cells. A critical role for a protein complex known as the NLRP3 inflammasome has been suggested to be at the center of such a scenario. This complex undergoes an initial ‘priming’ step mediated by 1 class of DAMPs and then an ‘activating’ step mediated by another class of DAMPs to activate interleukin-1beta and interleukin-18. These 2 cytokines then promote, via transactivation, the formation of lung inflammation. PMID:23637644

Land, Walter G.

2013-01-01

15

Exchange transfusion in acute episodes of maple syrup urine disease  

Microsoft Academic Search

Two neonates with maple syrup urine disease were treated by exchange transfusion. Within 15 h blood leucine and KICA concentrations were lowered from 2.6 mM to 1.1 mM using 570 to 620 ml blood per kg body weight. The other branched-chain amino acid\\/keto acid pairs fell to normal. During exchange transfusion the patient's nitrogen balance seems to be negative. Further

U. Wendel; U. Langenbeck; I. Lombeck; H. J. Bremer

1982-01-01

16

Transfusion practices for acute traumatic brain injury: a survey of physicians at US trauma centers  

Microsoft Academic Search

Purpose  To determine whether physician specialty influences transfusion threshold in patients with acute severe traumatic brain injury\\u000a (TBI).\\u000a \\u000a \\u000a \\u000a Methods  We surveyed transfusion preferences of chiefs of trauma surgery, chairs of neurosurgery, and surgical and neurosurgical ICU\\u000a directors at all 187 US Level I trauma centers using a scenario-based, multiple-choice instrument administered by mail. We\\u000a evaluated the hemoglobin value used as a transfusion

Matthew J. Sena; Ryan M. Rivers; J. Paul Muizelaar; Felix D. Battistella; Garth H. Utter

2009-01-01

17

Acute exacerbation of subclinical pulmonary fibrosis following red cell transfusion: a case report  

PubMed Central

Background Red cell transfusion is associated with lung injury in susceptible hosts, although many cases do not meet criteria for transfusion related acute lung injury. Patients with underlying pulmonary fibrosis can exhibit precipitous deteriorations in respiratory status of unknown etiology defined as acute exacerbations due to superimposed lung injury syndrome. It is unclear whether red cell transfusion is associated with acute exacerbation of underlying pulmonary fibrosis. Case Report We describe a patient who underwent an uneventful elective left total hip replacement but developed anemia post-operatively. Twenty-four hours following transfusion of her fifth non-leukoreduced AS-5 red cell unit, she developed new bilateral airspace infiltrates associated with progressive hypoxemia. These RBC units were 35-38 days old. Despite supportive care and diuresis, patient remained profoundly hypoxemic with infiltrates that progressed to fibrosis. Results The patient had mild sub-clinical lower-lobe predominant interstitial pulmonary fibrosis but developed diffuse bilateral ground glass opacities with areas of consolidation 24 h after receiving her last RBC unit. Transbronchial biopsy of the right lower lobe showed active organizing pneumonia and underlying interstitial fibrosis, supporting the clinical diagnosis of acute exacerbation of pulmonary fibrosis. The bronchoalveolar lavage showed progressive bloody effluent, consistent with diffuse alveolar hemorrhage, a marker of lung injury. There was no evidence of viral inclusions, fungal elements, pneumocystis, or bacterial organisms. Conclusion Transfusion of multiple units of aged RBCs was temporally associated with an acute exacerbation and rapid progression of underlying sub-clinical pulmonary fibrosis. PMID:21827507

Woodske, Matthew; Donahoe, Michael P.; Yazer, Mark; Lee, Janet S

2011-01-01

18

Blood transfusion in sickle cell disease.  

PubMed

Sickle cell anemia is an inherited disease that causes chronic hemolytic anemia. Its pathognomonic signs and symptoms are caused by hemoglobin (Hb) S, which results from a single nucleotide substitution in the ?-globin gene that places the amino acid valine with glutamic acid at codon 6 of the ?-globin chain. Hb S is an insoluble Hb that crystalizes at low oxygen tension and other precipitating conditions leading to rigidity of red cells and clumping in small blood vessels. Patients with sickle cell disease have a variable Hb level that may range from 7.0 to 11.0 g/dL in their steady state condition. The most common cause of hospital presentation is due to acute painful crisis that results from vaso-occlusion by sickled cells. These episodes are treated with hydration and analgesia and do not require blood transfusion. Blood transfusion should be aimed to increase tissue delivery of oxygen. Hb S is known to be a low affinity Hb and so delivers oxygen at a lower partial pressure of oxygen compared to Hb A. Even with adequate pre transfusion testing and precautions, blood transfusion is never totally safe and short or long term complications may occur. Blood transfusion in patients with sickle cell disease has only limited indications such as acute hemolytic, aplastic or sequestration crises. Chronic transfusion protocols are implemented in cases of strokes or high cerebral blood flow ultrasonic studies as a prophylactic measure. Exchange blood transfusion is used in some complications of the disease such as acute chest syndrome (ACS), priapism or peri operatively. Once it is decided to transfuse blood, the transfused blood should be Hb S negative, Rh and Kell antigen matched. PMID:21981466

Marouf, Rajaa

2011-01-01

19

[Acute adverse effects in transfusion. Proposals for the hemosurveillance system].  

PubMed

The management model based on risk prevention has become a major influence in shaping policies for transfusion safety. There are approximately sixty interactions between the health worker and the patient during the transfusion process,representing the number of times where you have the opportunity to make a mistake.We present an analysis of the weaknesses of the National Blood System, with particular attention to the haemovigilance donor and patient. The proposals include the implementation of the National Blood containing the need to establish from the National Blood Safety, significant changes in the regulatory framework and the internal regulations of the Ministry of Health, the CNTS and COFEPRIS. Is required to promote and coordinate the collection of accurate information from the committees of transfusion medicine, which will be accompanied by an initial diagnosis from the National Survey of Blood. Requires notice to other forms of funding to ensure the viability of the projects operating blood bank. Finally, as a strategic resource, the blood is of public, so access should not be restricted. PMID:23435081

Baptista González, Héctor

2013-01-01

20

The simultaneous incidence of acute pancreatitis and autoimmune hemolytic anemia: a rare duo in a patient with SLE  

PubMed Central

A young female presented with acute abdominal pain of two days duration consistent with acute pancreatitis. During her stay in the hospital she had a sudden drop in hemoglobin to 6 g/dl without any overt blood loss. On evaluation, it was evident that she had acute pancreatitis, in addition to displaying features of autoimmune hemolytic anemia. She had been a known case of systemic lupus erythematosus (SLE) and had discontinued her treatment. She was managed with methylprednisolone pulse therapy. Her clinical condition improved, and she has been regularly attending our clinic for the last 2 years. According to a literature search in Medline, it would appear that this is the first report of a case in which SLE with autoimmune hemolytic anemia has been associated with acute pancreatitis in a single case. PMID:25276114

Masoodi, Ibrahim

2014-01-01

21

Acute Lung Injury Complicating Blood Transfusion in Post-Partum Hemorrhage: Incidence and Risk Factors  

PubMed Central

Background We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). Methods We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without transfusion of fresh frozen plasma (FFP) and/or platelets (PLT). Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia, within 6 hours after transfusion, with bilateral pulmonary changes, in the absence of cardiogenic pulmonary edema were identified as TRALI. If an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed. Results Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer postpartum hospitalization. Among the diseases occurring in pregnancy- and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia, significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis including both transfusion- and patient-related risk factors, pregnancy-related, hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27–604.3, p=0.034). Conclusions Patients suffering from PPH represent a high-risk population for TRALI. The patients with gestational hypertension and pre-eclampsia, not receiving anti-hypertensive therapy, have the highest risk. Therefore, a careful monitoring of these patients after transfusions is recommended. PMID:25408855

Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A.; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano

2014-01-01

22

Exchange transfusion - series (image)  

MedlinePLUS

... the infant's blood and replacement with fresh donor blood or plasma. Guidelines for an exchange transfusion include: Hemolytic disease of the newborn (Rh disease) Life-threatening infection Severe disturbances in body chemistry Toxic effects of ...

23

Spontaneous remission of acute myeloid leukemia after infection and blood transfusion associated with hypergammaglobulinaemia  

Microsoft Academic Search

Spontaneous remissions of acute myeloid leukemia (AML) have been documented in association with infection as well as blood\\u000a transfusions. Activation of the immune system including an increased number of NK cells and cytokine release have been implicated\\u000a in the mechanism of this phenomenon. We have observed spontaneous remissions in two patients with AML (one with a t(8;21)-positive\\u000a M2, one with

M. Mitterbauer; M. Fritzer-Szekeres; G. Mitterbauer; I. Simonitsch; P. Knöbl; C. Rintelen; I. Schwarzinger; O. A. Haas; K. Silberbauer; K. Frey; B. Bibus; I. Pabinger; T. Radaszkiewicz; K. Lechner; U. Jaeger

1996-01-01

24

Transfusion related acute lung injury with massive pulmonary secretion during cardiac surgery. A case report  

PubMed Central

A Indo-Caribbean patient undergoing cardiac surgery developed Transfusion Related Acute Lung Injury (TRALI) with massive endobronchial secretion of clear fluid mimicking severe pulmonary edema. Hypoxemia and lung stiffness were so severe that didn’t allow closure of the sternum on completion of surgery. The patient was treated with invasive ventilation, high positive pressure and % FiO2 and aggressive endotracheal suction. After several hours, secretions reduced spontaneously and the patient made an uneventful recovery. PMID:24694086

2014-01-01

25

HEMOLYTIC ANEMIA Erythrocytes premature  

E-print Network

LABORATORY FINDINGS · M:E ratio decreased · Increased Reticulocytes · Nucleated RBC in peripheral blood, Venous Thrombosis, Infection, and Bone Marrow Hyperplasia · Ham Test #12;9/16/2013 6 HEMOLYTIC ANEMIA · Normocytic, Normochromic Anemia · Jaundice · Gallstones · Transfusions, Splenectomy #12;9/16/2013 7 IMMUNE

26

Hemolytic Anemia  

MedlinePLUS

... from the NHLBI on Twitter. What Is Hemolytic Anemia? Hemolytic anemia (HEE-moh-lit-ick uh-NEE-me-uh) ... blood cells to replace them. However, in hemolytic anemia, the bone marrow can't make red blood ...

27

Hemolytic anemia  

MedlinePLUS

Anemia - hemolytic ... Hemolytic anemia occurs when the bone marrow is unable to replace the red blood cells that are being destroyed. Immune hemolytic anemia occurs when the immune system mistakenly sees your ...

28

Suspected Transfusion Related Acute Lung Injury Improving following Administration of Tranexamic Acid: A Case Report  

PubMed Central

A 16-year-old woman with craniofacial injury developed severe acute respiratory failure under the primary reconstructive surgical procedure requiring several units of blood and plasma. A transfusion related acute lung injury (TRALI) was suspected and supportive treatment was initiated. Because of the severity of symptoms, acute extracorporeal membrane oxygenation (ECMO) was planned. During preparation for ECMO, a single intravenous dose, 1?g of tranexamic acid, was administered and a remarkable improvement was observed shortly thereafter. The patient was placed on ECMO for 16 hours. The further course was uncomplicated and the patient was discharged from ICU on the 6th day after admission fully and she recovered. A clinical improvement was observed in a timely fashion following the administration of tranexamic acid. The handling of a suspected TRALI and potential benefit from administration of tranexamic acid are discussed in this case report. PMID:24995132

Ryniak, Stan; Harbut, Piotr; Ostlund, Anders; Jakobsson, Jan G.

2014-01-01

29

Transfusion-related acute lung injury after intravenous immunoglobulin treatment in a lung transplant recipient.  

PubMed

Three weeks after single-lung transplantation for pulmonary fibrosis, a patient with high serum levels of de novo donor-specific antibodies received high-dose intravenous immunoglobulin (IVIG) infusion (scheduled dose: 2?g/kg on 2?days) to prevent antibody-mediated rejection. Within the first hours after completion of infusions, he experienced acute lung injury involving the transplanted lung. Given the clinical evolution and the absence of an alternative diagnosis, transfusion-related acute lung injury (TRALI) was diagnosed. The IVIG administered on each day was from the same batch. At day 110, because of an increase in the serum titers of donor-specific antibodies, IVIG therapy was reintroduced but from a different batch, with excellent clinical tolerance. The lung injury was explored biologically, but no mechanism was revealed. Given the increasing use of IVIG in solid-organ recipients, clinicians should be aware of possible TRALI after IVIG infusion. PMID:22985417

Stoclin, A; Delbos, F; Dauriat, G; Brugière, O; Boeri, N; Métivier, A C; Thabut, G; Camus, P; Mal, H

2013-02-01

30

Acute generalized exanthematous pustulosis and Coombs-positive hemolytic anemia in a child following Loxosceles reclusa envenomation.  

PubMed

Previously reported cases of acute generalized exanthematous pustulosis secondary to brown recluse spider bite have been questioned due to lack of identification of the spider or because of the concomitant administration of antibiotics. We report a 9-year-old boy who arrived at the emergency department with a confirmed Loxosceles reclusa bite to the neck. On the third day of hospitalization, he developed hundreds of monomorphous, sterile pustules, initially in intertriginous areas. The eruption disseminated and was followed by pinpoint desquamation typical for acute generalized exanthematous pustulosis. During this he also developed late onset Coombs-positive hemolytic anemia and systemic loxoscelism. Sphingomyelinase in Loxosceles venom induces the production of interleukin-8 and granulocyte-macrophage colony-stimulating factor, cytokines involved in the pathogenesis of acute generalized exanthematous pustulosis, providing a mechanism by which Loxosceles reclusa bite may trigger acute generalized exanthematous pustulosis. We suggest that this case adds Loxosceles envenomation to the spectrum of agents that can trigger acute generalized exanthematous pustulosis. PMID:22082464

Lane, Leanna; McCoppin, Holly H; Dyer, Jonathan

2011-01-01

31

Acute liver function decompensation in a patient with sickle cell disease managed with exchange transfusion and endoscopic retrograde cholangiography.  

PubMed

Sickle cell intrahepatic cholestasis is a relatively uncommon complication of homozygous sickle cell anemia, which may lead to acute hepatic failure and death. Treatment is mainly supportive, but exchange transfusion is used as salvage therapy in life threatening situations. We describe a case of a 16-year-old female with homozygous sickle cell anemia who presented to the emergency room with fatigue, malaise, dark urine, lower back pain, scleral icterus and jaundice. She was found to have marked hyperbilirubinemia, which persisted after exchange transfusion. Because of the concomitant presence of gallstones and choledocholithiasis, the patient underwent endoscopic ultrasound and laparoscopic cholecystectomy followed by endoscopic retrograde cholangiography and sphincterotomy. PMID:25177368

Papafragkakis, Haris; Ona, Mel A; Changela, Kinesh; Sadanandan, Swayamprabha; Jelin, Abraham; Anand, Sury; Duddempudi, Sushil

2014-09-01

32

Impact of chronic transfusion on incidence of pain and acute chest syndrome during the Stroke Prevention Trial (STOP) in sickle-cell anemia  

Microsoft Academic Search

Objective: The Stroke Prevention Trial (STOP) demonstrated that chronic transfusion is highly effective in reducing the risk of stroke in children with sickle-cell disease and an abnormal transcranial Doppler ultrasonography examination result. Our objective was to determine whether chronic transfusion therapy reduces the incidence of pain and acute chest syndrome. Methods: During STOP, 130 children with sickle-cell anemia or sickle

Scott T. Miller; Elizabeth Wright; Miguel Abboud; Brian Berman; Bea Files; Charles D. Scher; Lori Styles; Robert J. Adams

2001-01-01

33

Hemolytic uremic syndrome caused by Bordetella pertussis infection.  

PubMed

We report the case of a 4-week-old infant with severe Bordetella pertussis infection resulting in hemolytic anemia, thrombocytopenia, and acute renal failure leading to a diagnosis of hemolytic uremic syndrome (HUS) associated with pertussis. In addition to antibiotic and supportive therapy, he was treated with plasma transfusions based on the possibility of underlying complement defect, and he improved. The association of B. pertussis infection and HUS has previously been described in a patient with a mutation in the gene encoding complement factor H (CFH). However, whereas a genetic workup for complement regulator mutations was performed, no mutation was found in our patient. This case demonstrates the possible association between pertussis infection and HUS and highlights the need for increased vigilance for renal complications in this diagnosis. Despite negative results in this case, in-depth workup of the complement system may be important to guide treatment efforts and strategies. PMID:20145955

Chaturvedi, Swasti; Licht, Christoph; Langlois, Valerie

2010-07-01

34

Complications associated with the serological evaluation of febrile transfusion reactions.  

PubMed

The evaluation of a transfusion reaction is a complex process aimed at detecting acute intravascularhemolysis through clinicalinvestigation and serologic assays. However, several variables can complicate testing in the postreaction period and obscure an accurate diagnosis. We report a patient with myelodysplasia who was noted to have a febrile response to a unit of red blood cells (RBCs). Testing of the posttransfusion specimen raised concerns for a hemolytic transfusion reaction when the patient's RBCs demonstrated a positive direct antiglobulin test (DAT) and the plasma showed incompatibility with the donor RBCs. Further evaluation revealed that: (1) antibiotic treatment induced a "false" positive DAT in the patient, and (2) donor RBCs were coated with an autoantibody causing them to appear incompatible during postreaction testing. Thus, if donor and recipient incompatibility is encountered during a transfusion reaction evaluation, testing of donor RBCs may help resolve issues of serological incompatibility. PMID:20218043

Selbst, Megan; Ross, Rebecca; Tormey, Christopher A

2010-02-01

35

Therapeutic Options for Transfusion Related Acute Lung Injury; the Potential of the G2A Receptor  

PubMed Central

Priming of polymorphonuclear leukocytes (PMNs) enhances their adhesion to endothelium, the release of their granule content and their production of reactive oxygen species. These effects are etiological in transfusion related acute lung injury (TRALI) and many clinically important mediators of TRALI prime PMNs. A priming activity that develops over time in stored blood products has been shown to be due to the accumulation of lysophospatidylcholines (lyso-PCs) and has been found to be related clinically to TRALI. Lyso-PCs prime PMNs activating the G2A receptor and several inhibitors of this receptor, which could potentially be therapeutic in TRALI, have been identified. Recent work has described early steps in the signaling from the G2A receptor which has revealed potential targets for novel antagonists of lyso-PC mediated priming via G2A. Additionally, characterization of the process by which lyso-PCs are generated in stored blood products could allow development of inhibitors and additive solutions to block their formation in the first place. PMID:22621271

Ellison, Michael A; Ambruso, Daniel R; Silliman, Christopher C

2013-01-01

36

Acute methemoglobinemia with hemolytic anemia following bio-organic plant nutrient compound exposure: Two case reports.  

PubMed

Two young women, were reffered to our hospital on two different occasions with history of breathlessness and mental confusion, following consumption of two different bio-organic plant nutrient compounds with a suicidal intent. On examination, they had cyanotic mucous membranes, and their blood samples showed the classic 'dark chocolate brown' appearance. Work up revealed cyanosis unresponsive to oxygen supplementation and absence of cardiopulmonary abnormality. Pulse oximetry revealed saturation of 75% in case 1 and 80% in case 2, on 8 liters oxygen supplementation via face masks, although their arterial blood gas analysis was normal, suggestive of "saturation gap". Methemoglobinemia was suspected based on these findings and was confirmed by Carbon monoxide-oximetry (CO-oximetry). Methylene blue was administered and the patients showed dramatic improvement. Both the patients developed evidence of hemolysis approximately 72 hours following admission which improved with blood transfusion and supportive treatment. The patients were eventually discharged without any neurological sequalae. PMID:24678158

Malkarnekar, Santoshi Balkrishna; Anjanappa, Raveesha; Naveen, L; Kiran, B G

2014-02-01

37

Acute methemoglobinemia with hemolytic anemia following bio-organic plant nutrient compound exposure: Two case reports  

PubMed Central

Two young women, were reffered to our hospital on two different occasions with history of breathlessness and mental confusion, following consumption of two different bio-organic plant nutrient compounds with a suicidal intent. On examination, they had cyanotic mucous membranes, and their blood samples showed the classic ‘dark chocolate brown’ appearance. Work up revealed cyanosis unresponsive to oxygen supplementation and absence of cardiopulmonary abnormality. Pulse oximetry revealed saturation of 75% in case 1 and 80% in case 2, on 8 liters oxygen supplementation via face masks, although their arterial blood gas analysis was normal, suggestive of “saturation gap”. Methemoglobinemia was suspected based on these findings and was confirmed by Carbon monoxide-oximetry (CO-oximetry). Methylene blue was administered and the patients showed dramatic improvement. Both the patients developed evidence of hemolysis approximately 72 hours following admission which improved with blood transfusion and supportive treatment. The patients were eventually discharged without any neurological sequalae. PMID:24678158

Malkarnekar, Santoshi Balkrishna; Anjanappa, Raveesha; Naveen, L.; Kiran, B. G.

2014-01-01

38

DEL RBC transfusion should be avoided in particular blood recipient in East Asia due to allosensitization and ineffectiveness*  

PubMed Central

Previously, both primary and secondary anti-D alloimmunizations induced by “Asian type” DEL (RHD1227A allele) were observed in two incidents. We investigated how often these alloimmunization events occur. The transfusions of any D-negative patients were investigated in the First Affiliated Hospital of Xi’an Jiaotong University Medical College, China, during the entire 2009. The antigens of D, C, c, E, and e were routinely serotyped. The “Asian type” DEL variant was genotyped and the RHD heterozygote was determined through two published methods. The changes in anti-D levels were monitored by the indirect antiglobulin test (IAT) and flow cytometry. Thirty D-negative transfused patients were included in the study. We focused on 11 recipients who were transfused with packed red blood cells (RBCs) from DEL donors at least one time. Of those 11 recipients, seven were anti-D negative before transfusion and four were anti-D positive (one patient with an autoantibody). One of the seven pre-transfusion anti-D negative patients produced a primary-response anti-D after being transfused with 400 ml of DEL blood twice. All four pre-transfusion antibody positive patients were not observed hemoglobin (Hb) levels increased, as expected after transfusions. Two patients had an increase in anti-D from 1:8 to 1:64 by IAT, which was also shown by flow cytometry. None of the patients experienced an acute hemolytic episode. Our data indicated that the primary anti-D induced by DEL transfusion or the secondary anti-D elevated by DEL in a truly D-negative patient might not be unusual. We suggest that a truly D-negative childbearing-aged woman should avoid DEL transfusion to protect her from primary anti-D allosensitization. In addition, anti-D positive recipients should also avoid DEL red cell transfusion due to the delayed hemolytic transfusion reaction (DHTR). PMID:23125084

Shao, Chao-peng; Wang, Bao-yan; Ye, Shi-hui; Zhang, Wen-li; Xu, Hua; Zhuang, Nai-bao; Wu, Xiao-ying; Xu, Heng-gui

2012-01-01

39

The Acute Immunological Response to Blood Transfusion is Influenced by Polymicrobial Sepsis  

PubMed Central

Blood transfusion is a well-established risk factor for adverse outcomes during sepsis. The specific mechanisms responsible for this effect remain elusive, and few studies have investigated this phenomenon in a model that reflects not only the clinical circumstances in which blood is transfused, but also how packed red blood cells (PRBC) are created and stored. Using a cecal ligation and puncture model of polymicrobial sepsis as well as creating murine allogeneic and stored PRBC in a manner that replicates the clinical process, we have demonstrated that transfusion of PRBCs induces numerous effects on leukocyte subpopulations. In polymicrobial sepsis, these responses are profoundly dissimilar to the pro-inflammatory effects of PRBC transfusion observed in the healthy mouse. Transfused septic mice, as opposed to mice receiving crystalloid resuscitation, had a significant loss of blood, spleen and bone marrow lymphocytes, especially those with an activated phenotype. Myeloid cells behaved similarly, although they were able to produce more reactive oxygen species. Overall, transfusion in the septic mouse may contribute to the persistent immune dysfunction known to be associated with this process, rather than simply promote pro- or anti-inflammatory effects on the host. Thus, it is possible that blood transfusion contributes to the multiple known effects of sepsis on leukocyte populations that have been shown to result in increased morbidity and mortality. PMID:23143057

Nacionales, Dina C.; Cuenca, Alex G.; Ungaro, Ricardo; Gentile, Lori F.; Joiner, Dallas; Satoh, Minoru; Lomas-Neira, Joanne; Ayala, Alfred; Bihorac, Azra; Delano, Matthew J.; Ang, Darwin N.; Efron, Philip A.

2012-01-01

40

Role of Riboflavin- and UV Light-Treated Plasma in Prevention of Transfusion-Related Acute Lung Injury  

PubMed Central

Summary Introduction Risk reduction strategies for transfusion-related acute lung injury (TRALI) include the preferential use of male donors to provide fresh frozen plasma (FFP). Implementing this measure based on FFP quarantine program is a very complex process. To improve FFP inventory management and the availability of FFP from male donors, the Mirasol Pathogen Reduction Technology® (PRT) system for FFP using riboflavin and UV light was adopted in our region in 2012. Methods The percentage of male/female FFP units issued and TRALI cases in patients receiving FFP in the period before implementing riboflavin and UV light (2010–2011) was compared with the period post implementation of riboflavin and UV light (2012–2013). Results In 2010 and 2011, there was one FFP transfusion-related TRALI case reported per year, when the proportion of male/female FFP distributed to the hospitals was 60/40. During 2012 and 2013, there have been no FFP transfusion-related TRALI cases, when the proportion of male/female FFP distributed to the hospitals was around 97/3. Mirasol PRT allows quick availability (24 h from collection) compared to quarantined FFP (?3 months from collection). Conclusion Thanks to its readiness, simplicity and feasibility, riboflavin- and UV light-treated FFP implementation can facilitate the preferential use of FFP from male donors as a TRALI prevention strategy. PMID:25053929

Jimenez-Marco, Teresa; Ruiz-Alderton, Daniel; Bautista-Gili, Antonia M.; Girona-Llobera, Enrique

2014-01-01

41

Types of Hemolytic Anemia  

MedlinePLUS

... from the NHLBI on Twitter. Types of Hemolytic Anemia There are many types of hemolytic anemia. The ... the condition, but you develop it. Inherited Hemolytic Anemias With inherited hemolytic anemias, one or more of ...

42

DELAYING BLOOD TRANSFUSION IN EXPERIMENTAL ACUTE ANEMIA WITH A PERFLUOROCARBON EMULSION  

PubMed Central

Background To avoid unnecessary blood transfusions, physiologic transfusion triggers, rather than exclusively hemoglobin-based transfusion triggers have been suggested. The objective of this study was to determine systemic and microvascular effects of using a perfluorocarbon-based oxygen carrier (PFCOC) to maintaining perfusion and oxygenation during extreme anemia. Methods The hamster (weight 55-65 g) window chamber model was used. Two isovolemic hemodilution steps were performed using 10% hydroxyethyl starch at normoxic conditions to hematocrit of 19% (5.5 gHb/dl), point where the transfusion trigger was reached. Two additional hemodilution exchanges using the PFCOC (Oxycyte™, Synthetic Blood International, Inc. Costa Mesa, CA) and increasing fraction of inspired oxygen to 1.0 were performed to reduce hematocrit to 11% (3.8 gHb/dl) and 6% (2.0 gHb/dl), respectively. No control group was used in the study, as this level of hemodilution is lethal with conventional plasma expanders. Systemic parameters, microvascular perfusion, functional capillary density and oxygen tensions across the microvascular network were measured. Results At 6% hematocrit, the PFCOC maintained mean arterial pressure, cardiac output, systemic oxygen delivery and consumption. As hematocrit was lowered from 11% to 6%, functional capillary density, calculated microvascular oxygen delivery and consumption decreased, and oxygen extraction ratio was close to 100%. Peripheral tissue oxygenation was not predicted by systemic oxygenation. Conclusions PFCOC in conjunction with hyperoxia was able to sustain organ function, and partially provide systemic oxygenation during extreme anemia over the observation period. The PFCOC can work as a bridge until red blood cells are available for transfusion, or where additional oxygen is required, notwithstanding possible limitations in peripheral tissue oxygenation. PMID:21326091

Cabrales, Pedro; Briceno, Juan Carlos

2011-01-01

43

Blood Transfusions  

MedlinePLUS

... United States get blood transfusions. A Bit About Blood Blood is like the body's transportation system, busy ... his or her body. Continue What Is a Blood Transfusion? A transfusion is a relatively simple medical ...

44

Comparison of acute non-haemolytic transfusion reactions in female and male patients receiving female or male blood components  

PubMed Central

To study the relationship between antibodies detected in patients’ and/or donors’ sera and the clinical features of acute non-haemolytic transfusion reactions (ANHTRs), and to determine any gender-related difference. ANHTRs range from urticaria to transfusion-related acute lung injury (TRALI). Antibodies to human leukocyte antigen (HLA), granulocytes, platelets, and/or plasma proteins are implicated in some of the ANHTRs. A higher antibody positivity is expected for females than for males. A comparative study of ANHTRs for antibody positivity and their clinical features between females and males for both patients and donors is helpful for characterizing ANHTRs including TRALI more clearly, but such studies are few and outdated. Two hundred and twenty-three ANHTR cases reported by 45 hospitals between October 2000 and July 2005 were analysed. The patients and 196 donors of suspect blood products were screened for antibodies to HLA Class I, HLA Class II, granulocytes, and platelets. The patients were also screened for anti-plasma protein antibodies. The types and severity of ANHTR did not differ significantly between female and male patients. The frequency of the anti-HLA antibodies, but not that of the non-HLA antibodies, was significantly higher in females. Non-HLA antibodies were significantly associated with severe reactions in females. All the TRALI cases had predisposing risk factors for acute lung injury, and 60% of the cases showed anti-leucocyte antibodies. Although the anti-HLA antibodies were detected more frequently in females than males, no significant association of ANHTRs including TRALI with gender, not only for patients, but also for donors, could be shown in this study. PMID:18067650

Imoto, S; Araki, N; Shimada, E; Saigo, K; Nishimura, K; Nose, Y; Bouike, Y; Hashimoto, M; Mito, H; Okazaki, H

2007-01-01

45

A Jehovah's Witness with Acute Myeloid Leukemia Successfully Treated with an Epigenetic Drug, Azacitidine: A Clue for Development of Anti-AML Therapy Requiring Minimum Blood Transfusions  

PubMed Central

Therapy for acute leukemia in Jehovah's Witnesses patients is very challenging because of their refusal to accept blood transfusions, a fundamental supportive therapy for this disease. These patients are often denied treatment for fear of treatment-related death. We present the first Jehovah's Witness patient with acute myeloid leukemia (AML) treated successfully with azacitidine. After achieving complete remission (CR) with one course of azacitidine therapy, the patient received conventional postremission chemotherapy and remained in CR. In the case of patients who accept blood transfusions, there are reports indicating the treatment of AML patients with azacitidine. In these reports, azacitidine therapy was less toxic, including hematoxicity, compared with conventional chemotherapy. The CR rate in azacitidine-treated patients was inadequate; however, some characteristics could be useful in predicting azacitidine responders. The present case is useful for treating Jehovah's Witnesses patients with AML and provides a clue for anti-AML therapy requiring minimum blood transfusions. PMID:25371835

Yamamoto, Yumi; Kawashima, Akihito; Kashiwagi, Eri

2014-01-01

46

A Jehovah's Witness with Acute Myeloid Leukemia Successfully Treated with an Epigenetic Drug, Azacitidine: A Clue for Development of Anti-AML Therapy Requiring Minimum Blood Transfusions.  

PubMed

Therapy for acute leukemia in Jehovah's Witnesses patients is very challenging because of their refusal to accept blood transfusions, a fundamental supportive therapy for this disease. These patients are often denied treatment for fear of treatment-related death. We present the first Jehovah's Witness patient with acute myeloid leukemia (AML) treated successfully with azacitidine. After achieving complete remission (CR) with one course of azacitidine therapy, the patient received conventional postremission chemotherapy and remained in CR. In the case of patients who accept blood transfusions, there are reports indicating the treatment of AML patients with azacitidine. In these reports, azacitidine therapy was less toxic, including hematoxicity, compared with conventional chemotherapy. The CR rate in azacitidine-treated patients was inadequate; however, some characteristics could be useful in predicting azacitidine responders. The present case is useful for treating Jehovah's Witnesses patients with AML and provides a clue for anti-AML therapy requiring minimum blood transfusions. PMID:25371835

Yamamoto, Yumi; Kawashima, Akihito; Kashiwagi, Eri; Ogata, Kiyoyuki

2014-01-01

47

The Canadian Transfusion Surveillance System: what is it and how can the data be used?  

PubMed

Hemovigilance systems are important programs for: monitoring trends of known risks; evaluating effectiveness of steps taken to reduce risks; providing data to support recommendations for change and guideline development; and contributing overall to the safety of transfusion. The Transfusion Transmitted Injury Surveillance System is the hemovigilance system implemented in Canada. It evolved in 1999 as a pilot program and expanded across Canada in 2005. Each province reports their adverse reactions to the transfusion of blood products and plasma proteins to the Public Health Agency of Canada (PHAC) at predetermined intervals. PHAC reconciles, summarizes the data and publishes a report approximately 2 years after the data are collected. This is considered a passive reporting system but in spite of the delays, the program provides useful information to address a variety of questions. Examples include: assessing the impact of a provincial patient transfusion history registry in Québec on reporting of hemolytic transfusion reactions; identifying trends of bacterial contamination of blood products and assessing the impact of interventions on these events; and the impact of male-only plasma on the incidence of Transfusion Related Acute Lung Injury. Although hemovigilance data has been successfully used to improve blood safety, we must continue to explore ways to utilize such data to improve and implement safe transfusion practices. PMID:22503309

Ditomasso, Julie; Liu, Yang; Heddle, Nancy M

2012-06-01

48

A prospective, randomized, double-blind study, comparing unirradiated to irradiated white blood cell transfusions in acute leukemia patients.  

PubMed

A prospective, randomized double-blind study comparing the effects of irradiated and unirradiated white blood cells was conducted in 108 acute leukemia patients with life-threatening infections, refractory to antibiotics. The study demonstrated no significant improvement in 30-day survival or overall survival. Transfusion of unirradiated white cells did not compromise the patient's opportunity to undergo allogeneic stem cell transplant, nor the success rate or overall survival after allogeneic transplant. The important positive finding in this study was that the unirradiated white cells produced a significantly higher increment in circulating granulocytes and in a higher proportion of patients granulocyte count exceeded 1000 per microliter, approaching normal concentrations. The increase in the number and the improved survival of the unirradiated granulocytes suggest that this procedure might potentially be a method to improve the utility of granulocyte transfusions and merits further investigation. The study demonstrated non-inferiority for unirradiated white cells. There were no harmful effects such as graft-versus-host disease, indicating that such studies would be safe to conduct in the future. PMID:23072780

Freireich, E J; Lichtiger, B; Mattiuzzi, G; Martinez, F; Reddy, V; Kyle Wathen, J

2013-04-01

49

Platelet depletion and aspirin treatment protect mice in a two-event model of transfusion-related acute lung injury  

PubMed Central

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-associated mortality in the US. Previously, we established an immune-mediated TRALI mouse model, wherein mice with cognate antigen were challenged with MHC class I mAb. In this study, when mice housed in a rodent, specific pathogen–free barrier room were challenged with MHC I mAb, there was significant protection from TRALI compared with nonbarrier mice. Priming mice with LPS restored lung injury with mAb challenge. Using TLR4-deficient bone marrow chimeras, the priming phenotype was restricted to animals with WT hematopoietic cells, and depletion of either neutrophils or platelets was protective. Both neutrophils and platelets were sequestered in the lungs of mice with TRALI, and retention of platelets was neutrophil dependent. Interestingly, treatment with aspirin prevented lung injury and mortality, but blocking the P selectin or CD11b/CD18 pathways did not. These data suggest a 2-step mechanism of TRALI: priming of hematopoietic cells, followed by vascular deposition of activated neutrophils and platelets that then mediate the severe lung injury. Furthermore, our data offer an explanation for the increased incidence of TRALI in patients with immune priming conditions, and we suggest what we believe to be a novel therapeutic approach. PMID:19809160

Looney, Mark R.; Nguyen, John X.; Hu, Yongmei; Van Ziffle, Jessica A.; Lowell, Clifford A.; Matthay, Michael A.

2009-01-01

50

A Computerized Prediction Model of Hazardous Inflammatory Platelet Transfusion Outcomes  

PubMed Central

Background Platelet component (PC) transfusion leads occasionally to inflammatory hazards. Certain BRMs that are secreted by the platelets themselves during storage may have some responsibility. Methodology/Principal Findings First, we identified non-stochastic arrangements of platelet-secreted BRMs in platelet components that led to acute transfusion reactions (ATRs). These data provide formal clinical evidence that platelets generate secretion profiles under both sterile activation and pathological conditions. We next aimed to predict the risk of hazardous outcomes by establishing statistical models based on the associations of BRMs within the incriminated platelet components and using decision trees. We investigated a large (n?=?65) series of ATRs after platelet component transfusions reported through a very homogenous system at one university hospital. Herein, we used a combination of clinical observations, ex vivo and in vitro investigations, and mathematical modeling systems. We calculated the statistical association of a large variety (n?=?17) of cytokines, chemokines, and physiologically likely factors with acute inflammatory potential in patients presenting with severe hazards. We then generated an accident prediction model that proved to be dependent on the level (amount) of a given cytokine-like platelet product within the indicated component, e.g., soluble CD40-ligand (>289.5 pg/109 platelets), or the presence of another secreted factor (IL-13, >0). We further modeled the risk of the patient presenting either a febrile non-hemolytic transfusion reaction or an atypical allergic transfusion reaction, depending on the amount of the chemokine MIP-1? (<20.4 or >20.4 pg/109 platelets, respectively). Conclusions/Significance This allows the modeling of a policy of risk prevention for severe inflammatory outcomes in PC transfusion. PMID:24830754

Nguyen, Kim Anh; Hamzeh-Cognasse, Hind; Sebban, Marc; Fromont, Elisa; Chavarin, Patricia; Absi, Lena; Pozzetto, Bruno; Cognasse, Fabrice; Garraud, Olivier

2014-01-01

51

[Metastatic prostate cancer complicated with chronic disseminated intravascular coagulopathy causing acute renal failure, mimicking thrombotic thrombocytopenic purpura and hemolytic uremic syndrome: pathomechanism, differential diagnosis and therapy related to a case].  

PubMed

Disseminated intravascular coagulopathy (DIC) is characterized as activation of the clotting system resulting in fibrin thrombi, gradually diminishing levels of clotting factors with increased risk of bleeding. Basically two types of DIC are distinguished: (1) chronic (compensated) - with alteration of laboratory values and (2) acute (non-compensated) - with severe clinical manifestations: bleeding, shock, acute renal failure (ARF), transient focal neurologic deficit, delirium or coma. Chronic DIC related to metastatic neoplasia is caused by pancreatic, gastric or prostatic carcinoma in most of the cases. Incidence rate of DIC is 13-30% in prostate cancer, among those only 0.4-1.65% of patients had clinical signs and symptoms of DIC. In other words, chronic DIC is developed in one of eight patients with prostate cancer. DIC is considered as a poor prognostic factor in prostatic carcinoma. The similar clinical and laboratory findings of TTP-HUS (thrombotic thrombocytopenic purpura - hemolytic uremic syndrome) and DIC makes it difficult to differentiate between them. A 71 years old male patient with known chronic obstructive pulmonary disease, benign prostatic hyperplasia, significant carotid artery stenosis, gastric ulcer and alcoholic liver disease was admitted to another hospital with melena. Gastroscopy revealed intact gastric mucosa and actually non-bleeding duodenal ulcer covered by clots. Laboratory results showed hyperkalemia, elevated kidney function tests, indirect hyperbilirubinemia, increased liver function tests, leukocytosis, anemia, thrombocytopenia and elevated international normalized ratio (INR). He was treated with saline infusions, four units of red blood cells and one unit of fresh frozen plasma transfusions. Four days later he was transported to our Institution with ARF. Physical examination revealed dyspnoe, petechiae, hemoptoe, oliguria, chest-wall pain and aggressive behavior. Thrombocytopenia, signs of MAHA (fragmentocytes and helmet cells in the peripheral blood), normal INR, elevated lactate dehydrogenase (LDH) and ARF suggested TTP-HUS. Hemodialysis and six plasmaferesis (PF) were carried out. After the fifth PF, skin manifestations of thrombotic microangiopathy occurred on the feet. Clotting analysis revealed elevated D-dimer (>5 ?g/mL), normal fibrinogen (3.2 g/L), a slightly raised INR (1.36) and activated partial prothrombin time (APTT) (45.8 sec), normal reticulocyte (57 G/L) and a slightly low platelet count (123 G/L), which proved to be chronic DIC. Therapeutic dose of low-molecular-weight heparin (LMWH) was started. Elevated prostate-specific antigen (PSA) (109.6 ng/mL) suggested prostatic carcinoma. Prostate biopsy revealed adenocarcinoma (Gleason: 4+4 for left lobe and 3+3 for right lobe). Elevated alkaline phosphatase suggested metastases in the bone, which were confirmed by bone scintigraphy. Combined androgen blockade (CAB) was started. After three months follow-up our patient's status is satisfactory. PSA is in the normal range (4.6 ng/mL). Thrombocytopenia of uncertain origin with normal or raised INR, APTT, elevated D-dimer, normal fibrinogen and reticulocyte count prove the diagnosis of chronic DIC. This process warrants searching for metastatic neoplasia. Due to the relatively low serum levels of circulating procoagulant factors (e.g. tissue factor), therapeutic dose of LMWH can be used with good efficiency in chronic DIC with low risk of bleeding. Severe DIC as a complication of metastatic prostate cancer can be treated by androgen deprivation therapy (ADT) or CAB in combination with ketokonazole and concomitant use of supportive treatment. Deme D, Ragán M, Kovács L, Kalmár K, Varga E, Varga T, Rakonczai E. Metastatic prostate cancer complicated with chronic disseminated intravascular coagulopathy causing acute renal failure mimicking thrombotic thrombocytopenic purpura and hemolytic uremic syndrome: pathomechanism, differential diagnosis and therapy related to a case. PMID:21163766

Deme, Dániel; Ragán, Márton; Kalmár, Katalin; Kovács, Lajos; Varga, Erzsébet; Varga, Tünde; Rakonczai, Ervin

2010-12-01

52

Blood Transfusion  

MedlinePLUS

... from the NHLBI on Twitter. What Is a Blood Transfusion? A blood transfusion is a safe, common ... Very rarely, serious problems develop. Important Information About Blood The heart pumps blood through a network of ...

53

Transfusion malaria*  

PubMed Central

A global review of the problem of malaria accidentally transmitted by blood transfusion revealed that about 350 cases were reported during the period 1911-50 and 1756 during the period 1950-72. The great rise in the frequency of blood transfusions in medical practice and the increase of travel between countries in which malaria is absent and those where it is prevalent render transfusion malaria a problem of clinical and public health importance. Attention is drawn to the value of modern serological methods for the screening of blood donors. PMID:4613511

Bruce-Chwatt, L. J.

1974-01-01

54

A mouse model of hemolytic disease of the newborn.  

PubMed

In this issue of Blood, Stowell et al describe a novel mouse model of hemolytic disease of the fetus and newborn (HDFN) that recapitulates many of the key features of human disease.1 Recently, this same group of researchers described a transgenic mouse that expresses the human KEL2 (Chellano) red cell surface protein from the Kell system on red cells, and subsequently demonstrated that Kell differences on transfused blood induce antibody responses and hemolytic transfusion reactions similar to those seen in patients. In this latest report, Stowell et al demonstrate that similar to some patients, Kell differences between mother and father can lead to maternal antibody generation and hemolytic disease in utero. In so doing, they provide experimental confirmation of a long sought after animal model of HDFN. PMID:23970354

Luckey, Chance John; Silberstein, Leslie E

2013-08-22

55

Antibody Response to Shiga Toxins in Argentinean Children with Enteropathic Hemolytic Uremic Syndrome at Acute and Long-Term Follow-Up Periods  

PubMed Central

Shiga toxin (Stx)-producing Escherichia coli (STEC) infection is associated with a broad spectrum of clinical manifestations that include diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Systemic Stx toxemia is considered to be central to the genesis of HUS. Distinct methods have been used to evaluate anti-Stx response for immunodiagnostic or epidemiological analysis of HUS cases. The development of enzyme-linked immunosorbent assay (ELISA) and western blot (WB) assay to detect the presence of specific antibodies to Stx has introduced important advantages for serodiagnosis of HUS. However, application of these methods for seroepidemiological studies in Argentina has been limited. The aim of this work was to develop an ELISA to detect antibodies against the B subunit of Stx2, and a WB to evaluate antibodies against both subunits of Stx2 and Stx1, in order to analyze the pertinence and effectiveness of these techniques in the Argentinean population. We studied 72 normal healthy children (NHC) and 105 HUS patients of the urban pediatric population from the surrounding area of Buenos Aires city. Using the WB method we detected 67% of plasma from NHC reactive for Stx2, but only 8% for Stx1. These results are in agreement with the broad circulation of Stx2-expressing STEC in Argentina and the endemic behavior of HUS in this country. Moreover, the simultaneous evaluation by the two methods allowed us to differentiate acute HUS patients from NHC with a great specificity and accuracy, in order to confirm the HUS etiology when pathogenic bacteria were not isolated from stools. PMID:21559455

Fernandez-Brando, Romina J.; Bentancor, Leticia V.; Mejias, Maria Pilar; Ramos, Maria Victoria; Exeni, Andrea; Exeni, Claudia; del Carmen Laso, Maria; Exeni, Ramon; Isturiz, Martin A.; Palermo, Marina S.

2011-01-01

56

Implementation of a military-derived damage-control resuscitation strategy in a civilian trauma center decreases acute hypoxia in massively transfused patients  

PubMed Central

BACKGROUND Recent military experience supports a paradigm shift in shock resuscitation to damage-control resuscitation (DCR), which emphasizes a plasma-rich and crystalloid-poor approach to resuscitation. The effect of DCR on hypoxia after massive transfusion is unknown. We hypothesized that implementation of a military-derived DCR strategy in a civilian setting would lead to decreased acute hypoxia. METHODS A DCR strategy was implemented in 2007. We retrospectively reviewed patients receiving trauma surgeon operative intervention and 10 or more units of packed red blood cells (pRBCs) within 24 hours of injury at an adult Level I trauma center from 2001 to 2010. Demographic data, blood requirements, and PaO2/FIO2 ratios were analyzed. To evaluate evolving resuscitation strategies, we fit linear trend models to continuous variables and tested their slopes for statistical significance. RESULTS Two hundred sixteen patients met the study criteria, with a mean age of 35 ± 1.1 years and Injury Severity Score (ISS) of 31 ± 9.0. Of the patients, 80% were male, and 52% sustained penetrating injuries. Overall mortality was 32%. Overall mean pRBC and fresh frozen plasma (FFP) units infused in 24 hours were 23.2 ± 1.1 and 18.6 ± 1.1, respectively. Trends for patient age, sex, mechanism of injury, ISS, highest positive end-expiratory pressure, and mean total pRBC transfused over 24 hours were not statistically different from zero. An increasing trend in FFP and platelets transfused during the first 24 hours (p < 0.0001, p = 0.04, respectively) and a decrease in the pRBC/FFP ratio (p < 0.0001) were found. The amount of crystalloid infused during the initial 24 hours decreased with time (p < 0.0001). The lowest PaO2/FIO2 ratio recorded during the initial 24 hours increased during the study period (p = 0.01), indicating a statistically significant reduction in hypoxia. CONCLUSION A military-derived DCR strategy can be implemented in the civilian setting. DCR led to significant increases in FFP transfusion, decreases in crystalloid use, and acute hypoxia. PMID:23883912

Campion, Eric M.; Pritts, Timothy A.; Dorlac, Warren C.; Nguyen, Anjelica Q.; Fraley, Sara M.; Hanseman, Dennis; Robinson, Bryce R.H.

2014-01-01

57

Blood Transfusions  

MedlinePLUS

... might be the red blood cells, platelets or plasma . Rarely is whole blood (red cells, plasma, platelets, and white cells) used for a transfusion. ... important for other components such as platelets and plasma, where most of the red blood cells have ...

58

[Alternatives to allogenous blood transfusion].  

PubMed

Blood transfusion is usually meant to lower morbidity and mortality rates. Allogenous blood transfusion implies certain risks that can be avoided by autologous blood transfusions techniques including: preoperatory autologous blood donation, acute normovolemic hemodilution, intraoperatory and postoperatory blood salvage. Preoperatory blood donation and acute normovolemic hemodilution are used for planned interventions with an estimated blood loss higher than 20% of blood volume. These methods imply Erythropoietin and iron treatment. Intraoperatory and postoperatory blood salvage is performed by personnel trained in blood donation, handling and storage. Autologous blood transfusions are used for certain surgical procedures that commonly require transfusions: orthopedic surgery, radical prostatectomy, cardiovascular surgery, organ transplantation. An alternative to allogenous blood transfusion is the use of artificial oxygen transporters: human or animal hemoglobin solutions or pefluorocarbonate solutions. These solutions do not require cross reactions, do not carry diseases and are generally well tolerated and easily stored in the operating room, ambulance and other transport means. They have however a slight degree of toxicity. PMID:21495338

Cernea, Daniela; Vl?doianu, Alice; Stoica, Maria; Novac, M; Berteanu, Cristina

2009-01-01

59

Transfusion medicine  

SciTech Connect

These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

Murawski, K.; Peetoom, F.

1986-01-01

60

Blood transfusion in the perioperative period  

Microsoft Academic Search

In the perioperative period, blood transfusions are most commonly administered to address acute blood loss resulting from trauma, neoplasia, or surgery. In this setting, transfusions may be life saving, allowing time for clotting or surgical hemostasis. In recent years, however, there is a growing awareness that the administration of blood products may not be a benign treatment. In addition to

L. Ari Jutkowitz

2004-01-01

61

Types of Blood Transfusions  

MedlinePLUS

... especially in the joints (knees, ankles, and elbows). Plasma Transfusions Plasma is the liquid part of your blood. It's ... or a severe infection, you may need a plasma transfusion. Rate This Content: Blood Transfusion Clinical Trials ...

62

How atypical can Atypical Hemolytic Uremic Syndrome be?  

PubMed Central

Key Clinical Message A 24-year-old man with diarrhea found to have acute renal failure with microangiopathic hemolytic anemia (MAHA). A diagnosis of hemolytic uraemic syndrome (HUS) was made. He was initiated on plasma exchange and hemodialysis. On day 6, he was started on eculizumab. His renal functions progressively improved. His main complication during eculizumab therapy was hypertension-related posterior reversible encephalopathy syndrome.

Sajan, Thomas; Vinay, Srinivasa; Sonu, Nigam; Alan, Parnham

2014-01-01

63

Hemolytic activity of Serratia marcescens  

Microsoft Academic Search

A cell-bound hemolytic activity was found in several strains of Serratia marcescens. One Serratia cell per ten erythrocytes was sufficient to cause complete lysis of human erythrocytes within 2 h in the liquid assay. The hemolytic activity resided in the membrane fraction and could be inactivated by incubating cells with proteases. The hemolytic activity was greatly enhanced in actively metabolizing

Volkmar Braun; Hannelore Günther; Burkard Neuß; Christiane Tautz

1985-01-01

64

Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety.  

PubMed

The Serious Hazards of Transfusion (SHOT) UK confidential haemovigilance reporting scheme began in 1996. Over the 16 years of reporting, the evidence gathered has prompted changes in transfusion practice from the selection and management of donors to changes in hospital practice, particularly better education and training. However, half or more reports relate to errors in the transfusion process despite the introduction of several measures to improve practice. Transfusion in the UK is very safe: 2·9 million components were issued in 2012, and very few deaths are related to transfusion. The risk of death from transfusion as estimated from SHOT data in 2012 is 1 in 322,580 components issued and for major morbidity, 1 in 21,413 components issued; the risk of transfusion-transmitted infection is much lower. Acute transfusion reactions and transfusion-associated circulatory overload carry the highest risk for morbidity and death. The high rate of participation in SHOT by National Health Service organizations, 99·5%, is encouraging. Despite the very useful information gained about transfusion reactions, the main risks remain human factors. The recommendations on reduction of errors through a 'back to basics' approach from the first annual SHOT report remain absolutely relevant today. PMID:24032719

Bolton-Maggs, Paula H B; Cohen, Hannah

2013-11-01

65

A Case of Hemolytic Disease of the Newborn Infant due to Anti-? (Cellano)  

Microsoft Academic Search

Hemolytic disease of the newborn infant (HDN) due to anti-? (Cellano) is very uncommon in Caucasians. We report here a case of anti-? HDN. The anti-? alloimmunization appeared in the mother during her fifth pregnancy. This HDN needed an exchange transfusion immediately after delivery. The clinical outcome of the newborn infant was good.Copyright © 1991 S. Karger AG, Basel

P. Moncharmont; F. Juron-Dupraz; M. Doillon; M. Vignal; P. Debeaux

1991-01-01

66

Red blood cell transfusion in newborn infants  

PubMed Central

Red blood cell transfusion is an important and frequent component of neonatal intensive care. The present position statement addresses the methods and indications for red blood cell transfusion of the newborn, based on a review of the current literature. The most frequent indications for blood transfusion in the newborn are the acute treatment of perinatal hemorrhagic shock and the recurrent correction of anemia of prematurity. Perinatal hemorrhagic shock requires immediate treatment with large quantities of red blood cells; the effects of massive transfusion on other blood components must be considered. Some guidelines are now available from clinical trials investigating transfusion in anemia of prematurity; however, considerable uncertainty remains. There is weak evidence that cognitive impairment may be more severe at follow-up in extremely low birth weight infants transfused at lower hemoglobin thresholds; therefore, these thresholds should be maintained by transfusion therapy. Although the risks of transfusion have declined considerably in recent years, they can be minimized further by carefully restricting neonatal blood sampling. PMID:24855419

Whyte, Robin K; Jefferies, Ann L

2014-01-01

67

Hemolytic disease of the newborn due to anti-jkb: case report and review of the literature.  

PubMed

Although anti-Jkb is a well-defined cause of severe acute or delayed hemolytic transfusion reactions, it is rarely associated with severe Hemolytic Disease of the Newborn (HDN), even with high antibody titer. To date, only 13 cases have been reported, so the possible reasons for that still remain unclear. Most of HDN due to anti-Jkb are mild-to-moderate, and usually have a good prognosis. A 41-years-old woman, who had a positive antibody screening test in her 13th week of pregnancy, was sent to the blood bank for study before an amniocentesis. Antibody identification and red blood cell (RBC) phenotyping of the patient and his husband were performed, plus arrays study in the amniotic fluid. An anti-Jkb was identified in the patient's serum with a titer of 1:1, and her RBC phenotype was O Rh(D) positive, C(+), c(+), E(-), e(+), K(-), Jka(+), Jkb(-). The RBC genotype of the fetus was B Rh(D) positive, Jka(+), Jkb(+). Antibody titer remained stable and the pregnancy was uneventful. At birth, there was no need of phototherapy or exchange transfusion for the newborn and her Jk(b+) typing result was confirmed in a cord blood sample. Although most of HDN cases due to anti-Jkb have a good outcome, monitoring antibody titer should be done to prevent fatal complications. Furthermore, antenatal antibody screening should be performed in every pregnant woman irrespective of her Rh(D) antigen status in order to detect red cell alloimmunization to other clinically significant blood group antigens. PMID:24839369

Velasco Rodríguez, Diego; Pérez-Segura, G; Jiménez-Ubieto, A; Rodríguez, M A; Montejano, L

2014-06-01

68

Drug-induced immune hemolytic anemia  

MedlinePLUS

Immune hemolytic anemia secondary to drugs; Anemia - immune hemolytic - secondary to drugs ... Drugs that can cause this type of hemolytic anemia include: Cephalosporins (a class of antibiotics) -- most common ...

69

Hemolytic uremic syndrome associated with Clostridium difficile infection.  

PubMed

We report 3 cases of Clostridium difficile-associated hemolytic uremic syndrome (HUS) with biopsy proven renal thrombotic microangiopathy. Two patients with acute renal failure were kidney transplants recipients whereas the third patient developed renal failure in the native kidneys. The presentation was preceded by acute diarrhea and stool. Clostridium difficile toxin was detected in all the 3 patients. Stool studies were negative for Escherichia coli, Shigella dysenteriae and other enteric pathogens. The diagnosis of Clostridium difficile-associated hemolytic uremic syndrome was suspected due to presence of thrombocytopenia, microangiopathic hemolytic anemia and biopsy proven renal thrombotic microangiopathy without another clinically apparent cause. This case series suggest that Clostridium difficile infection may cause renal failure due to thrombotic microangiopathy (TMA) and should be considered in the differential diagnosis of diarrhea-associated HUS. PMID:23320969

Alvarado, Anthony S; Brodsky, Sergey V; Nadasdy, Tibor; Singh, Neeraj

2014-04-01

70

Pulmonary Hemorrhage Complicating a Typical Hemolytic-Uremic Syndrome  

Microsoft Academic Search

We describe a case of pulmonary bleeding and subsequent acute respiratory distress syndrome (ARDS) in a 20-month-old female suffering from a typical postdiarrheal hemolytic-uremic syndrome (HUS). Acute renal failure was treated early by peritoneal dialysis. It is of interest to underline that thrombocytopenia or any coagulative impairment was absent when this complication occurred, and spontaneous diuresis recovery was ongoing. All

M. Piastra; A. Ruggiero; A. Langer; E. Caresta; A. Chiaretti; S. Pulitanò; G. Polidori; R. Riccardi

2004-01-01

71

Simple theory of transfusions  

Microsoft Academic Search

A transfusion can be hypothesized to be required when a determination factor (D=probability of adverse effects if transfusion not given\\/adverse effects if transfusion is given) exceeds some predetermined\\u000a value.D varies between the limits 0 and ?, and in most clinical situations will be a small number on the order of 20. Since the probabilities\\u000a contributing to the denominator ofD are

Richard P. Spencer

1965-01-01

72

Blood Transfusion-Induced Immunomodulation  

Microsoft Academic Search

lood transfusion therapy is associated with many risks, including major or minor blood transfusion reaction, non-A non-B hepatitis, hepatitis B, and HIV infection. Blood transfusion may result in immunologic changes (immunomodulation) that are beneficial in some patients but harmful in others. After reports of increased renal allograft sur- vival in patients receiving pretransplant transfusion (l), Gantt (2) questioned whether transfusion

Dennis F. Landers; Gary E. Hill; K. C. Wong; Ira J. Fox

1996-01-01

73

Blood transfusion in sports.  

PubMed

Blood transfusion is an effective and unmediated means of increasing the number of red blood cells in the circulation in order to enhance athletic performance. Blood transfusion became popular in the 1970s among elite endurance athletes and declined at the end of the 1980s with the introduction of recombinant erythropoietin. The successive implementation in 2001 of a direct test to detect exogenous erythropoietin and in 2004 of a test to detect allogeneic blood transfusion forced cheating athletes to reinfuse fully immunologically compatible blood. The implementation of indirect markers of blood doping stored in an Athlete's Biological Passport provides a powerful means to deter any form of blood transfusion. PMID:20020370

Giraud, Sylvain; Sottas, Pierre-Edouard; Robinson, Neil; Saugy, Martial

2010-01-01

74

[Diagnosis and clinical features of hemolytic uremic syndrome].  

PubMed

The hemolytic-uremic syndrome (HUS) is an acute disorder, characterized by the triad of microangiopathic hemolytic anemia, nephropathy and thrombocytopenia. The great majority of patients are children, usually under 4 years of age, although adults can be affected. The onset is abrupt and usually follows gastroenteritis or upper respiratory infection. Later, clinical manifestations based on the triad, such as pallor, jaundice, edema, hypertension and purpura soon develop. The urinary output is reduced and the urine may appear dark yellow or tea-colored. Laboratory tests of peripheral blood show severe hemolytic anemia associated with fragmented red blood cells and thrombocytopenia, usually below 50,000/microliters. The blood urea nitrogen, serum creatinine and lactate dehydrogenase concentrations are elevated. Proteinuria and microscopic hematuria, which are indicative of active glomerular damage are also seen. Profound understanding of these manifestations is sufficient to permit an early diagnosis of HUS. PMID:8433521

Nakajima, M; Yoshioka, A

1993-01-01

75

Hemolytic disease of newborn due to anti-Jk b in a woman with high risk pregnancy  

Microsoft Academic Search

This case illustrates the importance of blood group antibodies in antenatal serology other than Rh system as a cause of hemolytic disease of newborn (HDN). In India, antenatal antibody screening is done at majority of transfusion centers in only Rh (D) negative mothers. In this multigravida woman with high risk obstetrical history, an antenatal antibody screening by indirect antiglobulin test

Beenu Thakral; Sheetal Malhotra; Karan Saluja; Praveen Kumar; Neelam Marwaha

2010-01-01

76

Platelet Transfusion - the Art and Science of Compromise  

PubMed Central

Summary Many modern therapies depend on platelet (PLT) transfusion support. PLTs have a 4- to 7-day shelf life and are frequently in short supply. In order to optimize the inventory PLTs are often transfused to adults without regard for ABO compatibility. Hemolytic reactions are infrequent despite the presence of ‘high titer’ anti-A and anti-B antibodies in some of the units. Despite the low risk for hemolysis, some centers provide only ABO identical PLTs to their recipients; this practice might have other beneficial outcomes that remain to be proven. Strategies to mitigate the risk of hemolysis and the clinical and laboratory outcomes following ABO-matched and mismatched transfusions will be discussed. Although the PLTs themselves do not carry the D antigen, a small number of RBCs are also transfused with every PLT dose. The quantity of RBCs varies by the type of PLT preparation, and even a small quantity of D+ RBCs can alloimmunize a susceptible D? host. Thus PLT units are labeled as D+/–, and most transfusion services try to prevent the transfusion of D+ PLTs to D– females of childbearing age. A similar policy for patients with hematological diseases is controversial, and the elements and mechanisms of anti-D alloimmunization will be discussed. PMID:23922541

Cid, Joan; Harm, Sarah K.; Yazer, Mark H.

2013-01-01

77

Atypical hemolytic uremic syndrome  

PubMed Central

Hemolytic uremic syndrome (HUS) is defined by the triad of mechanical hemolytic anemia, thrombocytopenia and renal impairment. Atypical HUS (aHUS) defines non Shiga-toxin-HUS and even if some authors include secondary aHUS due to Streptococcus pneumoniae or other causes, aHUS designates a primary disease due to a disorder in complement alternative pathway regulation. Atypical HUS represents 5 -10% of HUS in children, but the majority of HUS in adults. The incidence of complement-aHUS is not known precisely. However, more than 1000 aHUS patients investigated for complement abnormalities have been reported. Onset is from the neonatal period to the adult age. Most patients present with hemolytic anemia, thrombocytopenia and renal failure and 20% have extra renal manifestations. Two to 10% die and one third progress to end-stage renal failure at first episode. Half of patients have relapses. Mutations in the genes encoding complement regulatory proteins factor H, membrane cofactor protein (MCP), factor I or thrombomodulin have been demonstrated in 20-30%, 5-15%, 4-10% and 3-5% of patients respectively, and mutations in the genes of C3 convertase proteins, C3 and factor B, in 2-10% and 1-4%. In addition, 6-10% of patients have anti-factor H antibodies. Diagnosis of aHUS relies on 1) No associated disease 2) No criteria for Shigatoxin-HUS (stool culture and PCR for Shiga-toxins; serology for anti-lipopolysaccharides antibodies) 3) No criteria for thrombotic thrombocytopenic purpura (serum ADAMTS 13 activity > 10%). Investigation of the complement system is required (C3, C4, factor H and factor I plasma concentration, MCP expression on leukocytes and anti-factor H antibodies; genetic screening to identify risk factors). The disease is familial in approximately 20% of pedigrees, with an autosomal recessive or dominant mode of transmission. As penetrance of the disease is 50%, genetic counseling is difficult. Plasmatherapy has been first line treatment until presently, without unquestionable demonstration of efficiency. There is a high risk of post-transplant recurrence, except in MCP-HUS. Case reports and two phase II trials show an impressive efficacy of the complement C5 blocker eculizumab, suggesting it will be the next standard of care. Except for patients treated by intensive plasmatherapy or eculizumab, the worst prognosis is in factor H-HUS, as mortality can reach 20% and 50% of survivors do not recover renal function. Half of factor I-HUS progress to end-stage renal failure. Conversely, most patients with MCP-HUS have preserved renal function. Anti-factor H antibodies-HUS has favourable outcome if treated early. PMID:21902819

2011-01-01

78

Transfusion medicine and safety  

Microsoft Academic Search

Advances in safety of blood transfusion in clinical practice principally relate to preventing transfusion-transmitted infections (TTI). Epidemiological studies of TTI have resulted in the development, standardization, and implementation of an expanding array of immunoassays employed worldwide in routine screening of blood donated by voluntary blood donors. Exclusion of infected blood and their donors has remarkably reduced the risk of transmitting

Roger Dodd; W. Kurt Roth; Paul Ashford; Elizabeth M. Dax; Girish Vyas

2009-01-01

79

Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion  

PubMed Central

Background Most clinical practice guidelines recommend restrictive red cell transfusion practices, with the goal of minimising exposure to allogeneic blood. The purpose of this review is to compare clinical outcomes in patients randomised to restrictive versus liberal transfusion thresholds (triggers). Objectives To examine the evidence for the effect of transfusion thresholds on the use of allogeneic and/or autologous red cell transfusion, and the evidence for any effect on clinical outcomes. Search methods We identified trials by searching: the Cochrane Injuries Group Specialised Register (searched 1 February 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE (Ovid) 1948 to January Week 3 2011, EMBASE (Ovid) 1980 to 2011 (Week 04), ISI Web of Science: Science Citation Index Expanded (1970 to February 2011) and ISI Web of Science: Conference Proceedings Citation Index - Science (1990 to February 2011). We checked reference lists of other published reviews and relevant papers to identify any additional trials. Selection criteria Controlled trials in which patients were randomised to an intervention group or to a control group. We included trials where intervention groups were assigned on the basis of a clear transfusion ‘trigger’, described as a haemoglobin (Hb) or haematocrit (Hct) level below which a red blood cell (RBC) transfusion was to be administered. Data collection and analysis We pooled risk ratios of requiring allogeneic blood transfusion, transfused blood volumes and other clinical outcomes across trials using a random-effects model. Two people performed data extraction and assessment of the risk of bias. Main results We included 19 trials involving a total of 6264 patients and they were similar enough that results could be combined. Restrictive transfusion strategies reduced the risk of receiving a RBC transfusion by 39% (risk ratio (RR) 0.61, 95% confidence interval (CI) 0.52 to 0.72). This equates to an average absolute risk reduction (ARR) of 34% (95% CI 24% to 45%). The volume of RBCs transfused was reduced on average by 1.19 units (95% CI 0.53 to 1.85 units). However, heterogeneity between trials was statistically significant (P < 0.00001; I2 ? 93%) for these outcomes. Restrictive transfusion strategies did not appear to impact the rate of adverse events compared to liberal transfusion strategies (i.e. mortality, cardiac events, myocardial infarction, stroke, pneumonia and thromboembolism). Restrictive transfusion strategies were associated with a statistically significant reduction in hospital mortality (RR 0.77, 95% CI 0.62 to 0.95) but not 30-day mortality (RR 0.85, 95% CI 0.70 to 1.03). The use of restrictive transfusion strategies did not reduce functional recovery, hospital or intensive care length of stay. The majority of patients randomised were included in good-quality trials, but some items of methodological quality were unclear. There are no trials in patients with acute coronary syndrome. Authors’ conclusions The existing evidence supports the use of restrictive transfusion triggers in most patients, including those with pre-existing cardiovascular disease. As there are no trials, the effects of restrictive transfusion triggers in high-risk groups, such as acute coronary syndrome, need to be tested in further large clinical trials. In countries with inadequate screening of donor blood, the data may constitute a stronger basis for avoiding transfusion with allogeneic red cells. PMID:22513904

Carson, Jeffrey L; Carless, Paul A; Hebert, Paul C

2014-01-01

80

Plasmapheresis in a very young infant with atypical hemolytic uremic syndrome  

Microsoft Academic Search

Atypical hemolytic uremic syndrome (HUS) is a heterogeneous group of disorders, the pathogenesis of which is unclear. Plasma\\u000a transfusions and plasmapheresis are widely used modes of therapy for adults with this life-threatening syndrome. There is\\u000a very limited experience in using plasmapheresis therapy in children and infants with atypical HUS. Plasmapheresis, which is\\u000a considered a relatively safe procedure in adults and

Daniella Magen; Ana Oliven; Yael Shechter; Ronit Elhasid; Gad Bar-Joseph; Israel Zelikovic

2001-01-01

81

Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury  

PubMed Central

Transfusion-related acute lung injury (TRALI) is a form of posttransfusion acute pulmonary insufficiency that has been linked to the infusion of biologic response modifiers (BRMs), including antileukocyte antibodies and lipids. Soluble CD40 ligand (sCD40L) is a platelet-derived proinflammatory mediator that accumulates during platelet storage. We hypothesized that human polymorpho-nuclear leukocytes (PMNs) express CD40, CD40 ligation rapidly primes PMNs, and sCD40L induces PMN-mediated cytotoxicity of human pulmonary microvascular endothelial cells (HMVECs). Levels of sCD40L were measured in blood components and in platelet concentrates (PCs) implicated in TRALI or control PCs that did not elicit a transfusion reaction. All blood components contained higher levels of sCD40L than fresh plasma, with apheresis PCs evidencing the highest concentration of sCD40L followed by PCs from whole blood, whole blood, and packed red blood cells (PRBCs). PCs implicated in TRALI reactions contained significantly higher sCD40L levels than control PCs. PMNs express functional CD40 on the plasma membrane, and recombinant sCD40L (10 ng/mL-1 ?g/mL) rapidly (5 minutes) primed the PMN oxidase. Soluble CD40L promoted PMN-mediated cytotoxicity of HMVECs as the second event in a 2-event in vitro model of TRALI. We concluded that sCD40L, which accumulates during blood component storage, has the capacity to activate adherent PMNs, causing endothelial damage and possibly TRALI in predisposed patients. PMID:16772606

Khan, Samina Yasmin; Kelher, Marguerite R.; Heal, Joanna M.; Blumberg, Neil; Boshkov, Lynn K.; Phipps, Richard; Gettings, Kelly F.; McLaughlin, Nathan J.; Silliman, Christopher C.

2006-01-01

82

Intravenous Immunoglobulin G Treatment in ABO Hemolytic Disease of the Newborn, is it Myth or Real?  

PubMed

Intravenous Immunoglobulin G (IVIG) therapy has been used as a component of the treatment of hemolytic disease of the newborn. There is still no consensus on its use in ABO hemolytic disease of the newborn routinely. The aim of this study is to determine whether administration of IVIG to newborns with ABO incompatibility is necessary. One hundred and seventeen patients with ABO hemolytic disease and positive Coombs test were enrolled into the study. The subjects were healthy except jaundice. Infants were divided into two groups: Group I (n = 71) received one dose of IVIG (1 g/kg) and LED phototherapy whereas Group II (n = 46) received only LED phototherapy. One patient received erythrocyte transfusion in Group I, no exchange transfusion was performed in both groups. Mean duration of phototherapy was 3.1 ± 1.3 days in Group I and 2.27 ± 0.7 days in Group II (p < 0.05). Mean duration of hospital stay was 5.34 ± 2.2 days in Group I and 3.53 ± 1.3 days in Group II (p < 0.05). Mean duration of phototherapy was 4.0 ± 1.5 days and 2.73 ± 1.1 days in double and single doses of IVIG respectively, and this was statistically significant (p < 0.05). IVIG therapy didn't decrease neither phototherapy nor hospitalization duration in infants with ABO hemolytic disease. Meticulus follow-up of infants with ABO hemolytic disease and LED phototherapy decreases morbidity. IVIG failed to show preventing hemolysis in ABO hemolytic disease. PMID:24554813

Beken, Serdar; Hirfanoglu, Ibrahim; Turkyilmaz, Canan; Altuntas, Nilgun; Unal, Sezin; Turan, Ozden; Onal, Esra; Ergenekon, Ebru; Koc, Esin; Atalay, Yildiz

2014-03-01

83

Platelet kinetics after slow versus standard transfusions: A pilot study  

PubMed Central

Background Platelet transfusion is required in the acute phase of some thrombocytopenic disorders in order to prevent potentially dangerous hemorrhages.The purpose of this study was to assess the increase in platelet count following a slow platelet transfusion. Methods Patients suffering from thrombocytopenia due to various underlying diseases were enrolled in the prospective pilot feasibility trial and were randomly divided into two groups. Standard platelet transfusion was administered in one group, while slow transfusion was used in the other. The platelet count was examined at 1 hour, 24 hours, and 1 week following the transfusions. Results Although the platelet count was higher following 1 hour after transfusion via the standard method, the count tended to be higher 1 week after the transfusion in the slow transfusion group. This difference, however, only turned out to be statistically significant amongst females. Conclusion A therapy of slow platelet transfusion might be more effective for the prevention of platelet loss. Further studies will be required to strengthen this hypothesis. PMID:21679106

2011-01-01

84

Auto-immune hemolytic anemia in two horses.  

PubMed

Two cases of Auto-immune hemolytic anemia (AHA) in the horse are described. The pathogenesis of AHA in man is related to the findings in the horses. Besides from routine hematological and biochemical investigations specific data were obtained from the erythrocyte osmotic fragility test, the Coombs test, the serum haptoglobulin level and the cold agglutinin test. The first patient, a six month old Dutch standardbred colt, probably suffered from an acute attack of cold-induced hemoglobinuria with severe anemia and acronecrosis of the tops of both ears and of several parts of the skin that had been in close contact with the cold floor. The second patient, a nine years old Friesian mare, showed a type of AHA resembling the acute hemolyte type of cold agglutinin disease in man. This patient had a clear septicemic picture, extensive bacteriological examination, however, was negative. PMID:1162684

Lokhorst, H M; Breukink, H J

1975-07-15

85

Leukapheresis and granulocyte transfusion.  

PubMed

Granulocytes for transfusion can now be obtained from normal donors by one of four techniques that involve either centrifugation or reversible adhesion of granulocytes to nylon fibers. The leukapheresis process appears to be safe for donors and standards for the selection and care of donors are being formulated. It appears desirable to transfuse granulocytes that are compatible in a leukoagglutination crossmatching, however, better methods for histocompatibility testing must be developed. Granulocyte transfusions clearly are of benefit to patients with Gram-negative sepsis and granulocyte counts of less than 500/cu mm for at least ten days. They may be valuable for granulocytopenic patients with other severe infections; however, there is no indication that granulocyte transfusions are indicated prophylactically or for febrile granulocytopenic patients without evidence of infection. PMID:579963

McCullough, J

1978-02-01

86

Alternatives to Blood Transfusion  

MedlinePLUS

... Find Local ACS Find Support & Treatment » Treatments and Side Effects » Treatment Types » Blood Product Donation and Transfusion » Alternatives to ... Basics Cancer Prevention & Detection Signs & Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices ...

87

The prevention of transfusion-associated circulatory overload.  

PubMed

Transfusion-associated circulatory overload (TACO) is an important and potentially injurious complication of transfusion that is underappreciated by clinicians. Risk factors for TACO include being at an extreme of age, having preexisting cardiac and/or (potentially) renal dysfunction, acute myocardial infarction, and individuals receiving plasma. Keys to preventing TACO, aside from identifying high-risk individuals, should be multifaceted. We advocate for the widespread use of pretransfusion checklists and implementation of nonemergent transfusion protocols. We suggest the regular use of pretransfusion diuretics in high-risk individuals. When a transfusion is required, we believe that "critical" nursing supervision and leadership are instrumental in the coordination of slow transfusion rates on computerized infusion pumps and ensuring patients are appropriately monitored. We believe that using these methodologies on a global scale will prevent many TACO events and minimize the severity when it does occur. PMID:23465703

Alam, Asim; Lin, Yulia; Lima, Ana; Hansen, Mark; Callum, Jeannie L

2013-04-01

88

Alternatives to blood transfusion.  

PubMed

The use of alternatives to allogeneic blood continues to rest on the principles that blood transfusions have inherent risks, associated costs, and affect the blood inventory available for health-care delivery. Increasing evidence exists of a fall in the use of blood because of associated costs and adverse outcomes, and suggests that the challenge for the use of alternatives to blood components will similarly be driven by costs and patient outcomes. Additionally, the risk-benefit profiles of alternatives to blood transfusion such as autologous blood procurement, erythropoiesis-stimulating agents, and haemostatic agents are under investigation. Nevertheless, the inherent risks of blood, along with the continued rise in blood costs are likely to favour the continued development and use of alternatives to blood transfusion. We summarise the current roles of alternatives to blood in the management of medical and surgical anaemias. PMID:23706802

Spahn, Donat R; Goodnough, Lawrence T

2013-05-25

89

Chimerism in transfusion medicine  

PubMed Central

Transfusion therapy is complicated by the production of alloantibodies to antigens present in the donor and lacking in the recipient through the poorly-understood but likely multi-factorial process of alloimmunization. The low prevalence of alloimmunization in transfused patients (6.1%)1 suggests that processes central to immunologic tolerance may be operating in the vast majority of transfused patients who do not produce alloantibodies. Using RhD as a prototype, evidence is reviewed that the ability to make antibodies to red blood cell (RBC) antigens may result in part from immunologic tolerance acquired in utero. These ideas are extended to other examples of maternal microchimerism (MMc) of other non-inherited maternal antigens (NIMA). An evolutionary argument is offered that multi-generational immunity supports the hypothesis that MMc may partly explain the “non-responder” phenotype in RBC alloimmunization. PMID:24196285

Brunker, Patricia AR

2013-01-01

90

Blood Transfusion Center Check List  

E-print Network

Blood Transfusion Center Check List Patient Name: ______________________________ DOB/medications during their stay. Consent for blood transfusion dated and signed by physician _____________________________________________ Infection control None MRSA VRE Other (describe

Goldman, Steven A.

91

A case of hemolytic uremic syndrome preceded by intussusception  

PubMed Central

Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in young children. It is classically characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia. Further, not only is intussusception one of the differential diagnoses of HUS but it may also become a complication during disease progression. We report a case of HUS preceded by intussusception in a previously healthy 17-month-old boy. The patient presented at the emergency department with bloody stools that developed the day after reduction of intussusception. HUS was diagnosed 4 days after the reduction of intussusception. The patient was provided only supportive care and his laboratory test findings were normal at discharge. PMID:21738552

Ko, Eun Young; Kim, Joo Young; Lee, Hye Jin; Lee, Hyun Seung; Han, Ji Whan; Kim, Young Hoon; Kim, Jin Tack; Cheong, Hae Il

2011-01-01

92

Transfusion Predictors in Liver Transplant  

Microsoft Academic Search

In this study we sought to determine the factors influ- encing red blood cell (RBC) transfusions and to study the transfusion practice of anesthesiologists during liver transplants. A retrospective study of 206 succes- sive liver transplants was undertaken during a period of 52 mo. Transfused blood products were identified. Twenty variables were analyzed in a univariate fash- ion. For the

Luc Massicotte; Marie-Pascale Sassine; Serge Lenis

2004-01-01

93

Megadose Methylprednisolone (MDMP) Treatment in a Patient with Autoimmune Hemolytic Anemia (AIHA) Resistant to Conventional Corticosteroid Administration: A Case Report  

PubMed Central

A female in the Netherlands with severe autoimmune hemolytic anemia (AIHA) was treated with conventional corticosteroid (2 mg/kg/d in divided doses) and blood transfusions for 18 months without improvement. The presented patient responded to megadose methylprednisolone (MDMP) 30 mg/kg/d for 3 d, followed by 20 mg/kg for 4 d, and subsequently 10, 5, 2, and 1 mg/kg/d each for 1 week. Conflict of interest:None declared. PMID:24385786

Ozsoylu, Sinasi; Berenschot, Henriette WA

2013-01-01

94

Transfusion support for haemoglobinopathies.  

PubMed

The indications and management of blood transfusion in the haemoglobinopathies have been reviewed. The sickle cell diseases that require transfusion support are sickle cell anaemia, sickle haemoglobin-C and -D diseases and sickle beta-thalassaemia. Homozygous beta-thalassaemia (Cooley's anaemia) is the major problem among the thalassaemias. The pathophysiology of the sickle cell disorders is largely based on the secondary effects of increased blood viscosity, whereas in the thalassaemias the defect is ineffective haematopoiesis. In the former the major problems occur as manifestations of vaso-occlusive crises with disseminated bone and abdominal pain, priapism, stroke and leg ulcers. Bone infarction and aseptic necrosis occur but the widespread bone changes, underdevelopment and haemochromatosis that complicate the thalassaemia are not prominent. Transfusion therapy in the sickle cell diseases is mainly episodic and is guided by the frequency of crises and the severity of vaso-occlusive complications. Partial exchange transfusion and the maintenance of haemoglobin A concentrations at 40 to 50 per cent is frequently indicated. In the thalassaemias, maintenance of haemoglobin levels is essential for normal growth and development. The problem of haemochromatosis is very serious. With hypertransfusion regimens the haemoglobin and haemotocrit are maintained above 12-13 g/dl and 35 per cent. The resulting benefit appears to be reduced blood volume, less iron turnover, and less intestinal iron absorption. The splenomegaly in these disorders is frequently associated with hypersplenism requiring well-timed splenectomy. Chronic and intensive chelation is necessary to prevent the ravages of iron overload. The availability of automated equipment for in vivo and ex vivo blood cell separation has brought new possibilities for improving the management of these haemoglobinopathies. It is feasible, but not as yet practical, to offer transfusions of neocytes (red cells with a mean age of 30 days) which have a 50 per cent longer survival than routine red cell preparations (mean age of 60 days). Neocytes can be prepared ex vivo from fresh routine blood donations using blood cell separator devices. The result is reduced transfusion requirements. A more recent suggestion for using the new technology is to remove the patient's oldest and most abnormal corpuscles on the basis of buoyant density and replacing them with neocytes . Thus the short-lived abnormal red cells would be removed before they could unload their iron. With automation it is possible to perform these procedures on an outpatient basis. PMID:6373080

Greenwalt, T J; Zelenski, K R

1984-02-01

95

Humanized mouse model of glucose 6-phosphate dehydrogenase deficiency for in vivo assessment of hemolytic toxicity  

PubMed Central

Individuals with glucose 6-phosphate dehydrogenase (G6PD) deficiency are at risk for the development of hemolytic anemia when given 8-aminoquinolines (8-AQs), an important class of antimalarial/antiinfective therapeutics. However, there is no suitable animal model that can predict the clinical hemolytic potential of drugs. We developed and validated a human (hu)RBC-SCID mouse model by giving nonobese diabetic/SCID mice daily transfusions of huRBCs from G6PD-deficient donors. Treatment of SCID mice engrafted with G6PD-deficient huRBCs with primaquine, an 8-AQ, resulted in a dose-dependent selective loss of huRBCs. To validate the specificity of this model, we tested known nonhemolytic antimalarial drugs: mefloquine, chloroquine, doxycycline, and pyrimethamine. No significant loss of G6PD-deficient huRBCs was observed. Treatment with drugs known to cause hemolytic toxicity (pamaquine, sitamaquine, tafenoquine, and dapsone) resulted in loss of G6PD-deficient huRBCs comparable to primaquine. This mouse model provides an important tool to test drugs for their potential to cause hemolytic toxicity in G6PD-deficient populations. PMID:24101478

Rochford, Rosemary; Ohrt, Colin; Baresel, Paul C.; Campo, Brice; Sampath, Aruna; Magill, Alan J.; Tekwani, Babu L.; Walker, Larry A.

2013-01-01

96

Iron and transfusion medicine.  

PubMed

Blood bankers have focused their energy to secure blood transfusion, and only recently have studies been published on the effect of blood donation on iron metabolism. In many facilities, hemoglobin measurement is only performed just before or even during blood donation, but the determination of iron stores is largely ignored. The 2013 paradox of transfusion medicine is due to the fact that blood donation may be harmful and leads to iron deficiency with or without anemia, but for other individuals, it may be a healthy measure preventing type 2 diabetes. The purpose of this review is to discuss iron metabolism in the perspective of blood donation, notably regarding their possible genetic profiles that eventually will discriminate "good" iron absorbers from "bad" iron responders. PMID:24148756

Waldvogel-Abramovski, Sophie; Waeber, Gérard; Gassner, Christoph; Buser, Andreas; Frey, Beat M; Favrat, Bernard; Tissot, Jean-Daniel

2013-11-01

97

Abciximab-associated profound thrombocytopenia: Therapy with immunoglobulin and platelet transfusion  

Microsoft Academic Search

In summary, first time abciximab administration was associated with acute profound thrombocytopenia in 4 of 575 consecutive patients. Therapy with platelet transfusion is associated with a rapid and sustained increment in circulating platelet count and clinical hemostasis.

Dean J. Kereiakes; James H. Essell; Charles W. Abbottsmith; Thomas M. Broderick; John Paul Runyon

1996-01-01

98

[The problem of blood transfusion ++ in Jehova's Witnesses' children with oncological disease].  

PubMed

We present 2 cases of Jehovah's Witnesses' children suffering from oncological diseases (non-Hodgkin Lymphoma and Acute Lymphoblastic Leukaemia). During their treatment we used erythropoietin and no blood products were transfused. PMID:10731998

Ka?muk, A; So?ta-Jakimczyk, D; Janik-Moszant, A; Buba?a, H; Olejnik, I

1998-01-01

99

Advances in the Theory and Practice of Exchange Transfusions  

PubMed Central

In the management and prevention of hemolytic disease of the newborn, exchange transfusions seem destined to remain the mainstay of therapy for some time to come. Our current knowledge of bilirubin metabolism has altered the indications for the procedure and introduced such useful new adjuncts to therapy as albumin infusions. The decision to do an exchange transfusion cannot be made by any one rule, but must be individualized for each patient and take into account all the factors known to influence the risks of bilirubin toxicity and the exchange procedure. A thorough evaluation of the infant's condition, particularly his cardiorespiratory and metabolic status (including blood pH, gas and albumin determinations), will provide valuable information as a guide to therapy. The limited capacity of some newborn infants to make adequate physiological adaptations to a variety of stresses imposed by the procedure influences the preparation of donor blood, the rate and volume of exchange and the time at which it should be done. A clear understanding of the mechanics of the exchange and the distribution of indirect bilirubin within the body will permit more accurate prediction of what can be accomplished in bilirubin removal and correction of hematocrit with exchanges of different volumes. When weighing the risk of kernicterus against that of exchange transfusion, the experience of the operator and the availability of suitable facilities cannot be ignored. PMID:5342893

Phibbs, Roderic H.

1966-01-01

100

[Hemolytic anemias due to enzymopathies].  

PubMed

The most inherited enzymopathies associated with hemolytic anaemias are due to enzyme deficiencies (as a consequence of either synthesis reduction or impairement of the enzyme function). Such deficiencies can disturb some metabolism of the red cells. The most of enzyme deficiencies are involved in glycolysis that represents the main source of energy for this cell. Generally the genetic transmission of these enzymopathies is recessive autosomal with the exception of two cases (glucose 6-phosphate dehydrogenase and phosphoglycerate kinase) which are X-chromosome-linked. It stands to reason that the only treatment of these enzymopathies is dependent on gene therapy, a fine future method. Nevertheless prenatal diagnosis can be considered in some cases that display particularly severe symptoms. PMID:8235390

Rosa, R

1993-06-01

101

Increased carriage of resistant non-pneumococcal ?-hemolytic streptococci after antibiotic therapy  

Microsoft Academic Search

Objective: We compared colonization and resistance rates of non-pneumococcal ?-hemolytic streptococci (AHS) and Streptococcus pneumoniae in children receiving antibiotic therapy for acute otitis media. Study design: Between December 1997 and September 1998, children 6 months to 6 years of age, diagnosed with acute otitis media were randomly assigned to receive amoxicillin\\/clavulanate (Augmentin) 45 mg\\/kg\\/d in 2 divided doses for 10

Faryal Ghaffar; Ian R. Friedland; Kathy Katz; Luz Stella Muniz; Jeanette L. Smith; Phyllis Davis; Jason Reynolds; George H. McCracken

1999-01-01

102

Current understanding of allergic transfusion reactions: incidence, pathogenesis, laboratory tests, prevention and treatment  

PubMed Central

Non-haemolytic transfusion reactions are the most common type of transfusion reaction and include transfusion-related acute lung injury, transfusion-associated circulatory overload, allergic reactions, febrile reactions, post-transfusion purpura and graft-versus- host disease. Although life-threatening anaphylaxis occurs rarely, allergic reactions occur most frequently. If possible, even mild transfusion reactions should be avoided because they add to patients' existing suffering. During the last decade, several new discoveries have been made in the field of allergic diseases and transfusion medicine. First, mast cells are not the only cells that are key players in allergic diseases, particularly in the murine immune system. Second, it has been suggested that immunologically active undigested or digested food allergens in a donor's blood may be transferred to a recipient who is allergic to these antigens, causing anaphylaxis. Third, washed platelets have been shown to be effective for preventing allergic transfusion reactions, although substantial numbers of platelets are lost during washing procedures, and platelet recovery after transfusion may not be equivalent to that with unwashed platelets. This review describes allergic transfusion reactions, including the above-mentioned points, and focusses on their incidence, pathogenesis, laboratory tests, prevention and treatment. PMID:23215650

Hirayama, Fumiya

2013-01-01

103

Blood Transfusion Therapy and Diamond Blackfan Anemia  

MedlinePLUS

... blood transfusion therapy are uncommon but can include blood transfusion reactions, infections, the development of red blood cell antibodies, and ... the United States is very safe, so passing infections through blood transfusion is extremely rare. Red blood cell antibodies Everyone ...

104

Blood transfusion: the silent epidemic  

Microsoft Academic Search

Blood transfusion has been widely studied and the risk\\/benefit ratio remains unclear. Focus historically has been upon viral transmission, particularly hepatitis and HIV. Today, with advanced screening for these viruses, the risk for such transmission has become vanishingly small.Immunosuppression, with consequent postoperative bacterial infection and ABO incompatibility are now risks that physicians should consider as associated with allogeneic blood transfusion.

Bruce D. Spiess

2001-01-01

105

Reasons for moving toward a patient-centric paradigm of clinical transfusion medicine practice.  

PubMed

The combination of patient blood management (PBM) modalities and multicomponent apheresis permits us to administer even safer transfusions than those using the "safer-than-ever" blood components distributed in the beginning of the 21st century. PBM identifies a patient at risk of transfusion and formulates a multidisciplinary and multimodal-yet individualized-plan for reducing the need for allogeneic transfusion. Multicomponent apheresis can collect any combination of red blood cells, platelets, and plasma from the same donor during the same donation, and it should eventually reserve all components harvested from the same donation for transfusion to the same recipient. Together, PBM and multicomponent apheresis represent a new paradigm-the patient-centric paradigm-of transfusion medicine whose purpose is to reduce the transfusion risk for each individual patient to the level of the ALARA (as-low-as-reasonably-achievable) risk. PBM and multicomponent apheresis can meet a patient's transfusion needs with at least twofold fewer allogeneic donor exposures, thereby reducing the risk of infectious and immunologic complications of transfusion by at least twofold. The reduction in risk includes the leading cause of transfusion-related mortality (transfusion-related acute lung injury) and the cardinal threat to transfusion safety (the next "HIV-like" pathogen to emerge in the future). Once it is determined that PBM and multicomponent apheresis can replace the current blood-procurement system at a "reasonable" cost and without jeopardizing the supply of blood and components, the patient-centric paradigm should replace the current, component-centric paradigm of transfusion medicine to reduce the transfusion risk to the level of the ALARA risk. PMID:22882177

Vamvakas, Eleftherios C

2013-04-01

106

Clostridium septicum infection and hemolytic uremic syndrome.  

PubMed Central

Five cases of Clostridium septicum infection secondary to Escherichia coli O157-induced hemolytic uremic syndrome have been reported. We report on three cases (one of which is included in the above five) of dual Cl. septicum and E. coil infection; all three patients were exposed to farm animals. A common zoonotic source for Cl. septicum and E. coli O157 infections should be considered. Patients with hemolytic uremic syndrome should be treated aggressively and monitored closely for Cl. septicum superinfection. PMID:9621207

Barnham, M.; Weightman, N.

1998-01-01

107

[Ethics and blood transfusion].  

PubMed

Blood donation is an act of solidarity. Most often, this act is done on a volunteer basis and, depending on countries and circumstances, is not remunerated. The increase in need, the always-greater number of deferral criteria, the safety issues and the changes in the structures of our societies are among the many subjects for ethical debates. Taking these into account, the actors of the transfusion must analyze certain parameters: the value of a donation, the meaning of volunteering, the appropriateness of remunerating the act of giving a part of one's self, no longer as a donation or an expression of altruism and solidarity, but as a commercial act regimented by economic laws. PMID:23916572

Tissot, J-D; Garraud, O; Danic, B; Cabaud, J-J; Lefrère, J-J

2013-09-01

108

Treatment of autoimmune hemolytic anemias.  

PubMed

Autoimmune hemolytic anemia (AIHA) is a relatively uncommon disorder caused by autoantibodies directed against self red blood cells. It can be idiopathic or secondary, and classified as warm, cold (cold hemagglutinin disease (CAD) and paroxysmal cold hemoglobinuria) or mixed, according to the thermal range of the autoantibody. AIHA may develop gradually, or have a fulminant onset with life-threatening anemia. The treatment of AIHA is still not evidence-based. The first-line therapy for warm AIHA are corticosteroids, which are effective in 70-85% of patients and should be slowly tapered over a time period of 6-12 months. For refractory/relapsed cases, the current sequence of second-line therapy is splenectomy (effective approx. in 2 out of 3 cases but with a presumed cure rate of up to 20%), rituximab (effective in approx. 80-90% of cases), and thereafter any of the immunosuppressive drugs (azathioprine, cyclophosphamide, cyclosporin, mycophenolate mofetil). Additional therapies are intravenous immunoglobulins, danazol, plasma-exchange, and alemtuzumab and high-dose cyclophosphamide as last resort option. As the experience with rituximab evolves, it is likely that this drug will be located at an earlier point in therapy of warm AIHA, before more toxic immunosuppressants, and in place of splenectomy in some cases. In CAD, rituximab is now recommended as first-line treatment. PMID:25271314

Zanella, Alberto; Barcellini, Wilma

2014-10-01

109

Hemolytic anemias and erythrocyte enzymopathies.  

PubMed

The human erythrocyte generates high-energy adenosine triphosphate by anaerobic glycolysis and cycles oxidized and reduced nicotinamide adenine dinucleotide phosphate by the aerobic pentose phosphate shunt pathway. Certain enzymopathies of the pentose phosphate shunt are associated with hemolysis resulting from oxidative denaturation of hemoglobin. Glucose-6-phosphate dehydrogenase deficiency, an X-chromosome-linked disorder, is the prototype of these diseases and is genetically and clinically polymorphic. Six enzymopathies of anaerobic glycolysis cause hemolytic anemia; lactate dehydrogenase deficiency does not. In 2,3-diphosphoglycerate mutase deficiency, 2,3-diphosphoglycerate is greatly reduced and asymptomatic polycythemia is noted. Pyrimidine-5'-nucleotidase deficiency, an enzymopathy of nucleotide metabolism, is characterized by intracellular accumulations of pyrimidine-containing nucleotides, marked basophilic stippling on the stained blood film, splenomegaly, and hemolysis. Lead inhibits the nucleotidase and an identical syndrome occurs during severe lead poisoning. Hemolysis also accompanies an unusual enzymopathy characterized by a 40- to 70-fold increase (not decrease) in adenosine deaminase activity. PMID:2990276

Valentine, W N; Tanaka, K R; Paglia, D E

1985-08-01

110

Treatment of autoimmune hemolytic anemias  

PubMed Central

Autoimmune hemolytic anemia (AIHA) is a relatively uncommon disorder caused by autoantibodies directed against self red blood cells. It can be idiopathic or secondary, and classified as warm, cold (cold hemagglutinin disease (CAD) and paroxysmal cold hemoglobinuria) or mixed, according to the thermal range of the autoantibody. AIHA may develop gradually, or have a fulminant onset with life-threatening anemia. The treatment of AIHA is still not evidence-based. The first-line therapy for warm AIHA are corticosteroids, which are effective in 70–85% of patients and should be slowly tapered over a time period of 6–12 months. For refractory/relapsed cases, the current sequence of second-line therapy is splenectomy (effective approx. in 2 out of 3 cases but with a presumed cure rate of up to 20%), rituximab (effective in approx. 80–90% of cases), and thereafter any of the immunosuppressive drugs (azathioprine, cyclophosphamide, cyclosporin, mycophenolate mofetil). Additional therapies are intravenous immunoglobulins, danazol, plasma-exchange, and alemtuzumab and high-dose cyclophosphamide as last resort option. As the experience with rituximab evolves, it is likely that this drug will be located at an earlier point in therapy of warm AIHA, before more toxic immunosuppressants, and in place of splenectomy in some cases. In CAD, rituximab is now recommended as first-line treatment. PMID:25271314

Zanella, Alberto; Barcellini, Wilma

2014-01-01

111

Escherichia coli O 157:H7-associated hemolytic-uremic syndrome after ingestion of contaminated hamburgers.  

PubMed

We conducted a retrospective analysis of 37 children with Escherichia coli O157:H7-associated hemolytic-uremic syndrome. The infection was traced to contaminated hamburgers at a fast-food restaurant chain. Within 5 days of the first confirmed case, the Washington State Department of Health identified the source and interrupted transmission of infection. Ninety-five percent of the children initially had severe hemorrhagic colitis. Nineteen patients (51%) had significant extrarenal abnormalities, including pancreatitis, colonic necrosis, glucose intolerance, coma, stroke, seizures, myocardial dysfunction, pericardial effusions, adult respiratory disease syndrome, and pleural effusions. Three deaths occurred, each in children with severe multisystem disease. At follow-up two children have significant impairment of renal function (glomerular filtration rate < 80 ml/min/per 1.73 Hm2); both of these children have a normal serum creatinine concentration. Hemolytic-uremic syndrome is the most common cause of acute renal failure in children, and this experience emphasizes the systemic nature of this disease. Clinicians should anticipate that multisystem involvement may occur in these patients, necessitating acute intervention or chronic follow-up. This outbreak of Hemolytic-uremic syndrome also highlights the microbiologic hazards of inadequately prepared food and emphasizes the importance of public health intervention in controlling Hemolytic-uremic syndrome. PMID:7931869

Brandt, J R; Fouser, L S; Watkins, S L; Zelikovic, I; Tarr, P I; Nazar-Stewart, V; Avner, E D

1994-10-01

112

Gemcitabine-associated thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.  

PubMed

A patient being treated for metastatic adenocarcinoma of the pancreas presents to the clinic for a routine appointment. A complete blood count reveals hemoglobin of 6.5 g/dl and a platelet count of 30,000 K/mm3 thought to be from the last of many doses of gemcitabine. On assessment, the only complaint was fatigue with no evidence of bleeding or other abnormal physical findings other than pallor. Past medical history includes hypertension managed with three antihypertensive agents. Additional laboratory tests reveal elevated blood urea nitrogen (69 mg/dl), creatinine (2.76 mg/dl), and lactic dehydrogenase (LDH), was well as indirect bilirubin (2.1 mg/dl). The patient is admitted and transfused with packed red blood cells (pRBCs). The next day, the platelet count drops to 9,000 K/mm3 and the hemoglobin increases, appropriately, to 8.9 g/dl. Urinalysis is positive for hemoglobin (+ 3). The peripheral blood smear is positive for schistocytes (fragmented RBCs). A pheresis catheter is placed after the patient was evaluated by a hematologist and a nephrologist. A presumptive diagnosis of thrombotic thrombocytopenic purpura (TTP) with hemolytic uremic syndrome (HUS) was made. PMID:25158661

Held-Warmkessel, Jeanne

2014-09-01

113

Early intravenous immunoglobin (two-dose regimen) in the management of severe Rh hemolytic disease of newborn—a prospective randomized controlled trial  

Microsoft Academic Search

Phototherapy is the standard treatment in moderately severe hemolytic disease of newborn (HDN), whereas exchange transfusion\\u000a (ET) is the second line in progressive cases. Intravenous immunoglobin (IVIG) has been suggested to decrease the need for\\u000a ET. We aimed at assessing the efficacy of early two-dose regimens of IVIG to avoid unnecessary ET in severe Rh HDN. The study\\u000a included 90

Mohsen Saleh Elalfy; Nancy Samir Elbarbary; Heba Wegdan Abaza

2011-01-01

114

Technology Transfusion - A Network Recommendation.  

National Technical Information Service (NTIS)

This report verifies technology transfusion (the moving of high-payoff low-risk technologies from their first application to subsequent ones) takes too long and recommends several means to accelerate it. The recommendations were deduced by examining how s...

G. F. Padula

1988-01-01

115

Multiple Sclerosis and Blood Transfusion  

Microsoft Academic Search

It has recently been suggested that multiple sclerosis (MS) may be triggered by a retrovirally encoded superantigen. If true, then MS should be associated with risk factors that predispose to retroviral infection. Blood transfusions represent one such risk factor. 150 Scottish patients with 'clinically definite' or 'probable' MS and 150 age-\\/sex-matched neurological controls were questioned about blood transfusion. 7 (4.7%)

R. J. Swingler

1993-01-01

116

Coombs-positive hemolytic anemia secondary to brown recluse spider bite: a review of the literature and discussion of treatment.  

PubMed

The bite of the brown recluse spider (Loxosceles reclusa) typically results in local, dermonecrotic skin lesions. Rarely, these bites may precipitate systemic disturbances of varying severity collectively known as systemic loxoscelism. The more severe systemic alterations attributed to the venom of this arachnid include hemolytic anemia, multiorgan failure, disseminated intravascular coagulation, or even death. Coombs-positive hemolysis associated with brown recluse spider bites has rarely been documented in the literature. We report 2 cases of systemic loxoscelism in young women associated with severe Coombs-positive hemolytic anemia and systemic symptoms requiring hospitalization. Both patients were treated with aggressive wound care, hematologic monitoring with blood transfusion, and intravenous fluid replacement. Recovery was excellent in both cases. We review the literature and discuss the controversies surrounding the treatment of more severe brown recluse bite reactions. PMID:15663070

Lane, David R; Youse, Jeremy S

2004-12-01

117

A case of atypical hemolytic uremic syndrome.  

PubMed

A 9-year-old boy presented with fever not responding to antibiotic therapy and elevated blood urea and serum creatinine levels. The patient developed microangiopathic hemolytic anemia and thrombocytopenia during the hospital stay. Kidney biopsy confirmed the diagnosis of atypical hemolytic uremic syndrome (HUS). The patient had sufficient urine output, normal blood pressure, and no evidence of peripheral edema during the whole course of his disease. Serum levels of anti-Epstein-Barr virus immunoglobulin M was elevated, indicating the possible role of Epstein-Barr virus infection in inducing atypical HUS in this patient. The patient underwent hemodialysis with dramatic response. He was discharged with normal kidney function after a few days. Kidney function and platelet count were normal 12 months after the initial presentation. This case report shows that atypical hemolytic uremic syndrome could have unusual presentations such as the absence of oliguria, hypertension, and edema, with rapid recovery and good prognosis. PMID:25001143

Fallahzadeh, Mohammad Amin; Fallahzadeh, Mohammad Kazem; Derakhshan, Ali; Shorafa, Eslam; Mojtahedi, Yusof; Geramizadeh, Bita; Fallahzadeh, Mohammad Hossein

2014-07-01

118

Group A ?-hemolytic streptococcal pharyngotonsillitis outbreak.  

PubMed

The aim was to describe an outbreak of group A ?-hemolytic streptococcal pharyngotonsillitis in health care professionals. This is a cross-sectional descriptive study of 17 clients who dined at the same table in a restaurant in Barcelona in July 2012. The frequency, timing and severity of symptoms were analyzed, as were demographic variables and others concerning the food ingested. The attack rate was 58.8%. Six of the 10 clients were positive for group A ?-hemolytic streptococcal. Six of the 13 individuals who handled the food involved in the dinner had symptoms. No association was identified with the food consumed. There is epidemiological evidence of foodborne group A ?-hemolytic streptococcal transmission, but respiratory transmission could not be ruled out. PMID:24897054

Culqui, Dante R; Manzanares-Laya, Sandra; Van Der Sluis, Sarah Lafuente; Fanlo, Albert Anton; Comas, Rosa Bartolomé; Rossi, Marcello; Caylá, Joán A

2014-04-01

119

Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome  

PubMed Central

Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case. PMID:24678335

Chang, Hye Jin; Kim, Hwa Young; Choi, Jae Hong; Choi, Hyun Jin; Ko, Jae Sung; Ha, Il Soo; Cheong, Hae Il; Choi, Yong

2014-01-01

120

Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome.  

PubMed

Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case. PMID:24678335

Chang, Hye Jin; Kim, Hwa Young; Choi, Jae Hong; Choi, Hyun Jin; Ko, Jae Sung; Ha, Il Soo; Cheong, Hae Il; Choi, Yong; Kang, Hee Gyung

2014-02-01

121

Massive Bleeding and Massive Transfusion  

PubMed Central

Massive bleeding in trauma patients is a serious challenge for all clinicians, and an interdisciplinary diagnostic and therapeutic approach is warranted within a limited time frame. Massive transfusion usually is defined as the transfusion of more than 10 units of packed red blood cells (RBCs) within 24 h or a corresponding blood loss of more than 1- to 1.5-fold of the body's entire blood volume. Especially male trauma patients experience this life-threatening condition within their productive years of life. An important parameter for clinical outcome is to succeed in stopping the bleeding preferentially within the first 12 h of hospital admission. Additional coagulopathy in the initial phase is induced by trauma itself and aggravated by consumption and dilution of clotting factors. Although different aspects have to be taken into consideration when viewing at bleedings induced by trauma compared to those caused by major surgery, the basic strategy is similar. Here, we will focus on trauma-induced massive hemorrhage. Currently there are no definite, worldwide accepted algorithms for blood transfusion and strategies for optimal coagulation management. There is increasing evidence that a higher ratio of plasma and RBCs (e.g. 1:1) endorsed by platelet transfusion might result in a superior survival of patients at risk for trauma-induced coagulopathy. Several strategies have been evolved in the military environment, although not all strategies should be transferred unproven to civilian practice, e.g. the transfusion of whole blood. Several agents have been proposed to support the restoration of coagulation. Some have been used for years without any doubt on their benefit-to-risk profile, whereas great enthusiasm of other products has been discouraged by inefficacy in terms of blood transfusion requirements and mortality or significant severe side effects. This review surveys current literature on fluid resuscitation, blood transfusion, and hemostatic agents currently used during massive hemorrhage in order to optimize patients’ blood and coagulation management in emergency medical aid. PMID:22670125

Meißner, Andreas; Schlenke, Peter

2012-01-01

122

Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers.  

PubMed

Blood passport has been suggested as an indirect tool to detect various kinds of blood manipulations. Autologous blood transfusions are currently undetectable, and the objective of this study was to examine the sensitivities of different blood markers and blood passport approaches in order to determine the best approach to detect autologous blood transfusions. Twenty-nine subjects were transfused with either one (n=8) or three (n=21) bags of autologous blood. Hemoglobin concentration ([Hb]), percentage of reticulocytes (%ret) and hemoglobin mass (Hbmass) were measured 1 day before reinfusion and six times after reinfusion. The sensitivity and specificity of a novel marker, Hbmr (based on Hbmass and %ret), was evaluated together with [Hb], Hbmass and OFF-hr by different passport methods. Our novel Hbmr marker showed superior sensitivity in detecting the highest dosage of transfused blood, with OFF-hr showing equal or superior sensitivities at lower dosages. Hbmr and OFF-hr showed superior but equal sensitivities from 1 to 4 weeks after transfusion compared with [Hb] and Hbmass, with Hbmass being the only tenable prospect to detect acute transfusions. Because autologous blood transfusions can be an acute practice with blood withdrawal and reinfusion within a few days, Hbmass seems to be the only option for revealing this practice. PMID:19903320

Mørkeberg, J; Sharpe, K; Belhage, B; Damsgaard, R; Schmidt, W; Prommer, N; Gore, C J; Ashenden, M J

2011-04-01

123

Multiple cavitations in posterior reversible leukoencephalopathy syndrome associated with hemolytic-uremic syndrome  

Microsoft Academic Search

We describe a 4-year-old boy with posterior reversible leukoencephalopathy syndrome associated with hemolytic-uremic syndrome. He exhibited bloody stool by Escherichia coli O157: H7 infection with acute renal failure. He subsequently presented high blood pressure, followed by visual disturbance and loss of consciousness. Brain MRI revealed bilateral occipital high intensities by T2-weighted images and high value by apparent diffusion coefficient map,

Katsunori Fujii; Kaoru Matsuo; Tomozumi Takatani; Hideki Uchikawa; Yoichi Kohno

124

Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997–2003  

Microsoft Academic Search

Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is\\u000a preceded by an episode of diarrhea mostly due to Shiga-toxin-producing Escherichia coli. There is important geographical variation of many aspects of this syndrome. Nationwide data on childhood HUS in Switzerland\\u000a have not been available so far. In a prospective national study

Alexandra Schifferli; Rodo O. von Vigier; Matteo Fontana; Giuseppina Spartà; Hans Schmid; Mario G. Bianchetti; Christoph Rudin

2010-01-01

125

Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir  

Microsoft Academic Search

BackgroundCephalosporins were found to be more effective than penicillins in the eradication of group A ?-hemolytic streptococcal (GABHS) from tonsillar tissues. This study investigated the effect of amoxicillin and cefdinir therapies on the rate of eradication of GABHS from the tonsils of children with acute pharyngo-tonsillitis (PT).

Itzhak Brook; Alan E. Gober

2009-01-01

126

Non-transfusion-dependent thalassemias  

PubMed Central

Non-transfusion-dependent thalassemias include a variety of phenotypes that, unlike patients with beta (?)-thalassemia major, do not require regular transfusion therapy for survival. The most commonly investigated forms are ?-thalassemia intermedia, hemoglobin E/?-thalassemia, and ?-thalassemia intermedia (hemoglobin H disease). However, transfusion-independence in such patients is not without side effects. Ineffective erythropoiesis and peripheral hemolysis, the hallmarks of disease process, lead to a variety of subsequent pathophysiologies including iron overload and hypercoagulability that ultimately lead to a number of serious clinical morbidities. Thus, prompt and accurate diagnosis of non-transfusion-dependent thalassemia is essential to ensure early intervention. Although several management options are currently available, the need to develop more novel therapeutics is justified by recent advances in our understanding of the mechanisms of disease. Such efforts require wide international collaboration, especially since non-transfusion-dependent thalassemias are no longer bound to low- and middle-income countries but have spread to large multiethnic cities in Europe and the Americas due to continued migration. PMID:23729725

Musallam, Khaled M.; Rivella, Stefano; Vichinsky, Elliott; Rachmilewitz, Eliezer A.

2013-01-01

127

Audit of perioperative blood transfusion.  

PubMed

The main goal of perioperative transfusion is to reduce the morbidity and mortality associated with inadequate delivery of oxygen to the tissues during surgery. In this audit, the primary trigger for transfusion was clinical anaemia assessed by examination of a patient's conjunctiva [40.7%] followed by estimation of blood loss of greater 20% of total blood volume [29.3%]. Haemoglobin estimation in the operation theater was not done in 45.9% of studied patients and only 7.8% patients had transfusion based on this criteria. A common practice is to transfuse blood for hypovolaemia. This was the indication for blood transfusion in 96 patients (7.8%). Inappropriate use of blood in this way has led to wastage of a valuable resource and exposed patients to potential risks of unwanted side effects. Analysis of haemoglobin estimation at recovery room showed 32% of patient with co-morbidities had Hb > 10 gm% while 65% and 29.5% of patients without co-morbidities had Hb > 8 gm% and 10 gm% respectively. This reflects the practice of anaesthetists in maintaining a target of Hb of 10 gm% for both groups of patients while a target of 8 gm% is still relatively safe for patients with good cardiovascular reserves. This has resulted in signifant use of homologous blood which will certainly burden the blood bank and increase the cost of healthcare. PMID:18551933

Choy, Y C; Lim, W L; Ng, S H

2007-10-01

128

Transfusion reactions: the changing priorities.  

PubMed

Over the last dozen years the relative frequencies of specific transfusion reactions have markedly altered, in general for the better. Although AIDS remains the Public's primary concern, the risk of AIDS from a transfusion is extremely low at this point. Hepatitis remains the most common infectious complication of blood transfusion, but only 1 in 6,000 units now carry a risk, whereas in the early 1980's the risk is believed to have been close to 10% per patient. Transmission of HTLV-I/II has also been markedly reduced by tests of donor sera. In contrast, cytomegalovirus has become of increased importance in view of the large number of patients immunosuppressed for transplantation and cancer therapy; bacterial growth in blood components appears to be increasingly common; and Chagas disease is likely to become a serious transfusion problem in this country. More widespread use of filters which remove three logs or more of white blood cells from components should play a major role in reducing transfusion reactions further. PMID:7713589

Perkins, H

1995-01-01

129

Anesthetic management of living donor liver transplantation for complement factor H deficiency hemolytic uremic syndrome: a case report  

PubMed Central

We experienced a living donor liver transplantation for a 26-month-old girl with complement factor H deficiency. Complement factor H is a plasma protein that regulates the activity of the complement pathway. Complement overactivity induced by complement factor H deficiency is associated with atypical hemolytic uremic syndrome. Liver transplantation can be the proper treatment for this condition. During the liver transplantation of these patients, prevention of the complement overactivation is necessary. Minimizing complement activation, through the use of modalities such as plasma exchange before the surgery and transfusion of fresh frozen plasma throughout the entire perioperative period, may be the key for successful liver transplantation in these patients. PMID:25006375

Park, Suk-Hee

2014-01-01

130

[Ethics and transfusion--seminar report].  

PubMed

This paper brings together the abstracts and proceedings of a seminar held on the topic of "ethics and transfusion", October 15, 2013 at the National Institute of Blood Transfusion, Paris. PMID:24814818

Hervé, C; Tissot, J-D; Bouësseau, M-C; Pottier, R; Monsellier, M; Garraud, O; Hermine, O; Sannié, T; Cazenave, J-P; Cabaud, J-J; Lefrère, J-J

2014-05-01

131

Precautions and Adverse Reactions during Blood Transfusion  

MedlinePLUS

... as itching or a rash. Usually, acetaminophen Some Trade Names TYLENOL to reduce fever is the only ... need another transfusion may be given acetaminophen Some Trade Names TYLENOL before the next transfusion. Allergic reactions: ...

132

Developing nursing practice in platelet transfusions.  

PubMed

The number of platelet transfusions has risen steadily over the past five years. This article addresses some of the reasons for this increase and examines current transfusion practice in relation to findings of national audits of platelet use and current research. It explores the extended role of the nurse in platelet transfusions, including nurse authorisation, and presents an overview of education material available to inform practice and to ensure judicious use of platelet transfusions with maximum benefit for the patient. PMID:25388736

McSporran, Wendy; Watson, Denise

2014-11-12

133

Department and function: Director, Transfusion Medicine  

E-print Network

Department and function: Director, Transfusion Medicine Education: 1981-1987 Universities of Bochum and Essen, Medicine 1996 Specialist in Transfusion Medicine Positions: 1987-1988 University of Marburg and Oncology 1993-1998 Humboldt-University of Berlin, Transfusion Medicine 1998 Hannover Medical School

Manstein, Dietmar J.

134

Department and function: Institute for Transfusion Medicine  

E-print Network

Department and function: Institute for Transfusion Medicine Education: 1996 MD, Friedrich-Alexander-University Erlangen 2002 Medical specialist in transfusion medicine 2003 W1-Professor for molecular immunohematology Leader, Institute for Transfusion Medicine, Hanover Medical School, Hanover, Germany 2003-recent: W1

Manstein, Dietmar J.

135

Infectious and immunologic consequences of blood transfusion  

Microsoft Academic Search

Blood transfusions remain common practice in the critical care and surgical settings. Transfusions carry significant risks, including risks for transmission of infectious agents and immune suppression. Transmission of bacterial infections, although rare, is the most common adverse event with transfusion. The risk for transmission of viral infections has decreased over time, clearly because tests are becoming more sensitive in detecting

E Patchen Dellinger; Daniel A Anaya

2004-01-01

136

Blood transfusion: Yesterday, today, and tomorrow  

Microsoft Academic Search

The evolution of blood transfusion practice into modern transfusion medicine is reported. The impact of great wars on the technique of blood storage and organization of blood supply is discussed. The progress of immunotechnology and fractionation of plasma contributed greatly to contemporary transfusion medicine and the implementation of blood and plasma component therapy. Three basic indications for use of blood

Witold J. Rudowski

1987-01-01

137

Rhesus-D zygosity and hemolytic disease of fetus and newborn.  

PubMed

Alloimmunization against the Rhesus-D (RhD) antigen still remains as a major cause of hemolytic disease of fetus and newborn (HDFN). Determination of paternal RhDzygosity is performed by molecular testing and is valuable for the management of alloimmunized pregnant women. A 30-year-old pregnant woman with AB negative blood group presented with two consecutive abortions and no history of blood transfusion. By application of the antibody screening, identification panel, and selected cells, she was found to be highly alloimmunized. RhDzygosity was performed on her partner and was shown to be homozygous for RhD. The sequence- specific priming-polymerase chain reaction used in this report is essential to establish whether the mother requires an appropriate immunoprophylaxis or the fetus is at risk of HDFN. PMID:24014950

Moghaddam, Mostafa; Naghi, Amirali; Hassani, Fatemeh; Amini, Sedighe

2013-07-01

138

Rhesus-D zygosity and hemolytic disease of fetus and newborn  

PubMed Central

Alloimmunization against the Rhesus-D (RhD) antigen still remains as a major cause of hemolytic disease of fetus and newborn (HDFN). Determination of paternal RhDzygosity is performed by molecular testing and is valuable for the management of alloimmunized pregnant women. A 30-year-old pregnant woman with AB negative blood group presented with two consecutive abortions and no history of blood transfusion. By application of the antibody screening, identification panel, and selected cells, she was found to be highly alloimmunized. RhDzygosity was performed on her partner and was shown to be homozygous for RhD. The sequence- specific priming-polymerase chain reaction used in this report is essential to establish whether the mother requires an appropriate immunoprophylaxis or the fetus is at risk of HDFN. PMID:24014950

Moghaddam, Mostafa; Naghi, Amirali; Hassani, Fatemeh; Amini, Sedighe

2013-01-01

139

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension associated with hemolytic anemia  

PubMed Central

Hereditary hemoglobin disorders affecting the globin chain synthesis namely thalassemia syndromes and sickle cell disease (SCD) are the most common genetic disorders in human. Around 7% of the world population carries genes for these disorders, mainly the Mediterranean Basin, Middle and Far East, and Sub-Saharan Africa. An estimated 30 million people worldwide are living with sickle cell disease, while 60-80 million carry beta thalassemia trait. About 400,000 children are born with severe hemoglobinopathies each year. Cardiovascular complications of hemoglobinopathies include left and right ventricular (RV) dysfunction, arrhythmias, pericarditis, myocarditis, valvular heart disease, myocardial ischemia, and notably pulmonary hypertension (PH). Because of a unique pathophysiology, pulmonary hypertension associated with hemolytic disorders was moved from WHO group I to group V PH diseases. Treatment strategies are also unique and include blood transfusion, iron chelation, hydroxyurea, and oxygen therapy. The role of PH-specific agents has not been established. PMID:25077000

Saleemi, Sarfraz

2014-01-01

140

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension associated with hemolytic anemia.  

PubMed

Hereditary hemoglobin disorders affecting the globin chain synthesis namely thalassemia syndromes and sickle cell disease (SCD) are the most common genetic disorders in human. Around 7% of the world population carries genes for these disorders, mainly the Mediterranean Basin, Middle and Far East, and Sub-Saharan Africa. An estimated 30 million people worldwide are living with sickle cell disease, while 60-80 million carry beta thalassemia trait. About 400,000 children are born with severe hemoglobinopathies each year. Cardiovascular complications of hemoglobinopathies include left and right ventricular (RV) dysfunction, arrhythmias, pericarditis, myocarditis, valvular heart disease, myocardial ischemia, and notably pulmonary hypertension (PH). Because of a unique pathophysiology, pulmonary hypertension associated with hemolytic disorders was moved from WHO group I to group V PH diseases. Treatment strategies are also unique and include blood transfusion, iron chelation, hydroxyurea, and oxygen therapy. The role of PH-specific agents has not been established. PMID:25077000

Saleemi, Sarfraz

2014-07-01

141

Molecular basis of erythroenzymopathies associated with hereditary hemolytic anemia: tabulation of mutant enzymes.  

PubMed

Molecular abnormalities of erythroenzymopathies associated with hereditary hemolytic anemia have been determined by means of molecular biology. Pyruvate kinase (PK) deficiency is the most common and well-characterized enzyme deficiency in the glycolytic pathway, and it causes hereditary hemolytic anemia. To date, 47 gene mutations have been identified. We identified one base deletion, one splicing mutation, and six distinct missense mutations in 12 unrelated families with a homozygous PK deficiency. Mutations located near the substrate or fructose-1,6- diphosphate binding site may change the conformation of the active site, resulting in a drastic loss of activity and severe clinical symptoms. Glucose-6-phosphate dehydrogenase (G6PD)deficiency is the most common metabolic disorder, and it is associated with chronic hemolytic anemia and/or drug- or infection-induced acute hemolytic attack. An estimated 400 million people are affected worldwide. The mutations responsible for about 78 variants have been determined. Some have polymorphic frequencies in different populations. Most variants are produced by one or two nucleotide substitutions. Molecular studies have disclosed that most of the class 1 G6PD variants associated with chronic hemolysis have the mutations surrounding either the substrate or the NADP binding site. Among rare enzymopathies, missense mutations have been determined in deficiencies of glucosephosphate isomerase, (TPI), phosphoglycerate kinase, and adenylate kinase. Compound heterozygosity with missense mutation and base deletion has been determined in deficiencies of hexokinase and diphosphoglyceromutase. Compound heterozygosity with missense and nonsense mutations has been identified in TPI deficiency. One base junction mutations resulting in abnormally spliced PFK-M mRNA have been identified in homozygous PFK deficiency. An exception is hemolytic anemia due to increased adenosine deaminase activity. The basic abnormality appears to result from the overproduction of a structurally normal enzyme. PMID:8579052

Miwa, S; Fujii, H

1996-02-01

142

Microchimerism in the transfused obstetric population.  

PubMed

Microchimerism (MC), the coexistence of allogeneic populations of cells within a host, is well described in pregnancy and blood transfusion. To date, transfusion-associated MC (TA-MC) appears unique to patients transfused after severe traumatic injury. We sought to determine whether transfusion in the peripartum period results in enduring, high-level TA-MC. We conducted a prospective cohort study of 22 women who were newly transfused within 48 h of delivery. Two subjects showed evidence of transient TA-MC; however, MC was not detected at 6 weeks and 6 months. The negative findings suggest that enduring TA-MC does not occur in this population. PMID:25040346

Bloch, E M; Busch, M P; Lee, T-H; Montalvo, L; Matthews, Y; Bird, A; Bruhn, R; Stefan, V

2014-11-01

143

Severe Hemolytic Anemia Associated with Mild Pneumonia Caused by Mycoplasma pneumonia  

PubMed Central

We report a case of M. pneumoniae infection presenting with severe hemolytic anemia in a 4-year-old girl, with a ten-day history of paleness, weakness, and nonproductive cough. She was very pale and tachycardic. However, she was not tachypneic. Chest examination showed normal breath sounds. No rhoncus or whistling was heard. As the erythrocyte sedimentation rate was excessively elevated, the differential diagnosis primarily comprised hematological malignancies. Direct Coombs' test was positive. Diagnosis of M. pneumoniae infection was confirmed by elevated levels of M. pneumoniae IgG and IgM antibodies and a chest X-ray suggestive of atypical pneumonia. The patient was treated with clarithromycin and packed red cell transfusion and showed a favorable recovery within ten days after admission. In conclusion, this case demonstrates that severe hemolytic anemia caused by M. pneumoniae is not always associated with severe pulmonary involvement, even when the respiratory infection is very mild, M. pneumoniae may be the cause of severe anemia. PMID:23049568

Kurugol, Zafer; Onen, Serife Sebnem; Koturoglu, Guldane

2012-01-01

144

Distribution of hemolytic complement in the normal cornea.  

PubMed

Hemolytic activities in the central cornea were compared with hemolytic activities in the peripheral cornea for each of the following complement components: C1, C4, C2, C3, C5, C6, and C7. For all seven complement components studied, hemolytic activities in the peripheral cornea were higher than hemolytic activities in the central cornea, and the differences were statistically significant. The most striking difference was for C1, which had a ratio of mean hemolytic activity in the peripheral cornea to that in the central cornea of almost 5:1. For the other six complement components, the ratio of the mean hemolytic activity in the peripheral cornea to that in the central cornea was approximately 1.2:1. This distribution of complement activity in the cornea suggests that the major source of complement components is the limbal vessels and that complement components diffuse from the limbus to the central cornea. PMID:7020664

Mondino, B J; Brady, K J

1981-08-01

145

Transfusion-transmitted parasitic infections  

PubMed Central

The transmission of parasitic organisms through transfusion is relatively rare. Of the major transfusion-transmitted diseases, malaria is a major cause of TTIP in tropical countries whereas babesiosis and Chagas’ disease pose the greatest threat to donors in the USA In both cases, this is due to the increased number of potentially infected donors. There are no reliable serologic tests available to screen donors for any of these organisms and the focus for prevention remains on adherence to donor screening guidelines that address travel history and previous infection with the etiologic agent. One goal is the development of tests that are able to screen for and identify donors potentially infectious for parasitic infections without causing the deferral of a large number of non-infectious donors or significantly increasing costs. Ideally, methods to inactivate the infectious organism will provide an element of added safety to the blood supply. PMID:20859503

Singh, Gagandeep; Sehgal, Rakesh

2010-01-01

146

Alemtuzumab plus cyclosporine treatment of the autoimmune hemolytic anemia in an adult bowel transplant.  

PubMed

An adult male underwent a bowel transplant for tufting enteropathy, receiving alemtuzumab, tacrolimus, and steroids as immunosuppressants. Five years later, he developed an autoimmune hemolytic anemia (AIHA), anti-IgG positive, with reduced reticulocyte count, leukopenia, and thrombocytopenia with antiplatelet antibodies. After an unsuccessful initial treatment with high dose steroids, reduction in tacrolimus dose, and intravenous immunoglobulin (IVIG), a bone marrow biopsy revealed absence of erythroid maturation with precursor hyperplasia. The patient was switched to sirolimus and received four doses of rituximab plus two courses of plasmapheresis, which decreased his transfusion requirements. After a febrile episode one month later, the AIHA relapsed with corresponding decreases in platelet and leukocyte count: cyclosporine A (CsA) was started with a second course of rituximab and IVIG without response, even though repeat bone marrow biopsy did not reveal morphology correlated to an acquired pure red cell aplasia (APRCA). Considering the similarity in his clinical and laboratory findings to APRCA, alemtuzumab was added (three doses over a week) with CsA followed by steroids. The patient was eventually discharged transfusion-independent, with increasing hemoglobin (Hb) levels and normal platelet and leukocyte count. One year later he is still disease-free with functioning graft. PMID:25177510

Lauro, A; Stanzani, M; Finelli, C; Zanfi, C; Morelli, M C; Pasqualini, E; Dazzi, A; Ravaioli, M; Di Simone, M; Giudice, V; Pironi, L; Pinna, A D

2014-01-01

147

Hemolytic crisis in a G6PD-deficient infant after ingestion of pumpkin  

PubMed Central

A 8 month-old infant presented with acute onset of severe jaundice, anemia requiring transfusion and Glucose-6-Phosphate Dehydrogenase deficiency. The infant did not take drugs, he did not consume fava beans, but fava beans DNA was found on pumpkin he consumed the day before jaundice onset. This is the first case of hemolysis triggered by ingestion of food cross-contaminated with fava beans. PMID:25048415

2014-01-01

148

Hemolytic crisis in a G6PD-deficient infant after ingestion of pumpkin.  

PubMed

A 8 month-old infant presented with acute onset of severe jaundice, anemia requiring transfusion and Glucose-6-Phosphate Dehydrogenase deficiency. The infant did not take drugs, he did not consume fava beans, but fava beans DNA was found on pumpkin he consumed the day before jaundice onset. This is the first case of hemolysis triggered by ingestion of food cross-contaminated with fava beans. PMID:25048415

Zuccotti, Gian Vincenzo; Redaelli, Francesca; Gualdi, Valentina; Rizzi, Valeria; Mameli, Chiara; Dilillo, Dario; Fabiano, Valentina

2014-01-01

149

Patients' perceptions of blood transfusion risks in Karachi, Pakistan  

Microsoft Academic Search

Objective: To evaluate the understanding of and attitudes toward risks of blood transfusions among transfusion recipients in Karachi.Methods: One hundred forty-one transfusion recipients from 13 major Karachi hospitals were interviewed. Indications for transfusion were obtained by reviewing the patients' medical records.Results: The most common indications for transfusion were surgical complications (n = 77, 55%), anemia (n = 34, 24%), and

Stephen P. Luby; Qaiser Niazt; Sheeraz Siddiquit; Syed A. Mujeeb; Susan Fisher-Hoch

2001-01-01

150

[Blood transfusion assessment to 112 homozygous sickle-cell disease patients in university hospital of Brazzaville].  

PubMed

Homozygous, sickle-cell disease (SCD) is responsible for acute complication, especially anaemic crisis and special situation such as acute chest syndrome, stroke and acute priapism. Pregnancy sickle-cell disease presents high risk for the mother and the fetus. In these indications, blood transfusion is the main therapy aiming to reduce anaemia in order to restore hemoglobin's rate or to increase normal Hb proportion. This study aims to assess the short-term efficiency of the red cell transfusion in SCD homozygous form. One hundred and twelve homozygous sickle-cell patients were enrolled in this prospective study: 59 females and 53 males, median age is 21,8 years (extremes: 2 and 45 years). These patients are mostly with very low income. Two groups of patients are included in this study. In the first group, patients present acute anemia crisis caused by infections disease (malaria, bacterial infections). In the second group (20 cases), SCD patients have particularly situations: pregnancy (10 cases); stroke (six cases); cardiac failure (two cases) and priapism (two cases). Transfusion treatment in first group is simple regimen. Transfusion of EC increased median Hb level at 2,9 g/dl (extremes: 1,1 and 4,7). In the second group of patients, 16 cases were transfused by manual partial exchange (1-3) and four patients received simple regimen of transfusion. Median Hb level was 3,1g/dl (extremes: 2,4-4,9 g/dl). HbS percentage reduction was after PTE between -30 and -66,8% (median: -52,6%). According to our diagnostic possibilities (blood serologic test), we have not found any contamination by HIV, HBV and HCV (virus). PMID:19369104

Dokekias, A Elira; Ossini, L Ngolet; Tsiba, F O Atipo; Malanda, F; Koko, I; De Montalembert, M

2009-01-01

151

Blood Transfusion Transmitted Infections in Multiple Blood Transfused Patients of Beta Thalassaemia  

Microsoft Academic Search

Transfusion Transmitted Infection (TTI) continue to be a problem in many parts of world and multi-transfused patients of beta\\u000a thalassaemia major are at a particularly increased risk of TTI. This study is aimed to estimate the prevalence of blood TTI\\u000a in multiple blood transfused patients of beta thalassaemia major. Cross-sectional study of 200 multi-transfused patients of\\u000a beta thalassaemia major, who

Prakash J. Vidja; J. H. Vachhani; S. S. Sheikh; P. M. Santwani

152

[Blood transfusion and infectious diseases].  

PubMed

Blood transfusion is essential in current medical treatment. In the era of selling blood, around 50% of recipients seemed to be infected by hepatitis virus. After the establishment of the blood donation system and many safety measures, the risk of blood contamination has decreased markedly; however, blood products still have a risk of known and unknown pathogens. In this manuscript, we discuss the remaining problems of HBV and HIV-1. As emerging infectious diseases, we examine Trypanosoma crusi, West Nile virus, Chikungunya virus, and Dengue virus. Finally, XMRV is exemplified as a rumored virus. Gathering accurate information about pathogens and preparing for outbreaks in advance are crucial for blood safety. PMID:23947180

Hamaguchi, Isao

2013-05-01

153

Transfusion Practices in the Management of Sickle Cell Disease: A Survey of Florida Hematologists/Oncologists  

PubMed Central

The purpose of this study was to characterize transfusion practices in the management of sickle cell disease and to identify factors attributing to differences in prescribing practices among Florida hematologists/oncologists. A cross-sectional study was performed in 2005-2006 utilizing a mail survey. The survey instrument addressed practice characteristics, sickle cell patient populations, transfusion settings, indications and techniques, red blood cell phenotype specifications/modifications, use of practice guidelines, and educational resource utilization. One hundred fifty two physicians (75% adult-oriented, 25% pediatric) completed the survey. Non-academic practice settings (78 %) were the primary location. Pediatric practices had a larger percentage of patients with overt strokes, and receiving hydroxyurea therapy than adult-oriented practices. The majority of survey respondents did not request limited phenotypically matched red blood cells on a routine basis. The majority of pediatric practices (60%) had individually defined transfusion practice guidelines in contrast to 8% of adult-oriented practices. There were statistically significant differences for pediatric and adult-oriented practices in managing certain acute and chronic transfusion indications. Analysis of clinical vignette data revealed variation among hematologists/oncologists in the transfusion management of common clinical scenarios. The study underscores the need for the development and dissemination of comprehensive sickle cell transfusion guidelines and protocols. PMID:23316379

Dunbar, Levette N.; Coleman Brown, LaRae; Rivera, Donna R.; Hartzema, Abraham G.; Lottenberg, Richard

2012-01-01

154

Hemolytic activity of five different calcium silicates.  

PubMed Central

Mineral characteristics and the in vitro hemolytic activity of three synthetic and two natural calcium silicates (CaSi) are compared. Hemolysis is higher for the synthetic compounds than for the natural ones. The difference is accentuated by weak ultrasonication of the minerals. No variation was observed within the two groups, including both acicular and fibrous forms. Calcium was released from the minerals during storage in Tris-buffered saline. At the same time, hemolysis decreased, and crystallographic alterations occurred in the leached minerals. Treatment of the CaSi with calcium chelators (EGTA and EDTA) did not change hemolytic activity. An increase was observed when 30 mM calcium was added. Hemolysis is related to specific surface areas and the crystalline structure of the minerals. Calcium may also be a contributing factor. Images FIGURE 1. a FIGURE 1. b FIGURE 1. c FIGURE 1. d FIGURE 1. e FIGURE 1. f FIGURE 7. a FIGURE 7. b FIGURE 7. c FIGURE 7. d FIGURE 7. e FIGURE 7. f PMID:6315361

Skaug, V; Gylseth, B

1983-01-01

155

Operative blood transfusion quality improvement audit  

PubMed Central

Context: To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. Aims: To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the blood transfusion administration. Settings and Design: Setting: A large tertiary care reference and teaching hospital. Design: A prospective quality improvement. Elaboration on steps for administration of transfusion from policies and procedures to anaesthetized patients; and analysis of the audit forms for conducted transfusions. Subjects and Methods: An audit form was used to get key performance indicators (KPIs) observed in all procedures involve blood transfusion and was ticked as item was met, partially met, not met or not applicable. Statistical Analysis Used: Descriptive statistics as number and percentage Microsoft excel 2003. Central quality improvement committee presented the results in number percentage and graphs. Results: The degree of compliance in performing the phases of blood transfusion by anesthesia staff reached high percentage which let us feel certain that the quality is assured that the internal policy and procedures (IPP) are followed in the great majority of all types of red cells and other blood products transfusion from the start of requesting the blood or blood product to the prescript of checking the patient in the immediate post-transfusion period. Conclusions: Specific problem area of giving blood transfusion to anaesthetized patient was checking KPI concerning the phases of blood transfusion was audited and assured the investigators of high quality performance in procedures of transfusion.

Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

2014-01-01

156

Generation of hemolytic activity in ozone-treated phosphatidylcholine  

SciTech Connect

When liposomes prepared from purified soybean phosphatidylcholine were treated with ozone, at least two types of hemolytic agents were formed. One type was stable at 0 degree C but was destroyed rapidly at 37 degrees C. A second type was evolved during storage of ozone-treated phosphatidylcholine at 37 degrees C in the absence of EDTA. This study is concerned mainly with the heat-labile type. The hemolytic activity was not associated with lipid hydroperoxides. A number of substances were shown to inhibit the hemolytic activity and these may be divided into two classes. The first included cysteine, polyamines, n-heptylamine, semicarbazide, and tryptophan. Preincubation of the ozone-treated phosphatidylcholine was necessary with a Class 1 inhibitor, presumably for the interaction of the inhibitor with a functional group of the hemolytic agents. The Class II inhibitors, including BHT and vitamin C, required no preincubation. These possibly abolished the hemolytic activity by scavenging free radicals in the process.

Butterman, J.; Chan, P.C.; Kesner, L.

1987-04-01

157

Duration of oliguria and anuria as predictors of chronic renal-related sequelae in post-diarrheal hemolytic uremic syndrome  

Microsoft Academic Search

Prior long-term retrospective studies have described renal sequelae in 25–50% of postdiarrheal hemolytic uremic syndrome (HUS)\\u000a survivors, but the ability to predict the likelihood of chronic renal-related sequelae at the time of hospital discharge is\\u000a limited. We surveyed 357 children in our HUS registry who survived an acute episode of post diarrheal HUS (D+HUS) and were\\u000a without end-stage renal disease

Robert S. Oakes; Justin K. Kirkhamm; Raoul D. Nelson; Richard L. Siegler

2008-01-01

158

Indications and organisational methods for autologous blood transfusion procedures in Italy: results of a national survey  

PubMed Central

Introduction Pre-operative donation of autologous blood is a practice that is now being abandoned. Alternative methods of transfusing autologous blood, other than predeposited blood, do however play a role in limiting the need for transfusion of allogeneic blood. This survey of autologous blood transfusion practices, promoted by the Italian Society of Transfusion Medicine and Immunohaematology more than 2 years after the publication of national recommendations on the subject, was intended to acquire information on the indications for predeposit in Italy and on some organisational aspects of the alternative techniques of autotransfusion. Materials and methods A structured questionnaire consisting of 22 questions on the indications and organisational methods of autologous blood transfusion was made available on a web platform from 15 January to 15 March, 2013. The 232 Transfusion Services in Italy were invited by e-mail to complete the online survey. Results Of the 232 transfusion structures contacted, 160 (69%) responded to the survey, with the response rate decreasing from the North towards the South and the Islands. The use of predeposit has decreased considerably in Italy and about 50% of the units collected are discarded because of lack of use. Alternative techniques (acute isovolaemic haemodilution and peri-operative blood salvage) are used at different frequencies across the country. Discussion The data collected in this survey can be considered representative of national practice; they show that the already very limited indications for predeposit autologous blood transfusion must be adhered to even more scrupulously, also to avoid the notable waste of resources due to unused units. Users of alternative autotransfusion techniques must be involved in order to gain a full picture of the degree of use of such techniques; multidisciplinary agreement on the indications for their use is essential in order for these indications to have an effective role in “patient blood management” programmes. PMID:25350961

Catalano, Liviana; Campolongo, Alessandra; Caponera, Maurizio; Berzuini, Alessandra; Bontadini, Andrea; Furlo, Giuseppe; Pasqualetti, Patrizio; Liumbruno, Giancarlo M.

2014-01-01

159

Psychrobacter arenosus bacteremia after blood transfusion, France.  

PubMed

We report a case of transfusion-associated bacteremia caused by Psychrobacter arenosus. This psychrotolerant bacterium was previously isolated in 2004 from coastal sea ice and sediments in the Sea of Japan, but not from humans. P. arenosus should be considered a psychrotolerant bacterial species that can cause transfusion-transmitted bacterial infections. PMID:23764120

Caspar, Yvan; Recule, Christine; Pouzol, Patricia; Lafeuillade, Bruno; Mallaret, Marie-Reine; Maurin, Max; Croize, Jacques

2013-07-01

160

Emerging viral infections relevant to transfusion medicine  

Microsoft Academic Search

The development of new technologies leads to the discovery of new viruses. For each of these new infectious agents relevance to transfusion needs to be assessed. The questions to be answered are transmissibility by transfusion, pathogenicity, prevalence in blood donors, persistence and the availability of screening assays. Since 1995, three new viruses have been identified and extensively studied. GB virus-C\\/hepatitis

J.-P. Allain

2000-01-01

161

The Immunosuppressive Aspects of Blood Transfusion  

Microsoft Academic Search

Blood transfusion is associated with immunosuppression, although the exact etiology of the immunosuppressive effect is not fully understood. The clinical significance of the immunosuppressive effect of blood transfusion has been examined in three situations: (1) studies of renal allograft survival after renal transplantation, (2) outcome studies in patients who have had surgical resection of solid cancer tumors, and (3) studies

Thomas A. Mickler; David E. Longnecker

1992-01-01

162

Blood Transfusion and Donation - Multiple Languages: MedlinePlus  

MedlinePLUS

... Bosanski) Chinese - Simplified (????) Chinese - Traditional (????) French (français) Hindi (??????) Japanese (???) Korean (???) Portuguese ( ... Community Health Resource Center Return to top French (français) Receiving Blood Transfusions Recevoir des transfusions sanguines - français ( ...

163

Hemostatic Function and Transfusion Efficacy of Apheresis Platelet Concentrates Treated with Gamma Irradiation in Use for Thrombocytopenic Patients  

PubMed Central

Summary Background During the transfusion of blood components, the transfer of allogeneic donor white blood cells (WBCs) can mediate transfusion-associated graft-versus-host disease (TA-GVHD). To minimize the reaction, exposure of blood products to gamma irradiation is currently the standard of care. The aim of our study was to evaluate and compare hemostatic function, transfusion efficacy, and safety of gamma-irradiated single-donor apheresis platelet concentrates (PCs) and of conventional non-irradiated PCs in patients with chemotherapy-induced thrombocytopenia. Methods 20 double-dose single-donor leukoreduced PCs were split in two identical units; one was gamma-irradiated with 25 Gy (study arm A) and the other remains non-irradiated (study arm B). Both units were stored under equal conditions. Hematologic patients were randomly assigned to receive gamma-irradiated or conventional non-irradiated PCs. Hemostatic function was evaluated by thrombelastography (TEG). TEG measurements were taken pre transfusion and 1 and 24 h post transfusion. TEG profiles were measured, noting the time to initiate clotting (R), the angle of clot formation (?), and the maximum amplitude (clot strength (MA)). Whole blood samples were collected from these thrombocytopenic patients at 1 and 24 h for PLT count increments (CIs) and corrected count increments (CCIs) with assessments of transfusion efficacy. Time to next PLT transfusion, transfusion requirement of RBCs, active bleeding, and adverse events (AEs), were analyzed. Results No differences could be found in hemostatic function parameters (MA, R, and ?) between study arms A and B (all p values > 0.096) pre transfusion as well as 1 and 24 h post transfusion. No differences between study arms A and B were observed for mean (± standard deviation (SD)) 1-hour CCI (12.83 ± 6.33 vs. 11.59 ± 5.97) and 24-hour CCI (6.56 ± 4.10 vs. 5.76 ± 4.05). Mean 1-hour CI and 24-hour CI were not significantly different in both study arms (p = 0.254 and p = 0.242 respectively). Median time to the next PC transfusion after study PC was not significantly different between groups: (2.4 vs. 2.2 days, p = 0.767). No differences could be found in transfusion requirement of red blood cells (p = 0.744) between both study arms. There were also no regarding bleeding, adverse events, and acute transfusion reaction(s). Conclusions This study confirms safety of gamma-irradiated PCs for treatment thrombocytopenia. Hemostatic function, transfusion efficacy, bleeding, and safety of single-donor apheresis PCs treated with gamma irradiation versus untreated control PCs are comparable. PMID:25053932

Zhu, Mei; Xu, Wei; Wang, Bao-Long; Su, Hong

2014-01-01

164

The transfusion medicine we want  

PubMed Central

The Associação Brasileira de Hematologia e Hemoterapia (ABHH), through its Board of Directors, hosted a national symposium called "Forum: The Transfusion Medicine we want", to discuss proposed policies and techniques related to the area. This meeting was held in São Paulo on August 19 and 20, 2010, with the participation of experts, authorities and representatives of organized groups of patients and users. The discussions were organized around three specific issues selected from over 100 suggestions sent to the ABHH through public consultation on the web: 1. Strategies; 2. Financing; 3. Blood products. A plenary session, held at the end of the meeting, adopted recommendations that are relevant to the different discussion topics. This document contains actions proposed by the ABHH to meet the demands discussed. PMID:23284248

2011-01-01

165

The transfusion medicine we want.  

PubMed

The Associação Brasileira de Hematologia e Hemoterapia (ABHH), through its Board of Directors, hosted a national symposium called "Forum: The Transfusion Medicine we want", to discuss proposed policies and techniques related to the area. This meeting was held in São Paulo on August 19 and 20, 2010, with the participation of experts, authorities and representatives of organized groups of patients and users. The discussions were organized around three specific issues selected from over 100 suggestions sent to the ABHH through public consultation on the web: 1. Strategies; 2. Financing; 3. Blood products. A plenary session, held at the end of the meeting, adopted recommendations that are relevant to the different discussion topics.This document contains actions proposed by the ABHH to meet the demands discussed. PMID:23284248

2011-01-01

166

Blood transfusion and infection after cardiac surgery.  

PubMed

Cardiac surgery is the largest consumer of blood products in medicine; although believed life saving, transfusion carries substantial adverse risks. This study characterizes the relationship between transfusion and risk of major infection after cardiac surgery. In all, 5,158 adults were prospectively enrolled to assess infections after cardiac surgery. The most common procedures were isolated coronary artery bypass graft surgery (31%) and isolated valve surgery (30%); 19% were reoperations. Infections were adjudicated by independent infectious disease experts. Multivariable Cox modeling was used to assess the independent effect of blood and platelet transfusions on major infections within 60 ± 5 days of surgery. Red blood cells (RBC) and platelets were transfused in 48% and 31% of patients, respectively. Each RBC unit transfused was associated with a 29% increase in crude risk of major infection (p < 0.001). Among RBC recipients, the most common infections were pneumonia (3.6%) and bloodstream infections (2%). Risk factors for infection included postoperative RBC units transfused, longer duration of surgery, and transplant or ventricular assist device implantation, in addition to chronic obstructive pulmonary disease, heart failure, and elevated preoperative creatinine. Platelet transfusion decreased the risk of infection (p = 0.02). Greater attention to management practices that limit RBC use, including cell salvage, small priming volumes, vacuum-assisted venous return with rapid autologous priming, and ultrafiltration, and preoperative and intraoperative measures to elevate hematocrit could potentially reduce occurrence of major postoperative infections. PMID:23647857

Horvath, Keith A; Acker, Michael A; Chang, Helena; Bagiella, Emilia; Smith, Peter K; Iribarne, Alexander; Kron, Irving L; Lackner, Pamela; Argenziano, Michael; Ascheim, Deborah D; Gelijns, Annetine C; Michler, Robert E; Van Patten, Danielle; Puskas, John D; O'Sullivan, Karen; Kliniewski, Dorothy; Jeffries, Neal O; O'Gara, Patrick T; Moskowitz, Alan J; Blackstone, Eugene H

2013-06-01

167

Transfusion associated circulatory overload: a critical incident.  

PubMed

Transfusion associated circulatory overload (TACO) is a serious but under-recognised complication of blood transfusion. While the exact incidence rate is unknown the associated morbidity and mortality make this a transfusion reaction worthy of attention. This article provides details of a critical incident involving TACO followed by a literature review and discussion written from the perspective of a student ODP. The goal of this article is to raise awareness of TACO amongst hospital staff to facilitate faster recognition and earlier intervention in future events. PMID:24516967

Goodall, E

2014-01-01

168

Postoperative Atypical Hemolytic Uremic Syndrome Associated with Complement C3 Mutation  

PubMed Central

Atypical hemolytic uremic syndrome (aHUS) can be distinguished from typical or Shiga-like toxin-induced HUS. The clinical outcome is unfavorable; up to 50% of affected patients progress to end-stage renal failure and 25% die during the acute phase. Multiple conditions have been associated with aHUS, including infections, drugs, autoimmune conditions, transplantation, pregnancy, and metabolic conditions. aHUS in the nontransplant postsurgical period, however, is rare. An 8-month-old boy underwent surgical repair of tetralogy of Fallot. Neurological disturbances, acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia developed 25 days later, and aHUS was diagnosed. Further evaluation revealed that his complement factor H (CFH) level was normal and that anti-FH antibodies were not detected in his plasma. Sequencing of his CFH, complement factor I, membrane cofactor protein, complement factor B, and thrombomodulin genes was normal. His ADAMTS-13 (a disintegrin-like and metalloprotease with thrombospondin-1 repeats 13) activity was also normal. However, he had a potentially causative mutation (R425C) in complement component C3. Restriction fragment length polymorphism analysis revealed that his father and aunt also had this mutation; however, they had no symptoms of aHUS. We herein report a case of aHUS that developed after cardiovascular surgery and was caused by a complement C3 mutation.

Matsukuma, Eiji; Imamura, Atsushi; Iwata, Yusuke; Takeuchi, Takamasa; Yoshida, Yoko; Fujimura, Yoshihiro; Fan, Xinping; Miyata, Toshiyuki; Kuwahara, Takashi

2014-01-01

169

Blood doping: the flip side of transfusion and transfusion alternatives.  

PubMed

Blood doping in sports has been a hot topic of present. Longitudinal follow up of hematological parameters in different endurance sports, during the 1990s and early 2000s, has provided considerable suspicions about extensive blood manipulation, with performance enhancing effects. Recent doping revelations in the media also prove that blood doping is not an anticipated myth but it is, in fact, real. Erythropoiesis stimulating agents and autologous blood transfusions are used in synergy with substantial effect on the maximum oxygen uptake and delivery to muscles. Whilst both methods of blood manipulation represent a potential health hazard, in the context of an elevated hematocrit, nevertheless despite a number of suspicious deaths amongst athletes, this has not yet been fully documented. A reliable test for detection of recombinant human erythropoietin was implemented in 2000, but this is probably circumvented by microdose regimens. The Athlete's Biological Passport represents the progeny of the idea of an indirect approach based on long term monitoring of hematological parameters, thus making it possible to detect autologous blood doping and erythropoietin use after the substance is excreted. Nevertheless with advances in anti-doping measures it is possible that the levels of excretion of substances used can be masked. Clearly more sensitive and specific diagnostic tools and research/development in these areas of major concern are warranted, which, combined with changes in the athlete's attitude, will help in reaching the vision of fair play. PMID:23791798

Cacic, Daniel Limi; Hervig, Tor; Seghatchian, Jerard

2013-08-01

170

Fatal Aspergillus pancarditis after incompatible blood transfusion intended to be an autologous blood transfusion  

Microsoft Academic Search

Aspergillus pancarditis is a rare infection, and it has rarely been reported after blood transfusion. In this report, we describe a fatal case of Aspergillus pancarditis in a patient who received antibiotics and corticoids after an incompatible blood transfusion intended to be an autologous blood transfusion. A 64-year-old man suffering from herniation of intervertebral disk between C4 and C5 received

Isao Ohya; Yasuo Bunai; Masatake Tsujinaka; Kayoko Akaza; Isao Nakamura

2001-01-01

171

Comparative analysis of autologous blood transfusion and allogeneic blood transfusion in surgical patients  

PubMed Central

Objective: To investigate application effects of autologous blood transfusion and allogeneic blood transfusion in surgically treated patients receiving spine surgery, abdomen surgery and ectopic pregnancy surgery. Methods: 130 patients who would undergo selective operations were divided into autologous transfusion group and allogeneic transfusion group. Both groups received the same anesthesia, and there was no significant difference in transfusion volume or fluid infusion volume. Results: The serum TNF-? level in autologous transfusion group after operation showed a clear upward trend and had significant difference compared with that before operation (P < 0.05). Meanwhile, after operation, the serum TNF-? level in autologous transfusion group was all significantly higher than that allogeneic transfusion group and the comparative difference was statistically significant (P < 0.05). IgG level in treatment group did not significantly fluctuate during perioperative period, but IgG level in allogeneic transfusion group after operation was all significantly lower than that before operation, and there was statistically significant difference between both groups (P < 0.05). At the same time, complement C3 level in treatment group after operation was significantly higher than that before operation (P < 0.05), but complement C3 level in allogeneic transfusion group did not significantly change. After operation, there was statistically significant difference in complement C3 level between both groups (P < 0.05). Conclusion: Autologous transfusion is already a widely accepted transfusion method at present, and it can increase TNF-? and complement C3 levels in the body of surgically treated patients to strengthen immune ability against infection.

Long, Miao-Yun; Liu, Zhong-Han; Zhu, Jian-Guang

2014-01-01

172

Perioperative intravenous iron: an upfront therapy for treating anaemia and reducing transfusion requirements.  

PubMed

Perioperative anaemia, with iron deficiency being its leading cause, is a frequent condition among surgical patients, and has been linked to increased postoperative morbidity and mortality, and decreased quality of life. Postoperative anaemia is even more frequent and is mainly caused by perioperative blood loss, aggravated by inflammation-induced blunting of erythropoiesis. Allogenic transfusion is commonly used for treating acute perioperative anaemia, but it also increases the rate of morbidity and mortality in surgical and critically ill patients. Thus, overall concerns about adverse effects of both preoperative anaemia and allogeneic transfusion have prompted the review of transfusion practice and the search for safer and more biologically rational treatment options. In this paper, the role of intravenous iron therapy (mostly with iron sucrose and ferric carboxymaltose), as a safe and efficacious tool for treating anaemia and reducing transfusion requirements in surgical patients, as well as in other medical areas, has been reviewed. From the analysis of published data and despite the lack of high quality evidence in some areas, it seems fair to conclude that perioperative intravenous iron administration, with or without erythropoiesis stimulating agents, is safe, results in lower transfusion requirements and hastens recovery from postoperative anaemia. In addition, some studies have reported decreased rates of postoperative infection and mortality, and shorter length of hospital stay in surgical patients receiving intravenous iron. PMID:23588429

Muñoz, M; Gómez-Ramírez, S; Martín-Montañez, E; Pavía, J; Cuenca, J; García-Erce, J A

2012-01-01

173

Reappraisal of the Etiology of Extracorpuscular Non-Autoimmune Acquired Hemolytic Anemia in 2657 Hospitalized Patients with Non-Neoplastic Disease  

PubMed Central

INTRODUCTION Unlike autoimmune hemolytic anemia (AIHA), literature on the etiological study of non-autoimmune hemolytic anemia (non-AIHA) is scarce. The incidence and prevalence of non-AIHA in different geographic regions are largely unknown perhaps owing to the lack of perspective investigation and different profiles of etiologies from different geographic regions. We aimed to examine the real-world etiology or mechanisms of the non-hereditary non-AIHA from a nationwide population-based administrative claim database in Taiwan. PATIENTS AND METHODS The National Health Insurance Research Database of Taiwan was adopted for this research. The studied population was total inpatient claim records including both pediatric and adult patients, contributed by a population of 23 million insured individuals in Taiwan. From 2002 to 2008, we retrieved 3,903 patients having no pre-existing malignancy discharged after inpatient management for acquired hemolytic anemia, which was defined as coding in discharge diagnoses containing ICD-9-CM code 283. By contrast, ICD-9-CM code 282 and all of the sub-codes are for hereditary hemolytic anemias. RESULTS AIHA accounted for 32% of the total cases. Among 2,657 patients with non-AIHA, mechanical or microangiopathic mechanism accounted for 19% of cases; hemolytic-uremic syndrome (HUS) 4%, hemoglobinuria because of hemolysis from external causes such as paroxysmal nocturnal hemoglobinuria (PNH) and march hemoglobinuria 7%, and chronic idiopathic hemolytic anemia or other unspecified non-AIHA 69%. We looked further for specific etiology or mechanism for this group of patients with non-hereditary extrinsic non-AIHA (n = 2,657). The explanatory disease states or conditions were splenomegaly; alcohol use disorder (spur cell hemolysis); heart-valve prosthesis; malignant hypertension; disseminated intravascular coagulation; transfusion reaction; dengue fever-induced hemolytic anemia; direct parasitization; snake, lizard, or spider bite; and Wilson’s disease with internal toxin mechanism. All these cases can explain up to 34.6% of all the non-hereditary extrinsic non-AIHA cases. Fragmentation hemolysis (HUS, heart-valve prosthesis, malignant hypertension, and disseminated intravascular coagulation) accounted for 7.4% of non-AIHA hospitalized patients with non-neoplastic disease. CONCLUSIONS This article is the first one to clearly demonstrate that the non-neoplastic-induced HUS requiring hospitalization cases in Taiwan, which has a population of over 23 million were 110 over a span of seven years, 16 cases per year. Although the etiologies of non-AIHA are well known and described in the literature, this work added the statistical percentages of the various etiologies of non-AIHA in Taiwan. PMID:24808725

Kok, Victor C; Lee, Chien-Kuan; Horng, Jorng-Tzong; Lin, Che-Chen; Sung, Fung-Chang

2014-01-01

174

Prevention and Management of Platelet Transfusion Refractoriness  

Microsoft Academic Search

Platelet transfusion refractoriness is a major complication of long–term platelet supportive care. Refractoriness may lead to fatal bleeding complications in thrombocytopenic patients. Major factors involved are factors related to the clinical condition of the patient as well as HLA alloimmunisation. Non–alloimmune factors may occur in up to 80% of the patients. However, platelet transfusion outcome is impaired in only 50%

V. M. J. Novotny

1999-01-01

175

Mechanisms of transfusion-associated immunosuppression.  

PubMed

Many studies have reported allogeneic blood transfusions to be associated with adverse effects in recipients. These include a variety of transfusion reactions, graft-versus-host disease, alloimmunization, the transmission of infectious agents, and immunomodulation. In some instances the immunomodulatory effect has been reported to be beneficial to the recipient, i.e., recipients of renal allografts, individuals with Crohn's disease, and women with recurrent spontaneous abortions. Recent evidence indicates, however, that this autologous blood transfusion-associated immunomodulation might adversely affect the prognosis in patients with a malignancy as well as increase their risk for postoperative bacterial infection. The mechanisms of the autologous blood transfusion-associated immunosuppressive effect remain ill defined, although recent evidence indicates that such effects are probably due to the infusion of allogeneic donor leukocytes, or their products, present in the cellular blood products used for the transfusion. Recent experimental animal data indicate that this autologous blood transfusion-associated immunomodulatory effect can be ameliorated by the prestorage leukodepletion of allogeneic blood. Although data from animal experiments are useful in defining various in vivo biologic activities, properly designed prospective clinical trials are required to provide definitive indications as to whether patients with a malignancy undergoing curative surgery should receive leukodepleted allogeneic cellular blood products and the appropriate timing for such leuko-depletion. PMID:9371323

Blajchman, M A; Bordin, J O

1994-11-01

176

Autoimmune hemolytic anemia in chronic mucocutaneous candidiasis.  

PubMed Central

Chronic mucocutaneous candidiasis is an immunodeficiency disease characterized by T-cell dysregulation and chronic superficial candidal infections. We report on three patients with chronic mucocutaneous candidiasis who developed autoantibodies to erythrocytes. Our first patient, a 19-year-old female, developed autoimmune hemolytic anemia (AIHA) that required multiple courses of treatment, including corticosteroids, intravenous immunoglobulin, and danazol. During the last exacerbation of AIHA, intensive treatment with corticosteroids and intravenous immunoglobulin failed and yet the patient responded to plasmapheresis. Our second patient, a 21-year-old male, developed AIHA which responded to oral corticosteroid therapy. Our third patient, a 6-year-old female without evidence of hemolysis, was found to have erythrocyte autoantibodies on routine screening. These three patients had positive direct antiglobulin tests, and the first patient had both immunoglobulin G (IgG) and IgM erythrocyte autoantibodies, while the remaining two patients had only IgG autoantibody. This is the first report of the association of AIHA with chronic mucocutaneous candidiasis. We suggest that all patients with chronic mucocutaneous candidiasis be screened periodically for erythrocyte autoantibodies. Plasmapheresis, a safe ancillary procedure in the management of AIHA, may be life-saving in some cases. The occurrence of erythrocyte autoantibodies in mucocutaneous candidiasis may be related to immunoregulatory disorders in this disease. PMID:7496919

Oyefara, B I; Kim, H C; Danziger, R N; Carroll, M; Greene, J M; Douglas, S D

1994-01-01

177

Effect of a fixed-ratio (1:1:1) transfusion protocol versus laboratory-results-guided transfusion in patients with severe trauma: a randomized feasibility trial  

PubMed Central

Background: Hemorrhage coupled with coagulopathy remains the leading cause of preventable in-hospital deaths among trauma patients. Use of a transfusion protocol with a predefined ratio of 1:1:1 (1 each of red blood cells [RBC], frozen plasma [FP] and platelets) has been associated with improved survival in retrospective studies in military and civilian settings, but such a protocol has its challenges and may increase the risk of respiratory complications. We conducted a randomized controlled trial to assess the feasibility of a 1:1:1 transfusion protocol and its effect on mortality and complications among patients with severe trauma. Methods: We included 78 patients seen in a tertiary trauma centre between July 2009 and October 2011 who had hypotension and bleeding and were expected to need massive transfusion (? 10 RBC units in 24 h). We randomly assigned them to either the fixed-ratio (1:1:1) transfusion protocol (n = 40) or to a laboratory-results–guided transfusion protocol (control; n = 38). The primary outcome, feasibility, was assessed in terms of blood product ratios and plasma wastage. Safety was measured based on 28-day mortality and survival free of acute respiratory distress syndrome. Results: Overall, a transfusion ratio of 1:1:1 was achieved in 57% (21/37) of patients in the fixed-ratio group, as compared with 6% (2/32) in the control group. A ratio of 1:1 (RBC:FP) was achieved in 73% (27/37) in the fixed-ratio group and 22% (7/32) in the control group. Plasma wastage was higher with the intervention protocol (22% [86/390] of FP units v. 10% [30/289] in the control group). The 28-day mortality and number of days free of acute respiratory distress syndrome were statistically similar between the groups. Interpretation: The fixed-ratio transfusion protocol was feasible in our study, but it was associated with increased plasma wastage. Larger randomized trials are needed to evaluate the efficacy of such a protocol in trauma care. Trial registration: ClinicalTrials.gov, no. NCT00945542 PMID:23857856

Nascimento, Bartolomeu; Callum, Jeannie; Tien, Homer; Rubenfeld, Gordon; Pinto, Ruxandra; Lin, Yulia; Rizoli, Sandro

2013-01-01

178

A case of atypical hemolytic uremic syndrome successfully treated with eculizumab.  

PubMed

Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathy (TMA) characterized by the triad of hemolytic anemia, thrombocytopenia, and acute renal failure. Eculizumab, a monoclonal complement C5 antibody which prevents the induction of the terminal complement cascade, has recently emerged as a therapeutic option for aHUS. We report a case of aHUS successfully treated with eculizumab. A 51-year-old male was admitted to the hospital following a mechanical fall. His past medical history was significant for rheumatic valve disease and mitral valve replacement; he was on warfarin for anticoagulation. A computed tomography scan of the head revealed a right-sided subdural hematoma due to coagulopathy resulting from a supratherapeutic international normalized ratio (INR). Following treatment with prothrombin complex concentrate to reverse the INR, urine output dropped and his serum creatinine subsequently increased to 247.52 ?mol/l from the admission value of 70.72 ?mol/l. Laboratory evaluation was remarkable for hemolytic anemia, thrombocytopenia, elevated lactate dehydrogenase (LDH), low haptoglobin, and low complement C3. A renal biopsy was consistent with TMA, favoring a diagnosis of aHUS. Treatment with eculizumab was initiated which resulted in the stabilization of his hemoglobin, platelets, and LDH. Hemodialysis was terminated after 2.5 months due to improvement in urine output and solute clearance. The interaction between thrombin and complement pathway might be responsible for the pathogenesis of aHUS in this case. Eculizumab is an effective therapeutic agent in the treatment of aHUS. Early targeting of the complement system may modify disease progression and thus treat aHUS more effectively. PMID:24570684

Thajudeen, B; Sussman, A; Bracamonte, E

2013-07-01

179

Long-Term follow up after intra-Uterine transfusionS; the LOTUS study  

Microsoft Academic Search

BACKGROUND: The Leiden University Medical Center (LUMC) is the Dutch national referral centre for pregnancies complicated by haemolytic disease of the fetus and newborn (HDFN) caused by maternal alloimmunization. Yearly, 20-25 affected fetuses with severe anaemia are transfused with intra-uterine blood transfusions (IUT). Mothers of whom their fetus has undergone IUT for HDFN are considered high responders with regard to

Esther P Verduin; Irene TM Lindenburg; Vivianne EHJ Smits-Wintjens; Jeanine MM van Klink; Henk Schonewille; Inge L van Kamp; Dick Oepkes; Frans J Walther; Humphrey HH Kanhai; Ilias IN Doxiadis; Enrico Lopriore; Anneke Brand

2010-01-01

180

Usefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection  

Microsoft Academic Search

Background: A retrospective investigation was conducted to determine whether autologous blood collection could reduce allogenic transfusion after resection of esophageal cancer and whether allogenic transfusion influenced postoperative infection. Methods: Patients (n = 100) who met the criteria for hemoglobin, age, body weight, and serum protein donated 800 mL of autologous blood from May 1994 to December 1997. The control group

Yoshihiro Kinoshita; Harushi Udagawa; Kenji Tsutsumi; Masanori Ueno; Toyohide Nakamura; Hiroshi Akiyama; Kouki Takahashi; Yoshiaki Kajiyama; Masahiko Tsurumaru

2000-01-01

181

[Severe hemolytic disease of the newborn as a result of late and undiagnosed alloimmunization--case report].  

PubMed

We report a case of a hemolytic disease in a newborn from the first pregnancy due to anti-D antibodies. The maternal blood group was A Rhesus negative. She had an antibody screening test twice during the pregnancy (in the second trimester) and it was negative. The pregnancy was uneventful, without any invasive procedures and bleeding. The infant was born at 39 weeks of gestation in good overall condition. After the delivery the blood group of the neonate was indicated - A Rhesus positive, BOC positive. Anti-D antibodies were detected in maternal blood. Neonatal blood tests revealed severe anemia (hemoglobin level: 6.0g/dl, hematocrit: 22.2%, erythrocytes: 2.01T/L). During the first day of neonatal life, the newborn received two transfusions of red blood cells. Bilirubin level and rate of rise were not recommendation enough for exchange transfusion. The newborn was treated with continuous phototherapy since the delivery The perinatal period was complicated with intrauterine infection and respiratory failure. Hematopoietic vitamins and iron supplementation was initiated in the second week of neonatal life due to persistent anemia. The child remained under medical care of a hematologic clinic and received human recombinant erythropoietin treatment. PMID:24783436

Drozdowska-Szymczak, Agnieszka; Czapli?ska, Natalia; Borek-Dziecio?, Beata; Kociszewska-Najman, Bozena; Bartkowiak, Robert; Wielgo?, Miros?aw

2014-03-01

182

Establishment of permanent chimerism in a lactate dehydrogenase-deficient mouse mutant with hemolytic anemia  

SciTech Connect

Pluripotent hemopoietic stem cell function was investigated in the homozygous muscle type lactate dehydrogenase (LDH-A) mutant mouse using bone marrow transplantation experiments. Hemopoietic tissues of LDH-A mutants showed a marked decreased in enzyme activity that was associated with severe hemolytic anemia. This condition proved to be transplantable into wild type mice (+/+) through total body irradiation (TBI) at a lethal dose of 8.0 Gy followed by engraftment of mutant bone marrow cells. Since the mutants are extremely radiosensitive (lethal dose50/30 4.4 Gy vs 7.3 Gy in +/+ mice), 8.0-Gy TBI followed by injection of even high numbers of normal bone marrow cells did not prevent death within 5-6 days. After a nonlethal dose of 4.0 Gy and grafting of normal bone marrow cells, a transient chimerism showing peripheral blood characteristics of the wild type was produced that returned to the mutant condition within 12 weeks. The transfusion of wild type red blood cells prior to and following 8.0-Gy TBI and reconstitution with wild type bone marrow cells prevented the early death of the mutants and permanent chimerism was achieved. The chimeras showed all hematological parameters of wild type mice, and radiosensitivity returned to normal. It is concluded that the mutant pluripotent stem cells are functionally comparable to normal stem cells, emphasizing the significance of this mouse model for studies of stem cell regulation.

Datta, T.; Doermer, P.

1987-12-01

183

Association of sickle cell disease, priapism, exchange transfusion and neurological events: ASPEN syndrome.  

PubMed

Priapism and acute neurological events are believed to be unrelated complications of sickle cell hemoglobinopathy. We describe a syndrome based on our experience and a review of the literature of significant neurological events after partial exchange transfusion to treat priapism in sicklemic patients. Severe headache is often the initiating symptom of this complex. The ensuing neurological events range from seizure activity to obtundation requiring ventilatory support. The proposed pathophysiology of these neurological events is related to cerebral ischemia after an acute increase in per cent total hemoglobin, concomitant decrease in per cent hemoglobin S and subsequent release of vasoactive substances during penile detumescence. We have termed this constellation of events the ASPEN syndrome, an eponym for association of sickle cell disease, priapism, exchange transfusion and neurological events. Early recognition and aggressive medical management resulted in complete reversal of neurological sequela. PMID:8411432

Siegel, J F; Rich, M A; Brock, W A

1993-11-01

184

Current treatment of atypical hemolytic uremic syndrome  

PubMed Central

Summary Tremendous advances have been made in understanding the pathogenesis of atypical Hemolytic Uremic Syndrome (aHUS), an extremely rare disease. Insights into the molecular biology of aHUS resulted in rapid advances in treatment with eculizumab (Soliris®, Alexion Pharmaceuticals Inc.). Historically, aHUS was associated with very high rates of mortality and morbidity. Prior therapies included plasma therapy and/or liver transplantation. Although often life saving, these were imperfect and had many complications. We review the conditions included under the rubric of aHUS: S. pneumoniae HUS (SpHUS), inborn errors of metabolism, and disorders of complement regulation, emphasizing their differences and similarities. We focus on the clinical features, diagnosis, and pathogenesis, and treatment of aHUS that results from mutations in genes encoding alternative complement regulators, SpHUS and HUS associated with inborn errors of metabolism. Mutations in complement genes, or antibodies to their protein products, result in unregulated activity of the alternate complement pathway, endothelial injury, and thrombotic microangiopathy (TMA). Eculizumab is a humanized monoclonal antibody that inhibits the production of the terminal complement components C5a and the membrane attack complex (C5b-9) by binding to complement protein C5a. This blocks the proinflammatory and cytolytic effects of terminal complement activation. Eculizumab use has been reported in many case reports, and retrospective and prospective clinical trials in aHUS. There have been few serious side effects and no reports of tachphylaxis or drug resistance. The results are very encouraging and eculizumab is now recognized as the treatment of choice for aHUS. PMID:25343125

Kaplan, Bernard S.; Ruebner, Rebecca L.; Spinale, Joann M.; Copelovitch, Lawrence

2014-01-01

185

Transfusion and blood donation in comic strips.  

PubMed

The representation of blood transfusion and donation of blood in the comic strip has never been studied. The comic strip, which is a relatively recent art, emerged in the 19th century before becoming a mass medium during the 20th century. We have sought, by calling on collectors and using the resources of Internet, comic strips devoted, wholly or in part, to the themes of transfusion and blood donation. We present some of them here in chronologic order, indicating the title, country of origin, year of publication, and names of authors. The theme of the superhero using transfusion to transmit his virtues or his powers is repeated throughout the 20th century in North American comic strips. More recently, comic strips have been conceived from the outset with a promotional aim. They perpetuate positive images and are directed toward a young readership, wielding humor to reduce the fear of venipuncture. Few comic strips denounce the abuse of the commercialization of products derived from the human body. The image of transfusion and blood donation given by the comic strips is not to be underestimated because their readership is primarily children, some of whom will become blood donors. Furthermore, if some readers are transfused during their lives, the impact of a memory more or less conscious of these childhood readings may resurface, both in hopes and in fears. PMID:23643789

Lefrère, Jean-Jacques; Danic, Bruno

2013-07-01

186

Transfusion Associated Microchimerism: The Hybrid Within  

PubMed Central

Microchimerism, the coexistence of genetically disparate populations of cells in a receptive host, is well described in both clinical and physiological settings, including transplantation and pregnancy. Microchimerism can also occur following allogeneic blood transfusion in traumatically injured patients, where donor cells have been observed decades after transfusion. To date, transfusion-associated microchimerism (TA-MC) appears confined to this clinical subset, most likely due to the immune perturbations that occur following severe trauma that allow foreign donor cells to survive. TA-MC appears to be unaffected by leukoreduction and has been documented following transfusion with an array of blood products. The only significant predictor of TA-MC to date is the age of red cells, with fresher units associated with higher risk. Thus far, no adverse clinical effect has been observed in limited studies of TA-MC. There are, however, hypothesized links to transfusion-associated graft vs. host disease (TA-GvHD) that may be unrecognized and consequently under-reported. Microchimerism in other settings has gained increasing attention due to a plausible link to autoimmune diseases, as well as its diagnostic and therapeutic potential vis-a-vis ante-natal testing and adoptive immunotherapy, respectively. Furthermore, microchimerism provides a tool to further our understanding of immune tolerance and regulation. PMID:23102759

Bloch, Evan M; Jackman, Rachael P; Lee, Tzong-Hae; Busch, Michael P

2012-01-01

187

Current problems and future directions of transfusion-induced alloimmunization: summary of an NHLBI working group.  

PubMed

In April 2010, a working group sponsored by the National Heart, Lung, and Blood Institute was assembled to identify research strategies to improve our understanding of alloimmunization caused by the transfusion of allogeneic blood components and to evaluate potential approaches to both reduce its occurrence and manage its effects. Significant sequelae of alloimmunization were discussed and identified, including difficulties in maintaining chronic transfusion of red blood cells and platelets, hemolytic disease of the newborn, neonatal alloimmune thrombocytopenia, and rejection of transplanted cells and tissues. The discussions resulted in a consensus that identified key areas of future research and developmental areas, including genetic and epigenetic recipient factors that regulate alloimmunization, biochemical specifics of transfused products that affect alloimmunization, and novel technologies for high-throughput genotyping to facilitate extensive and efficient antigen matching between donor and recipient. Additional areas of importance included analysis of unappreciated medical sequelae of alloimmunization, such as cellular immunity and its effect upon transplant and autoimmunity. In addition, support for research infrastructure was discussed, with an emphasis on encouraging collaboration and synergy of animal models biology and human clinical research. Finally, training future investigators was identified as an area of importance. In aggregate, this communication provides a synopsis of the opinions of the working group on the above issues and presents both a list of suggested priorities and the rationale for the topics of focus. The areas of research identified in this report represent potential fertile ground for the medical advancement of preventing and managing alloimmunization in its different forms and mitigating the clinical problems it presents to multiple patient populations. PMID:21251006

Zimring, James C; Welniak, Lis; Semple, John W; Ness, Paul M; Slichter, Sherrill J; Spitalnik, Steven L

2011-02-01

188

Renal recovery with eculizumab in atypical hemolytic uremic syndrome following prolonged dialysis.  

PubMed

Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy (TMA) which encompasses hemolytic anemia, thrombocytopenia, and organ impairment. Around 10% of cases are atypical HUS (aHUS), a rare disease with poor outcomes caused by uncontrolled activation of the alternative complement pathway. This case describes a young woman with clinical manifestations compatible with TMA during childhood and adolescence who was formally diagnosed with aHUS at the age of 21. She was managed with intensive plasma exchange and hemodialysis, which failed to improve her severe acute kidney injury and other hematological manifestations of aHUS. This was further compounded by several episodes of flash pulmonary edema and the posterior reversible encephalopathy syndrome (PRES). Treatment with the monoclonal anti-C5 inhibitor, eculizumab, improved all hematological parameters with almost full renal recovery following 3.5 months of dialysis. So far, long-term use of eculizumab (> 11 months) continues to be effective and without complication. Our case illustrates the difficulty but importance of early consideration of aHUS in patients presenting with TMA. More importantly, we highlight that near-normal renal recovery may be attained with eculizumab in adults even after a long dependence on dialysis - an observation that has not been reported in the literature so far. PMID:23557793

Povey, Hannah; Vundru, Rahul; Junglee, Naushad; Jibani, Mahdi

2014-11-01

189

Familial Atypical Hemolytic Uremic Syndrome: A Review of Its Genetic and Clinical Aspects  

PubMed Central

Atypical hemolytic uremic syndrome (aHUS) is a rare renal disease (two per one million in the USA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Both sporadic (80% of cases) and familial (20% of cases) forms are recognized. The study of familial aHUS has implicated genetic variation in multiple genes in the complement system in disease pathogenesis, helping to define the mechanism whereby complement dysregulation at the cell surface level leads to both sporadic and familial disease. This understanding has culminated in the use of Eculizumab as first-line therapy in disease treatment, significantly changing the care and prognosis of affected patients. However, even with this bright outlook, major challenges remain to understand the complexity of aHUS at the genetic level. It is possible that a more detailed picture of aHUS can be translated to an improved understanding of disease penetrance, which is highly variable, and response to therapy, both in the short and long terms. PMID:23251215

Bu, Fengxiao; Borsa, Nicolo; Gianluigi, Ardissino; Smith, Richard J. H.

2012-01-01

190

Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997-2003.  

PubMed

Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is preceded by an episode of diarrhea mostly due to Shiga-toxin-producing Escherichia coli. There is important geographical variation of many aspects of this syndrome. Nationwide data on childhood HUS in Switzerland have not been available so far. In a prospective national study through the Swiss Pediatric Surveillance Unit 114 cases (median age 21 months, 50% boys) were reported between April 1997 and March 2003 by 38 pediatric units (annual incidence 1.42 per 10(5) children < or =16 years). Shiga-toxin-producing E. coli were isolated in 32 (60%) of tested stool samples, serotype O157:H7 in eight. Sixteen children presented with only minimal renal involvement, including three with underlying urinary tract infection. Six patients presented with atypical hemolytic-uremic syndrome, and six with HUS due to invasive Streptococcus pneumoniae infection. Mortality was 5.3%, including two out of six children with S. pneumoniae infection. The severity of thrombocytopenia and the presence of central nervous system involvement significantly correlated with mortality. In conclusion, childhood HUS is not rare in Switzerland. Contrasting other countries, E. coli O157:H7 play only a minor role in the etiology. Incomplete manifestation is not uncommon. PMID:19830454

Schifferli, Alexandra; von Vigier, Rodo O; Fontana, Matteo; Spartà, Giuseppina; Schmid, Hans; Bianchetti, Mario G; Rudin, Christoph

2010-05-01

191

Maple syrup urine disease: Treatment of the acutely ill newborn  

Microsoft Academic Search

Three patients with maple syrup urine disease were treated during the acute neonatal stage. Multiple exchange transfusions proved to be a satisfactory means of achieving rapid clinical and biochemical improvement during this phase. On the other hand, evidence is provided suggesting that in addition to exchange transfusions, a high calorie intake above 150 Cal\\/kg body weight\\/day is necessary to lower

G. Hammersen; L. Wille; H. Schmidt; P. Lutz; H. Bickel

1978-01-01

192

A well-designed online transfusion reaction reporting system improves the estimation of transfusion reaction incidence and quality of care in transfusion practice.  

PubMed

Recognizing and reporting a transfusion reaction is important in transfusion practice. However, the actual incidence of transfusion reactions is frequently underestimated. We designed an online transfusion reaction reporting system for nurses who take care of transfusion recipients. The common management before and after transfusion and the 18 most common transfusion reactions were itemized as tick boxes. We found the overall documented incidence of transfusion reaction increased dramatically, from 0.21% to 0.61% per unit of blood, after we started using an online reporting system. Overall, 94% (30/32) of nurses took only 1 week to become familiar with the new system, and 88% (28/32) considered the new system helpful in improving the quality of clinical transfusion care. By using an intranet connection, blood bank physicians can also identify patients who are having a reaction and provide appropriate recommendations immediately. A well-designed online reporting system may improve the ability to estimate the incidence of transfusion reactions and the quality of transfusion care. PMID:22095368

Yeh, Su-Peng; Chang, Ci-Wen; Chen, Ju-Chuan; Yeh, Wan-Chen; Chen, Pei-Chi; Chuang, Su-Jung; Lin, Chiou-Ping; Hsu, Ling-Nu; Chen, Han-Mih; Lu, Jang-Jih; Peng, Ching-Tien

2011-12-01

193

Racial difference in incidence of ABO hemolytic disease.  

PubMed Central

In this review of 7,464 consecutive infants born at North Carolina Memorial Hospital, hemolytic disease from ABO incompatibility was found to be two to three times as common in black infants as in white infants. The statistical significance of the difference remained high as more restrictive criteria for ABO hemolytic disease were applied. ABO disease, serious enough to cause an indirect serum bilirubin of 15 mg/100ml or higher, had an incidence in black newborns as great as the incidence of Rh hemolytic disease in whites. In contrast, the general prevalence and severity of hyperbilirubinemia was not found to be higher in black newborns than in white infants. The difference cannot be attributed to differences in the prevalence of ABO blood groups between the two races. Policies of early discharge of newborns could be affected by the finding that ABO erythroblastosis is two to three times as common in black infants as in white infants. PMID:961953

Bucher, K A; Patterson, A M; Elston, R C; Jones, C A; Kirkman, H N

1976-01-01

194

Red blood cell transfusion in septic shock - clinical characteristics and outcome of unselected patients in a prospective, multicentre cohort  

PubMed Central

Background Treating anaemia with red blood cell (RBC) transfusion is frequent, but controversial, in patients with septic shock. Therefore we assessed characteristics and outcome associated with RBC transfusion in this group of high risk patients. Methods We did a prospective cohort study at 7 general intensive care units (ICUs) including all adult patients with septic shock in a 5-month period. Results Ninety-five of the 213 included patients (45%) received median 3 (interquartile range 2–5) RBC units during shock. The median pre-transfusion haemoglobin level was 8.1 (7.4–8.9) g/dl and independent of shock day and bleeding. Patients with cardiovascular disease were transfused at higher haemoglobin levels. Transfused patients had higher Simplified Acute Physiology Score (SAPS) II (56 (45-69) vs. 48 (37-61), p?=?0.0005), more bleeding episodes, lower haemoglobin levels days 1 to 5, higher Sepsis-related Organ Failure Assessment (SOFA) scores (days 1 and 5), more days in shock (5 (3-10) vs. 2 (2-4), p?=?0.0001), more days in ICU (10 (4-19) vs. 4 (2-8), p?=?0.0001) and higher 90-day mortality (66 vs. 43%, p?=?0.001). The latter association was lost after adjustment for admission category and SAPS II and SOFA-score on day 1. Conclusions The decision to transfuse patients with septic shock was likely affected by disease severity and bleeding, but haemoglobin level was the only measure that consistently differed between transfused and non-transfused patients. PMID:24571858

2014-01-01

195

78 FR 79469 - Strategies To Address Hemolytic Complications of Immune Globulin Infusions; Public Workshop  

Federal Register 2010, 2011, 2012, 2013

...Hemolytic Complications of Immune Globulin Infusions; Public Workshop AGENCY: Food and Drug...Hemolytic Complications of Immune Globulin Infusions.'' The purpose of the public workshop...Globulin Intravenous (IGIV) (Human) infusion. Complications of hemolysis...

2013-12-30

196

Alloantibodies to a paternally derived RBC KEL antigen lead to hemolytic disease of the fetus/newborn in a murine model.  

PubMed

Exposure to nonself red blood cell (RBC) antigens, either from transfusion or pregnancy, may result in alloimmunization and incompatible RBC clearance. First described as a pregnancy complication 80 years ago, hemolytic disease of the fetus and newborn (HDFN) is caused by alloimmunization to paternally derived RBC antigens. Despite the morbidity/mortality of HDFN, women at risk for RBC alloimmunization have few therapeutic options. Given that alloantibodies to antigens in the KEL family are among the most clinically significant, we developed a murine model with RBC-specific expression of the human KEL antigen to evaluate the impact of maternal/fetal KEL incompatibility. After exposure to fetal KEL RBCs during successive pregnancies with KEL-positive males, 21 of 21 wild-type female mice developed anti-KEL alloantibodies; intrauterine fetal anemia and/or demise occurred in a subset of KEL-positive pups born to wild type, but not agammaglobulinemic mothers. Similar to previous observations in humans, pregnancy-associated alloantibodies were detrimental in a transfusion setting, and transfusion-associated alloantibodies were detrimental in a pregnancy setting. This is the first pregnancy-associated HDFN model described to date, which will serve as a platform to develop targeted therapies to prevent and/or mitigate the dangers of RBC alloantibodies to fetuses and newborns. PMID:23801629

Stowell, Sean R; Henry, Kate L; Smith, Nicole H; Hudson, Krystalyn E; Halverson, Greg R; Park, Jaekeun C; Bennett, Ashley M; Girard-Pierce, Kathryn R; Arthur, C Maridith; Bunting, Silvia T; Zimring, James C; Hendrickson, Jeanne E

2013-08-22

197

Alloantibodies to a paternally derived RBC KEL antigen lead to hemolytic disease of the fetus/newborn in a murine model  

PubMed Central

Exposure to nonself red blood cell (RBC) antigens, either from transfusion or pregnancy, may result in alloimmunization and incompatible RBC clearance. First described as a pregnancy complication 80 years ago, hemolytic disease of the fetus and newborn (HDFN) is caused by alloimmunization to paternally derived RBC antigens. Despite the morbidity/mortality of HDFN, women at risk for RBC alloimmunization have few therapeutic options. Given that alloantibodies to antigens in the KEL family are among the most clinically significant, we developed a murine model with RBC-specific expression of the human KEL antigen to evaluate the impact of maternal/fetal KEL incompatibility. After exposure to fetal KEL RBCs during successive pregnancies with KEL-positive males, 21 of 21 wild-type female mice developed anti-KEL alloantibodies; intrauterine fetal anemia and/or demise occurred in a subset of KEL-positive pups born to wild type, but not agammaglobulinemic mothers. Similar to previous observations in humans, pregnancy-associated alloantibodies were detrimental in a transfusion setting, and transfusion-associated alloantibodies were detrimental in a pregnancy setting. This is the first pregnancy-associated HDFN model described to date, which will serve as a platform to develop targeted therapies to prevent and/or mitigate the dangers of RBC alloantibodies to fetuses and newborns. PMID:23801629

Stowell, Sean R.; Henry, Kate L.; Smith, Nicole H.; Hudson, Krystalyn E.; Halverson, Greg R.; Park, Jaekeun C.; Bennett, Ashley M.; Girard-Pierce, Kathryn R.; Arthur, C. Maridith; Bunting, Silvia T.; Zimring, James C.

2013-01-01

198

Minneapolis bridges falling down: emergency transfusion preparedness.  

PubMed

The 7/1/2007 bridge collapse into the Mississippi River was instructional from both a disaster response and a mass casualty transfusion response perspective. It is a well cited example of how community disaster response coordination can work well, especially following systematic preparation of an integrated response network. The blood center is and should be an integral part of this disaster response and should be included in drills where appropriate. We give personal perspectives on both the hospital and transfusion service response to this particularly dramatic event. PMID:23820433

Gorlin, Jed B; Hick, John L

2013-12-01

199

Hemolytic uremic syndrome due to homozygous factor H deficiency  

Microsoft Academic Search

The majority of complement factor H mutations associated with atypical hemolytic uremic syndrome (HUS) are heterozygous. Homozygous\\u000a mutations causing atypical hemolytic uremic syndrome are rare. We report a 7-month-old boy with HUS, severe hypocomplementemia\\u000a (low C3 and normal C4 levels), and extremely low circulating levels of factor H. Genetic analysis showed homozygous 4 bp deletion\\u000a in the gene encoding factor H in the patient,

Sidharth Kumar Sethi; Dragon-Durey Marie-Agnes; Neelam Thaker; Pankaj Hari; Arvind Bagga

2009-01-01

200

Coomb's Positive Hemolytic Anemia Due To Insect Bite  

PubMed Central

Hemolytic anemia has occasionally been described in association with insect bites. The venom of certain spiders, bees and wasps, and some snakes can rarely cause intravascular hemolysis. We report here a case of Coombs positive hemolytic anemia due to an insect bite. These bites often pose diagnostic challenges and when associated with systemic manifestations necessitate early intervention. This communication reviews the clinico- hematologic spectrum in these cases and also emphasizes the need to capture the insect as identification would help in early diagnosis and management. PMID:22400097

2007-01-01

201

What Are the Risks of a Blood Transfusion?  

MedlinePLUS

... will have a reaction after the transfusion. Iron Overload Getting many blood transfusions can cause too much iron to build up in your blood (iron overload). People who have a blood disorder like thalassemia , ...

202

Reappraising the concept of massive transfusion in trauma  

E-print Network

obtained from the trauma registries of five large trauma research networks. A fractional polynomial was used to model the transfusion-associated probability of death. A logistic regression model for the prediction of massive transfusion, defined as 10...

Stanworth, Simon J; Morris, Timothy P; Gaarder, Christine; Goslings, J Carel; Maegele, Marc; Cohen, Mitchell J; Koenig, Thomas C; Davenport, Ross A; Pittet, Jean-Francois; Johannson, Par I; Allard, Shubha; Johnson, Tony; Brohi, Karim

2010-12-30

203

Studies on the factors affecting the growth and hemolytic activity of Anabaena variabilis  

Microsoft Academic Search

The hemolytic activity of the cell-free culture supernatant of Anabaena variabilis OL S1 was investigated using the hemolysis of rabbit erythrocytes as an assay. The culture medium of A. variabilis started to exhibit hemolytic activity at the late exponential growth phase, and maximized at the stationary phase. The hemolytic\\u000a toxin is heat-stable and can be extracted in dichloromethane. The hemolytic

Wei Wang; Xiu-Kai Song; Shao-Guo Ru

2007-01-01

204

Department and function: Professor, Institute for Transfusion Medicine  

E-print Network

Department and function: Professor, Institute for Transfusion Medicine Education: 1988 ­ 1993, Institute for Transfusion Medicine, MHH Positions: 1996-1999 Research Group Leader at the German Red Cross Institute, Springe 1999-2003 Research Group Leader, Institute for Transfusion Medicine, MHH 2003-recent W1

Manstein, Dietmar J.

205

Distributed System for Transfusion Supervision Based on Embedded System  

Microsoft Academic Search

In view of the shortcomings exist in current process of medical transfusion, a wireless distributed system for transfusion supervision was designed with infrared detection technology, computer network technology, embedded system technology and wireless transmission technology. The system is a network which consisted of a host computer, transfusion monitors, and interconnection mechanisms between the host computer and monitors. Comprised by a

Fenge Bai; Lifeng Huo; Li Bai; Junying Wang

2008-01-01

206

Postoperative infections after oesophageal resections: the role of blood transfusions  

Microsoft Academic Search

BACKGROUND: Perioperative blood transfusion carries numerous potential risks concerning the transmission of infective diseases and immunodepression that can facilitate the occurrence of postoperative infectious complications. Explanation of connections between perioperative blood transfusion and postoperative septic complication worldwide is not well documented. Many studies have described a correlation between perioperative blood transfusions and postoperative infections. On the contrary, other studies indicate

Francesca Rovera; Gianlorenzo Dionigi; Luigi Boni; Andrea Imperatori; Alessandra Tabacchi; Giulio Carcano; Mario Diurni; Renzo Dionigi

2006-01-01

207

Immunomodulation after Blood Transfusion – Impact on Incidence of Postoperative Infection  

Microsoft Academic Search

Summary Objective: Overview of complications and side effects related to perioperative transfusion of allogeneic blood components. Data Sources: Present literature based on electronical search (PubMed). Results: Transfusion of blood components is one of the most common therapeutic methods used in medicine. However, transfusion of allogeneic blood components may be associated with certain postoperative complications. Recent data indicate that some of

P. Hobisch-Hagen

2002-01-01

208

Blood Transfusion: What Does It Mean to the Surgeon?  

Microsoft Academic Search

In addition to organ transplantation, the immunomodulating effect of allogeneic blood transfusion might also have consequences for patients with malignancies or other surgical patients requiring blood transfusion. It has been suggested that this effect of allogeneic blood transfusion could adversely affect the prognosis of patients with a malignant disorder or increase the susceptibility for postoperative infections. These deleterious effects of

H. E. Lont; O. R. C. Busch; C. H. J. van Eijck; R. L. Marquet; J. Jeekel

1997-01-01

209

Red Blood Cell Transfusions for Selected Neonatal and Pediatric Patients  

Microsoft Academic Search

\\u000a Neonatal and pediatric transfusion practice includes consideration of the neonate’s immature immunologie, renal, and hepatic\\u000a function; and it encompasses new technologies and innovative programs that limit donor exposures and infectious disease risks.\\u000a Neonatal and pediatric transfusion practice is not merely the transfusion of small volumes of blood to small people.

Elaine K. Jeter; Mary Ann Spivey

210

Transfusion of Prematures (TOP) Trial: Does a Liberal Red Blood Cell Transfusion  

E-print Network

Improve Neurologically-Intact Survival of Extremely-Low-Birth-Weight Infants as Compared Frequency ofBlood Transfusions in Neonatal Units ................................................................................... 3 3.0 INNOVATION 6 3.1 Research Design and Milieu

Baker, Chris I.

211

Transmission of prion diseases by blood transfusion  

Microsoft Academic Search

Attempts to detect infectivity in the blood of humans and animals affected with transmissible spongiform encephalopathies (TSEs or prion diseases) have often been inconclusive because of the limitations of cross-species bioassays and the small volumes of blood that can be injected by the intracerebral route. A model has been developed for the experimental study of TSE transmission by blood transfusion

Nora Hunter; James Foster; Angela Chong; Sandra McCutcheon; David Parnham; Samantha Eaton; Calum MacKenzie; Fiona Houston

2002-01-01

212

Transfusion Associated Graft Versus Host Disease Following Whole Blood Transfusion from an Unrelated Donor in an Immunocompetent Patient  

Microsoft Academic Search

Graft-versus-host disease (GVHD) is a well-known complication of allogeneic bone marrow transplantation. Transfusion associated\\u000a graft-versus-host disease (TA-GVHD) is much less common and nearly uniformly fatal complication of blood transfusion. The\\u000a risk factors underlying the development of TA- GVHD are incompletely defined, but it is commonly seen in individuals with\\u000a congenital or acquired immunodeficiency, transfusions from blood relatives, intrauterine transfusions and

Ketan K. Patel; Atul K. Patel; Rajiv R. Ranjan; Apurva P. Shah

2010-01-01

213

Severe hemolytic disease of the newborn from anti-e  

Microsoft Academic Search

Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following

R M McAdams; S A Dotzler; L W Winter; J D Kerecman

2008-01-01

214

Isolated abducens nerve palsy in hemolytic uremic syndrome.  

PubMed

Isolated abducens nerve (VI cranial nerve) palsies are reported in a dialyzed child with Escherichia coli 0157:H7-associated hemolytic uremic syndrome (HUS). There were no other neurological manifestations and he made a complete recovery, suggesting that isolated abducens nerve palsy in HUS may represent a minor neurological complication. PMID:15185136

Durkan, Anne; Menascu, Shay; Langlois, Valerie

2004-08-01

215

Congenital Nonspherocytic Hemolytic Anemia With an Unstable Hexokinase Variant  

Microsoft Academic Search

We report a family with a new hexokinase mal reaction kinetics, and normal dee- variant that gives rise to nonspherocytic trophoretic properties, but has reduced hemolytic anemia in one apparently activity and is apparently inactivated homozygous family member. The variant rapidly as the affected erythrocytes age. enzyme has a normal pH optimum, nor- B ECAUSE ERYTHROCYTE HEXOKINASE (HK) has a

P. G. Board; R. Trueworthy; J. E. Smith; Kateri Moore

1978-01-01

216

Hemolytic anemia associated with heterograft replacement of the mitral valve.  

PubMed

The first case of overt hemolytic anemia following mitral valve replacement with a porcine heterograft is reported. Cardiac catheterization failed to reveal a paravalvular leak or valvular incompetence to account for the hemolysis. Red cell traumatization by the Dacron-covered Stellite ring and stent is suggested as the cause of hemolysis with the porcine heterograft. PMID:567264

Myers, T J; Hild, D H; Rinaldi, M J

1978-08-01

217

TT viral infection through blood transfusion: retrospective investigation on patients in a prospective study of post-transfusion hepatitis  

Microsoft Academic Search

AIM To investigate the role of blood transfusion in TT viral infection (TTV). METHODS We retrospectively studied serum samples from 192 trans fusion recipients who underwent cardiovascular surgery and blood transfusion between July 1991 and June 1992. All patients had a follow-up every other week for at least 6 months after transfusion. Eighty recipients received blood before screening donors for

Yang SS; Huang YY; Huang CS

2000-01-01

218

Hemolytic reactions mechanically induced by kinked hemodialysis lines.  

PubMed

Ten hemolytic reactions occurred in our outpatient hemodialysis unit over a 12-month period (December 1989 to December 1990). Eight patients were hospitalized and one died. All patients developed severe abdominal or back pain an average of 2.5 hours into a 4-hour hemodialysis session using a bleach/formaldehyde reprocessed hollow-fiber cupraphan dialyzer (average reuse, three times) with blood flow rates of 375 mL/min. All had visible hemolysis in a spun hematocrit, seven had a significant decrease in hematocrit, and six developed pancreatitis. Hemolysis was further confirmed by a decrease in haptoglobin in all patients and an increase in lactic dehydrogenase in all but the last case. Investigation of each episode failed to find an abnormality in dialysate temperature or tonicity; dialysate or water levels of copper, zinc, nitrates, chloramine, or formaldehyde; or blood pump or venous alarm. Hemolytic reactions continued despite changing to 15-gauge needles, removing bleach from the reuse procedure, or stopping reuse. During the eighth episode, a kink was noted in the arterial blood line. Two subsequent hemolytic reactions occurred, and in each kinks were found in the arterial blood line, either in the excess tubing between the blood pump and drip chamber or in the predialyzer. No further hemolytic reactions occurred after changing to a new arterial blood line without redundant tubing and securing all lines. Hemolytic reactions occurring during hemodialysis have many etiologies, including mechanical trauma, which we report may result from kinking of dialyzer lines. With new blood lines on the market, attention to this aspect of dialysis is mandatory. PMID:8659503

Sweet, S J; McCarthy, S; Steingart, R; Callahan, T

1996-02-01

219

Impairment of Bone Health in Pediatric Patients with Hemolytic Anemia  

PubMed Central

Introduction Sickle cell anemia and thalassemia result in impaired bone health in both adults and youths. Children with other types of chronic hemolytic anemia may also display impaired bone health. Study Design To assess bone health in pediatric patients with chronic hemolytic anemia, a cross-sectional study was conducted involving 45 patients with different forms of hemolytic anemia (i.e., 17 homozygous sickle cell disease and 14 hereditary spherocytosis patients). Biochemical, radiographic and anamnestic parameters of bone health were assessed. Results Vitamin D deficiency with 25 OH-vitamin D serum levels below 20 ng/ml was a common finding (80.5%) in this cohort. Bone pain was present in 31% of patients. Analysis of RANKL, osteoprotegerin (OPG) and osteocalcin levels indicated an alteration in bone modeling with significantly elevated RANKL/OPG ratios (control: 0.08+0.07; patients: 0.26+0.2, P?=?0.0007). Osteocalcin levels were found to be lower in patients compared with healthy controls (68.5+39.0 ng/ml vs. 118.0+36.6 ng/ml, P?=?0.0001). Multiple stepwise regression analysis revealed a significant (P<0.025) influence of LDH (partial r2?=?0.29), diagnosis of hemolytic anemia (partial r2?=?0.05) and age (partial r2?=?0.03) on osteocalcin levels. Patients with homozygous sickle cell anemia were more frequently and more severely affected by impaired bone health than patients with hereditary spherocytosis. Conclusion Bone health is impaired in pediatric patients with hemolytic anemia. In addition to endocrine alterations, an imbalance in the RANKL/OPG system and low levels of osteocalcin may contribute to this impairment. PMID:25299063

Schundeln, Michael M.; Goretzki, Sarah C.; Hauffa, Pia K.; Wieland, Regina; Bauer, Jens; Baeder, Lena; Eggert, Angelika; Hauffa, Berthold P.; Grasemann, Corinna

2014-01-01

220

Predictors of blood transfusion requirement in elective liver resection  

PubMed Central

Background: Liver resection remains major surgery frequently requiring intra-operative blood transfusion. Patients are typically over cross-matched, and with blood donor numbers falling, cross-matching and transfusion policies need rationalizing. Aim: To identify predictors of peri-operative blood transfusion. Methods: A retrospective review of elective hepatic resections over a 4-year period was performed. Twenty-six variables including clinicopathological variables and intra-operative data were collated, together with the number of units of blood cross-matched and transfused in the immediate peri-operative period (48 h). Multivariate regression analysis was performed to identify independent predictors of blood transfusion, and a Risk Score for transfusion constructed. Results: Five hundred and eighty-nine patients were included in the study, and were cross-matched with a median 10 units of blood. Seventeen per cent of patients received a blood transfusion; median transfusion when required was 2 units. Regression analysis identified seven factors predictive of transfusion: haemoglobin <12.5 g/dL, pre-operative biliary drainage, coronary artery disease, largest tumour >3.5 cm, cholangiocarcinoma, redo resection and extended resection (5+ segments). Patients were stratified into high or low risk of transfusion based on Risk Score with a sensitivity of 73% [receiver-operating characteristic (ROC) 0.77]. Conclusions: Patients undergoing elective liver resection are over-cross-matched. Patients can be classified into high and low risk of transfusion using a Risk Score, and cross-matched accordingly. PMID:20495645

Cockbain, Andrew J; Masudi, Tahir; Lodge, J Peter A; Toogood, Giles J; Prasad, K Raj

2010-01-01

221

Effect of blood transfusions on canine renal allograft survival  

SciTech Connect

In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

van der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

1982-04-01

222

Correlation between red blood cell transfusion volume and mortality in patients with massive blood transfusion: A large multicenter retrospective study  

PubMed Central

This study aimed to explore the correlation between red blood cell (RBC) transfusion volume and patient mortality in massive blood transfusion. A multicenter retrospective study was carried out on 1,601 surgical inpatients who received massive blood transfusion in 20 large comprehensive hospitals in China. According to RBC transfusion volume and duration, the patients were divided into groups as follows: 0–4, 5–9, 10–14, 15–19, 20–24, 25–29, 30–39 and ?40 units within 24 or 72 h. Mortality in patients with different RBC transfusion volumes was analyzed. It was found that patient mortality increased with the increase in the volume of RBC transfusion when the total RBC transfusion volume was ?10 units within 24 or 72 h. Survival analysis revealed significant differences in mortality according to the RBC transfusion volume (?2=72.857, P<0.001). Logistic regression analysis revealed that RBC transfusion volume is an independent risk factor [odds ratio (OR) = 0.52; confidence interval (CI): 0.43–0.64; P<0.01] for the mortality of patients undergoing a massive blood transfusion. When RBCs were transfused at a volume of 5–9 units within 24 and 72 h, the mortality rate was the lowest, at 3.7 and 2.3% respectively. It is concluded that during massive blood transfusion in surgical inpatients, there is a correlation between RBC transfusion volume within 24 or 72 h and the mortality of the patients. Patient mortality increases with the increase in the volume of RBC transfusion. RBC transfusion volume, the length of stay at hospital and intensive care unit stay constitute the independent risk factors for patient mortality.

YANG, JIANG-CUN; SUN, YANG; XU, CUI-XIANG; DANG, QIAN-LI; LI, LING; XU, YONG-GANG; SONG, YAO-JUN; YAN, HONG

2015-01-01

223

Filling a gap in transfusion medicine education and research.  

PubMed

After the outbreak of the HIV/AIDS epidemic, attention was focused on the restructuring and reorganization of nationally supported safe and sustainable blood supply systems. Networking and human capacity building in transfusion medicine were developed through World Health Organization initiatives. Educational materials were created for the core elements of the blood transfusion chain. However, the management aspects of transfusion medicine as well as applied health science research in transfusion medicine were not addressed. In 2000, the World Health Organization initiated the creation of the Academic Institute for International Development of Transfusion Medicine (IDTM). This would focus on the development of a postgraduate master's course in management of transfusion medicine (MMTM) and the development of research programs for transfusion medicine-related health sciences. The Academic Institute IDTM was created at the University of Groningen Faculty of Medical Sciences, The Netherlands. The MMTM course was thus established, and since September 2007 fourteen fellows from economically restricted countries have entered the course. PMID:19765517

Sibinga, Cees Th Smit

2009-10-01

224

Transfusion support in patients with dengue fever.  

PubMed

Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles. PMID:25298950

Kaur, Paramjit; Kaur, Gagandeep

2014-09-01

225

Pathology Case Study: Post Transfusion Hemolysis  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 56-year-old female with a 20 year history of systemic lupus erythematosis with a history of deep venous thrombosis and a recent myocardial infarct. Visitors are given patient history and admission data along with data results from the resulting transfusion reaction investigation. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and transfusion medicine.

Hari, Raj

2009-03-24

226

Transfusion support in patients with dengue fever  

PubMed Central

Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles. PMID:25298950

Kaur, Paramjit; Kaur, Gagandeep

2014-01-01

227

Use of an identification system based on biometric data for patients requiring transfusions guarantees transfusion safety and traceability  

PubMed Central

Background One of the most serious risks of blood transfusions is an error in ABO blood group compatibility, which can cause a haemolytic transfusion reaction and, in the most severe cases, the death of the patient. The frequency and type of errors observed suggest that these are inevitable, in that mistakes are inherent to human nature, unless significant changes, including the use of computerised instruments, are made to procedures. Methods In order to identify patients who are candidates for the transfusion of blood components and to guarantee the traceability of the transfusion, the Securblood system (BBS srl) was introduced. This system records the various stages of the transfusion process, the health care workers involved and any immediate transfusion reactions. The patients and staff are identified by fingerprinting or a bar code. The system was implemented within Ragusa hospital in 16 operative units (ordinary wards, day hospital, operating theatres). Results In the period from August 2007 to July 2008, 7282 blood components were transfused within the hospital, of which 5606 (77%) using the Securblood system. Overall, 1777 patients were transfused. In this year of experience, no transfusion errors were recorded and each blood component was transfused to the right patient. We recorded 33 blocks of the terminals (involving 0.6% of the transfused blood components) which required the intervention of staff from the Service of Immunohaematology and Transfusion Medicine (SIMT). Most of the blocks were due to procedural errors. Conclusions The Securblood system guarantees complete traceability of the transfusion process outside the SIMT and eliminates the possibility of mistaken identification of patients or blood components. The use of fingerprinting to identify health care staff (nurses and doctors) and patients obliges the staff to carry out the identification procedures directly in the presence of the patient and guarantees the presence of the doctor at the start of the transfusion. PMID:19657483

Bennardello, Francesco; Fidone, Carmelo; Cabibbo, Sergio; Calabrese, Salvatore; Garozzo, Giovanni; Cassarino, Grazia; Antolino, Agostino; Tavolino, Giuseppe; Zisa, Nuccio; Falla, Cadigia; Drago, Giuseppe; Di Stefano, Giovanna; Bonomo, Pietro

2009-01-01

228

Principles of transfusion medicine in small animals.  

PubMed

The purpose of this review was to provide the reader with an updated overview of small animal transfusion medicine, and an approach to integrating it into private practice, based on a review of the veterinary and human literature spanning the last 3 decades. Electronic, online databases that were searched included CAB International and Medline; multiple keywords or subject headings were searched that were appropriate to each of the sections reviewed: canine and feline blood groups, blood-typing and crossmatching, donors, blood collection, storage, blood components, blood transfusion, blood component therapy, blood substitutes, and adverse reactions. The safe use of blood component therapy requires knowledge of blood groups and antibody prevalence, and knowledge of the means to minimize the risk of adverse reactions by including the use of proper donors and screening assays that facilitate detection of serological incompatibility. The 2 assays available to the practitioner are crossmatching, which is readily done in-house, and blood typing. Blood typing is available in the form of a commercial testing kit, through use of purchased reagents, or via a request to an external laboratory. The risk of potentially fatal adverse reactions is higher in cats than in dogs. The decision to transfuse and the type of product to administer depend on several factors, such as the type of anemia and the size of the animal. In conclusion, transfusion medicine has become more feasible in small animal practice, with improved access to blood products through either on-site donors, the purchase of blood bank products, external donor programs, or the availability of blood component substitutes. PMID:11424576

Lanevschi, A; Wardrop, K J

2001-06-01

229

[Transfusion safety: emergent or hypothetical risks].  

PubMed

Three categories of emerging risks are studied: 1) A new variant of Creutzfeld-Jakob disease, different from its sporadic form; limited to the British isles (48 of 51 cases), it affects younger patients, and has a higher duration with a predominance of psychiatric symptoms. Environmental risk factors include a previous stay in the British isles and oral transmission via contaminated food. No link has been made evident between blood component (BC) transfusion and occurrence of the disease. A potential risk exists if its agent is found in blood and peripheral lymphoid tissues and if buffy coat from infected animals has been inoculated intracerebrally. Since 1993, prevention measures have been taken: exclusion of donors with a potential risk as well as transfused donors, systematic leukocyte reduction and implementation of disease surveillance. Excluding donors after a several month-stay in the British Isles is being discussed. 2) Novel hepatitis viruses. Hepatitis G virus (HGV) has been detected in 2-4% of blood donors. Ten percent of patients with chronic non-A-E hepatitis are HGV RNA positive. The incidence of HGV infection is higher than expected from PCR studies. HGV has a high prevalence in the world. Novel DNA non-enveloped virus (TTV) has a normal distribution. Its prevalence varies from 2 to 80%, depending on the country. Although it has not been shown to be aggressive for the liver, prolonged follow-up is required. 3) Human herpes virus 8 (HHV8) is associated with Kaposi's sarcoma in 80% of cases. Its prevalence (0-20%) varies depending on the country. Kaposi's sarcoma has never been reported after BC transfusion. PCR-based viral DNA searches have yielded negative results in 19 poly-transfused subjects. Continuous monitoring is required for recipients at risk (e.g., immunosuppressed). In response to a possible health risk, emerging risks govern the "Precaution Principle", so difficult to implement. PMID:10730344

Hervé, P

2000-02-01

230

Effect of blood transfusions on canine renal allograft survival  

SciTech Connect

In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Futhermore, no improvement in graft survival has been found after a peroperative transfuson of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion of irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

Van Der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

1982-04-01

231

Blood transfusion; additional historical aspects. Part 1. The birth of transfusion immunology.  

PubMed

The decades around the turn of the 19th into the 20th centuries covered a seminal period in the history of transfusion medicine as there was an increasing appreciation of a potential role in the management of surgical and obstetric bleeding, and also in severe non-surgical anaemias. The main obstacles to transfusing human blood were first the occasional devastating adverse reactions due, we now know, to ABO blood group incompatibility; and second the awkward propensity of shed blood to clot. This article describes in more detail how the pioneers in human transfusion immunology in the late 19th century and early 20th century learnt to recognise and avoid ABO incompatibility, and includes some hitherto obscure and rarely cited material. A companion article (Boulton, 2013, Submitted for publication) describes early attempts to find suitable anticoagulants. PMID:24003949

Boulton, F E

2013-12-01

232

Hemolytic Disease of the Newborn Anti c Antibody Induced Hemolysis  

Microsoft Academic Search

Hemolytic disease in the newborn, as a cause of early jaundice, is not uncommon. This is mostly due to Rh (D), ABO incompatibility\\u000a and rarely due to other minor blood group incompatibility. The authors report two cases of Rh anti c isoimmunization presenting\\u000a as significant early neonatal jaundice within the 20 h of life. Both the babies were treated with intensive

Srinivas Murki; Hemasree Kandraju; Surekha A. Devi

233

Direct Hyperbilirubinemia Complicating ABO Hemolytic Disease of the Newborn  

Microsoft Academic Search

A retrospective study of the diagnostic implications of conjugated hyperbilirubinemia com plicating ABO hemolytic disease of the newborn (HDN) was done by studying the records of 264 infants with ABO-HDN. Direct hyperbilirubinemia was found to complicate ABO-HDN in 3 per cent of the infants, all being full term. Eighty-seven per cent were female and familial occurrence was noted in half

Yakov Sivan; Paul Merlob; Jacob Nutman; Salomon H. Reisner

1983-01-01

234

Hemolytic venoms from marine cnidarian jellyfish - an overview  

PubMed Central

Cnidarian jellyfish are viewed as an emergent problem in several coastal zones throughout the world. Recurrent outbreaks pose a serious threat to tourists and bathers, as well as to sea-workers, involving health and economical aspects. As a rule, cnidarian stinging as a consequence of nematocyst firing induces merely local symptoms but cardiovascular or neurological complications can also occur. Hemolysis is a frequent effect of cnidarian stinging; this dangerous condition is known to be caused by several venoms and can sometimes be lethal. At present, the bulk of data concerning hemolytic cnidarian venoms comes from the study of benthic species, such as sea anemones and soft corals, but hemolytic factors were found in venoms of several siphonophore, cubozoan and scyphozoan jellyfish, which are mainly involved in the envenomation of bathers and sea-workers. Therefore, the aim of this paper is to review the scientific literature concerning the hemolytic venoms from cnidarian jellyfish taking into consideration their importance in human pathology as well as health implications and possible therapeutic measures. PMID:25386336

Mariottini, Gian Luigi

2014-01-01

235

Hemolytic activity in extracts of the diatom Nitzschia.  

PubMed

The few reports about diatom toxins are related to central nervous system toxicity, induced by domoic acid. In the present work Nitzschia sp. (Bacillariophyceae) was studied. The cells were cultured in f/2 medium, under 4000 lux and 14/10 hr light/dark cycle. After massive growth (5 x 10(6) cells/ml) the diatom cells were filtered, and an extract was prepared and partitioned in two fractions (polar and apolar). After cell harvesting by filtration, the diatom cells were shaken in artificial sea water to extract the water-soluble extracellular matrix (mucilage). An extract was prepared with the washed cells (free of mucilage), and polar and apolar fractions were obtained. Hemolytic assays were performed using 4.0 and 0.5% erythrocyte suspensions. Both the diatom polar and apolar fractions showed hemolytic activity. The membrane phospholipid sphingomyelin was tested as an acceptor for the hemolysins in the polar and apolar fractions. The mucilage did not exhibit hemolytic activity. PMID:9080587

Rangel, M; Malpezzi, E L; Susini, S M; de Freitas, J C

1997-02-01

236

Autologous and allogeneic blood transfusions in colorectal cancer  

Microsoft Academic Search

Since blood transfusion became a therapeutical option in patient care, the surgical\\u000apossibilities have increased tremendously. Since the problems of anticoagulation and blood\\u000agroup typing were largely resolved, blood transfusions were in only a minority of cases\\u000adirectly lethal. However, it was estimated that still up to 20% of the blood transfusions\\u000ainduces a sort of adverse side-effect. Because the

O. R. C. Busch

1995-01-01

237

The chiasm: transfusion practice versus patient blood management.  

PubMed

In recent years it became increasingly clear that allogeneic red blood cell (RBC) transfusions result in increased mortality and major adverse clinical outcomes. The major risk factors for RBC transfusions are preoperative anaemia, high perioperative blood loss and liberal transfusion triggers. Patient blood management (PBM), the bundle of preoperative anaemia treatment, measures to reduce perioperative blood loss and optimising anaemia tolerance, aims at minimising RBC transfusion needs and improving clinical outcomes. PBM has been adopted by the World Health Organization as the new standard of care and all member states are urged to implement this concept. Australia is leading the world in that PBM is indeed implemented at the current time. PMID:23590914

Spahn, Donat R; Shander, Aryeh; Hofmann, Axel

2013-03-01

238

Evidence-based platelet transfusion recommendations in neonates.  

PubMed

Even though for certain varieties of neonatal thrombocytopenia, intravenous immunoglobulin or corticosteroids are recommended as treatments, platelet transfusions represent the only specific therapy currently available for most thrombocytopenic neonates in NICUs. The majority of these NICU platelet transfusions, up to 98% in some recent reports, are given to prevent, rather than to treat, bleeding. The trigger limit of platelet count to prophylactically treat non-bleeding patients is generally arbitrary. A complete definition, of the benefits and the risks of prophylactic platelet transfusions in thrombocytopenic neonates is necessary. In fact, there is great variability worldwide in neonatal platelet transfusion practice, due to the lack of concrete evidence to guide transfusion decisions. Evidence-based guidelines do not exist to decide when platelet transfusion should be given. The practice of neonatal platelet transfusions is based almost entirely on expert opinion and reasoning. Consequently, these practices, not supported by definitive data, vary widely. To increase benefits and safety, new widespread changes in platelet transfusion guidelines are necessary. New transfusion paradigms should not be based on reasoning alone, but on important experimental validation. The neonatologists would better accept them and more closely adhere to. PMID:21878062

Del Vecchio, Antonio; Motta, Mario

2011-10-01

239

[Closed-loop blood transfusion management system based on PDA].  

PubMed

A closed-loop transfusion management system is constructed that covers blood preservation, transportation, transfer, distribution of blood, distribution, clinical blood specimen collection and blood transfusion process, which can monitor the implementation of doctor's advice, view the transport process of blood and blood samples, and record blood transfusion and adverse reaction information. These measurements can play a good effect in reduction of manual records and handover links in blood transfusion management, enhance the blood bank management, guarantee safely using blood, and realize the goal of real-time monitoring and closed-loop management. PMID:24409802

Chen, Yiyi; Chen, Canda; Luo, Luo; Yin, Zhou; Zhou, Min; Xie, Qiong; Xu, Min; Zhang, Qiutao

2013-09-01

240

Platelet transfusion trigger in difficult patients.  

PubMed

There is general consensus that a prophylactic pre-transfusion trigger at 10.000 platelets/microL in stable oncohematological patients is as safe as the traditional trigger of 20.000/microL, and that perioperative triggers at 50.000 and 100.000/microL are adequate in most surgical and neurosurgical conditions respectively. Guidelines on the trigger and other issues related to platelet transfusion can be found in nine documents published during 1987-2001 by the National Institutes of Health (NIH), the British Committee on Standardization in Hematology, the Royal College of Physicians of Edinburgh, the College of American Pathologists, the American Society of Anesthesiology and the American Society of Clinical Oncology (ASCO). Although consensus may be less evident on specific triggers for 'difficult' patients, the following triggers, listed by progressively increasing levels, have been proposed in the literature and have found general agreement: a stable oncohematological recipient: 10.000; lumbar puncture in a stable pediatric leukemic patient: 10.000; thrombocytopenia secondary to gpIIb/IIIa receptor inhibitors [corrected]:10.000; bone marrow aspiration and biopsy: 20.000; gastrointestinal endoscopy in cancer: 20.000-40.000; disseminated intravascular coagulation: 20.000-50.000; fiber-optic bronchoscopy in a bone marrow transplant recipient: 20.000-50.000; neonatal alloimmune thrombocytopenia: 30.000; major surgery in leukemia: 50.000; thrombocytopenia secondary to massive transfusion: 50.000; invasive procedures in cirrhosis: 50.000; cardiopulmonary bypass: 50.000-60.000; liver biopsy: 50.000-100.000; a nonbleeding premature infant: 60.000; neurosurgery: 100.000. The proposed values must be considered within the context of careful clinical evaluation of each individual patient, and attention should be given to the power of discrimination of platelet counters at low counts and to the prompt availability of good quality platelet products in the case of emergency. PMID:11499971

Rebulla, P

2001-06-01

241

Internet-based transfusion audit system  

NASA Astrophysics Data System (ADS)

This project is aimed at developing a cost-effective working environment for the transfusion medicine specialists of American Red Cross (ARC). In this project we are developing a multimedia-based consultation environment that uses Internet and teleconferencing to increase the quality of services and to replace currently used 800 telephone lines. Through the use of Internet/LAN/ISDN the physicians can share information and references while they discuss patient cases. A multimedia interface allows the physician to access data from the office and from the house. This paper discusses the approach, current status of the project and future plans to extend the approach to other areas of medicine.

Maitan, Jacek; Haley, Rebecca

1995-03-01

242

[Transfusion problems in artificial blood circulation].  

PubMed

Results of differentiated administration of blood components to cardiac surgical patients are presented. Frozen washed erythrocytes and erythromass were successively used in the perfusate and postoperatively. A transfusion pattern for patients with rare A2B blood group has been elaborated. The feasibility of prevention of artificial-circulation-induced thrombocytopenia by introduction of large quantities of platelet components right after AC is demonstrated. The necessity of the ACT-test for adequate blood heparinisation and neutralisation during the AC is established. Results of successful autohemotransfusion in cardiac surgery and application of fibrinolytic blood and its components are discussed. PMID:2688339

Shanoian, S A; Dmitrieva, V A; Sharova, Iu A; Samsonova, N N; Pospelova, E P

1989-01-01

243

Neurologic events after partial exchange transfusion for priapism in sickle cell disease.  

PubMed

We describe six boys with homozygous sickle cell disease, aged 7 to 13 years, in whom acute, severe neurologic abnormalities developed 1 to 11 days after partial exchange transfusion was performed to treat priapism that was unresponsive to more conservative therapy. Hemoglobin levels were 10.5 to 13.4 gm/dl (mean 12.1 gm/dl), and hemoglobin S levels were 18% to 33% (mean 27%) before the onset of neurologic complications. Severe headache was the initial finding in five patients, four of whom had increased intracranial pressure and three of whom required tracheal intubation and hyperventilation. Four patients had seizures; three had focal neurologic deficits for more than 24 hours. Cerebral arteriography demonstrated vascular abnormalities, including irregularity, stenosis, and complete occlusion of vessels. Patients treated with regular erythrocyte transfusions had no recurrence of neurologic signs or symptoms when hemoglobin S levels were kept at 30% to 50%. The occurrence of serious neurologic complications after partial exchange transfusion in patients with homozygous sickle cell disease from three centers indicates the possibility of a causal relationship between the events. Early and thorough investigation of neurologic symptoms, especially severe headache, is warranted in this clinical setting. PMID:1593347

Rackoff, W R; Ohene-Frempong, K; Month, S; Scott, J P; Neahring, B; Cohen, A R

1992-06-01

244

Transfusion Practices Committee of a public blood bank network in Minas Gerais, Brazil  

PubMed Central

Objective This study aimed to verify the performance of blood transfusion committees in transfusion services linked to the public blood bank network of the state of Minas Gerais. Methods A cross-sectional observational study was conducted between 2007 and 2008 using questionnaires and proficiency tests to evaluate the reporting and investigation of transfusion reactions comparing transfusion services with and without transfusion committees in the public transfusion services of the state of Minas Gerais. Results Nineteen of Hemominas own transfusion services and 207 that contracted the services of the foundation located in 178 municipalities were visited between 2007 and 2008. Established transfusion committees were present in 63.4% of the services visited. Transfusion incidents were reported by 53 (36.8%) transfusion services with transfusion committees and by eight (9.6%) without transfusion committees (p < 0.001) with 543 (97.5%) and 14 (2.5%) notifications, respectively. Of the reported transfusion incidents, 40 (75.5%) transfusion services with transfusion committees and only two (25%) of those without transfusion committees investigated the causes. Conclusion The incidence of notification and investigation of the causes of transfusion reactions was higher in transfusion services where a transfusion committee was present. Despite these results, the performance of these committees was found to be incipient and a better organization and more effective operation are required. PMID:23323064

de Carvalho, Ricardo Vilas Freire; Brener, Stela; Ferreira, Angela Melgaco; do Valle, Marcele Cunha Ribeiro; Moraes-Souza, Helio

2012-01-01

245

Contemporary issues in transfusion medicine informatics  

PubMed Central

The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS. PMID:21383927

Sharma, Gaurav; Parwani, Anil V.; Raval, Jay S.; Triulzi, Darrell J.; Benjamin, Richard J.; Pantanowitz, Liron

2011-01-01

246

Severe neonatal hyperbilirubinemia leading to exchange transfusion  

PubMed Central

Background: Severe neonatal hyperbilirubinemia is associated with significant morbidity and mortality. This study was conducted to investigate the causes of severe hyperbilirubinemia leading to Exchange Transfusion (ET) from March 2009 to March 2011 in Bahrami children hospital, Tehran, Iran in order to establish guidelines to prevent profound jaundice & ET. Methods: 94 neonates underwent ET for severe hyperbilirubinemia data for demographic data, and onset of jaundice, history of severe hyperbilirubinemia in siblings, blood group of both mother and neonate, G6PD activity, hemoglobin, hematocrite, reticulocyte count, peripheral blood smear, total and direct bilirubin before and after ET, direct and indirect Coombs, times of transfusion and the cause of hyperbilirubinemia were all recorded for analysis. Results: Ninety four neonates (56.4% boys and 43.6% girls) underwent ET with a mean birth weight of 1950±40 g and a mean gestational age of 35.2±1.4 weeks. Premature labor, breastfeeding jaundice, ABO incompatibility and G6PDD with the frequency of 59(63%), 33(35%), 25(24/5%) and 12(12.8%) were of major causes of ET. Conclusions: Predisposing factors for severe hyperbilirubinemia in this study were premature labor, breastfeeding jaundice, ABO incompatibility and G6PDD. The authors recommend prevention of premature labor, reevaluation of successful breastfeeding education for mothers and screening infants for blood group and G6PD In the first of life. Arranging earlier and continuous visits in neonates with these risk factors during the first four days of life is also recommended.

Alizadeh Taheri, Peymaneh; Sadeghi, Mandana; Sajjadian, Negar

2014-01-01

247

Tattoos as risk factors for transfusion-transmitted diseases  

Microsoft Academic Search

Background: Several infectious diseases have been found to be associated with tattooing, including some transfusion transmitted diseases (TTDs). Information on tattooing has been included in screening interviews of prospective blood donors and may be a reason for deferral.Methods: Review of articles identified through MEDLINE (and other computerized data bases) using medical subject heading (MeSH) terms and textwords for “tattooing,” “transfusion,”

Sérgio de A. Nishioka; Theresa W. Gyorkos

2001-01-01

248

Ethical issues in the forced transfusion of Jehovah's Witness children  

Microsoft Academic Search

This paper examines the views of Jehovah's Witnesses in regards to their refusal of blood transfusions for themselves and their children. After setting out the legal framework society presently has in place for dealing with such refusals, the paper reviews the ethics literature that justifies the intervention by the State to force the transfusion of Jehovah's Witness children. It is

Mark Sheldon

1996-01-01

249

The risk of contracting an infectious disease from blood transfusion  

Microsoft Academic Search

In the general population, the likelihood of an individual receiving a transfusion has been calculated to be about 0.89% per year, increasing dramatically with age. Massive intraoperative hemorrhage from trauma, cardiopulmonary bypass, and orthotopic liver transplantation need substantial replacement therapy. In renal transplantation, blood transfusion is a debated induction tool for specific allograft tolerance, since it causes a nonspecific down-regulation

L Ceccherini-Nelli; F Filipponi; F Mosca; M Campa

2004-01-01

250

Emerging risks and outcomes of blood transfusion in surgery  

Microsoft Academic Search

Prior to 1900, blood transfusions were fraught with danger and often caused more complications than the underlying disease. Discovery of the ABO compatibility system in the early twentieth century opened the modern era of blood transfusion, yet ABO incompatibility—as a result of clerical error—remains a significant threat to the recipient today. The risk of disease transmission now includes new and

Aryeh Shander

2004-01-01

251

Fractures in Transfusion Dependent Beta Thalassemia - An Indian Study  

Microsoft Academic Search

Aim of Study: To analyse the incidence of fractures in beta thalassemia patients and to identify causative factors. Methods: We examined all cases of transfusion dependent beta thalassemia (TDBT) seen at our institute over a two-year period. The transfusion records, incidence of fractures, cause of fracture and Hb levels were recorded. Radiographs of the involved parts were taken in cases

Praveen L Basanagoudar; Shivinder S Gill; Mandeep S Dhillon; Ram K Marwaha

252

[Blood transfusion security: one train may conceal another!].  

PubMed

The discovery of antibodies with specificities that are directed toward antigens of high prevalence is a difficult situation to manage in emergency blood transfusion. The reactions they produce interfere with the identification of reactions due to other, clinically significant antibodies. We report a case which illustrates this problem in terms of transfusion safety and time to carry out the tests. PMID:15217772

Trueba, F; Clavier, B; Bertin, B; Noizat-Pirenne, F; Janus, G; Joussemet, M

2004-01-01

253

Alterations in Bone and Erythropoiesis in Hemolytic Anemia: Comparative Study in Bled, Phenylhydrazine-Treated and Plasmodium-Infected Mice  

PubMed Central

Sustained erythropoiesis and concurrent bone marrow hyperplasia are proposed to be responsible for low bone mass density (BMD) in chronic hemolytic pathologies. As impaired erythropoiesis is also frequent in these conditions, we hypothesized that free heme may alter marrow and bone physiology in these disorders. Bone status and bone marrow erythropoiesis were studied in mice with hemolytic anemia (HA) induced by phenylhydrazine (PHZ) or Plasmodium infection and in bled mice. All treatments resulted in lower hemoglobin concentrations, enhanced erythropoiesis in the spleen and reticulocytosis. The anemia was severe in mice with acute hemolysis, which also had elevated levels of free heme and ROS. No major changes in cellularity and erythroid cell numbers occurred in the bone marrow of bled mice, which generated higher numbers of erythroid blast forming units (BFU-E) in response to erythropoietin. In contrast, low numbers of bone marrow erythroid precursors and BFU-E and low concentrations of bone remodelling markers were measured in mice with HA, which also had blunted osteoclastogenesis, in opposition to its enhancement in bled mice. The alterations in bone metabolism were accompanied by reduced trabecular bone volume, enhanced trabecular spacing and lower trabecular numbers in mice with HA. Taken together our data suggests that hemolysis exerts distinct effects to bleeding in the marrow and bone and may contribute to osteoporosis through a mechanism independent of the erythropoietic stress. PMID:23029401

Moreau, Robert; Tshikudi Malu, Diane; Dumais, Mathieu; Dalko, Esther; Gaudreault, Veronique; Romero, Hugo; Martineau, Corine; Kevorkova, Olha; Dardon, Jaime Sanchez; Dodd, Erin Lynn; Bohle, David Scott; Scorza, Tatiana

2012-01-01

254

Production of a bacteriolysin by a hemolytic Escherichia coli strain.  

PubMed Central

Nonhemolytic Escherichia coli were outnumbered by hemolytic E. coli within 24 h after being inoculated in a mixed culture at an initial ratio of 200 nonhemolytic to 1 hemolytic organism. The hemolytic strain was found to produce a cell-free, filterable substance which causes lysis of nonhemolytic E. coli B when grown in liquid cultures but not when grown on agar plates. The bacteriolysin is inactivated by boiling, by freezing and thawing, and by incubation with trypsin. The inability to inhibit growth on an agar plate, dependence on cell concentration for its effect, lysis of the sensitive cells, and appearance of phage particles in the cell lysates suggest that this substance is not like colicins or microcins previously described. After lysis of E. coli B, bacteriophage particles were visible in transmission electron micrographs of material pelleted by ultracentrifugation. However, no bacteriophage were observed in pellets from the bacteriolysin-containing supernatants before lysis of E. coli B. Failure to find bacteriophage in these preparations, and the fact that some bacteriolysin activity remains in the supernatant solution after centrifugation at 150,000 X g for 6.5 h, indicate that the bacteriolysin is not itself a bacteriophage. Exposure of E. coli B to UV light and mitomycin C did not induce production of a temperate phage. The properties of this system, in which a cell-free substance produced by one strain of bacteria causes lysis of another strain, appear to differ from those of the various types of bacteriocins and bacteriophages described to date. Images PMID:6350182

Jorgensen, S E; Mussen, H K; Mulcahy, P F; Wu, G K

1983-01-01

255

Production of a bacteriolysin by a hemolytic Escherichia coli strain.  

PubMed

Nonhemolytic Escherichia coli were outnumbered by hemolytic E. coli within 24 h after being inoculated in a mixed culture at an initial ratio of 200 nonhemolytic to 1 hemolytic organism. The hemolytic strain was found to produce a cell-free, filterable substance which causes lysis of nonhemolytic E. coli B when grown in liquid cultures but not when grown on agar plates. The bacteriolysin is inactivated by boiling, by freezing and thawing, and by incubation with trypsin. The inability to inhibit growth on an agar plate, dependence on cell concentration for its effect, lysis of the sensitive cells, and appearance of phage particles in the cell lysates suggest that this substance is not like colicins or microcins previously described. After lysis of E. coli B, bacteriophage particles were visible in transmission electron micrographs of material pelleted by ultracentrifugation. However, no bacteriophage were observed in pellets from the bacteriolysin-containing supernatants before lysis of E. coli B. Failure to find bacteriophage in these preparations, and the fact that some bacteriolysin activity remains in the supernatant solution after centrifugation at 150,000 X g for 6.5 h, indicate that the bacteriolysin is not itself a bacteriophage. Exposure of E. coli B to UV light and mitomycin C did not induce production of a temperate phage. The properties of this system, in which a cell-free substance produced by one strain of bacteria causes lysis of another strain, appear to differ from those of the various types of bacteriocins and bacteriophages described to date. PMID:6350182

Jorgensen, S E; Mussen, H K; Mulcahy, P F; Wu, G K

1983-09-01

256

Pleural solitary fibrous tumor complicated with autoimmune hemolytic anemia.  

PubMed

We herein report a 74-year-old woman who presented with autoimmune hemolytic anemia (AIHA) associated with pleural solitary fibrous tumor (SFT). Her AIHA was initially treated with 1 mg/kg daily of oral prednisolone (PSL) for 2 months, which had a limited effect. However, after surgical tumor resection, the patient showed remarkable improvement of AIHA with normalizations of serum lactate dehydrogenase and bilirubin levels, and we were able to rapidly reduce the PSL dosage. This is the first description of a case of AIHA caused by SFT. PMID:25030571

Takahashi, Hiroshi; Ohkawara, Hiroshi; Ikeda, Kazuhiko; Harada-Shirado, Kayo; Furukawa, Miki; Sukegawa, Masumi; Shichishima-Nakamura, Akiko; Noji, Hideyoshi; Wakamatsu, Saho; Tasaki, Kazuhiro; Suzuki, Hiroyuki; Ogawa, Kazuei; Takeishi, Yasuchika

2014-01-01

257

The increasing importance of Intellectual Property in Transfusion Medicine.  

PubMed

The Scottish National Blood Transfusion Service (SNBTS) originated in Edinburgh in the 1920's by dentist Jack Copland. Since that time the scope of Transfusion Medicine has broadened significantly to accommodate advances in technologies such as cell isolation, culture and manipulation. Many transfusion services, including SNBTS, now provide expertise both in the traditional field of blood transfusion and the newer, wider field of human cell (including 'adult' and embryonic stem cells) and tissue procurement and culture - in all the new science of "regenerative medicine". This paper describes the importance of Intellectual Property in the provision of Transfusion Medicine today and provides guidance on the management of Intellectual Property so that advances in the field have the best chance of successful translation into clinical practice. PMID:21733756

Hardie, Ian D; Rooney, Catherine

2011-08-01

258

Dangerous drug interactions leading to hemolytic uremic syndrome following lung transplantation  

Microsoft Academic Search

BACKGROUND: To report our experience of a rather uncommon drug interaction, resulting in hemolytic uremic syndrome (HUS). METHODS: Two consecutive cases of hemolytic uremic syndrome were diagnosed in our service. In both patients the use of macrolides in patients taking Tacrolimus, resulted in high levels of Tacrolimus. RESULTS: The first patient was a 48 years old female with Bilateral emphysema.

Haralabos Parissis; Kate Gould; John Dark

2010-01-01

259

Hemolytic activity of venom from crown-of-thorns starfish Acanthaster planci spines  

PubMed Central

Background The crown-of-thorns starfish Acanthaster planci is a venomous species from Taiwan whose venom provokes strong hemolytic activity. To understand the hemolytic properties of A. planci venom, samples were collected from A. planci spines in the Penghu Islands, dialyzed with distilled water, and lyophilized into A. planci spine venom (ASV) powder. Results Both crude venom and ASV cause 50% hemolysis at a concentration of 20 ?g/mL. The highest hemolytic activity of ASV was measured at pH 7.0-7.4; ASV-dependent hemolysis was sharply reduced when the pH was lower than 3 or greater than 8. There was almost no hemolytic activity when the Cu2+ concentration was increased to 10 mM. Furthermore, incubation at 100°C for 30 to 60 minutes sharply decreased the hemolytic activity of ASV. After treatment with the protease ?-chymotrypsin, the glycoside hydrolase cellulase, and the membrane component cholesterin, the hemolytic activity of ASV was significantly inhibited. Conclusions The results of this study provide fundamental information about A. planci spine venom. The hemolytic activity was affected by pH, temperature, metal ions, EDTA, cholesterin, proteases, and glycoside hydrolases. ASV hemolysis was inhibited by Cu2+, cholesterin, ?-chymotrypsin, and cellulose, factors that might prevent the hemolytic activity of venom and provide the medical treatment for sting. PMID:24063308

2013-01-01

260

Hemolytic action and surface activity of triterpene saponins from Anchusa officinalis L. Part 21: On the costituents of Boraginaceae.  

PubMed

Relationship between chemical structure, hemolytic action and surface activity of five glucosides of oleanolic acid were studied. Monodesmosidic saponins are more hemolytic than bisdesmosidic. The hemolytic activity of monodesmosides decreased with the length and the branching of the glucosidic chain. Surface activity is major in bisdesmosides. This property increases with the length of the glucosidic chain in monodesmosides. Increase of hemolytic action is accompanied by a decrease of surface activity. PMID:7433502

Romussi, G; Cafaggi, S; Bignardi, G

1980-08-01

261

Two novel ADAMTS13 gene mutations in thrombotic thrombocytopenic purpura\\/hemolytic-uremic syndrome (TTP\\/HUS)  

Microsoft Academic Search

Two novel ADAMTS13 gene mutations in thrombotic thrombocytopenic purpura\\/hemolytic-uremic syndrome (TTP\\/HUS).BackgroundThrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS) are now considered to be variants of one single syndrome called thrombotic thrombocytopenic purpura\\/hemolytic-uremic syndrome (TTP\\/HUS). Key features are thrombocytopenia, hemolytic anemia, and subsequently impaired function of different organs, especially the kidneys and the central nervous system (CNS). One possible reason is

CHRISTOPH LICHT; LUDWIG STAPENHORST; THORSTEN SIMON; ULRICH BUDDE; REINHARD SCHNEPPENHEIM; BERND HOPPE

2004-01-01

262

Maternal ?-Hemolytic Streptococcal Pharyngeal Exposure and Colonization in Pregnancy  

PubMed Central

Objectives. To report the pharyngeal colonization rate of ?-hemolytic streptococci and changes in the value of antistreptolysin O (ASO) and anti-DNase B serology titers during pregnancy. Methods. Healthy pregnant women were recruited and blood was drawn in each trimester. The upper limit of normal (ULN) values for ASO and anti-DNase B was calculated for each trimester. Throat swabs were collected for culture and positive cultures were further assessed for the identification of serogroup of the isolated ?-hemolytic streptococcus. Results. Out of a total of 126 pregnant women, 34.1% had positive throat cultures. Group C and group G strains were isolated in 18.2% of throat cultures while group F was detected in 13.5% of cases. The rate of colonization with GAS was 1.6%. There was an overall drop in ASO titer during pregnancy while anti-DNase B titers remained relatively unchanged. ULN values of 164IU, 157IU, and 156IU were calculated for ASO at the first, second, and third trimesters, respectively. Based on the ULN values, 28.6% of patients had recent streptococcal exposure. Conclusions. These results show that pregnant women act as a reservoir for spreading potentially immunogenic (groups C and G) and disease producing (group F) virulent strains of streptococci.

Brar, Anoop K.; Hathcock, Trupti; Cunningham, Madeleine W.; Eghtesady, Pirooz

2014-01-01

263

Hemolytic mechanism of dioscin proposed by molecular dynamics simulations.  

PubMed

Saponins are a class of compounds containing a triterpenoid or steroid core with some attached carbohydrate modules. Many saponins cause hemolysis. However, the hemolytic mechanism of saponins at the molecular level is not yet fully understood. In an attempt to explore this issue, we have studied dioscin-a saponin with high hemolytic activity-through extensive molecular dynamics (MD) simulations. Firstly, all-atom MD simulations of 8 ns duration were conducted to study the stability of the dioscin-cholesterol complex and the cholesterol-cholesterol complex in water and in decane, respectively. MM-GB/SA computations indicate that the dioscin-cholesterol complex is energetically more favorable than the cholesterol-cholesterol complex in a non-polar environment. Next, several coarse-grained MD simulations of 400 ns duration were conducted to directly observe the distribution of multiple dioscin molecules on a DPPC-POPC-PSM-CHOL lipid bilayer. Our results indicate that dioscin can penetrate into the lipid bilayer, accumulate in the lipid raft micro-domain, and then bind cholesterol. This leads to the destabilization of lipid raft and consequent membrane curvature, which may eventually result in the hemolysis of red cells. This possible mechanism of hemolysis can well explain some experimental observations on hemolysis. PMID:19513766

Lin, Fu; Wang, Renxiao

2010-01-01

264

Recessive mutations in DGKE cause atypical hemolytic-uremic syndrome  

PubMed Central

Pathologic thrombosis is a major cause of mortality. Hemolytic-uremic syndrome (HUS) features episodes of small vessel thrombosis resulting in microangiopathic hemolytic anemia, thrombocytopenia and renal failure1. Atypical HUS (aHUS) can result from genetic or autoimmune factors2 that lead to pathologic complement cascade activation3. By exome sequencing we identify recessive mutations in DGKE (diacylglycerol kinase epsilon) that co-segregate with aHUS in 9 unrelated kindreds, defining a distinctive Mendelian disease. Affected patients present with aHUS before age 1, have persistent hypertension, hematuria and proteinuria (sometimes nephrotic range), and develop chronic kidney disease with age. DGKE is found in endothelium, platelets, and podocytes. Arachidonic acid-containing diacylglycerols (DAG) activate protein kinase C, which promotes thrombosis. DGKE normally inactivates DAG signaling. We infer that loss of DGKE function results in a pro-thrombotic state. These findings identify a new mechanism of pathologic thrombosis and kidney failure and have immediate implications for treatment of aHUS patients. PMID:23542698

Lemaire, Mathieu; Fremeaux-Bacchi, Veronique; Schaefer, Franz; Choi, Murim; Tang, Wai Ho; Le Quintrec, Moglie; Fakhouri, Fadi; Taque, Sophie; Nobili, Francois; Martinez, Frank; Ji, Weizhen; Overton, John D.; Mane, Shrikant M.; Nurnberg, Gudrun; Altmuller, Janine; Thiele, Holger; Morin, Denis; Deschenes, Georges; Baudouin, Veronique; Llanas, Brigitte; Collard, Laure; Majid, Mohammed A.; Simkova, Eva; Nurnberg, Peter; Rioux-Leclerc, Nathalie; Moeckel, Gilbert W.; Gubler, Marie Claire; Hwa, John; Loirat, Chantal; Lifton, Richard P.

2013-01-01

265

Molecular aspects of erythroenzymopathies associated with hereditary hemolytic anemia.  

PubMed

Since the discovery of glucose 6-phosphate dehydrogenase (G6PD) and of pyruvate kinase deficiencies, erythroenzymopathies associated with hereditary hemolytic anemia have been extensively investigated. Kinetic and electrophoretic studies have shown that most, if not all, erythroenzymopathies are caused by the production of a mutant enzyme. Except for a few enzymes that are abundant in blood and tissues, it is difficult to obtain enough sample to study the functional and structural abnormalities of mutant enzymes associated with genetic disorders in man. The primary structures of only two normal red cell enzymes which can cause hereditary hemolytic anemia, phosphoglycerate kinase (PGK) and adenylate kinase, have been determined. Single amino acid substitutions of PGK variants have been found, and the identification of the exact molecular abnormalities of such variants has helped us to understand the accompanying functional abnormality. Gene cloning makes possible the identification of the DNA sequence that codes for enzyme proteins. Recently, human complementary DNA (cDNA) for aldolase, PGK, G6PD, and adenosine deaminase (ADA) have been isolated, and the nucleotide sequences for PGK and ADA determined. In the near future, human cDNA sequencing should permit identification of the gene alteration that gives rise to the mutant enzymes. PMID:2990202

Miwa, S; Fujii, H

1985-07-01

266

Isolation of a Variant of Subtilosin A with Hemolytic Activity?  

PubMed Central

Bacillus subtilis produces an anionic bacteriocin called subtilosin A that possesses antibacterial activity against certain gram-positive bacteria. In this study, we uncovered a hemolytic mutant of B. subtilis that produces an altered form of subtilosin A. The mutant bacteriocin, named subtilosin A1, has a replacement of threonine at position 6 with isoleucine. In addition to the hemolytic activity, subtilosin A1 was found to exhibit enhanced antimicrobial activity against specific bacterial strains. The B. subtilis albB mutant that does not produce a putative immunity peptide was more sensitive to both subtilosin A and subtilosin A1. A spontaneous suppressor mutation of albB that restored resistance to subtilosin A and subtilosin A1 was obtained. The sbr (subtilosin resistance) mutation conferring the resistance is not linked to the sboA-alb locus. The sbr mutation does not increase the resistance of B. subtilis to other cell envelope-targeted antimicrobial agents, indicating that the mutation specifically confers the resistance to subtilosins. The findings suggest possible bioengineering approaches for obtaining anionic bacteriocins with enhanced and/or altered bactericidal activity. Furthermore, future identification of the subtilosin-resistant mutation could provide insights into the mechanism of subtilosin A activity. PMID:19633086

Huang, Tai; Geng, Hao; Miyyapuram, Venugopal R.; Sit, Clarissa S.; Vederas, John C.; Nakano, Michiko M.

2009-01-01

267

Isolation of a variant of subtilosin A with hemolytic activity.  

PubMed

Bacillus subtilis produces an anionic bacteriocin called subtilosin A that possesses antibacterial activity against certain gram-positive bacteria. In this study, we uncovered a hemolytic mutant of B. subtilis that produces an altered form of subtilosin A. The mutant bacteriocin, named subtilosin A1, has a replacement of threonine at position 6 with isoleucine. In addition to the hemolytic activity, subtilosin A1 was found to exhibit enhanced antimicrobial activity against specific bacterial strains. The B. subtilis albB mutant that does not produce a putative immunity peptide was more sensitive to both subtilosin A and subtilosin A1. A spontaneous suppressor mutation of albB that restored resistance to subtilosin A and subtilosin A1 was obtained. The sbr (subtilosin resistance) mutation conferring the resistance is not linked to the sboA-alb locus. The sbr mutation does not increase the resistance of B. subtilis to other cell envelope-targeted antimicrobial agents, indicating that the mutation specifically confers the resistance to subtilosins. The findings suggest possible bioengineering approaches for obtaining anionic bacteriocins with enhanced and/or altered bactericidal activity. Furthermore, future identification of the subtilosin-resistant mutation could provide insights into the mechanism of subtilosin A activity. PMID:19633086

Huang, Tai; Geng, Hao; Miyyapuram, Venugopal R; Sit, Clarissa S; Vederas, John C; Nakano, Michiko M

2009-09-01

268

Transfusion medicine in the era of proteomics.  

PubMed

Blood components (BCs) are highly complex mixtures of plasma proteins and cells. At present, BC and blood derivatives (BDs) quality control is mainly focused on standardized quantitative assessment, providing relatively limited information about products. Unfortunately, during the production, inactivation, and storage processes there is the risk of changes in their integrity, especially at the protein level, which could cause negative effects on transfusion. It is therefore a major challenge to identify significant alterations of these products, and, in this context, proteomics can play a potentially relevant role in transfusion medicine (TM) to assess the protein composition of blood-derived therapeutics, particularly for identifying modified proteins. It can provide comprehensive information about changes occurring during processing and storage of BCs and BDs and can be applied to assess or improve them, therefore potentially enabling a global assessment of processing, inactivation and storage methods, as well as of possible contaminants and neoantigens that may influence the immunogenic capacity of blood-derived therapeutics. Thus, proteomics could become a relevant part of quality-control process to verify the identity, purity, safety, and potency of various blood therapeutics. A more detailed understanding of the proteins found in blood and blood products, and the identification of their interactions, may also yield important information for the design of new small molecule therapeutics and also for future improvements in TM. Proteomics, together with genomics in the near future, will presumably have an impact on disease diagnosis and prognosis as well as on further advances in the production, pathogen inactivation and storage processes of blood-based therapeutics. PMID:18541472

Liumbruno, Giancarlo; D'Amici, Gian Maria; Grazzini, Giuliano; Zolla, Lello

2008-04-30

269

Adult-onset eculizumab-resistant hemolytic uremic syndrome associated with cobalamin C deficiency.  

PubMed

A 20-year-old man was hospitalized for malignant hypertension, mechanical hemolysis, and kidney failure. Kidney biopsy confirmed glomerular and arteriolar thrombotic microangiopathy. Etiologic analyses, which included ADAMTS13 activity, stool culture, complement factor proteins (C3, C4, factor H, factor I, and MCP [membrane cofactor protein]), anti-factor H antibodies, HIV (human immunodeficiency virus) serology, and antinuclear and antiphospholipid antibodies, returned normal results. Malignant hypertension was diagnosed. Ten months later, we observed a relapse of acute kidney injury and mechanical hemolysis. Considering a diagnosis of complement dysregulation-related atypical hemolytic uremic syndrome (HUS), we began treatment with eculizumab. Despite the efficient complement blockade, the patient's kidney function continued to decline. We performed additional analyses and found that the patient's homocysteine levels were dramatically increased, with no vitamin B12 (cobalamin) or folate deficiencies. We observed very low plasma methionine levels associated with methylmalonic aciduria, which suggested cobalamin C disease. We stopped the eculizumab infusions and initiated specific treatment, which resulted in complete cessation of hemolysis. MMACHC (methylmalonic aciduria and homocystinuria type C protein) sequencing revealed compound heterozygosity for 2 causative mutations. To our knowledge, this is the first report of adult-onset cobalamin C-related HUS. Considering the wide availability and low cost of the homocysteine assay, we suggest that it be included in the diagnostic algorithm for adult patients who present with HUS. PMID:24210589

Cornec-Le Gall, Emilie; Delmas, Yahsou; De Parscau, Loïc; Doucet, Laurent; Ogier, Hélène; Benoist, Jean-François; Fremeaux-Bacchi, Véronique; Le Meur, Yannick

2014-01-01

270

The relationship between transfusion and hypoxemia in combat casualties.  

PubMed Central

The relationship between transfusion and subsequent hypoxemia was examined retrospectively in the records of combat casualties studied by the first three U.S. Army Surgical Research Teams in Vietnam. There was no evident relationship in 425 casualties studied before anesthesia and operation. In 199 casualties studied preoperatively and on at least two of the first three postoperative days, there was no evident relationship in those with injuries not involving the chest or abdomen. Eighteen such casualties received over ten units of blood each (average 24.5) and exhibited subsequent changes in arterial oxygen tension (PaO2) which were indistinguishable from those transfused lesser amounts or not all. Similar observations were made in casualties with injuries to the abdomen, although there was a tendency to lower PaO2 two days after injury in those heavily transfused. In those with thoracic injury, there was statistically significantly lower PaO2 on the first two postoperative days in those heavily transfused. Two possible interpretations are considered, one that blood transfusion contributed to hypoxemia, and alternatively, that a greater magnitude of the injuries accounted for both the worsened hypoxemia and the need for more transfusions. The latter was thought more likely. The differences in PaO2 related to the type of injury exceeded the differences associated with transfusion. PMID:697435

Collins, J A; James, P M; Bredenberg, C E; Anderson, R W; Heisterkamp, C A; Simmons, R L

1978-01-01

271

Clinical Factors and the Decision to Transfuse Chronic Dialysis Patients  

PubMed Central

Summary Background and objectives Red blood cell transfusion was previously the principle therapy for anemia in CKD but became less prevalent after the introduction of erythropoiesis-stimulating agents. This study used adaptive choice-based conjoint analysis to identify preferences and predictors of transfusion decision-making in CKD. Design, setting, participants, & measurements A computerized adaptive choice-based conjoint survey was administered between June and August of 2012 to nephrologists, internists, and hospitalists listed in the American Medical Association Masterfile. The survey quantified the relative importance of 10 patient attributes, including hemoglobin levels, age, occult blood in stool, severity of illness, eligibility for transplant, iron indices, erythropoiesis-stimulating agents, cardiovascular disease, and functional status. Triggers of transfusions in common dialysis scenarios were studied, and based on adaptive choice-based conjoint-derived preferences, relative importance by performing multivariable regression to identify predictors of transfusion preferences was assessed. Results A total of 350 providers completed the survey (n=305 nephrologists; mean age=46 years; 21% women). Of 10 attributes assessed, absolute hemoglobin level was the most important driver of transfusions, accounting for 29% of decision-making, followed by functional status (16%) and cardiovascular comorbidities (12%); 92% of providers transfused when hemoglobin was 7.5 g/dl, independent of other factors. In multivariable regression, Veterans Administration providers were more likely to transfuse at 8.0 g/dl (odds ratio, 5.9; 95% confidence interval, 1.9 to 18.4). Although transplant eligibility explained only 5% of decision-making, nephrologists were five times more likely to value it as important compared with non-nephrologists (odds ratio, 5.2; 95% confidence interval, 2.4 to11.1). Conclusions Adaptive choice-based conjoint analysis was useful in predicting influences on transfusion decisions. Hemoglobin level, functional status, and cardiovascular comorbidities most strongly influenced transfusion decision-making, but preference variations were observed among subgroups. PMID:23929931

Whitman, Cynthia B.; Shreay, Sanatan; Gitlin, Matthew; van Oijen, Martijn G. H.

2013-01-01

272

Autologous blood transfusion: The benefits to the patient undergoing abdominal aortic aneurysm repair  

Microsoft Academic Search

The clinical benefits of using intraoperative autologous blood transfusion during abdominal aortic aneurysm bypass surgery become increasingly apparent when use of autologous and homologous blood transfusions is compared. That homologous blood transfusions carry some risk is widely recognized. When autologous blood is used as a sole source of blood transfusion, the risk of transmission of infectious agents and potential immunologic

Anna Farrer; J. I. Spark; D. J. A. Scott

1997-01-01

273

Randomized trial comparing packed red cell blood transfusion with and without leukocyte depletion for gastrointestinal surgery  

Microsoft Academic Search

BACKGROUND: Allogeneic transfusion is associated with postoperative infections that significantly prolong hospital stays and increase costs. Recent studies suggest that filtering leukocytes from blood prior to transfusion reduces the risk of postoperative infection associated with blood transfusion. We compared the incidence of postoperative infections, hospital stays, and hospital charges of gastrointestinal surgery patients transfused with packed red cells or leukocyte-depleted

Paul Ian Tartter; Kala Mohandas; Penny Azar; Jill Endres; Jess Kaplan; Morton Spivack

1998-01-01

274

No Evidence of Xenotropic Murine Leukemia Virus-Related Virus Transmission by Blood Transfusion from Infected Rhesus Macaques  

PubMed Central

The discovery of xenotropic murine leukemia virus-related virus (XMRV) in human tissue samples has been shown to be due to virus contamination with a recombinant murine retrovirus. However, due to the unknown pathogenicity of this novel retrovirus and its broad host range, including human cell lines, it is important to understand the modes of virus transmission and develop mitigation and management strategies to reduce the risk of human exposure and infection. XMRV transmission was evaluated by whole-blood transfusion in rhesus macaques. Monkeys were infected with XMRV to serve as donor monkeys for blood transfers at weeks 1, 2, and 3 into naïve animals. The donor and recipient monkeys were evaluated for XMRV infection by nested PCR assays with nucleotide sequence confirmation, Western blot assays for development of virus-specific antibodies, and coculture of monkey peripheral blood mononuclear cells (PBMCs) with a sensitive target cell line for virus isolation. XMRV infection was demonstrated in the virus-injected donor monkeys, but there was no evidence of virus transmission by whole-blood transfusion to naïve monkeys based upon PCR analysis of PBMCs using XMRV-specific gag and env primers, Western blot analysis of monkey plasma up to 31 to 32 weeks after transfusion, and coculture studies using monkey PBMCs from various times after transfusion. The study demonstrates the lack of XMRV transmission by whole-blood transfusion during the acute phase of infection. Furthermore, analysis of PBMC viral DNA showed extensive APOBEC-mediated G-to-A hypermutation in a donor animal at week 9, corroborating previous results using macaques and supporting the possible restriction of XMRV replication in humans by a similar mechanism. PMID:23236064

Williams, Dhanya K.; Galvin, Teresa A.; Gao, Yamei; O'Neill, Christina; Glasner, Dustin

2013-01-01

275

No evidence of xenotropic murine leukemia virus-related virus transmission by blood transfusion from infected rhesus macaques.  

PubMed

The discovery of xenotropic murine leukemia virus-related virus (XMRV) in human tissue samples has been shown to be due to virus contamination with a recombinant murine retrovirus. However, due to the unknown pathogenicity of this novel retrovirus and its broad host range, including human cell lines, it is important to understand the modes of virus transmission and develop mitigation and management strategies to reduce the risk of human exposure and infection. XMRV transmission was evaluated by whole-blood transfusion in rhesus macaques. Monkeys were infected with XMRV to serve as donor monkeys for blood transfers at weeks 1, 2, and 3 into naïve animals. The donor and recipient monkeys were evaluated for XMRV infection by nested PCR assays with nucleotide sequence confirmation, Western blot assays for development of virus-specific antibodies, and coculture of monkey peripheral blood mononuclear cells (PBMCs) with a sensitive target cell line for virus isolation. XMRV infection was demonstrated in the virus-injected donor monkeys, but there was no evidence of virus transmission by whole-blood transfusion to naïve monkeys based upon PCR analysis of PBMCs using XMRV-specific gag and env primers, Western blot analysis of monkey plasma up to 31 to 32 weeks after transfusion, and coculture studies using monkey PBMCs from various times after transfusion. The study demonstrates the lack of XMRV transmission by whole-blood transfusion during the acute phase of infection. Furthermore, analysis of PBMC viral DNA showed extensive APOBEC-mediated G-to-A hypermutation in a donor animal at week 9, corroborating previous results using macaques and supporting the possible restriction of XMRV replication in humans by a similar mechanism. PMID:23236064

Williams, Dhanya K; Galvin, Teresa A; Gao, Yamei; O'Neill, Christina; Glasner, Dustin; Khan, Arifa S

2013-02-01

276

High Oxygen Partial Pressure Decreases Anemia-Induced Heart Rate Increase Equivalent to Transfusion  

PubMed Central

Background Anemia is associated with morbidity and mortality and frequently leads to transfusion of erythrocytes. We sought to compare directly the effect of high inspired oxygen fraction vs. transfusion of erythrocytes on the anemia-induced increased heart rate (HR) in humans undergoing experimental acute isovolemic anemia. Methods We combined HR data from healthy subjects undergoing experimental isovolemic anemia in seven studies performed by our group. We examined HR changes associated with breathing 100% oxygen by non-rebreathing face mask vs. transfusion of erythrocytes at their nadir hemoglobin (Hb) concentration of 5 g/dL. Data were analyzed using a mixed-effects model. Results HR had an inverse linear relationship to hemoglobin concentration with a mean increase of 3.9 beats per minute per gram of Hb (beats/min/g Hb) decrease (95% confidence interval [CI], 3.7 – 4.1 beats/min/g Hb), P < 0.0001. Return of autologous erythrocytes significantly decreased HR by 5.3 beats/min/g Hb (95% CI, 3.8 – 6.8 beats/min/g Hb) increase, P < 0.0001. HR at nadir Hb of 5.6 g/dL (95% CI, 5.5 – 5.7 g/dL) when breathing air (91.4 beats/min; 95% CI, 87.6 – 95.2 beats/min) was reduced by breathing 100% oxygen (83.0 beats/min; 95% CI, 79.0 -87.0 beats/min), P < 0.0001. The HR at hemoglobin 5.6 g/dL when breathing oxygen was equivalent to the HR at Hb 8.9 g/dL when breathing air. Conclusions High arterial oxygen partial pressure reverses the heart rate response to anemia, probably owing to its usability, rather than its effect on total oxygen content. The benefit of high arterial oxygen partial pressure has significant potential clinical implications for the acute treatment of anemia and results of transfusion trials. PMID:21768873

Feiner, John R.; Finlay-Morreale, Heather E.; Toy, Pearl; Lieberman, Jeremy A.; Viele, Maurene K.; Hopf, Harriet W.; Weiskopf, Richard B.

2011-01-01

277

Clinical Application of Immunofluorescence I. Grouping ?-Hemolytic Streptococci  

PubMed Central

Smith, Thomas B. (Armed Forces Institute of Pathology, Washington, D.C.). Clinical application of immunofluorescence. I. Grouping ?-hemolytic streptococci. J. Bacteriol. 89:198–204. 1965.—Procedures are described for the production of antistreptococcal serum in rabbits and for the preparation of group-specific conjugates for Lancefield groups A, C, and G. A modification of the conventional technique of absorption and inhibition to prevent cross-reactions with common antigens was used with excellent results. In addition, a promising new approach to eliminating cross-reactions of group A conjugate with antigens of groups C and G by dilution with group A-variant antiserum was tested. A complete method is introduced that enables the clinical laboratory to report whether group A streptococci are present in a given throat culture well within 24 hr after the physician collects the sample. Images PMID:14255663

Smith, Thomas B.

1965-01-01

278

Recurrent ocular involvement in pediatric atypical hemolytic uremic syndrome.  

PubMed

Atypical hemolytic uremic syndrome (HUS) is a subtype of thrombotic microangiopathy associated with complement alternative pathway dysregulation. It is clinically characterized by a relapsing course and a poor prognosis. Multiple organ systems are commonly affected by thrombotic microangiopathy in pediatric atypical HUS; however, ocular involvement is rarely reported. The case of an 11-year-old girl diagnosed as having atypical HUS who presented with bilateral central retinal vein occlusions with macular subhyaloid hemorrhage during her initial onset and ophthalmoplegia, diplopia, and optic disc edema during her relapsing episode 1 year later is described. All ocular manifestations occurred in the convalescence phase of atypical HUS. No other extrarenal complications were found and full recovery was achieved following typical treatment for atypical HUS (ie, plasma infusion, steroid, and supportive therapy). This is thought to be the first reported case of recurrent ocular involvement in pediatric atypical HUS. [J Pediatr Ophthalmol Strabismus 2014;51:e62-e65.]. PMID:25347082

Zheng, Xiaoyu; Gorovoy, Ian R; Mao, Jianhua; Jin, Ji; Chen, Xi; Cui, Qi N

2014-01-01

279

Blood transfusion: implications of treating a Jehovah's Witness patient.  

PubMed

Jehovah's Witnesses believe that an individual's life is contained within blood, and that accepting transfusion of blood and blood products is sinful. The administration of blood to a Jehovah's Witness who has refused to accept transfusion may lead to criminal or civil proceedings. From an ethical viewpoint, if a rational adult who has been fully apprised of the consequences of not receiving this treatment persists in a refusal, the decision should be respected. Medical and nursing staff faced with such a problem should explore fully with the patient any transfusion alternatives that the patient might find acceptable, such as cell salvage, volume expanders, antifibrinolytics and pharmaceutical options, such as erythropoietin. This article examines the legal and consent issues around blood transfusion in Jehovah's Witness patients and their implications for medical and surgical management. PMID:19223803

Effa-Heap, Gladys

280

Cell salvage for minimising perioperative allogeneic blood transfusion  

PubMed Central

Background Concerns regarding the safety of transfused blood have prompted reconsideration of the use of allogeneic (from an unrelated donor) red blood cell (RBC) transfusion, and a range of techniques to minimise transfusion requirements. Objectives To examine the evidence for the efficacy of cell salvage in reducing allogeneic blood transfusion and the evidence for any effect on clinical outcomes. Search methods We identified studies by searching CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to June 2009), EMBASE (1980 to June 2009), the internet (to August 2009) and bibliographies of published articles. Selection criteria Randomised controlled trials with a concurrent control group in which adult patients, scheduled for non-urgent surgery, were randomised to cell salvage (autotransfusion) or to a control group who did not receive the intervention. Data collection and analysis Data were independently extracted and the risk of bias assessed. Relative risks (RR) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated. Data were pooled using a random-effects model. The primary outcomes were the number of patients exposed to allogeneic red cell transfusion and the amount of blood transfused. Other clinical outcomes are detailed in the review. Main results A total of 75 trials were included. Overall, the use of cell salvage reduced the rate of exposure to allogeneic RBC transfusion by a relative 38% (RR 0.62; 95% CI 0.55 to 0.70). The absolute reduction in risk (ARR) of receiving an allogeneic RBC transfusion was 21% (95% CI 15% to 26%). In orthopaedic procedures the RR of exposure to RBC transfusion was 0.46 (95% CI 0.37 to 0.57) compared to 0.77 (95% CI 0.69 to 0.86) for cardiac procedures. The use of cell salvage resulted in an average saving of 0.68 units of allogeneic RBC per patient (WMD ?0.68; 95% CI ?0.88 to ?0.49). Cell salvage did not appear to impact adversely on clinical outcomes. Authors’ conclusions The results suggest cell salvage is efficacious in reducing the need for allogeneic red cell transfusion in adult elective cardiac and orthopaedic surgery. The use of cell salvage did not appear to impact adversely on clinical outcomes. However, the methodological quality of trials was poor. As the trials were unblinded and lacked adequate concealment of treatment allocation, transfusion practices may have been influenced by knowledge of the patients’ treatment status potentially biasing the results in favour of cell salvage. PMID:20393932

Carless, Paul A; Henry, David A; Moxey, Annette J; O'Connell, Dianne; Brown, Tamara; Fergusson, Dean A

2014-01-01

281

Jehovah's Witnesses and autonomy: honouring the refusal of blood transfusions.  

PubMed

This paper explores the scriptural and theological reasons given by Jehovah's Witnesses (JWs) to refuse blood transfusions. Julian Savulescu and Richard W Momeyer argue that informed consent should be based on rational beliefs and that the refusal of blood transfusions by JWs is irrational, but after examining the reasons given by JWs, I challenge the claim that JW beliefs are irrational. I also question whether we should give up the traditional notion of informed consent. PMID:22790086

Bock, Gregory L

2012-11-01

282

Blood Transfusions, Thrombosis and Mortality in Hospitalized Cancer Patients  

PubMed Central

Background Anemia is frequent in cancer patients, but there are concerns regarding treatment with erythropoiesis-stimulating agents (ESAs). Blood transfusions are commonly used as an alternative, but with little data regarding outcomes. We investigated the association between transfusions, venous thromboembolism (VTE), arterial thromboembolism (ATE) and mortality in hospitalized cancer patients. Methods We conducted a retrospective cohort study using the discharge database of the University HealthSystem Consortium. This included 504,208 hospitalizations of cancer patients between 1995 and 2003 at 60 United States medical centers. Results Of the patients included, 70,542 (14.0%) received at least 1 red blood cell (RBC) and 15,237 (3%) received at least 1 platelet transfusion. Among patients receiving RBC transfusions, 7.2% developed VTE and 5.2% developed ATE and this was significantly greater than rates of 3.8% and 3.1%, respectively, for the rest of the study population (P<0.0001 In multivariate analysis, both RBC [OR 1.60, (95%CI 1.53–1.67)] and platelet transfusion [OR 1.20(95% CI 1.11–1.29)] were independently associated with an increased risk of VTE. RBC [OR 1.53 (95%CI 1.46–1.61)] and platelet transfusion [OR 1.55 (95%CI 1.40–1.71)] were also associated with ATE (P<0.0001 for each). Transfusions were also associated with an increased risk of in-hospital mortality [OR 1.34 (95% CI 1.29–1.38) for RBC and 2.40 (95% CI 2.27–2.52) for platelets, p<0.0001]. Conclusions RBC and platelet transfusions are associated with an increased risk of venous and arterial thrombotic events and mortality in hospitalized cancer patients. Further investigation is necessary to determine whether this relationship is causal. PMID:19029504

Khorana, Alok A.; Francis, Charles W.; Blumberg, Neil; Culakova, Eva; Refaai, Majed A.; Lyman, Gary H.

2009-01-01

283

Perioperative haemotherapy: II. Risks and complications of blood transfusion  

Microsoft Academic Search

Major life-threatening complications following blood transfusion are rare and human error remains an important aetiological\\u000a factor in many. The infectious risk from blood transfusion is predominantly hepatitis, and non-A, non-B and hepatitis C (HCV)\\u000a are the most common subtypes noted. The risk of posttransfusion hepatitis (PTH) appears to be decreasing and this is attributed\\u000a to both deferral of high-risk donors

Edward T. Crosby

1992-01-01

284

Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios  

PubMed Central

Objective Preoperative over-ordering of blood is common and leads to the wastage of blood bank resources. The preoperative blood ordering and transfusion practices for common elective general surgical procedures were evaluated in our university hospital to formulate a maximum surgical blood order schedule (MSBOS) for those procedures where a cross-match appears necessary. Methods We evaluated blood ordering practices retrospectively in all elective general surgical procedures in our institution over a 6-month period. Cross-match-to-transfusion ratios (C:T) were calculated and compared to current trust and the British Society of Haematology (BSH) guidelines. The adjusted C:T ratio was also calculated and was defined as the C:T ratio when only cross-matched blood used intraoperatively was included in the calculation. Results 541 patients were identified during the 6-month period. There were 314 minor and 227 major surgeries carried out. 99.6% (n = 226) of the patients who underwent major surgery and 95.5% (n = 300) of the patients having minor surgery had at least a group and save (G and S) test preoperatively. A total of 507 units of blood were cross-matched and 238 units were used. The overall C:T ratio was therefore 2.1:1, which corresponds to a 46.9% red cell usage. There was considerable variation in the C:T ratio, depending on the type of surgery performed. The adjusted C:T ratio varied between 3.75 and 37. Conclusions Compliance with transfusion policies is poor and over-ordering of blood products commonplace. Implementation of the updated recommended MSBOS and introduction of G and S for eligible surgical procedures is a safe, effective and cost-effective method to prevent preoperative over-ordering of blood in elective general surgery. Savings of GBP 8,596.00 per annum are achievable with the incorporation of updated evidence-based guidelines in our university hospital. PMID:23637646

Hall, Thomas C.; Pattenden, Clare; Hollobone, Chloe; Pollard, Cristina; Dennison, Ashley R.

2013-01-01

285

MICROHEMODYNAMIC ABERRATIONS CREATED BY TRANSFUSION OF STORED BLOOD  

PubMed Central

BACKGROUND Human red blood cells (RBCs) can be stored for up to 42 days under controlled conditions. Physical and chemical changes occur during RBC storage, altering their function. This study links stored cells mechanical changes with hemodynamic functional alterations upon transfusion. STUDY DESIGN AND METHODS Mechanical properties of fresh and stored RBCs were evaluated in vitro. Their transfusion effects were evaluated in vivo using intravital microscopy of the rat's cremaster muscle preparation. Rats were hemodiluted to 30% hematocrit, to mimic an anemic state pre-transfusion, then exchange transfused with fresh or stored cells. RESULTS In vitro studies on rheology and oxygen affinity of stored cells confirmed previously published results. Storage was found to modify static and dynamic red cell mechanic behavior. Post transfusion, systemic hemodynamics were similar for fresh and stored cells; however, microvascular hemodynamics were drastically affected by stored cells. Stored cells reduced blood flow and oxygen delivery. Additionally, the presence of stored cells in circulation affected cell-to-cell and cell-to-wall interactions, affected cell hydrodynamics. Stored cells disrupted the erythrocyte cell free layer (CFL) and wall shear stress (WSS) signals. CONCLUSION The reduced cell deformability due to RBC “storage lesions” caused pathological changes in microvascular hemodynamics, endothelial cell mechanotransduction, and RBC dynamics. Thus, the mechanical changes of blood banked cells can limit transfusion ability to achieve its intended goal. PMID:23901933

Yalcin, Ozlem; Ortiz, Daniel; Tsai, Amy G.; Johnson, Paul C.; Cabrales, Pedro

2014-01-01

286

Hydroxyurea Treatment in Transfusion-Dependent ?-Thalassemia Patients  

PubMed Central

Background: ?-Thalassemia is an inherited hemoglobin disorder caused by defective synthesis of ß-globin chains. Hemoglobin (Hb) F induction is a possible therapeutic approach which can partially compensate for ? and non-? globin chains imbalance. Objectives: We aimed to investigate the efficacy and safety of Hydroxyurea (HU) in diminishing transfusion requirements of patients with ?-thalassemia major in Southern Iran. Patients and Methods: In this single-arm clinical trial, all transfusion-dependent ?-thalassemia patients older than two years old (n = 97) who had inclusion criteria of the study and had been registered for at least six months in Dastgheib thalassemia outpatient clinic (a referral center affiliated to Shiraz University of Medical Sciences) were evaluated from October 2010 to December 2011. The patients were treated with HU with a mean dose of 10.5 mg/kg for a mean duration of 8 months (range 3-14 months). Transfusion needs and Hb levels were compared before and after HU treatment. Results: The mean volume of blood transfusion decreased significantly following HU treatment (0.71 mL/kg/day vs. 0.43 mL/kg/day, P < 0.001). Two-thirds of the patients showed good and partial response. No serious adverse reaction was observed except persistent neutropenia in two patients. Conclusions: Hydroxyurea can be safely used in some transfusion-dependent ?-thalassemia patients to decrease their transfusion needs. PMID:25068055

Bordbar, Mohammad Reza; Silavizadeh, Samir; Haghpanah, Sezaneh; Kamfiroozi, Roza; Bardestani, Marzieh; Karimi, Mehran

2014-01-01

287

Partial exchange transfusion for polycythemia hyperviscosity syndrome.  

PubMed

The objective of this study was to examine the use of partial exchange transfusion (PET) performed for polycythemia hyperviscosity syndrome (PHS) over time. A retrospective review of 141 infants who received a PET for PHS at Yale-New Haven Hospital between 1986 and 2007 was performed, querying maternal and neonatal medical records. Patient demographics, risk factors for PHS, indications for PET, and complications associated with PET and PHS were collected. Overall, there was no change in the number of PET performed over the study period ( R(2)=0.082, P=0.192). Eighty-eight percent of patients had at least one risk factor for PHS, most commonly maternal diabetes. Over time, there was a statistically significant decrease in maternal diabetes as a risk factor for PHS. Forty percent of patients had a significant complication attributed to PHS prior to PET. Eighteen percent of patients had a complication attributed to PET. Life-threatening complications of PHS or PET were rare. In conclusion, PHS continues to be a problem observed in neonatal intensive care units, particularly in at-risk populations. PHS and PET are associated with significant complications. Well-designed studies with long-term follow up are needed to assess the risks and benefits of PET for PHS. PMID:21365533

Hopewell, Bridget; Steiner, Laurie A; Ehrenkranz, Richard A; Bizzarro, Matthew J; Gallagher, Patrick G

2011-08-01

288

Assessment of the Red Cell Proteome of Young Patients with Unexplained Hemolytic Anemia by Two-Dimensional Differential In-Gel Electrophoresis (DIGE)  

PubMed Central

Erythrocyte cytosolic protein expression profiles of children with unexplained hemolytic anemia were compared with profiles of close relatives and controls by two-dimensional differential in-gel electrophoresis (2D-DIGE). The severity of anemia in the patients varied from compensated (i.e., no medical intervention required) to chronic transfusion dependence. Common characteristics of all patients included chronic elevation of reticulocyte count and a negative workup for anemia focusing on hemoglobinopathies, morphologic abnormalities that would suggest a membrane defect, immune-mediated red cell destruction, and evaluation of the most common red cell enzyme defects, glucose-6-phosphate dehydrogenase and pyruvate kinase deficiency. Based upon this initial workup and presentation during infancy or early childhood, four patients classified as hereditary nonspherocytic hemolytic anemia (HNSHA) of unknown etiology were selected for proteomic analysis. DIGE analysis of red cell cytosolic proteins clearly discriminated each anemic patient from both familial and unrelated controls, revealing both patient-specific and shared patterns of differential protein expression. Changes in expression pattern shared among the four patients were identified in several protein classes including chaperons, cytoskeletal and proteasome proteins. Elevated expression in patient samples of some proteins correlated with high reticulocyte count, likely identifying a subset of proteins that are normally lost during erythroid maturation, including proteins involved in mitochondrial metabolism and protein synthesis. Proteins identified with patient-specific decreased expression included components of the glutathione synthetic pathway, antioxidant pathways, and proteins involved in signal transduction and nucleotide metabolism. Among the more than 200 proteins identified in this study are 21 proteins not previously described as part of the erythrocyte proteome. These results demonstrate the feasibility of applying a global proteomic approach to aid characterization of red cells from patients with hereditary anemia of unknown cause, including the identification of differentially expressed proteins as potential candidates with a role in disease pathogenesis. PMID:22509282

von Lohneysen, Katharina; Scott, Thomas M.; Soldau, Katrin; Xu, Xiuling; Friedman, Jeffrey S.

2012-01-01

289

A retrospective review of patient factors, transfusion practices, and outcomes in patients with transfusion-associated circulatory overload.  

PubMed

Transfusion-associated circulatory overload (TACO) is a common yet underrecognized and underreported complication of transfusion associated with significant morbidity and mortality. The objective of this study was to examine patient and transfusion characteristics in a cohort of TACO cases. A retrospective medical record review of 100 consecutive TACO episodes reported at 2 academic centers was performed. Information related to demographics, medical history, radiologic and echocardiographic investigations, infusion practices, reaction features, management, and outcome were collected. Ninety-eight cases were accessible for review. A history of congestive heart failure (41%), renal dysfunction (44%), and age more than 70 years (56%) were common in TACO patients. Suboptimal fluid status management and inappropriate infusion practices were often seen (eg, verbal orders, double red cell transfusions, rapid infusion rates, lack or improper timing of preemptive diuretics). The median volume of blood ordered was 500 mL, and the median volume of crystalloid or colloid (preceding 24 hours) was 2200 mL. A physician order specifying the infusion rate was documented in 50% of transfusion orders. Preemptive diuretics were ordered in only 29% of cases, most commonly introduced midway or after the transfusion at a dose of furosemide 20 mg intravenously. After TACO, 18% of patients required transfer to the intensive care unit, 8% suffered a major complication, and 2% died. Suboptimal ordering and infusion practices may be contributing to the high incidence and severity of TACO. Research in TACO prevention strategies, such as slow rates of infusion and preemptive diuretics, is warranted. PMID:24075097

Lieberman, Lani; Maskens, Carolyn; Cserti-Gazdewich, Christine; Hansen, Mark; Lin, Yulia; Pendergrast, Jacob; Yi, Qi Long; Callum, Jeannie

2013-10-01

290

Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture  

PubMed Central

Background The practice of transfusing red blood cells is still liberal in some centres suggesting a lack of compliance with guidelines recommending transfusion of red blood cells at haemoglobin levels of 6–8 g/dL in the non-bleeding patient. Few databases provide ongoing feedback of data on pre-transfusion haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels. Materials and methods Hospital data on admissions, diagnoses and surgical procedures were used to define the populations of patients. Data on haemoglobin measurements and red blood cell transfusions were used to calculate pre-transfusion haemoglobin, percentage of transfused patients and transfusion volumes. Results The model dataset include 33,587 admissions, of which 10% had received at least one unit of red blood cells. Haemoglobin measurements preceded 96.7% of the units transfused. The median pre-transfusion haemoglobin was 8.9 g/dL (interquartile range 8.2–9.7) at the hospital level. In only 6.5% of the cases, transfusion was initiated at 7.3 g/dL or lower as recommended by the Danish national transfusion guideline. In 27% of the cases, transfusion was initiated when the haemoglobin level was 9.3 g/dL or higher, which is not recommended. A median of two units was transfused per transfusion episode and per hospital admission. Transfusion practice was more liberal in surgical and intensive care units than in medical departments. Discussion We described pre-transfusion haemoglobin levels, transfusion rates and volumes at hospital and departmental levels, and in surgical subpopulations. Initial data revealed an extensive liberal practice and low compliance with national transfusion guidelines, and identified wards in need of intervention. PMID:24960656

Norgaard, Astrid; de Lichtenberg, Trine Honnens; Nielsen, Jens; Johansson, Par I.

2014-01-01

291

Blood transfusion in Europe: basic principles for initial and continuous training in transfusion medicine: an approach to an European harmonisation  

Microsoft Academic Search

Over the past few decades, transfusion medicine and haemotherapy have evolved into complex medical disciplines comprising a broad field of subspecialties such as immunohaematology, blood component production, haemapheresis and haemostaseology. Transfusion medicine is thus an important qualification at the interfaces of analytical laboratory medicine, pharmaceutical production and clinical disciplines such as internal medicine, anaesthesiology or surgery. Physicians specialising in transfusion

M. M. Mueller; E. Seifried

2006-01-01

292

Transfusion transmitted infections - A retrospective analysis from the National Blood Transfusion Service in Eritrea  

PubMed Central

Background The emergence of transfusion transmitted infection (TTI) especially HIV/AIDS has created a huge obstacle in ensuring blood safety. To assess the situation in Eritrea, we carried out a retrospective study of 29,501 blood donors for the prevalence of TTI's i.e. HIV, HBV, HCV and Syphilis. Methods The study population included all donors who donated blood from January 2006 to November 2009. The data was collected from the National Blood Transfusion Services (NTBS) of Eritrea and includes category of donor and result for TTI markers. Results A total of 29,501 units of blood were collected from 23,385(79%) voluntary blood donors and the rest 6,116(21%) units were collected from family replacement donors. The over all prevalence of TTI's were 3.8% with 3.5% in voluntary blood donors and 5.1% in family replacement donors. The sero-prevalence for TTI markers were 0.18% HIV, 2.58% HBV, 0.57% HCV and 0.49% Syphilis. Conclusion In conclusion, even if the TTI prevalence rate among Eritrean blood donors is low, ensuring blood safety has a long way to go. PMID:22145069

Fessehaye, Nahom; Naik, Durgadas; Fessehaye, Tesfay

2011-01-01

293

Sigma E Regulators Control Hemolytic Activity and Virulence in a Shrimp Pathogenic Vibrio harveyi  

E-print Network

Members of the genus Vibrio are important marine and aquaculture pathogens. Hemolytic activity has been identified as a virulence factor in many pathogenic vibrios including V. cholerae, V. parahaemolyticus, V. alginolyticus, ...

Rattanama, Pimonsri

294

Drag reducing polymers as simple indicators of hemolytic potential in biomechanical devices  

E-print Network

An experimental study was carried out to determine if drag reducing polymers can be simple indicators of hemolytic potential in biomechanical devices. Specifically, three different blood pumps, known as a left ventricle ...

Shieh, Sarah

2009-01-01

295

Acute lymphoblastic leukaemia in a Jehovah's Witness: a management dilemma.  

PubMed

Jehovah's witnesses represent a unique group of patients whose religious beliefs prohibit receiving transfusion of all blood products. Since most chemotherapeutic regimens used to treat acute leukemia are myelosuppressive and often resulting in potentially life threatening pancytopenia, their refusal of blood products poses a challenge to clinicians. We report a case of a Jehovah's Witness patient with acute lymphoblastic leukemia (ALL) who was successfully treated with non-myelosuppressive chemotherapy for both first and second remission and achieved complete remissions both times without transfusion of blood products. PMID:24621157

Zhou, Louise; Mohsen, Amr; Khan, Mohammad A; Guthrie, Troy

2014-06-01

296

Survival of red blood cells after transfusion: processes and consequences  

PubMed Central

The currently available data suggest that efforts toward improving the quality of red blood cell (RBC) blood bank products should concentrate on: (1) preventing the removal of a considerable fraction of the transfused RBCs that takes place within the first hours after transfusion; (2) minimizing the interaction of the transfused RBCs with the patient's immune system. These issues are important in reducing the number and extent of the damaging side effects of transfusions, such as generation of alloantibodies and autoantibodies and iron accumulation, especially in transfusion-dependent patients. Thus, it becomes important for blood bank research not only to assess the classical RBC parameters for quality control during storage, but even more so to identify the parameters that predict RBC survival, function and behavior in the patient after transfusion. These parameters are likely to result from elucidation of the mechanisms that underly physiological RBC aging in vivo, and that lead to the generation of senescent cell antigens and the accumulation of damaged molecules in vesicles. Also, study of RBC pathology-related mechanisms, such as encountered in various hemoglobinopathies and membranopathies, may help to elucidate the mechanisms underlying a storage-associated increase in susceptibility to physiological stress conditions. Recent data indicate that a combination of new approaches in vitro to mimick RBC behavior in vivo, the growing knowledge of the signaling networks that regulate RBC structure and function, and the rapidly expanding set of proteomic and metabolomic data, will be instrumental to identify the storage-associated processes that control RBC survival after transfusion. PMID:24391593

Bosman, Giel J. C. G. M.

2013-01-01

297

Plasma Fibrinogen Concentration in ABO-Hemolytic Disease of the Newborn  

Microsoft Academic Search

Plasma fibrinogen and total serum proteins were measured in infants affected by ABO-hemolytic disease and in normal infants’ cord blood and blood taken 48 h after birth. The average plasma fibrinogen concentrations in the blood of infants with ABO-hemolytic disease was 447.36 mg\\/dl as compared with 267.09 mg\\/dl (p < 0.005) in cord blood and 313.82 mg\\/dl (p < 0.005)

E. L. Romano; J. Linares; G. Suárez

1982-01-01

298

THE QUESTION OF SENSITIZATION OF JOINTS WITH NON-HEMOLYTIC STREPTOCOCCI  

PubMed Central

It was impossible to demonstrate a condition of specific joint sensitization to non-hemolytic streptococci by first injecting the joints of rabbits with small doses of killed non-hemolytic streptococci, or with extracts of these organisms, and subsequently inoculating the rabbits intravenously with homologous living bacteria. Joints so treated were no more liable to involvement than were other untreated joints of the same animals. PMID:19868811

Swift, Homer F.; Boots, Ralph H.

1923-01-01

299

Hemolytic-Anemia-Associated Pulmonary Hypertension: Sickle-Cell-Disease- and Thalassemia-Associated Pulmonary Hypertension  

Microsoft Academic Search

\\u000a Pulmonary hypertension (PH) is now recognized as a complication of both chronic and acquired hemolytic anemias. The process\\u000a of hemolysis appears to be central to disease pathogenesis. Sickle cell disease (SCD), a congenital hemoglobinopathy affecting\\u000a as many as 30 million individuals worldwide, is the best characterized hemolytic anemia associated with PH. Multiple clinical\\u000a studies have demonstrated a 10–30% prevalence of

Elizabeth S. Klings; Mark T. Gladwin

300

DISSOCIATION OF HEMOLYTIC AND LYMPHOCYTE-TRANSFORMING ACTIVITIES OF STREPTOLYSIN S PREPARATIONS  

PubMed Central

The ability of streptolysin S preparations to induce high percentages of transformation in human peripheral blood lymphocytes was confirmed in a series of apparently healthy donors. Transforming activity was not demonstrated in the two media used for streptolysin S production, nor in control preparations in which a strain each of Streptococcus viridans, Staphylococcus aureus (nonhemolytic), and Diplococcus pneumoniae was substituted for the beta hemolytic streptococcal strain used for streptolysin S production. The relation of the hemolytic activity to the lymphocyte transforming activity of streptolysin S preparations was studied by means of inactivation and fractionation experiments. Heating produced a loss in both activities, but more in the hemolytic than in the transforming activity. The transformation obtained with a heated preparation had a high degree of correlation with that obtained with the unheated preparation in a series of normal subjects and patients with various rheumatic diseases, whose lymphocytes were often less responsive to stimulation with streptolysin S preparations (both heated and unheated) than the lymphocytes of the normal subjects studied. Treatment of streptolysin S preparations with chymotrypsin, vegetable lecithin, or trypan blue (the latter in minute amounts) resulted in preparations with no detectable hemolytic activity but with undiminished lymphocyte transforming activity. Chromatographic fractionations on DEAE-Sephadex columns yielded fractions endowed with transforming but not with hemolytic activity, and other fractions endowed with hemolytic but not with transforming activity. The recovery of the hemolytic activity was not complete and quantitation of the recovery of the transforming activity was not attempted. These experiments indicate that the hemolytic and transforming activities of streptolysin S preparations are independent of each other, and specifically that they are the attributes of two different streptococcal products, one of which is streptolysin S. The other is a nonhemolytic streptococcal product present in streptolysin S preparations but previously unrecognized. Some implications of these findings are discussed. PMID:4387992

Taranta, Angelo; Cuppari, Girolamo; Quagliata, Franco

1969-01-01

301

Aortic valve replacement for a patient with glucose-6-phosphate dehydrogenase deficiency and autoimmune hemolytic anemia.  

PubMed

Autoimmune hemolytic anemia and deficiency of glucose-6-phosphate deyhdrogenase (G6PD) result in severe hemolysis with different mechanisms. In patients with both pathologies, the effects of cardiopulmonary bypass on red blood cells and thrombocytes demand special care before and after open heart surgery. We evaluated the preoperative management and postoperative care of a patient with severe aortic insufficiency associated with G6PD deficiency and autoimmune hemolytic anemia who underwent aortic valve replacement. PMID:15985145

Tas, Serpil; Donmez, Arzu Antal; Kirali, Kaan; Alp, Mete H; Yakut, Cevat

2005-01-01

302

Hemolytic disease of the fetus and newborn with late-onset anemia due to anti-M: a case report and review of the Japanese literature.  

PubMed

Hemolytic disease of the fetus and newborn (HDFN) attributed to M/N-incompatibility varies from asymptomatic to lethally hydropic. Case reports are rare, and the clinical significance of anti-M is not completely understood. A challenging case of HDFN due to anti-M prompted an investigation of the Japanese literature, in order to characterize the clinical spectrum of M/N-incompatibility pregnancies in Japan and report results to English-language readers. Japanese reports of HDFN attributed to M/N incompatibility were compiled. Abstracted data include maternal antibody titers at delivery, fetal direct antiglobulin test, hemoglobin, total bilirubin, reticulocyte count at birth, and therapeutic interventions. We investigated characteristics of HDFN due to M/N-incompatible pregnancies in Japan after encountering a case of severe HDFN along with late-onset anemia in an infant born to a woman carrying IgG anti-M with a titer of 1. In total, thirty-three babies with HDFN due to anti-M and one due to anti-N have been reported in Japan since 1975. The median maternal antibody titer was 64 at delivery and was 16 or less in 10 of 34 women (29%). Five of 34 babies (15%) were stillborn or died as neonates. Twenty-one of 29 survivors (72%) had severe hemolytic anemia and/or hydrops fetalis. The reticulocyte count of neonates with anemia stayed below the reference interval. Sixteen (55%) developed late-onset anemia and 14 (48%) were transfused with M-negative RBCs. Significant positive correlation (P < .05) between the hemoglobin value and the reticulocyte count within 4 days of birth was obtained in 16 babies with anti-M HDFN. In the Japanese population, 21 of 34 cases of M/N-incompatible HDFN (72%) have manifested as severe hemolytic anemia and/or hydrops fetalis. Low reticulocyte count in neonates with late-onset anemia is consistent with suppressed erythropoiesis due to anti-M. PMID:24262303

Yasuda, Hiroyasu; Ohto, Hitoshi; Nollet, Kenneth E; Kawabata, Kinuyo; Saito, Shunnichi; Yagi, Yoshihito; Negishi, Yutaka; Ishida, Atsushi

2014-01-01

303

Reticulocytopenia in severe autoimmune hemolytic anemia (AIHA) of the warm antibody type.  

PubMed

A patient with severe AIHA of the warm antibody type, absence of reticulocytes and red cell hyperplasia of the bone marrow is described. In order to maintain a reasonable hemoglobin level 38 units of washed packed red cells were required within 24 days. The treatment with high doses of steroids showed no permanent beneficial effect. After splenectomy the red cell destruction was immediately reduced and the patient went into a remission. Bone marrow culture studies during the acute phase of the disease and at the time of complete hemato- and immunological remission, i.e. 4 months after splenectomy suggested a circulating autoantibody directed to early erythroid progenitors (BFU-E). The inhibitory activity in the patient's plasma did not influence granulocytic or mixed colony formation (CFU-GEMM). In addition to autoantibodies directed to erythroblasts and erythropoietin involved in the pathogenic mechanisms leading to red cell aplasia type I and II the culture studies suggest an unusual autoantibody that might cause the observed reticulocytopenia and erythropoietic hyperplasia of the bone marrow in AIHA. After the splenectomy the patient recovered, he required no further blood transfusions and his disease has not recurred. PMID:6850101

Hauke, G; Fauser, A A; Weber, S; Maas, D

1983-06-01

304

Dose of Prophylactic Platelet Transfusions and Prevention of Hemorrhage  

PubMed Central

BACKGROUND We conducted a trial of prophylactic platelet transfusions to evaluate the effect of platelet dose on bleeding in patients with hypoproliferative thrombocytopenia. METHODS We randomly assigned hospitalized patients undergoing hematopoietic stem-cell transplantation or chemotherapy for hematologic cancers or solid tumors to receive prophylactic platelet transfusions at a low dose, a medium dose, or a high dose (1.1×1011, 2.2×1011, or 4.4×1011 platelets per square meter of body-surface area, respectively), when morning platelet counts were 10,000 per cubic millimeter or lower. Clinical signs of bleeding were assessed daily. The primary end point was bleeding of grade 2 or higher (as defined on the basis of World Health Organization criteria). RESULTS In the 1272 patients who received at least one platelet transfusion, the primary end point was observed in 71%, 69%, and 70% of the patients in the low-dose group, the medium-dose group, and the high-dose group, respectively (differences were not significant). The incidences of higher grades of bleeding, and other adverse events, were similar among the three groups. The median number of platelets transfused was significantly lower in the low-dose group (9.25×1011) than in the medium-dose group (11.25×1011) or the high-dose group (19.63×1011) (P = 0.002 for low vs. medium, P<0.001 for high vs. low and high vs. medium), but the median number of platelet transfusions given was significantly higher in the low-dose group (five, vs. three in the medium-dose and three in the high-dose group; P<0.001 for low vs. medium and low vs. high). Bleeding occurred on 25% of the study days on which morning platelet counts were 5000 per cubic millimeter or lower, as compared with 17% of study days on which platelet counts were 6000 to 80,000 per cubic millimeter (P<0.001). CONCLUSIONS Low doses of platelets administered as a prophylactic transfusion led to a decreased number of platelets transfused per patient but an increased number of transfusions given. At doses between 1.1×1011 and 4.4×1011 platelets per square meter, the number of platelets in the prophylactic transfusion had no effect on the incidence of bleeding. (ClinicalTrials.gov number, NCT00128713.) PMID:20164484

Slichter, Sherrill J.; Kaufman, Richard M.; Assmann, Susan F.; McCullough, Jeffrey; Triulzi, Darrell J.; Strauss, Ronald G.; Gernsheimer, Terry B.; Ness, Paul M.; Brecher, Mark E.; Josephson, Cassandra D.; Konkle, Barbara A.; Woodson, Robert D.; Ortel, Thomas L.; Hillyer, Christopher D.; Skerrett, Donna L.; McCrae, Keith R.; Sloan, Steven R.; Uhl, Lynne; George, James N.; Aquino, Victor M.; Manno, Catherine S.; McFarland, Janice G.; Hess, John R.; Leissinger, Cindy; Granger, Suzanne

2010-01-01

305

Long-Term follow up after intra-Uterine transfusionS; the LOTUS study  

PubMed Central

Background The Leiden University Medical Center (LUMC) is the Dutch national referral centre for pregnancies complicated by haemolytic disease of the fetus and newborn (HDFN) caused by maternal alloimmunization. Yearly, 20-25 affected fetuses with severe anaemia are transfused with intra-uterine blood transfusions (IUT). Mothers of whom their fetus has undergone IUT for HDFN are considered high responders with regard to red blood cell (RBC) antibody formation. Most study groups report high perinatal survival, resulting in a shift in attention towards short- and long-term outcome in surviving children. Methods/Design We set up a large long-term observational follow-up study (LOTUS study), in cooperation with the Sanquin Blood Supply Foundation and the LUMC departments of Obstetrics, Neonatology and ImmunoHematology & Bloodtransfusion. The first part of this study addresses several putative mechanisms associated with blood group alloimmunization in these mothers. The second part of this study determines the incidence of long-term neurodevelopment impairment (NDI) and associated risk factors in children treated with IUT. All women and their life offspring who have been treated with IUT for HDFN in the LUMC from 1987-2008 are invited to participate and after consent, blood or saliva samples are taken. RBC and HLA antigen profile and antibodies are determined by serologic or molecular techniques. Microchimerism populations are tested by real time polymerase chain reaction (RT PCR). All children are tested for their neurological, cognitive and psychosocial development using standardised tests and questionnaires. The primary outcome is neurodevelopmental impairment (NDI), a composite outcome defined as any of the following: cerebral palsy, cognitive or psychomotor development < 2 standard deviation, bilateral blindness and/or bilateral deafness. Discussion The LOTUS study includes the largest cohort of IUT patients ever studied and is the first to investigate post-IUT long-term effects in both mother and child. The results may lead to a change in transfusion policy, in particular future avoidance of certain incompatibilities. Additionally the LOTUS study will provide clinicians and parents better insights in the long-term neurodevelopmental outcome in children with HDFN treated with IUTs, and may improve the quality of antenatal counselling and long-term guidance. PMID:21122095

2010-01-01

306

[Results of partial transfusion exchange in 42 homozygous sickle cell patients at university hospital of Brazzaville].  

PubMed

The standard of care for major sickle cell diseases in crisis is based on blood transfusion, but this remains a risky therapy in sub-Saharan Africa. The objective of this retrospective and prospective study was to assess exchange transfusion (ET) in homozygous sickle cell disease between 1st July 2005 and 30th June 2008 at the transfusion centre of university hospital of Brazzaville. The ET technique used was manual and made of three stages: bleeding, infusion of solution, and infusion of red cell concentrate. Clinical and biological assessments were done before and after exchanges. The indication for ET were: pregnancy (19 cases); strokes (seven cases); vaso-occlusive crisis (five cases), priapism (four cases), cardiac failure (three cases) and miscellaneous (four cases), the values of hematocut in red cell blood bag between 0.55 and 0.70 (median 0.65). The median haemoglobin level before exchange was about 5.8 g/dl (4.1-7.4 g/dl), that of HbS from haemoglobin electrophoresis about 98.4 % (94.6-100 %). Before the exchanges, viral serological tests were done with the following results: two patients with HBV antigen positive and one patient antibodies to HCV. In acute situation interval between exchanges is 3 to 10 days, whereas during chronic situation is between 14 to 28 days. No major immediate complications have been observed. Clinical situation after exchange characterized by stabilization of cerebral vascular stroke and over and control of one case of priapism complications. Assessment after exchange showed the following results: medium rate of Hb level: 9.5 g/dl (an increase of 3.7 g/dl); medium percentage of HbS reduced to 46.8 % (approximately a decrease of 51.6 %). Patient's serological status to HCV changed for one patient. This study illustrates the benefit and the limitations of the transfusion exchange during sickle cell disease in sub-Saharan Africa. PMID:20965766

Dokekias, A E; Basseila, G B

2010-10-01

307

Toward a patient-based paradigm for blood transfusion  

PubMed Central

The current “manufacturing paradigm” of transfusion practice has detached transfusion from the clinical environment. As an example, fresh whole blood in large-volume hemorrhage may be superior to whole blood reconstituted from multiple components. Multicomponent apheresis can overcome logistical difficulties in matching patient needs with fresh component availability and can deliver the benefits of fresh whole blood. Because of the different transfusion needs of patients in emerging economies and the vulnerability of these blood systems to emerging infections, fresh whole blood and multicomponent apheresis can better meet patient needs when compared with transplants of the “manufacturing paradigm”. We propose that patient blood management, along with panels of repeat, paid, accredited apheresis and fresh whole-blood donors can be used in emerging economies to support decentralized blood services. This alternative transfusion–medicine paradigm could eventually also be adopted by established economies to focus transfusion medicine on local patient needs and to alleviate the problem of the aging volunteer donor base. PMID:24520208

Farrugia, Albert; Vamvakas, Eleftherios

2014-01-01

308

Decreasing Prevalence of Transfusion Transmitted Infection in Indian Scenario  

PubMed Central

Transfusion transmitted infections are major problem associated with blood transfusion. Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply and evaluating the efficacy of currently employed screening procedures. The present study was carried out to assess the percentage of voluntary donors and replacement donors and to find out prevalence and changing trends of various TTIs blood donors in recent years. A study was carried out on blood units of voluntary and replacement donors which were collected from January 2008 to December 2012. On screening of 180,371 replacement units, seropositivity of transfusion transmitted disease in replacement donors was 0.15% in HIV, 1.67% in hepatitis B surface antigen, 0.49% in hepatitis C virus, 0.01% in VDRL, and 0.009% in malaria. Of 11,977 voluntary units, seropositivity of transfusion transmitted disease in voluntary donors was 0.08% in HIV, 0.24% in hepatitis B surface antigen, 0.001% in hepatitis C virus, 0.008% in VDRL (sexually transmitted disease), and 0.01% in malaria. From results it has been concluded that prevalence of transfusion transmitted infection (HIV, HBV, HCV, VDRL, and malaria) was more in replacement donors in comparison to voluntary donors. Extensive donor selection and screening procedures will help in improving the blood safety. PMID:24616614

Rizvi, S. Nishat Fatima; Agarwal, Devisha

2014-01-01

309

Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome  

PubMed Central

Objective. To describe the rare association between prenatal vascular limb occlusion and twin-to-twin transfusion syndrome. The Case. A woman with severe twin-to-twin transfusion syndrome was treated with fetoscopic laser ablation at 19-week gestation. At 27 weeks, the twins were delivered by an emergency caesarean section. The right arm of twin 1, the recipient twin, was noted to be “ischaemic” and was later amputated. Conclusion. This case is unusual in that it affected the upper limb and there was no evidence of polycythaemia, which is a suggested pathological mechanism. It was initially thought that the limb damage was due to the laser ablation, but after discussion with the fetal medicine team vascular limb occlusion in association with twin-to-twin transfusion syndrome was considered. Limb ischaemia is a serious complication of twin-to-twin transfusion syndrome and is unrelated to any form of fetal therapy. Implications. Neonatologists and paediatricians need to be aware of this association as it has medicolegal implications and parents should be counselled as to the possible, albeit rare, occurrence, especially when twin-to-twin transfusion syndrome is of advanced stage at presentation. PMID:24386580

Kilby, Mark

2013-01-01

310

[Blood transfusion in emergency settings: French military health service experience].  

PubMed

Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. PMID:21051268

Sailliol, A; Ausset, S; Peytel, E

2010-12-01

311

Clinical heterogeneity and predictors of outcome in primary autoimmune hemolytic anemia: a GIMEMA study of 308 patients.  

PubMed

The clinical outcome, response to treatment, and occurrence of acute complications were retrospectively investigated in 308 primary autoimmune hemolytic anemia (AIHA) cases and correlated with serological characteristics and severity of anemia at onset. Patients had been followed up for a median of 33 months (range 12-372); 60% were warm AIHA, 27% cold hemagglutinin disease, 8% mixed, and 5% atypical (mostly direct antiglobulin test negative). The latter 2 categories more frequently showed a severe onset (hemoglobin [Hb] levels ?6 g/dL) along with reticulocytopenia. The majority of warm AIHA patients received first-line steroid therapy only, whereas patients with mixed and atypical forms were more frequently treated with 2 or more therapy lines, including splenectomy, immunosuppressants, and rituximab. The cumulative incidence of relapse was increased in more severe cases (hazard ratio 3.08; 95% confidence interval, 1.44-6.57 for Hb ?6 g/dL; P < .001). Thrombotic events were associated with Hb levels ?6 g/dL at onset, intravascular hemolysis, and previous splenectomy. Predictors of a fatal outcome were severe infections, particularly in splenectomized cases, acute renal failure, Evans syndrome, and multitreatment (4 or more lines). The identification of severe and potentially fatal AIHA in a largely heterogeneous disease requires particular experienced attention by clinicians. PMID:25232059

Barcellini, Wilma; Fattizzo, Bruno; Zaninoni, Anna; Radice, Tommaso; Nichele, Ilaria; Di Bona, Eros; Lunghi, Monia; Tassinari, Cristina; Alfinito, Fiorella; Ferrari, Antonella; Leporace, Anna Paola; Niscola, Pasquale; Carpenedo, Monica; Boschetti, Carla; Revelli, Nicoletta; Villa, Maria Antonietta; Consonni, Dario; Scaramucci, Laura; De Fabritiis, Paolo; Tagariello, Giuseppe; Gaidano, Gianluca; Rodeghiero, Francesco; Cortelezzi, Agostino; Zanella, Alberto

2014-11-01

312

Strategies for Surveillance of Pediatric Hemolytic Uremic Syndrome: Foodborne Diseases Active Surveillance Network (FoodNet), 2000-2007  

PubMed Central

Background.?Postdiarrheal hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure among US children. The Foodborne Diseases Active Surveillance Network (FoodNet) conducts population-based surveillance of pediatric HUS to measure the incidence of disease and to validate surveillance trends in associated Shiga toxin–producing Escherichia coli (STEC) O157 infection. Methods.?We report the incidence of pediatric HUS, which is defined as HUS in children <18 years. We compare the results from provider-based surveillance and hospital discharge data review and examine the impact of different case definitions on the findings of the surveillance system. Results.?During 2000–2007, 627 pediatric HUS cases were reported. Fifty-two percent of cases were classified as confirmed (diarrhea, anemia, microangiopathic changes, low platelet count, and acute renal impairment). The average annual crude incidence rate for all reported cases of pediatric HUS was 0.78 per 100 000 children <18 years. Regardless of the case definition used, the year-to-year pattern of incidence appeared similar. More cases were captured by provider-based surveillance (76%) than by hospital discharge data review (68%); only 49% were identified by both methods. Conclusions.?The overall incidence of pediatric HUS was affected by key characteristics of the surveillance system, including the method of ascertainment and the case definitions. However, year-to-year patterns were similar for all methods examined, suggesting that several approaches to HUS surveillance can be used to track trends. PMID:22572665

Ong, Kanyin L.; Apostal, Mirasol; Comstock, Nicole; Hurd, Sharon; Webb, Tameka Hayes; Mickelson, Stephanie; Scheftel, Joni; Smith, Glenda; Shiferaw, Beletshachew; Boothe, Effie

2012-01-01

313

Acute lymphoblastic leukemia presenting with gross hematuria  

PubMed Central

A case of a six-year-old boy presenting with gross hematuria is reported. Investigations revealed the etiology of the hematuria to be thrombocytopenia in the setting of newly diagnosed acute lymphoblastic leukemia. The diagnosis of leukemia was confirmed by bone marrow examination. The patient’s hematuria completely resolved with platelet transfusions. Although thrombocytopenia is a very common presenting feature of acute lymphoblastic leukemia, gross hematuria is exceedingly rare. Thus, thrombocytopenia potentially caused by acute leukemia should be considered in a child presenting with gross hematuria. PMID:19030428

Kalbani, Naifain Al; Weitzman, Sheila; Abdelhaleem, Mohamed; Carcao, Manuel; Abla, Oussama

2007-01-01

314

[Detection and Analysis of ABO Hemolytic Disease in Newborn].  

PubMed

This study was purposed to investigate the incidence and the model of ABO hemolytic disease in newborn (ABO-HDN) and the results of the three hemolysis test, so as to provide the evidences for clinical diagnosis and therapy. A total of 227 cases of maternal-fetal ABO incompatibility from January 2013 to October 2013 in the First Affiliated Hospital of Xiamen University were enrolled in the study. The ABO blood group of newborn and mother was detemined and three hemolysis tests (direct antiglobulin test, free antibody test, RBC antibody release test) were performed. The results indicated that in 227 cases of ABO incompatible pregnancies,186 cases were ABO-HDN (81.94%). There was no significant difference in the incidence between O-A and O-B incompatible pregnancies (P > 0.05). The positive ratio of direct antiglobulin test, free antibody test and RBC antibody release test were 59.14% (110/186), 84.78% (156/186) and 94.62% (176/186) respectively. It is concluded that the incidence of ABO-HDN is high. The main models of ABO-HDN were O-A and O-B. There was no significant difference in the incidence between O-A and O-B incompatible pregnancies. Three hemolysis tests are high sensitivity and are helpful in early diagnosis and early treatment of HDN. PMID:25338602

Lin, Zhao-Xia; Dong, Qing-Song

2014-09-01

315

Desmopressin use for minimising perioperative allogeneic blood transfusion  

PubMed Central

Background Public concerns regarding the safety of blood have prompted reconsideration of the use of allogeneic blood (blood from an unrelated donor) transfusion and a range of techniques designed to minimise transfusion requirements. Objectives To examine the efficacy of desmopressin acetate (1-deamino-8-D-arginine-vasopressin) in reducing peri-operative blood loss and the need for red blood cell (RBC) transfusion in patients who do not have congenital bleeding disorders. Search methods We identified studies by searching CENTRAL (The Cochrane Library 2008, Issue 1), MEDLINE (1950 to 2008), EMBASE (1980 to 2008), the Internet (to May 2008), and bibliographies of published articles. Selection criteria Controlled parallel-group trials in which adult patients scheduled for non-urgent surgery were randomised to desmopressin (DDAVP) or to a control group that did not receive DDAVP treatment. Trials were eligible for inclusion if they reported data on the number of patients exposed to allogeneic red cell transfusion or the volume of blood transfused. Data collection and analysis Primary outcomes were: the number of patients exposed to allogeneic red blood cell (RBC) transfusion, and the amount of blood transfused. Other outcomes measured were: blood loss, re-operation for bleeding, post-operative complications (thrombosis, myocardial infarction, stroke), mortality, and length of hospital stay. Treatment effects were pooled using a random-effects model. Main results Nineteen trials that included a total of 1387 patients reported data on the number of patients exposed to allogeneic RBC transfusion. DDAVP did not significantly reduce the risk of exposure to allogeneic RBC transfusion (relative risk (RR) 0.96, 95% confidence interval (CI) 0.87 to 1.06). However, the use of DDAVP significantly reduced total blood loss (weighted mean difference (WMD) ?241.78 ml, 95% CI ?387.55 to ?96.01 ml). Although DDAVP appeared to reduce the overall volume of allogeneic blood transfused during the peri-operative period the result would not be considered clinically significant (WMD ?0.3 units, 95% CI ?0.60 to ?0.01 units). Risk of re-operation due to bleeding was not reduced (RR 0.69, 95% CI 0.26 to 1.83). DDAVP treatment was not associated with an increased risk of death or myocardial infarction (RR 1.72, 95% CI 0.68 to 4.33; RR 1.38, 95% CI 0.77 to 2.50, respectively). Authors’ conclusions There is no convincing evidence that desmopressin (DDAVP) minimises peri-operative allogeneic RBC transfusion in patients who do not have congenital bleeding disorders. Although the data suggest that there is some benefit of using DDAVP as a means of reducing peri-operative blood loss the observed reductions were small and generally not clinically important. Based on the currently available evidence, the use of DDAVP to reduce peri-operative blood loss or allogeneic RBC transfusion cannot be supported. PMID:14973974

Carless, Paul A; Stokes, Barrie J; Moxey, Annette J; Henry, David A

2014-01-01

316

The Fetal Heart in Twin-to-Twin Transfusion Syndrome.  

PubMed

Twin-to-twin transfusion syndrome is a severe complication occurring in 10% of monochorionic twin pregnancies. The disease is usually explained as due to an intrauterine imbalance in intertwin blood exchange, which leads to a volume depleted-donor twin and an overfilled recipient twin. The recipient has signs of cardiac dysfunction, which can be measured using echocardiography or blood and amniotic fluid derived biomarkers. Whereas cardiac dysfunction typically progresses in pregnancies treated with amniodrainage, it usually disappears within a few weeks after fetoscopic laser coagulation of the connecting intertwin anastomoses. Nevertheless, recipients remain at a increased risk of pulmonary stenosis. In this paper, we summarize the cardiac alterations in twin-to-twin transfusion syndrome, describe the changes seen after fetal therapy, list the newly proposed staging systems based on fetal cardiac function, and make recommendations about the use of fetal echocardiography in the evaluation and followup of pregnancies complicated by twin-to-twin transfusion syndrome. PMID:20811613

Van Mieghem, Tim; Lewi, Liesbeth; Gucciardo, Léonardo; Dekoninck, Philip; Van Schoubroeck, Dominique; Devlieger, Roland; Deprest, Jan

2010-01-01

317

Resuscitation and transfusion principles for traumatic hemorrhagic shock  

PubMed Central

SUMMARY The transfusion approach to massive hemorrhage has continually evolved since it began in the early 1900s. It started with fresh whole blood and currently consists of virtually exclusive use of component and crystalloid therapy. Recent US military experience has reinvigorated the debate on what the most optimal transfusion strategy is for patients with traumatic hemorrhagic shock. In this review we discuss recently described mechanisms that contribute to traumatic coagulopathy, which include increased anticoagulation factors and hyperfibrinolysis. We also describe the concept of damage control resuscitation (DCR), an early and aggressive prevention and treatment of hemorrhagic shock for patients with severe life-threatening traumatic injuries. The central tenants of DCR include hypotensive resuscitation, rapid surgical control, prevention and treatment of acidosis, hypothermia, and hypocalcemia, avoidance of hemodilution, and hemostatic resuscitation with transfusion of red blood cells, plasma, and platelets in a 1:1:1 unit ratio and the appropriate use of coagulation factors such as rFVIIa and fibrinogen-containing products (fibrinogen concentrates, cryoprecipitate). Fresh whole blood is also part of DCR in locations where it is available. Additional concepts to DCR since its original description that can be considered are the preferential use of “fresh” RBCs, and when available thromboelastography to direct blood product and hemostatic adjunct (anti-fibrinolytics and coagulation factor) administration. Lastly we discuss the importance of an established massive transfusion protocol to rapidly employ DCR and hemostatic resuscitation principles. While the majority of recent trauma transfusion papers are supportive of these general concepts, there is no Level 1 or 2 data available. Taken together, the preponderance of data suggests that these concepts may significantly decrease mortality in massively transfused trauma patients. PMID:19695750

Spinella, Philip C.; Holcomb, John B.

2011-01-01

318

Blood transfusion rate in congolese patients with sickle cell anemia  

Microsoft Academic Search

Objective  The main objective of this study was to evaluate the rate of blood transfusion in African Sickle Cell Patients and the risks\\u000a related to the use of total blood.\\u000a \\u000a \\u000a \\u000a Methods  186 sickle cell patients (95 males and 91 females) aged 0–21 years were regularly followed over a 3 years period in Katanga\\u000a province, DR Congo. Indications for blood transfusion were mainly

L. M. Tshilolo; R. K. Mukendi; S. O. Wembonyama

2007-01-01

319

[Preventing blood transfusion in a severely burned Jehovah's witness].  

PubMed

The treatment rationale of a burn victim (35% TBSA) who was child of Jehova's witnesses is described. Following a combined approach including erythropoetin and blood saving surgical techniques we were able to excise and graft the burn areas without blood transfusion. An extremely low hemoglobin of 3.4 g/dl was tolerated postoperatively and showed an increase to 10.9 g/dl 25 days later when the child was dismissed from the burn unit in stable condition. Possibilities to minimize blood loss and to avoid blood transfusions are discussed. PMID:7821070

Vogt, P M; Kurz-Müller, K; Peter, F W; Büttemeyer, R; Tryba, M; Steinau, H U

1994-11-01

320

Pathology Case Study: Drop in Hemoglobin Following Platelet Transfusion  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 55-year-old man experienced a drop in hemoglobin four months after a allogeneic peripheral blood stem cell transplant. Visitors are given the patient history, transfusion reaction workup, and the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and transfusion medicine.

Arida, Muammar; Puca, Kathleen

2009-02-23

321

Graves' Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature  

PubMed Central

Graves' disease (GD) is associated with various hematologic abnormalities but pancytopenia and autoimmune hemolytic anemia (AIHA) are reported very rarely. Herein, we report a patient with GD who had both of these rare complications at different time intervals, along with a review of the related literature. The patient was a 70-year-old man who, during a hospitalization, was also noted to have pancytopenia and elevated thyroid hormone levels. Complete hematologic workup was unremarkable and his pancytopenia was attributed to hyperthyroidism. He was started on methimazole but unfortunately did not return for followup and stopped methimazole after a few weeks. A year later, he presented with fatigue and weight loss. Labs showed hyperthyroidism and isolated anemia (hemoglobin 7?g/dL). He had positive direct Coombs test and elevated reticulocyte index. He was diagnosed with AIHA and started on glucocorticoids. GD was confirmed with elevated levels of thyroid stimulating immunoglobulins and thyroid uptake and scan. He was treated with methimazole and radioactive iodine ablation. His hemoglobin improved to 10.7?g/dL at discharge without blood transfusion. Graves' disease should be considered in the differential diagnosis of hematologic abnormalities. These abnormalities in the setting of GD generally respond well to antithyroid treatment. PMID:24319463

Kumar, Geetika; Dewani, Shabana; Diedrich, William A.; Gupta, Ankur

2013-01-01

322

Increasing Patient Safety and Efficiency in Transfusion Therapy Using Formal Process Definitions  

E-print Network

), errors and adverse events in transfusion medicine are a significant concern, and many problems may transfusion medicine profes- sionals were one of the first groups to design and implement methodologies

Massachusetts at Amherst, University of

323

Treatment of acute kidney injury in children: from conservative management to renal replacement therapy  

Microsoft Academic Search

Over the past two decades, the etiology and therapy of acute kidney injury (AKI) in children has changed. Historically, hemolytic uremic syndrome was the major cause of pediatric AKI, but advances in technology have meant that sepsis and deterioration of often unrecognized long-term organ dysfunction are now more common causes of pediatric AKI in the developed world. At the same

Timothy E Bunchman

2008-01-01

324

Radiation resistance of a hemolytic micrococcus isolated from chicken meat  

SciTech Connect

The effects of environmental factors on a highly radiation-resistant hemolytic micrococcus isolated from chicken meat were studied. NaCl tolerance and gamma radiation resistance of the cells were growth phase-related. The cells were resistant to injury from drying or freezing/thawing. Under certain conditions, cells in the frozen state required approximately 5 Mrad to inactivate 90% of the population; 0.2 Mrad injured an equivalent proportion. Survival curve of the cells heated at 60/sup 0/C showed a unique pattern which was in three distinct phases. Heat-stressed cells were much more sensitive to radiation inactivation than unheated cells. When suspended in fresh m-Plate Count Broth (PCB), the injured cells repaired without multiplication during incubation at 32/sup 0/C. The repair process in this bacterium, however, was slower compared to thermally injured organisms studied by other workers. An improved replica-plating technique, was devised for isolation of radiation-sensitive mutants of pigmented bacteria. A simple method to demonstrate radiation-inducible radiation resistance in microbial cells was developed. The new method required neither washing/centrifugation nor procedures for cell enumeration. Mutagenesis treatment of radiation-resistant micrococcal bacterium with N-methyl-N'-nitro-N-nitrosoguanidine (NTG) followed by FPR and screening steps resulted in isolation of two radiation-sensitive mutants. The more sensitive mutant strain, designated as 702, was seven times as sensitive to gamma or UC radiation as the wild type. No apparent difference was observed between 702 and the wild type in (1) cell morphology, colonial morphology, and pigment production or (2) tolerance to NaCl, drying/storage, freezing/thawing, and heating. Sodium dodecyl sulfate treatment (for curing) of wild type did not result in isolation of a radiation-sensitive mutant.

Tan, S.T.

1982-01-01

325

The Lbw2 locus promotes autoimmune hemolytic anemia.  

PubMed

The lupus-prone New Zealand Black (NZB) strain uniquely develops a genetically imposed severe spontaneous autoimmune hemolytic anemia (AIHA) that is very similar to the corresponding human disease. Previous studies have mapped anti-erythrocyte Ab (AEA)-promoting NZB loci to several chromosomal locations, including chromosome 4; however, none of these have been analyzed with interval congenics. In this study, we used NZB.NZW-Lbw2 congenic (designated Lbw2 congenic) mice containing an introgressed fragment of New Zealand White (NZW) on chromosome 4 encompassing Lbw2, a locus previously linked to survival, glomerulonephritis, and splenomegaly, to investigate its role in AIHA. Lbw2 congenic mice exhibited marked reductions in AEAs and splenomegaly but not in anti-nuclear Abs. Furthermore, Lbw2 congenics had greater numbers of marginal zone B cells and reduced expansion of peritoneal cells, particularly the B-1a cell subset at early ages, but no reduction in B cell response to LPS. Analysis of a panel of subinterval congenic mice showed that the full effect of Lbw2 on AEA production was dependent on three subloci, with splenomegaly mapping to two of the subloci and expansions of peritoneal cell populations, including B-1a cells to one. These results directly demonstrated the presence of AEA-specific promoting genes on NZB chromosome 4, documented a marked influence of background genes on autoimmune phenotypes related to Lbw2, and further refined the locations of the underlying genetic variants. Delineation of the Lbw2 genes should yield new insights into both the pathogenesis of AIHA and the nature of epistatic interactions of lupus-modifying genetic variants. PMID:22371393

Scatizzi, John C; Haraldsson, Maria K; Pollard, K Michael; Theofilopoulos, Argyrios N; Kono, Dwight H

2012-04-01

326

Uses and sources of data on long-term survival after blood transfusion  

Microsoft Academic Search

Several public policy decisions in transfusion medicine require information on the long-term (?10-year) survival of transfused patients. This information is needed (1) to estimate the number of surviving transfusion recipients who have contracted a particular infection through transfusion, (2) to assess the cost-effectiveness of measures introduced to further improve the safety of the allogeneic blood supply, (3) to estimate the

Eleftherios C Vamvakas

2003-01-01

327

Allogeneic blood transfusion and prognosis following total hip replacement: a population-based follow up study  

Microsoft Academic Search

BACKGROUND: Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR). However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. METHODS: A population-based follow-up study was performed using data from medical databases in Denmark. We identified 28,087 primary THR

Alma B Pedersen; Frank Mehnert; Soren Overgaard; Soren P Johnsen

2009-01-01

328

[Experience of mismatched blood transfusion for an rh negative patient and reconsideration of emergency blood transfusion manual in the hospital].  

PubMed

We report a B Rh negative patient undergoing total pelvic exenteration, who received both ABO and Rh incompatible packed red blood cells in an emergency situation. After this experience, we revised the manual of emergency blood transfusion. We defined level of severity to share information with surgeon, nurses, anesthesiologists and the member of the blood center. We changed anesthesia information management system for showing blood type including Duffy blood group system and checking out whether we can transfuse Rh positive blood to Rh negative patient in an emergency situation at the timeout of surgery. PMID:23984584

Yoshimatsu, Aya; Hoshi, Takuo; Nishikawa, Masashi; Aya, Daisuke; Ueda, Hiroshi; Yokouchi, Takako; Tanaka, Makoto

2013-08-01

329

Valuation of transfusion-free living in MDS: results of health utility interviews with patients  

Microsoft Academic Search

BACKGROUND: This study measured how myelodysplastic syndrome (MDS) patients value transfusion independence (TI), reduced transfusions (RT) and transfusion-dependence (TD) using health utility assessment methodology. METHODS: 47 MDS patients were interviewed, US (n = 8), France (n = 9), Germany (n = 9) and the UK (n = 21), to elicit the utility value of TI, RT and TD. Health states

Agota Szende; Caroline Schaefer; Thomas F Goss; Kathy Heptinstall; Robert Knight; Michael Lübbert; Barbara Deschler; Pierre Fenaux; Ghulam J Mufti; Sally Killick; Alan F List

2009-01-01

330

FIELD EVALUATION OF AN INTELLIGENT TUTORING SYSTEM FOR TEACHING PROBLEM-SOLVING SKILLS IN TRANSFUSION MEDICINE  

E-print Network

IN TRANSFUSION MEDICINE Jodi Heinz Obradovich*, Philip 3. Smith*, Stephanie A. Cuerlain**, Sally Rudman*, Jack W tool to assist with tutoring in a class laboratory setting, useof the Transfusion Medicine Tutor (TMT-system, the Transfusion Medicine Tutor (TMT), by medical technology studentsto learn an important problem-solving task

Virginia, University of

331

Students' Corner Letter to the Editor Blood Transfusion Practices: Leasing life or injecting death?  

Microsoft Academic Search

Madam, Blood transfusions have emerged as an important medical therapy in the current century. From elective surgery to trauma patients, from patients with haemoglobinopathies to thalassaemics, blood transfusions are benefiting patients in a wide spectrum of clinical settings. However, like the two sides of a mirror, blood transfusions are fraught with serious risks that must be addressed with the utmost

Taimur Saleem; Madiha Syed; Sidra Ishaque

332

Introduction to Iranian Blood Transfusion Organization and Blood Safety in Iran  

Microsoft Academic Search

Currently, in Iran blood transfusion is an integral part of the national health system and blood donation is voluntary and nonremunerated and blood and its components may not be a source of profit. In 1974 and following establishment of Iranian Blood Transfusion Organization (IBTO) all blood transfusion activities from donor recruitment to production of blood com- ponents and delivery of

H Abolghasemi; M Maghsudlu; S Amini Kafi-Abad; A Cheraghali

333

Immunologic Effects of Allogeneic versus Autologous Blood Transfusion in Patients Undergoing Radical Oesophagectomy  

Microsoft Academic Search

Blood transfusion is often required in patients undergoing radical oesophagectomy, and is associated with immunosuppression that may worsen postoperative and long-term outcomes. However, the immunologic effects of allogeneic versus autologous transfusion have not been studied in this group of patients. We analyzed 103 patients who underwent radical oesophagectomy for oesophageal cancer, including 45 patients who received allogeneic transfusions (Allo), 16

M. Takemura; H. Osugi; N. Takada; H. Kinoshita; M. Higashino

2003-01-01

334

Systems Contributing to the Assurance of Transfusion Safety in the United Kingdom  

Microsoft Academic Search

In 1996, the United Kingdom launched a voluntary ‘haemovigilance’ system for confidential reporting of transfusion–related deaths and major adverse events. The Serious Hazards of Transfusion (SHOT) initiative provided the first comprehensive overview of transfusion safety in the UK, with 12 fatalities reported in the first year. The most important finding was that of a total of 169 reports, 47% were

Lorna M. Williamson

1999-01-01

335

Transfusion rate associated with hysterectomy for benign disease.  

PubMed

The transfusion rate associated with hysterectomy for benign disease is an indirect indicator of haemorrhage. It is used in quality assurance activities and is one measure of standard of care. This retrospective study was conducted to determine the transfusion rate for these operations in a tertiary referral hospital. In addition, it was considered that the information could be used in deciding the need for a routine preoperative group and save policy (G and S). The Blood Bank records of all women undergoing hysterectomy for benign disease from 1993-1998 were examined and the number of women transfused was recorded. A total of 1220 hysterectomies were performed. Of women having vaginal hysterectomies only 0.38% required transfusion compared with 2.18% for abdominal hysterectomies. These data suggest that there is no need for a strict policy of preoperative G and S for all patients. In addition, this information can be used as a benchmark when reviewing morbidity associated with hysterectomy and in particular when various methods of hysterectomy are compared. PMID:11787922

Otton, G R; Mandapati, S; Streatfeild, K A; Hewson, A D

2001-11-01

336

Blood banking and transfusion medicine for the nephrologist.  

PubMed

Therapeutic Apheresis Medicine Services work closely with Blood Banking and Transfusion Medicine Services (BBTMS). The BBTMS performs patient testing and provides blood components for patients undergoing therapeutic apheresis procedures. This article will provide an overview of blood component descriptions, patient testing, and blood component options and preparations for therapeutic apheresis procedures. PMID:22276991

Wehrli, Gay

2012-01-01

337

Effects of a CME Program on Physicians' Transfusion Practices.  

ERIC Educational Resources Information Center

The hospital charts of 44 patients who were autologous blood donors undergoing elective orthopedic surgery and a matched group of 44 patients who were not autologous blood donors were analyzed to determine their physicians' transfusion practices. A continuing medical education program was developed. (Author/MLW)

Hull, Alan L.; And Others

1989-01-01

338

The VDRL test in a blood transfusion service  

Microsoft Academic Search

A survey has been made of the results of 12 months' VDRL screening in a blood transfusion service. Positive VDRL tests were found on 318 of the 73 350 blood donations collected during 1974. Thirty-four tests confirming specific treponemal infection were found in 24 donors. A battery of confirmatory tests showed the remaining 284 positive VDRL reactions from 235 donors

R W Beal; D J Merry

1975-01-01

339

Recombinant erythropoietin and blood transfusion in selected preterm infants  

Microsoft Academic Search

Objectives: To comprehensively identify preterm infants likely to require blood transfusion and to investigate the effectiveness of recombinant erythropoietin in this high risk subgroup.Design: Double blind randomised controlled trial.Setting: Neonatal Intensive Care Unit, Middlemore Hospital, Auckland, New Zealand.Patients: Preterm infants < 33 weeks gestation and < 1700 g birth weight meeting specific criteria indicating a high possibility of requiring blood

M P Meyer; E Sharma; M Carsons

2003-01-01

340

Emergency blood transfusion services after the 2005 earthquake in Pakistan  

PubMed Central

Background On 8 October 2005, an earthquake measuring 7.6 on the Richter Scale struck the Himalayan region of Kashmir and Hazara divisions, killing an estimated 73?000 people. Soon after, a situation and response analysis of the emergency blood transfusion services was carried out in the affected areas to ascertain specific needs and suggest appropriate measures to assist in the disaster plan. Method A semistructured questionnaire, complete with a checklist and participatory observation method, was used to collect data between 12 and 20 October 2005. Study sites were Abbotabad, Mansehra and Muzzafarabad in Pakistan, and interviewees were surgeons and blood bank personnel. Results Of the seven major hospitals in the area, 3 (43%) had a functional blood transfusion service. Although supply of voluntary blood was abundant, shortage of individual blood groups was noted at each centre. Quality assurance standards were either non?existent or inadequate. Only three blood banks had refrigerators, but with limited storage capacities. A complete breakdown of infrastructure coupled with frequent power failures posed a serious threat to safety of the blood. The continued aftershocks added to the problems. Although initial estimates of blood requirement were high, actual demand noted later was much lower. Discussion Timely establishment of blood banks in disaster areas, is a challenging task. Mobile blood banks can be advantageous in such situations. Organisation at a national level for blood transfusion services and development of a minimum standard of quality assurance in normal times should ensure safe emergency blood transfusion services when disaster strikes. PMID:17183037

Mujeeb, S A; Jaffery, S H

2007-01-01

341

Long term outcome of twin-twin transfusion syndrome  

Microsoft Academic Search

AIMSTo compare the perinatal mortality and morbidity of infants with twin-twin transfusion syndrome (TTTS) with those of gestation matched twin controls and to assess the neurodevelopmental outcome of surviving twins with TTTS.METHODSA cohort of 17 consecutive pregnancies with TTTS was enrolled over three years together with gestation matched twin pregnancies unaffected by TTTS. Serial amnioreduction for the TTTS pregnancies was

R B Cincotta; P H Gray; G Phythian; Y M Rogers; F Y Chan

2000-01-01

342

Does Acute Urinary Retention Respond to Alpha-Blockers Alone?  

Microsoft Academic Search

Studies show that men who undergo prostatectomy after acute urinary retention (AUR) are at increased risk of intraoperative complications, transfusions, postoperative complications and hospital death. Urethral catheterisation for AUR has also been shown to result in bacterial colonization at a rate of 4% per day. Consequently, it is preferable that patients undergo a trial without catheter (TWOC) after an episode

S. A. McNeill

2001-01-01

343

Blood management by transfusion triggers: when less is more  

PubMed Central

Background We reviewed the annual blood utilisation data at our institution for the past 6 years. The number of packed red blood cell units for allogeneic transfusions gradually increased from 3,989 (in 2004) to 4,762 (in 2008): a 19% increase. This exceeded the 7% increase in annual admissions of patients during the same period (from 20,470 in 2004 to 21,908 in 2005). Materials and methods In 2009, we introduced new transfusion guidelines (“triggers”), essentially adopting the recommendations of the Society for the Advancement of Blood Management. Most importantly, we reduced the trigger of blood transfusions in normovolaemic symptomatic chronic anaemia patients from 8 to 7 g/dL haemoglobin. At the same time, we created a new trigger of 9 g/dL haemoglobin for high-risk patients (e.g. those with cardiovascular and/or chronic pulmonary disease as well as those undergoing chemotherapy). Results We monitored the indications for blood transfusions during 2009 (2,717 consecutive orders) and sent out letters of reminder of the new guidelines to our clinicians if criteria were not met (a total of 102 letters, representing 4% of the reviewed orders). Our annual blood utilisation in 2009 showed some improvement (4,648 units) compared to the previous year (4,762 units) despite the increase in admissions of patients (from 21,908 to 22,734): this represents a 6% decrease in blood utilisation when corrected for the admissions of patients. If this trends holds up, the predicted blood utilisation for 2010 based on the January to November data (4,280) promises to show a further improvement (an 11% decrease compared to 2008). Discussion We conclude that blood utilisation may be improved in a community hospital setting by combining new, evidence-based transfusion triggers with physicians’ education. PMID:21839021

Ansari, Sana; Szallasi, Arpad

2012-01-01

344

National comparative audit of the use of platelet transfusions in the UK.  

PubMed

The objective of this national audit was to examine the use of platelet transfusions against audit standards developed from national guidelines. Hospitals were asked to provide data on 40 consecutive patients receiving platelet transfusions (15 haematology patients, 10 cardiac, 10 critical care and five in other clinical specialties). One hundred and eighty-seven UK hospitals participated, including 168/263 (64%) hospitals in England. A total of 4421 patients receiving platelet transfusions were audited. The reason for transfusion was documented in the medical records for 93% of transfusions and 57% were used for prophylaxis (in the absence of bleeding). Overall 3726/4421 (84%) of the transfusions were evaluable and 43% (1601/3726) were found to be non-compliant with the audit standards. A major non-compliance was failure to measure the platelet count before transfusion (29% of transfusions). Other non-compliances included the use of platelet transfusion in the absence of bleeding in 11% of cardiac surgery patients receiving platelet transfusions, the use of a threshold platelet count more than 10 x 10(9)/L for 60% of prophylactic platelet transfusions in haematology patients without risk factors indicating the need for a higher threshold, and a threshold platelet count more than 30 x 10(9)/L for 59% of prophylactic platelet transfusions in critical care. The reasons for the high rate of non-compliance were not explored in this audit, but this is a topic worthy of further study. The main recommendations were that hospitals should ensure there are written local guidelines for platelet transfusions, clinicians must be provided with training about their appropriate use, and hospitals should carry out regular audits of practice. More research should be carried out to develop the evidence base for the use of platelet transfusions, more detailed guidelines should be developed for platelet transfusions in critical care and cardiac surgery, and the audit should be repeated in about three years. PMID:18359658

Qureshi, H; Lowe, D; Dobson, P; Grant-Casey, J; Parris, E; Dalton, D; Hickling, K; Waller, F; Howell, C; Murphy, M F

2007-12-01

345

Perceptions about blood donation, transfusion and the risk of HIV infection: implications for the blood transfusion service  

Microsoft Academic Search

To assess perceptions of risk of AIDS\\/HIV infection from donation to, and receipt of, blood from the British Blood Transfusion Service, we undertook self completion surveys (n = 1874, response rate 74%) and an interview survey (n = 300, response rate 77%) of students in three higher\\/further education establishments in the North East of England. In the postal survey 20.9%

R. S. Bhopal; R. T. Mcewan; R. Madhok; A. Mccallum

1992-01-01

346

In vitro cytotoxic effect of alpha-hemolytic Escherichia coli on human blood granulocytes.  

PubMed Central

The cytotoxic effect of Escherichia coli bacteria on human blood granulocytes was measured by recording numbers of nonlysed cells and percentages of viable cells after in vitro incubation with bacteria in the presence of plasma. A total of 179 strains from various sources of infection were tested. Of 117 alpha-hemolytic strains, 59 were cytotoxic. Five nonhemolytic mutant strains, derived from alpha-hemolytic cytotoxic strains, were nontoxic. None of the 62 nonhemolytic strains were toxic. Four spontaneously occurring alpha-hemolytic, nontoxic mutant strains were isolated from cytotoxic ones. Cytotoxicity of bacteria reached a maximum after log-phase growth at 30 to 37 degrees C for 2.5 h, and the toxic capacity was equal after growth in various media, including human urine and plasma. The cytotoxic effect increased with the length of exposure of granulocytes to bacteria and with increasing numbers of bacteria per granulocyte. Cytotoxic strains showed different degrees of toxicity, highly cytotoxic strains lysing about 90% of the granulocytes and killing about one-half of nonlysed cells in 1 h. Bacteria killed by heat, formaldehyde, or UV light were nontoxic. Alpha-hemolytic strains of O groups 2, 4, 6, 25, and 75 originating from various infections in humans were more frequently cytotoxic than alpha-hemolytic strains of other O groups derived from human infections. Culture supernatants containing free alpha-hemolysin were highly cytotoxic to human blood granulocytes, monocytes, and lymphocytes in vitro, whether supernatants originated from cytotoxic or noncytotoxic bacteria. Cytotoxicity to phagocytes, which is mediated by or closely linked genetically to alpha-hemolysin, may be a mechanism by which alpha-hemolytic strains of E. coli strengthen their ability to establish and maintain infections. PMID:6376357

Gadeberg, O V; Orskov, I

1984-01-01

347

Effect of perioperative blood transfusion on clinical outcomes in hepatic surgery for cancer  

PubMed Central

Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives. PMID:19705491

Dionigi, Gianlorenzo; Boni, Luigi; Rovera, Francesca; Rausei, Stefano; Cuffari, Salvatore; Cantone, Giovanni; Bacuzzi, Alessandro; Dionigi, Renzo

2009-01-01

348

Hemolytic Disease of the Newborn Due to Anti-c Isoimmunization: A Case Report.  

PubMed

The Rhesus (Rh) blood group is one of the most complex blood groups known in humans. It has remained of primary importance in obstetrics, being the main cause of hemolytic disease of the newborn (HDN). Anti-D causes the most severe form of HDN. Other Rh allo antibodies that are capable of causing severe HDN include anti-c, which clinically is the most important Rh antigen after the D antigen. We report a case of hemolytic disease of the newborn due to Rh anti-c in an infant of an Rh positive mother. PMID:24426362

Sheeladevi, C S; Suchitha, S; Manjunath, G V; Murthy, Srinivas

2013-09-01

349

Alpha-methyldopa-induced autoimmune hemolytic anemia in the third trimester of pregnancy.  

PubMed

Alpha-methyldopa has been demonstrated to be safe for use during pregnancy and is now used to treat gestational hypertension. In pregnancy, alpha-methyldopa-induced autoimmune hemolytic anemia does not have typical features and the severity of symptoms ranges from mild fatigue to dyspnea, respiratory failure, and death if left untreated. A case of alpha-methyldopa-induced autoimmune hemolytic anemia in a 36-year-old gravida 2, para 1 woman at 37(+6) weeks of gestation is reported herein along with the differential diagnostic procedure and the potential risks to the mother and the fetus. PMID:24175105

Grigoriadis, Charalampos; Tympa, Aliki; Liapis, Angelos; Hassiakos, Dimitrios; Bakas, Panagiotis

2013-01-01

350

Alpha-Methyldopa-Induced Autoimmune Hemolytic Anemia in the Third Trimester of Pregnancy  

PubMed Central

Alpha-methyldopa has been demonstrated to be safe for use during pregnancy and is now used to treat gestational hypertension. In pregnancy, alpha-methyldopa-induced autoimmune hemolytic anemia does not have typical features and the severity of symptoms ranges from mild fatigue to dyspnea, respiratory failure, and death if left untreated. A case of alpha-methyldopa-induced autoimmune hemolytic anemia in a 36-year-old gravida 2, para 1 woman at 37+6 weeks of gestation is reported herein along with the differential diagnostic procedure and the potential risks to the mother and the fetus. PMID:24175105

Tympa, Aliki; Liapis, Angelos; Hassiakos, Dimitrios; Bakas, Panagiotis

2013-01-01

351

Case of cytomegalovirus-associated direct anti-globulin test-negative autoimmune hemolytic anemia.  

PubMed

A 1-year-old boy developed autoimmune hemolytic anemia after a negative direct anti-globulin test. The concentration of erythrocyte membrane-associated immunoglobulin G, determined using an immunoradiometric assay, correlated with disease activity. He was positive for cytomegalovirus (CMV) both serologically and by quantitative real-time polymerase chain reaction, indicating that his autoimmune hemolytic anemia was directly caused by CMV infection. Since anti-CMV immunoglobulin G was not absorbed by the patient's erythrocytes, cross-reaction between erythrocyte antigens and CMV was not likely a causative factor for hemolysis. PMID:24330288

Kaneko, Saeko; Sato, Masanori; Sasaki, Goro; Eguchi, Hiroyuki; Oishi, Tsutomu; Kamesaki, Toyomi; Kawaguchi, Hiroyuki

2013-12-01

352

The effect of intravenous iron on postoperative transfusion requirements in hip fracture patients: study protocol for a randomized controlled trial  

PubMed Central

Background Anaemia following hip fracture is common. Approximately 30 to 45% of patients have haemoglobin concentrations below population norms on admission, and around 10% are severely anaemic. Anaemia on admission, and in the postoperative period, is associated with poor outcomes with regard to mobility, postoperative mortality and readmission. There is currently no clear consensus on the optimal method of managing perioperative anaemia in this group of frail patients with frequent comorbidity. Liberal red cell transfusion in the postoperative period does not appear to improve outcome, whereas tranexamic acid appears to reduce transfusion rate at the expense of increased cardiovascular morbidity. There are encouraging results from one centre with the use of agents to stimulate red cell production, including intravenous iron and erythropoietin. UK practice differs significantly from these patients and these studies, and it is not clear whether these promising results will translate to the UK population. Methods/Design This is a single-centre randomized controlled parallel group trial, in a British university hospital.Randomization is achieved using a website and computer-generated concealed tables. Participants are 80 patients 70 years or over with acute hip fracture undergoing operative repair. The intervention group receive three daily infusions of 200 mg iron sucrose, starting within 24 hours of admission. The control group receive standard hospital care at the discretion of the clinical team. Red cell transfusions for each group are given in accordance with standard clinical triggers. The primary outcome is an increase in mean reticulocyte count in the intervention group at day 7. Secondary outcome measures include haemoglobin concentrations, early and late transfusion rates, infectious and cardiovascular complications, mobility and 30-day mortality. Discussion This is a pilot study to demonstrate haematopoietic efficacy of intravenous iron in this setting. Hence, we have chosen to measure change in reticulocyte count rather than the more clinically relevant differences in haemoglobin concentration or transfusion rate. If our results are positive, the study will provide the necessary information for development of a full-scale trial of intravenous iron. Trial registration Current Controlled Trials ISRCTN76424792; UK Medicines and Healthcare products Regulatory Authority (EuDRACT: 2011-003233-34). PMID:24015990

2013-01-01

353

Post-transfusion survival of 50Cr-labeled erythrocytes in neonatal foals.  

PubMed

Erythrocytes transfused allogeneically into mature horses have a short survival (less than 4 days) compared with an expected erythrocyte life span of 140-150 days. Yet, foals undergo transfusions for neonatal isoerythrolysis successfully. The authors have determined the survival of transfused erythrocytes in neonatal foals, using the stable isotope, 50Cr, to label the erythrocytes. Normal foals underwent transfusions with labeled erythrocytes from three sources: their own erythrocytes (autologous), the erythrocytes of their dam, and the erythrocytes of an unrelated castrated male. After transfusion, samples were taken at 15 minutes and then daily for a week and every 2 or 3 days for 20 days. A stable isotope of iron (57Fe) and 50Cr were determined on diluted-packed erythrocytes by inductively coupled argon-coupled mass spectrometry techniques. 57Fe was used as measure of the sample hemoglobin concentration. The ratio of 50Cr to 57Fe decreased exponentially in all foals. Half-time (T1/2) was 11.7 days (standard error = 2.2) for four foals that underwent autologous transfusions, 5.5 +/- 1.0 days for five foals that underwent transfusions with the erythrocytes of their dams, and 5.2 +/- 1.1 days for five foals that had transfusions with erythrocytes from an unrelated gelding. The authors conclude that erythrocytes that are transfused allogenically into neonatal foals will survive longer than those transfused into mature horses and that 50Cr labeling can be used to measure survival of transfused erythrocytes. PMID:1619595

Smith, J E; Dever, M; Smith, J; DeBowes, R M

1992-01-01

354

Comparison of methods for extraction of nucleic acid from hemolytic serum for PCR amplification of hepatitis B virus DNA sequences.  

PubMed Central

The sensitivity of PCR for the amplification of target nucleic acid sequences in clinical diagnostics may often be reduced due to the presence of inhibitory factors. Hemolytic serum contains a number of PCR inhibitors, one of which is hemin. In this study we have found that conventional methods of DNA extraction were not sufficient for the removal of PCR-inhibitory compounds in hemolytic serum. We have therefore compared the efficiency of several commercial and noncommercial methods of nucleic acid purification from hemolytic serum samples prior to PCR amplification. Separation with the QIAamp HCV kit, dialysis with Millipore filters, and bovine serum albumin absorption were all found to be suitable extraction methods for eliminating inhibitors from hemolytic serum for PCR amplification. Using these methods we were able to detect very low levels of hepatitis B virus DNA in hemolytic serum. PMID:9196220

Klein, A; Barsuk, R; Dagan, S; Nusbaum, O; Shouval, D; Galun, E

1997-01-01

355

Streptococcal acute pharyngitis.  

PubMed

Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A ?-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine. PMID:25229278

Anjos, Lais Martins Moreira; Marcondes, Mariana Barros; Lima, Mariana Ferreira; Mondelli, Alessandro Lia; Okoshi, Marina Politi

2014-07-01

356

Cocaine-induced microangiopathic hemolytic anemia mimicking idiopathic thrombotic thrombocytopenic purpura: A case report and review of the literature.  

PubMed

Our understanding of the pathogenesis of idiopathic thrombotic thrombocytopenic purpura (TTP) has increased, but remains incomplete, particularly with respect to cases of suspected TTP that are either unresponsive to therapeutic plasma exchange (TPE) or have normal ADAMTS13 (a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13) activity. A 53-year-old woman presented with severe anemia (hemoglobin 1.8 g/dL) and clinical and laboratory findings consistent with TTP in conjunction with acute cocaine use. The patient was treated with TPE until the pre-treatment ADAMTS13 activity was reported as normal without evidence of an inhibitor. TPE was stopped and the patient continued to improve without treatment. This patient's microangiopathic hemolytic anemia (MAHA) appeared to be secondary to cocaine use. The proposed pathogenesis is likely a combination of cocaine-induced vasoconstriction, vascular damage, platelet activation, and procoagulation. This is the fifth published report of cocaine-induced MAHA and to our knowledge the first with ADAMTS13 testing. J. Clin. Apheresis 29:284-289, 2014. © 2014 Wiley Periodicals, Inc. PMID:24753113

Odronic, Shelley; Quraishy, NurJehan; Manroa, Pooja; Kier, Yelena; Koo, Anna; Figueroa, Priscilla; Hamilton, Aaron

2014-10-01

357

Survival and haematological recovery of children with severe malaria transfused in accordance to WHO guidelines in Kilifi, Kenya  

Microsoft Academic Search

BACKGROUND: Severe anaemia requiring emergency blood transfusion is a common complication of malaria in children. To ensure access for urgent blood transfusion, the World Health Organization has developed clear guidelines with haemoglobin thresholds prevent unwarranted transfusion,. Few studies have reported outcome and haematological recovery of children with severe malaria where transfusion practice complies with WHO recommendations. METHODS: A prospective observational

Samuel O Akech; Oliver Hassall; Allan Pamba; Richard Idro; Thomas N Williams; Charles RJC Newton; Kathryn Maitland

2008-01-01

358

Experimental reproduction of hemolytic disease of the newborn in lower monkeys  

Microsoft Academic Search

Summary The article describes the author's experiments with artificial induction in lower monkeys (Papiohamadryas) of a hemolytic disease of newborn. The experiments were made on monkey couples — sires and dams — incompatible in the isoantigenic respect. An increase in the immunologic incompatibility between the fetus and the maternal body was achieved by immunization of females with blood erythrocytes from

L. S. Volkova; M. Sh. Verbitskii; A. V. Andreeva

1966-01-01

359

FETAL AND ADULT HEMOGLOBINS IN THE BLOOD OF INFANTS AFFECTED WITH HEMOLYTIC DISEASE OF THE NEWBORN  

Microsoft Academic Search

Hb by the Rh agglutinin-lysin system (Jonxis6) should be an increase in the proportion of adult Hb in the blood of infants affected with hemolytic dis- ease, and this proportion should be even greater if, as Jonxis believes, the affected infant develops adult Hb in utero as a protective mechanism. As pointed out by Baar,' the conclusions of Jonxis are

ERIC PONDER; PHILIP LEVINE

1950-01-01

360

Immunologic Basis and Immunoprophylaxis of RhD Induced Hemolytic Disease of the Newborn (HDN)  

Microsoft Academic Search

RhD antigen is the most immunogenic and clinically significant antigen of red blood cells after ABO system. It has historically been associated with hemolytic disease of the newborn (HDN) which is now routinely prevented by the administration of polyclonal anti-D immunoglobulin. This management of HDN has proven to be one of the most successful cases of prophylactic treatment based on

Roya Payam; Khaja Pasha; Fazel Shokri

361

Characterization of Maternal Isoagglutinins in ABO Hemolytic Disease of the Newborn  

Microsoft Academic Search

diagnosis of ABO hemolytic disease of the newborn (ABO HDN). The majority of the tests currently used in most hospital clinical laboratories for this purpose make use of certain serologic properties that differentiate the isoagglutinins into two groups. Although both groups probably arise as the result of antigenic stimulation, the early literature has termed them \\

Susis W. FONG; ARLENE NUCKTON; H. H. FUDENBERG

1966-01-01

362

Radionuclide studies of the kidney in children with hemolytic-uremic syndrome  

SciTech Connect

Twenty-six children with hemolytic-uremic syndrome (HUS) had radionuclide studies while oliguric or anuric in order to assess prognosis. Renographic abnormalities were compared with clinical and biochemical parameters and eventual outcome. Presence of an anephric pattern failed to predict development of irreversible renal damage. The authors conclude that radionuclide renography is of no value in children with HUS.

Campos, A.; Kim, Y.; Miller, K.; Maner, S.M.; Loken, M.K.; Michael, A.F.

1982-12-01

363

Asbestos Hemolysis' Chrysotilc fibers rsert a marked hemolytic activity OII suspensions of \\vnshed sheq  

E-print Network

Asbestos Hemolysis' Chrysotilc fibers rsert a marked hemolytic activity OII suspensions of \\vnshed of chrysotile asbestos is dependent on the openness of the fibrrs as chnractrrized by the air permeability>- repeated trratmcnt with ret1 blood cells. The nlechanism of asbestos helnolysis cannot yet 1x1

Ahmad, Sajjad

364

Unexplained hemolytic anemia of pregnancy: Case report with review of related literature  

Microsoft Academic Search

We present a case of a multipara lady who developed hemolytic anemia during pregnancy with spontaneous remission after delivery. She was managed with low dose steroid for hemolysis during pregnancy with good feto-maternal outcome. Despite extensive investigations carried out to determine the cause, they remained in vain. Very few of such cases have been described in the literature, which merits

Paban Sharma; Rekha Sthapit

2008-01-01

365

Comparing micellar, hemolytic, and antibacterial properties of di-and tricarboxyl dendritic amphiphiles  

E-print Network

amphiphiles Bhadreshkumar B. Maisuria a, , Marcelo L. Actis a,à , Shauntrece N. Hardrict a,§ , Joseph O April 2011 Keywords: Dendritic amphiphiles Staphylococcus aureus MRSA Critical micelle concentrations Hemolytic activities a b s t r a c t Homologous dicarboxyl dendritic amphiphiles--RCONHC(CH3)(CH2CH2COOH)2

Falkinham, Joseph

366

The Hemolytic Enterotoxin HBL Is Broadly Distributed among Species of the Bacillus cereus Group  

Microsoft Academic Search

The prevalence of the hemolytic enterotoxin complex HBL was determined in all species of the Bacillus cereus group with the exception of Bacillus anthracis. hblA, encoding the binding subunit B, was detected by PCR and Southern analysis and was confirmed by partial sequencing of 18 strains. The sequences formed two clusters, one including B. cereus and Bacillus thuringiensis strains and

BIRGIT M. PRU; RICHARD DIETRICH; BIRGIT NIBLER; ERWIN MARTLBAUER; SIEGFRIED SCHERER

1999-01-01

367

Deficiencies of glycolytic enzymes as a possible cause of hemolytic anemia.  

PubMed

The critical minimum values of Na,K-ATPase and glycolytic enzyme activities at which the erythrocyte viability is lost were calculated using the mathematical model of the erythrocyte, which included all reactions of glycolysis, adenylate metabolism, ionic balance, and osmotic regulation of erythrocyte volume. The criterion for cell death was an increase in its volume to the level at which it is sequestrated from the circulation or is lysed. In hemolytic anemia associated with hexokinase or pyruvate kinase deficiency, activities of these enzymes measured in patient erythrocytes appeared to be close to the calculated critical values. By contrast, in hemolytic anemia associated with phosphofructokinase, glucosephosphate isomerase, triosephosphate isomerase, or phosphoglycerate kinase deficiency, activities of these enzymes measured in patient erythrocytes were significantly greater than the calculated critical values. In this case, if the deficient enzyme were stable, i.e. its activity in the cell were low, but constant in time, the deficiency observed would not account for the erythrocyte destruction observed and the development of hemolytic anemia. It was shown, however, that in phosphofructokinase, glucosephosphate isomerase, triosephosphate isomerase, or phosphoglycerate kinase deficiency, hemolytic anemia can arise because of the instability of these enzymes in time. PMID:10699493

Martinov, M V; Plotnikov, A G; Vitvitsky, V M; Ataullakhanov, F I

2000-03-01

368

Guidelines for safety management of granulocyte transfusion in Japan  

Microsoft Academic Search

Granulocyte transfusion (GTX) has recently been revived by the ability to stimulate granulocyte donors with granulocyte colony-stimulating\\u000a factor (G-CSF), resulting in a greatly increased number of cells that can be collected. However, there is a paucity of guidelines\\u000a for assessing the appropriateness and safety management of GTX. The objective of this study was to establish guidelines for\\u000a the safety management

Akimichi Ohsaka; Atsushi Kikuta; Hitoshi Ohto; Akira Ohara; Akaru Ishida; Koji Osada; Tetsunori Tasaki; Akira Kamitamari; Asayuki Iwai; Shunro Kai; Taira Maekawa; Yasutaka Hoshi

2010-01-01

369

Craniosynostosis: an assessment of blood loss and transfusion practices  

Microsoft Academic Search

Assessment and accurate replacement of blood loss during primary craniosynostosis repair is difficult due to patient size\\u000a and surgical technique. Eighty-five charts of all patients undergoing primary craniosynostosis repair over a 15-year period\\u000a were reviewed to determine blood loss and to assess blood transfusion practices both intraoperatively and postoperatively.\\u000a Blood loss was calculated on the basis of estimated red cell

Ramona A. Kearney; Jose K. Rosales; William J. Howes

1989-01-01

370

Bone density in transfusion dependent thalassemia patients in Urmia, Iran  

PubMed Central

Background Patients with thalassemia major and intermedia are susceptible to osteopenia and osteoporosis. The mechanism of osteoporosis in these patients is multifactorial. Transfusion related iron overload in endocrine organs leads to impaired growth hormone secretion, diabetes mellitus, hypothyroidism, hypoparathyroidism, lack of sex steroids and vitamin D deficiency that contribute to impairment in achieving an adequate bone mass .The aim of this study was assessment of frequency of bone loss in patients with thalassemia major and intermedia in Urmia City of West Azerbaijan, Iran Materials and Methods In this cross sectional descriptive study,10 patients (lower than 18 y/o)with transfusion dependent thalassemia attending to Motahari and Emam Khomeini hospitals in Urmia city of Iran were enrolled and scanned for Bone Mineral Density (BMD) starting at around 10 years old. Results Tenatients (6 male and 4 female) with transfusion dependent thalassemia (?-thalassemia major and intermedia) aged 13to 17 years in Urmia city of Iran were enrolled. Mean age of patients was 15.1±.37year old. Among them, 8 patients (80%)had low BMD and2 of them (20%) had normal BMD in lumbar spine. Only 30% of patients had low BMD in the neck of femur. Conclusion We should perform annual BMD in patients with thalassemia major and intermedia and hemoglobin H disease in age of higher than 8 year old and treat low BMD with administration of bisphosphonate, calcium and vitamin D supplements. Medical consultation with a rheumatologist and /or an endocrinologist should be performed in these patients. Changing lifestyle with mild daily exercise, adequate calcium containing foods, avoiding heavy activities, stop smoking, iron chelation therapy in adequate dosage, early diagnosis and treatment of endocrine insufficiency and regular blood transfusions can help to achieve an optimal bone density in these patients. PMID:25002928

Valizadeh, N; Farrokhi, F; Alinejad, V; Said Mardani, SM; Valizadeh, N; Hejazi, S; Noroozi, M

2014-01-01

371

Bioethics and religious bodies: refusal of blood transfusions in Germany.  

PubMed

The refusal of medical treatment is a recurrent topic in bioethical debates and Jehovah's Witnesses often constitute an exemplary case in this regard. The refusal of a potentially life-saving blood transfusion is a controversial choice that challenges the basic medical principle of acting in patients' best interests and often leads physicians to adopt paternalistic attitudes toward patients who refuse transfusion. However, neither existing bioethical nor historical and social sciences scholarship sufficiently addresses experiences of rank-and-file Witnesses in their dealings with the health care system. This article draws on results of a nine-month (2010, 2011-2012) ethnographic research on the relationship between religious, legal, ethical, and emotional issues emerging from the refusal of blood transfusions by Jehovah's Witnesses in Germany (mainly in Berlin). It shows how bioethical challenges are solved in practice by some German physicians and what they perceive to be the main goal of biomedicine: promoting the health or broadly understood well-being of patients. I argue that two different understandings of the concept of autonomy are at work here: autonomy based on reason and autonomy based on choice. The first is privileged by German physicians in line with a Kantian philosophical tradition and constitutional law; the second, paradoxically, is utilized by Jehovah's Witnesses in their version of the Anglo-Saxon Millian approach. PMID:23538204

Rajtar, Ma?gorzata

2013-12-01

372

[Identity vigilance and implementation of transfusion software in hospitals].  

PubMed

In hospitals, patients' identity mismatch is the cause of serious incidents during transfusion or other healthcare processes. With a wider use of healthcare software, new dysfunctions and risks may occur in case of ID mismatch between different software and for transfusion between blood bank and hospital. Four critical stages are to be considered when using software management of hospital care: initial patients' identification, modifications of identification data during hospital stay and then synchronization of all different software, proper use of patient's identification means by hospital staff and share of patient's identification data with others such as the Etablissement français du sang (EFS) for transfusional purposes. Perpignan Hospital has put in place an identity vigilance group whose role is to enforce a safe patients' identification policy. It has to inform and train hospital staff, make sure that all software requiring patients' ID are correctly synchronized, especially when sharing data with EFS and monitor improvement with a surveillance system. As transfusion care is one of the more patients' ID sensitive, particularly when computer assisted, haemovigilance officers are highly involved in identity vigilance. PMID:18930682

Raynal, M-J

2008-11-01

373

Allogeneic blood transfusion and prognosis following total hip replacement: a population-based follow up study  

PubMed Central

Background Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR). However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. Methods A population-based follow-up study was performed using data from medical databases in Denmark. We identified 28,087 primary THR procedures performed from 1999 to 2007, from which we computed a propensity score for red blood cell transfusion based on detailed data on patient-, procedure-, and hospital-related characteristics. We were able to match 2,254 transfused with 2,254 non-transfused THR patients using the propensity score. Results Of the 28,087 THR patients, 9,063 (32.3%) received at least one red blood cell transfusion within 8 days of surgery. Transfused patients had higher 90-day mortality compared with matched non-transfused patients: the adjusted OR was 2.2 (95% confidence interval (CI): 1.2-3.8). Blood transfusion was also associated with increased odds of pneumonia (OR 2.1; CI: 1.2-3.8), whereas the associations with cardiovascular or cerebrovascular events (OR 1.4; CI: 0.9-2.2) and venous thromboembolism (OR 1.2; CI: 0.7-2.1) did not reach statistical significance. The adjusted OR of reoperation due to infection was 0.6 (CI: 0.1-2.9). Conclusions Red blood cell transfusion was associated with an adverse prognosis following primary THR, in particular with increased odds of death and pneumonia. Although the odds estimates may partly reflect unmeasured bias due to blood loss, they indicate the need for careful assessment of the risk versus benefit of transfusion even in relation to routine THR procedures. PMID:20040083

2009-01-01

374

Sigma E Regulators Control Hemolytic Activity and Virulence in a Shrimp Pathogenic Vibrio harveyi  

PubMed Central

Members of the genus Vibrio are important marine and aquaculture pathogens. Hemolytic activity has been identified as a virulence factor in many pathogenic vibrios including V. cholerae, V. parahaemolyticus, V. alginolyticus, V. harveyi and V. vulnificus. We have used transposon mutagenesis to identify genes involved in the hemolytic activity of shrimp-pathogenic V. harveyi strain PSU3316. Out of 1,764 mutants screened, five mutants showed reduced hemolytic activity on sheep blood agar and exhibited virulence attenuation in shrimp (Litopenaeus vannamei). Mutants were identified by comparing transposon junction sequences to a draft of assembly of the PSU3316 genome. Surprisingly none of the disrupted open reading frames or gene neighborhoods contained genes annotated as hemolysins. The gene encoding RseB, a negative regulator of the sigma factor (?E), was interrupted in 2 out of 5 transposon mutants, in addition, the transcription factor CytR, a threonine synthetase, and an efflux-associated cytoplasmic protein were also identified. Knockout mutations introduced into the rpoE operon at the rseB gene exhibited low hemolytic activity in sheep blood agar, and were 3-to 7-fold attenuated for colonization in shrimp. Comparison of whole cell extracted proteins in the rseB mutant (PSU4030) to the wild-type by 2-D gel electrophoresis revealed 6 differentially expressed proteins, including two down-regulated porins (OmpC-like and OmpN) and an upregulated protease (DegQ) which have been associated with ?E in other organisms. Our study is the first report linking hemolytic activity to the ?E regulators in pathogenic Vibrio species and suggests expression of this virulence-linked phenotype is governed by multiple regulatory pathways within the V. harveyi. PMID:22384269

Rattanama, Pimonsri; Thompson, Janelle R.; Kongkerd, Natthawan; Srinitiwarawong, Kanchana; Vuddhakul, Varaporn; Mekalanos, John J.

2012-01-01

375

Isovolemic exchange transfusion with increasing concentrations of low oxygen affinity hemoglobin solution limits oxygen delivery due to vasoconstriction.  

PubMed

O2-carrying fluids based on hemoglobin (Hb) are in various stages of clinical trials to determine their suitability as O2-carrying plasma expanders. Polymerized Hb solutions are characterized by their vasoactivity, low O2 affinity, oncotic effect, prolonged shelf life, and stability. Physiological responses to facilitated O2 transport after exchange transfusion with polymerized bovine Hb (PBH) were studied in the hamster window chamber model during acute moderate anemia to determine how PBH affects microvascular perfusion and tissue oxygenation. The anemic state [29% hematocrit (Hct)] was induced by hemodilution with a plasma expander (70 kDa dextran). After hemodilution, animals were randomly assigned to different exchange transfusion groups. Study groups were based on the concentration of PBH used, namely: PBH at 13 g Hb/dl [PBH13], PBH diluted to 8 (PBH8) or 4 (PBH4) g Hb/dl in albumin solution at matching colloidal osmotic pressure (COP), and no PBH (only albumin solution) at matching COP (PBH0). Measurement of systemic parameters, microvascular hemodynamics, capillary perfusion, and intravascular and tissue O2 levels was performed at 18% Hct. Restitution of O2-carrying capacity with PBH13 increased arterial pressure and triggered vasoconstriction, low perfusion, and high peripheral resistance. PBH4 and PBH0 exhibited lower arterial pressures compared with PBH13. Exchange transfused animals with PBH8 and PBH4 better maintained perfusion and functional capillary density than PBH13. Blood gas parameters and acid-base balance were recovered proportional to microvascular perfusion. Arterial O2 tensions were improved with PBH4 and PBH8 by preventing O2 precapillary release and increasing O2 reserve. Further studies to establish PBH optimal dosage, efficacy, safety, and its effect on outcome are indicated before Hb-based O2-carrying blood substitutes are implemented in routine practice. PMID:18835914

Cabrales, Pedro; Tsai, Amy G; Intaglietta, Marcos

2008-11-01

376

Transfusion practices in a neonatal intensive care unit in a city in Brazil  

PubMed Central

Objective Newborn infants are the most heavily transfused population inside intensive care units. The hemoglobin level used to indicate the need of transfusions is not well established. The aim of this study was to evaluate transfusional practices in newborns in the neonatal intensive care units of one specific city. Methods Red blood cell transfusion practices of all transfused newborns in all five of the neonatal intensive care units of the city were analyzed. Data are reported as descriptive statistics, including numbers and percentages and means and standard deviation. Univariate analysis, followed by stepwise logistic regression was performed in respect to transfusional data and outcomes. Results A total of 949 patients were admitted to the intensive care units during the 12-month study period with 20.9% receiving at least one transfusion, most (62.4%) of whom received more than one transfusion. The mean number of transfusions per infant was 2.7 ± 2.16; in the liberal transfusion group the mean number was 1.59 ± 1.63 and in the restrictive group it was 1.08 ± 1.51. The mean hemoglobin and hematocrit levels were 9.0 g/dL (±1.4 g/dL) and 27.4% (±4.3%), respectively. The most common indications for blood transfusions were sepsis and prematurity. Conclusion This study shows that the characteristics and the transfusion practices for newborns admitted in the neonatal intensive care units of Juiz de Fora are similar to recent pubications. There was no significant reduction in the number of transfusions per child in the restrictive group compared to the liberal group. Restrictive transfusions are an independent risk factor for peri-intraventricular hemorrhages and death. PMID:25031162

Portugal, Carolina Augusta Arantes; de Paiva, Amanda Povoa; Freire, Erika Santos; Chaoubah, Alfredo; Duarte, Marta Cristina; Hallack Neto, Abrahao Elias

2014-01-01

377

Safety and efficacy of shed mediastinal blood transfusion after cardiac surgery: A multicenter observational study  

Microsoft Academic Search

Objective: To examine the efficacy and safety of shed mediastinal blood (SMB) transfusion in preventing allogenic red blood cell (RBC) transfusion.Design: An observational clinical study.Setting: Twelve US academic medical centers.Participants: Six hundred seventeen patients undergoing elective primary coronary artery bypass grafting.Interventions: Patients were administered SMB transfusion or not, according to institutional and individual practice, without random assignment.Measurements and Results: The

Simon C. Body; Jolene Birmingham; Reg Parks; Catherine Ley; Rosemarie Maddi; Stanton K. Shernan; Lawrence C. Siegel; E. Price Stover; Michael N. D'Ambra; Jack Levin; Dennis T. Mangano; Bruce D. Spiess

1999-01-01

378

Strict guideline reduces the need for RBC transfusions in premature infants.  

PubMed

The aim of this study was to verify if the adoption of a strict guideline would reduce the need for red blood cell transfusions in the first 28 days of life in very low birth weight preterm infants. Retrospective study of two cohorts of very low birth weight infants transfused according to neonatologist decision (Period 1) or according to a strict guideline for erythrocytes transfusion (Period 2). Clinical and hematological data of 80 premature infants transfused in both periods of the study were obtained by chart review. During the first 28 days of life, 45 (62.5%) of 72 premature infants born in the Period 1, and 44 (55.7%) of 79 newborns born in Period 2 received at least one erythrocyte transfusion; p = 0.40. Among patients transfused, the median number of transfusions was four per infant transfused (range: 1-13; mean: 4.6 +/- 3.2) in Period 1 and 3 (range: 1-18; mean: 4.0 +/- 3.5) in Period 2; p = 0.26. The median volume of erythrocytes administered per infant transfused in Period 1 was 40 ml kg(-1) (range: 10-170; mean: 48.8 +/- 38.3) and in Period 2 was 30 ml kg(-1) (range: 10-225; mean: 43.4 +/- 40.4), p = 0.41. Multiple linear regression analysis, after adjusting for birth weight, clinical risk index for babies, blood loss and days of ventilation, showed that the adoption of the strict guideline reduced the volume of erythrocytes transfused in 15.91 ml kg(-1) per infant transfused (95% CI: -24.69-7.14) p < 0.001. The adoption of a strict guideline reduced the need for red blood cells transfusions in very low birth weight infants. PMID:17166932

Venâncio, Josiene Pereira; Santos, Amélia Miyashiro Nunes Dos; Guinsburg, Ruth; Peres, Clóvis de Araújo; Shinzato, Alexandre Ryuzo; Lora, Mayra Ivanoff

2007-04-01

379

Prognostic significance of perioperative blood transfusions in resectable thoracic esophageal cancer  

Microsoft Academic Search

OBJECTIVE:The perioperative blood transfusions have been associated with tumor recurrence and decreased survival in various types of alimentary tract cancer. There exist, however, contradictory studies showing no relationship between blood transfusions and survival. For patients with esophageal cancer, only one report suggested that blood transfusions did not by itself decrease the chance of cure after esophagectomy.METHODS:Among 235 patients with primary

Mitsuo Tachibana; Hideki Tabara; Tsukasa Kotoh; Shoichi Kinugasa; Dipok Kumar Dhar; Yoshitaka Hishikawa; Reiko Masunaga; Hirofumi Kubota; Naofumi Nagasue

1999-01-01

380

Common Transfusion-transmitted Infectious Agents among Thalassaemic Children in Bangladesh  

Microsoft Academic Search

Transfusion-dependent children are more prone to acquiring various transfusion-transmitted infections (TTIs), such as hepatitis B (HBV), hepatitis C (HCV), HIV, and others. Since the magnitude of these infections among thalassaemic children in Bangladesh is not well-known, this study was conducted to assess the prevalence of TTIs among them (who received more than three blood transfusions) compared to their age- and

Abid Hossain Mollah; Nazmun Nahar; A. Siddique; Kazi Selim Anwar; Tariq Hassan

381

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies  

Microsoft Academic Search

The aim of the present study was to determine the risk factors and impact on outcome of blood transfusions following pneumonectomy for thoracic malignancies. A retrospective analysis of 432 consecutive patients was carried out, of whom 183 (42.4%) were transfused post-operatively. The associations between blood transfusions and 20 variables were assessed by univariate and multivariate analysis. Survival analysis included log-rank

P. Thomas; P. Michelet; F. Barlesi; X. Thirion; C. Doddoli; R. Giudicelli; P. Fuentes

2007-01-01

382

The Efficacy of Predeposited Autologous Blood Transfusions in General Pediatric Surgery  

Microsoft Academic Search

Allogeneic blood transfusions are associated with a risk of infection, immunological reactions, immunosuppression, and the\\u000a induction of antibodies in blood cells. We report our results of giving predeposited autologous blood transfusions (PABT)\\u000a to children when it was anticipated that transfusions would be required for an elective operation. Autologous blood was collected\\u000a for deposit from 16 patients ranging in age from

Tomoaki Taguchi; Sachiyo Suita; Makoto Nakao; Takeshi Yamanouchi; Shoichi Inaba

2000-01-01

383

EFFECT OF TRANSFUSION THERAPY ON TRANSCRANIAL DOPPLER ULTRASONOGRAPHY VELOCITIES IN CHILDREN WITH SICKLE CELL DISEASE  

PubMed Central

Background Children with sickle cell disease and abnormal transcranial Doppler (TCD) ultrasonography have a high risk of stroke, but this risk is greatly reduced when chronic transfusion therapy is administered. The change in TCD velocities during chronic transfusion therapy and rate and frequency of normalization of TCD findings have not been studied extensively. Procedures Using data from children with sickle cell disease enrolled as potential subjects in the Optimizing Primary Stroke Prevention in Sickle Cell Anemia (STOP 2) trial, we characterized the change in TCD velocities on transfusion therapy and identified predictors of developing a normal TCD. Results Among 88 children with serial TCD data after starting transfusions for abnormal TCD 46 (52%) converted to normal TCD after a mean of 4.3 months (median 3.0; range 0.85-14.3 months) of transfusions. TCD studies remained abnormal in 19/88 (21.6%) after a mean of 2.4 years of transfusion. The median TCD velocity was lowered by 38 cm/s within three months of initiating transfusions, followed by a more gradual decline then stabilization of velocities, although with significant individual variation. Factors associated with conversion to normal TCD included lower initial TCD velocity, younger age, and higher pre-transfusion hemoglobin level during transfusion therapy. Conclusion Younger children with higher pre-transfusion hemoglobin levels and lower abnormal TCD velocities are most likely to have rapid normalization of TCD on transfusions. Long-term follow-up of children with persistently abnormal exams or worsening velocities on transfusion is needed to determine if these children are at higher risk of stroke. PMID:21370410

Kwiatkowski, Janet L.; Yim, Eunsil; Miller, Scott; Adams, Robert J.

2011-01-01

384

Group G Beta-Hemolytic Streptococcal Bacteremia Characterized by 16S Ribosomal RNA Gene Sequencing  

PubMed Central

Little is known about the relative importance of the four species of Lancefield group G beta-hemolytic streptococci in causing bacteremia and the factors that determine the outcome for patients with group G beta-hemolytic streptococcal bacteremia. From 1997 to 2000, 75 group G beta-hemolytic streptococcal strains were isolated from the blood cultures of 66 patients. Sequencing of the 16S rRNA genes of the group G beta-hemolytic streptococci showed that all 75 isolates were Streptococcus dysgalactiae subspecies equisimilis. The API system (20 STREP) and Vitek system (GPI) successfully identified 65 (98.5%) and 62 (93.9%) isolates, respectively, as S. dysgalactiae subspecies equisimilis with >95% confidence, whereas the ATB Expression system (ID32 STREP) only successfully identified 49 isolates (74.2%) as S. dysgalactiae subspecies equisimilis with >95% confidence. The median age of the patients was 76 years (range, 33 to 99 years). Fifty-six patients (85%) were over 60 years old. All patients had underlying diseases. No source of the bacteremia was identified (primary bacteremia) in 34 patients (52%), whereas 17 (26%) had cellulitis and 8 (12%) had bed sore or wound infections. Fifty-eight patients (88%) had community-acquired group G streptococcal bacteremia. Sixty-two patients (94%) had group G Streptococcus recovered in one blood culture, whereas 4 patients (6%) had it recovered in multiple blood cultures. Fifty-nine patients (89%) had group G Streptococcus as the only bacterium recovered in their blood cultures, whereas in 7 patients other bacteria were recovered concomitantly with the group G Streptococcus in the blood cultures (Staphylococcus aureus in 3, Clostridium perfringens in 2, Citrobacter freundii in 1, and Bacteroides fragilis in 1). Overall, 10 patients (15%) died. Male sex, diagnosis other than cellulitis, hospital-acquired bacteremia, and multiple positive blood cultures were associated with mortality {P < 0.005 (relative risk [RR] = 7.6), P < 0.05 (RR = 3.7), P < 0.005 (RR = 5.6), and P < 0.05 (RR = 5.6), respectively}. Unlike group C beta-hemolytic streptococcal bacteremia, group G beta-hemolytic streptococcal bacteremia is not a zoonotic infection in Hong Kong. PMID:11526143

Woo, Patrick C. Y.; Fung, Ami M. Y.; Lau, Susanna K. P.; Wong, Samson S. Y.; Yuen, Kwok-Yung

2001-01-01

385

Blood transfusion as a risk factor for non-Hodgkin lymphoma.  

PubMed Central

In a case-control study of 280 out of 426 consecutive patients with a recent diagnosis of non-Hodgkin lymphoma (NHL) and 1827 control subjects, 53 (19%) and 230 (13%) respectively had received blood transfusions 1 year or more before the interview. Using an age- and sex-stratified analysis the odds ratio (OR) for transfusion was 1.74 (95% CI 1.24-2.44). ORs were also determined for transfusions received in the intervals 1-5, 6-15, 16-25 and > or = 26 years before diagnosis. In the interval 6-15 years, the OR for transfusion was 2.83 (95% CI 1.60-4.99) whereas ORs for transfusions received in other intervals were lower and not significantly elevated. Histological diagnoses (Kiel classification) and results of staging procedures were known for 185 patients. For low-grade NHL of nodal B-cell chronic lymphocytic leukaemia (B-CLL) or immunocytoma type, the OR for transfusions was 4.15 (95% CI 1.92-9.01). For low-grade nodal lymphomas of follicle centre cell type and high-grade nodal lymphomas, no relation to transfusions could be demonstrated. For high-grade extranodal lymphoma as sole manifestation, OR for transfusions was 3.27 (95% CI 1.30-8.24). It is concluded that blood transfusion may be a risk factor for NHLs especially those of B-CLL or immunocytoma type and for high-grade extranodal lymphoma. PMID:8624279

Brandt, L.; Brandt, J.; Olsson, H.; Anderson, H.; Möller, T.

1996-01-01

386

Transfusion Medicine Problems and Solutions for the Pediatric Hematologist/Oncologist  

PubMed Central

Blood component transfusion is an integral part of the care of children with oncologic and hematologic conditions. The complexity of transfusion medicine may however lead to challenges for pediatric hematologists/oncologists. In this review, three commonly encountered areas of transfusion medicine are explored. The approach to the investigation and management of suspected platelet refractoriness is reviewed. The unique transfusion related challenges encountered by children undergoing stem cell transplantation are also discussed. Finally, issues arising out of the care of children with hemoglobinopathies are explored, with an emphasis on the incidence of allo- and autoimmunization. PMID:22238206

Luban, Naomi L.C.; McBride, Eileen; Ford, Jason C.; Gupta, Sumit

2012-01-01

387

Increased mortality in adult patients with trauma transfused with blood components compared with whole blood.  

PubMed

Hemorrhage is a preventable cause of death among patients with trauma, and management often includes transfusion, either whole blood or a combination of blood components (packed red blood cells, platelets, fresh frozen plasma). We used the 2009 National Trauma Data Bank data set to evaluate the relationship between transfusion type and mortality in adult patients with major trauma (n = 1745). Logistic regression analysis identified 3 independent predictors of mortality: Injury Severity Score, emergency medical system transfer time, and type of blood transfusion, whole blood or components. Transfusion of whole blood was associated with reduced mortality; thus, it may provide superior survival outcomes in this population. PMID:24399315

Jones, Allison R; Frazier, Susan K

2014-01-01

388

A predictive model to reduce allogenic transfusions in primary total hip arthroplasty.  

PubMed

An efficient Blood Conservation Program (BCP) should be considered in preparation of the surgical patient transfusion requirement. BCP should account for the association between bleeding reduction and anemia during or post surgery. In this paper, our aim was to develop a predictive model of bleeding that could help direct decision making about the strategy to reduce unnecessary transfusions. Such a strategy could guarantee an adequate peri-operative hemoglobin value, to reduce the patients' risk and rehabilitation time. Moreover, an accurate prediction of bleeding and anemia helps to plan preventive autologous transfusion or erythropoietic stimulus, to enhance a conservative transfusion approach, reducing both costs and risks. PMID:22018712

Pavesi, Marco; Inghilleri, Giovanni; Albano, Giovanni; Ricci, Cristian; Gaeta, Maddalena; Randelli, Filippo

2011-12-01

389

Allogenic Blood Transfusion Does Not Predispose to Infection After Cardiac Surgery  

Microsoft Academic Search

BackgroundMany retrospective studies report increased postoperative infection after allogenic blood transfusion. To investigate this phenomenon, we prospectively studied 232 patients undergoing cardiac surgery.

Ziad A. Ali; Eric Lim; Reza Motalleb-Zadeh; Ayyaz A. Ali; Chris J. Callaghan; Caroline Gerrard; Alain Vuylsteke; Juliet Foweraker; Steven Tsui

2004-01-01

390

Acute cholecystitis  

MedlinePLUS

Cholecystitis - acute ... uses to digest fats in the small intestine. Acute cholecystitis occurs when bile becomes trapped in the ... Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. ...

391

A Thermolabile Aldolase A Mutant Causes Fever-Induced Recurrent Rhabdomyolysis without Hemolytic Anemia  

PubMed Central

Aldolase A deficiency has been reported as a rare cause of hemolytic anemia occasionally associated with myopathy. We identified a deleterious homozygous mutation in the ALDOA gene in 3 siblings with episodic rhabdomyolysis without hemolytic anemia. Myoglobinuria was always triggered by febrile illnesses. We show that the underlying mechanism involves an exacerbation of aldolase A deficiency at high temperatures that affected myoblasts but not erythrocytes. The aldolase A deficiency was rescued by arginine supplementation in vitro but not by glycerol, betaine or benzylhydantoin, three other known chaperones, suggesting that arginine-mediated rescue operated by a mechanism other than protein chaperoning. Lipid droplets accumulated in patient myoblasts relative to control and this was increased by cytokines, and reduced by dexamethasone. Our results expand the clinical spectrum of aldolase A deficiency to isolated temperature-dependent rhabdomyolysis, and suggest that thermolability may be tissue specific. We also propose a treatment for this severe disease. PMID:25392908

Mamoune, Asmaa; Bahuau, Michel; Hamel, Yamina; Serre, Valérie; Pelosi, Michele; Habarou, Florence; Nguyen Morel, Marie-Ange; Boisson, Bertrand; Vergnaud, Sabrina; Viou, Mai Thao; Nonnenmacher, Luc; Piraud, Monique; Nusbaum, Patrick; Vamecq, Joseph; Romero, Norma; Ottolenghi, Chris; Casanova, Jean-Laurent; de Lonlay, Pascale

2014-01-01

392

Investigating the effect of increasing charge density on the hemolytic activity of synthetic antimicrobial polymers.  

PubMed

The current study is aimed at investigating the effect of fine-tuning the cationic character of synthetic mimics of antimicrobial peptides (SMAMPs) on the hemolytic and antibacterial activities. A series of novel norbornene monomers that carry one, two, or three Boc-protected amine functionalities was prepared. Ring-opening metathesis polymerization (ROMP) of the monomers, followed by deprotection of the amine groups resulted in cationic antimicrobial polynorbornenes that carry one, two, and three charges per monomer repeat unit. Increasing the number of amine groups on the most hydrophobic polymer reduced its hemolytic activity significantly. To understand the membrane activity of these polymers, we conducted dye leakage experiments on lipid vesicles that mimic bacteria and red blood cell membranes, and these results showed a strong correlation with the hemolysis data. PMID:18816096

Al-Badri, Zoha M; Som, Abhigyan; Lyon, Sarah; Nelson, Christopher F; Nüsslein, Klaus; Tew, Gregory N

2008-10-01

393

Synthesis of new sugar-based surfactants and evaluation of their hemolytic activities.  

PubMed

The synthesis of four sugar-based surfactants derived from glucose and (R)-12-hydroxystearic acid is described. The surfactants have a hydroxy group in the hydrophobic part, which is either free or acylated using acetyl chloride, hexanoyl chloride, or myristoyl chloride. Three of the synthesized surfactants are water-soluble and are evaluated with respect to their CMCs and hemolytic activities. The fourth surfactant has limited water solubility and is not further included in the study. The investigated surfactants are all hemolytic close to their respective CMC indicating that their use in parenteral formulations may be limited. Nevertheless, surfactants having the proposed structure appear as promising alternatives to existing solubilizing agents for pharmaceutical applications. PMID:16626152

Neimert-Andersson, Kristina; Sauer, Sven; Panknin, Olaf; Borg, Tessie; Söderlind, Erik; Somfai, Peter

2006-04-28

394

D-penicillamine therapy in AB0 hemolytic disease of the newborn infant  

Microsoft Academic Search

This study comprises 120 full-term infants with AB0 hemolytic disease admitted to the neonatal department during a period of 60 months from 1970 to 1975. During the first 30 months newborns (n=61) received no D-penicillamine therapy, whereas all infants (n=59) received this treatment (300–400 mg\\/kg\\/day, divided into 4 equal doses, for 2–5 days) during the last 30 months. The patients

L. Lakatos; B. Kövér; Gy. Oroszlán; Zsuzsa Vekerdy

1976-01-01

395

Paternal leukocyte alloimmunization as a treatment for hemolytic disease of the newborn in a rabbit model  

Microsoft Academic Search

Objective: The purpose of this study was to evaluate maternal alloimmunization to paternal leukocytes as a treatment for hemolytic disease of the fetus\\/newborn in a rabbit model. Study Design: Twelve does and paired red blood cell-incompatible bucks underwent the experimental protocol. Fetal hematologic parameters that were obtained by ultrasound-guided intracardiac sampling were compared from unaffected, compatible litters; from affected, incompatible

Paul W. Whitecar; Rod Farb; Lalitha Subramanyam; Karen Dorman; Rukmini B. Balu; Kenneth J. Moise Jr

2002-01-01

396

Hemolytic-Uremic Syndrome Following Bone Marrow Transplantation in Adults for Hematologic Malignancies  

Microsoft Academic Search

One hundred and sixty eight adult patients with B-cell non-Hodgkin's lymphoma (NHL) and other hematologic ma- lignancies who underwent autologous or allogeneic bone marrow transplantation (BMT) were investigated for the subsequent development of hemolytic-uremic syndrome (HUS). All patients were conditioned with cyclophosphamide and total body irradiation. When examined at 3-month intervals for the first year post-BMT, all patients had uniform

Susan N. Rabinowe; Robert J. Soiffer; Nancy J. Tarbell; Donna Neuberg; Arnold S. Freedman; Julian Seifter; Kelly W. Blake; John G. Gribben; Kenneth C. Anderson; Tak Takvorian; Jerome Ritz; Lee M. Nadler

1991-01-01

397

Complete Genome Assembly of Streptococcus pyogenes ATCC 19615, a Group A ?-Hemolytic Reference Strain  

PubMed Central

We present the complete genome assembly of Streptococcus pyogenes ATCC 19615 (Rosenbach) as submitted to GenBank under accession number CP008926. This group A nonmotile ?-hemolytic clinical isolate is used for quality control in a variety of commercially available tests. The assembled genome is 1.84 Mb (38.5% G+C content) and contains 1,788 coding regions. PMID:25258274

Minogue, T. D.; Daligault, H. A.; Davenport, K. W.; Bishop-Lilly, K. A.; Broomall, S. M.; Bruce, D. C.; Chain, P. S.; Chertkov, O.; Coyne, S. R.; Freitas, T.; Frey, K. G.; Gibbons, H. S.; Jaissle, J.; Redden, C. L.; Rosenzweig, C. N.; Xu, Y.

2014-01-01

398

Complete Genome Assembly of Streptococcus pyogenes ATCC 19615, a Group A ?-Hemolytic Reference Strain.  

PubMed

We present the complete genome assembly of Streptococcus pyogenes ATCC 19615 (Rosenbach) as submitted to GenBank under accession number CP008926. This group A nonmotile ?-hemolytic clinical isolate is used for quality control in a variety of commercially available tests. The assembled genome is 1.84 Mb (38.5% G+C content) and contains 1,788 coding regions. PMID:25258274

Minogue, T D; Daligault, H A; Davenport, K W; Bishop-Lilly, K A; Broomall, S M; Bruce, D C; Chain, P S; Chertkov, O; Coyne, S R; Freitas, T; Frey, K G; Gibbons, H S; Jaissle, J; Redden, C L; Rosenzweig, C N; Xu, Y; Johnson, S L

2014-01-01

399

Anti-Factor H Autoantibodies Associated with Atypical Hemolytic Uremic Syndrome  

Microsoft Academic Search

Several studies have demonstrated genetic predisposition in non-shigatoxin-associated hemolytic uremic syndrome (HUS), involving regulatory proteins of the complement alternative pathway: Factor H (FH) and membrane co-factor protein (CD46). Regarding the observations of thrombotic thrombocytopenic purpura patients, in whom a von Willebrand factor protease (ADAMST-13) deficiency may be inherited or acquired secondary to IgG antibodies, it was speculated that HUS might

Marie-Agnes Dragon-Durey; Chantal Loirat; Sylvie Cloarec; Marie-Alice Macher; Jacques Blouin; Hubert Nivet; Laurence Weiss; Wolf Herman Fridman; Veronique Fremeaux-Bacchi

2005-01-01

400

Paravertebral Mass in a Patient with Hemolytic Anemia: Computed Tomographic Findings  

PubMed Central

Extramedullary hematopoiesis is characterized by the presence of hematopoietic tissue outside of the bone marrow and is typically associated with chronic hemolytic anemias. Intrathoracic extramedullary hematopoiesis is a rare and usually asymptomatic condition. The authors report a case of a 57-year-old man with intrathoracic extramedullary hematopoiesis and hereditary spherocytosis. Clinical and laboratory evaluation, together with radiological findings, are described. The diagnosis of the disease was confirmed by tissue biopsy. PMID:20368781

Carvalho, Juliana Franca; Marchiori, Edson; Zanetti, Glaucia; Mano, Claudia Mauro; Sarcinelli-Luz, Branca; Vianna, Flavia Gavinho; Assed, Carla; Santos, Isabella Guedes; Santos, Alair Augusto S. M. D.; Vianna, Alberto Domingues

2010-01-01

401

Bacteremia caused by hemolytic, high-level gentamicin-resistant Enterococcus faecalis.  

PubMed Central

Between 1 January 1984 and 31 December 1987, 206 enterococcal blood isolates at the University of Wisconsin Hospital and Clinics were analyzed for high-level aminoglycoside resistance (hereafter high-level aminoglycoside resistance is simply referred to as "resistance") and hemolysin production. Of 190 Enterococcus faecalis isolates, 68 (35.8%) were resistant to gentamicin. Of these 68 strains, 67 (98.5%) contained a gene coding for the bifunctional aminoglycoside-modifying 6'-aminoglycoside acetyltransferase-2"-aminoglycoside phosphotransferase [AAC(6')-APH(2")] enzyme. Of 190 isolates, 85 (44.7%) were hemolytic and contained a gene coding for component A of the enterococcal hemolysin. Sixty-two of 68 (91.2%) gentamicin-resistant isolates but only 23 of 122 (18.8%) gentamicin-susceptible isolates were hemolytic (P less than 0.001). Twelve of the hemolytic, gentamicin-resistant E. faecalis blood isolates, but only 2 of 9 nonhemolytic or gentamicin-susceptible isolates, had identical chromosomal DNA restriction endonuclease digestion patterns, suggesting a common derivation for these strains. A historical cohort study from 1 July 1985 to 31 March 1987 identified by regression analysis postsurgical intensive care unit status (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.1 to 22.8) and prior treatment with an expanded- or broad-spectrum cephalosporin (OR, 3.0; 95% CI, 0.9 to 10.1) as risk factors for gentamicin-resistant E. faecalis bacteremia. Patients with hemolytic, gentamicin-resistant E. faecalis bacteremia had a fivefold-increased risk for death within 3 weeks of their bacteremia compared with patients with nonhemolytic, gentamicin-susceptible strains (95% CI, 1.0 to 25.4). Images PMID:1929336

Huycke, M M; Spiegel, C A; Gilmore, M S

1991-01-01

402

Hemolytic anemia after operation for aortic dissection using teflon felt strips.  

PubMed

We report three cases of hemolytic anemia caused by anastomotic stenosis after surgical treatment for aortic dissection in which internal and external Teflon (DuPont, Wilmington, DE) felt strips were used for reinforcement of the aortic stump. To detect this complication, laboratory findings typical of red cell fragmentation syndrome as well as appropriate imaging modalities are necessary. As a precaution, it is necessary to be meticulous when stitching the internal felt strip. PMID:18442587

Nakamura, Yuki; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Kitamura, Soichiro

2008-05-01

403

Pore formation, polymerization, hemolytic and leukotoxic effects of a new Enterobacter cloacae toxin neutralized by antiserum.  

PubMed

A new toxin of Enterobacter cloacae was purified and studied by SDS-PAGE electrophoresis with the purpose of investigating its ability to generate polymers and their molecular mass. Monomer of 13.3 kDa and structures of multimeric mass were detected. The toxin of 66 kDa was the most abundant form of toxin. This polymer and the monomer were selected to examine blood cells damage. Membrane pores caused by both toxin forms seemed to be of similar dimension (estimated in 3.6 nm by experiments with osmotic protectors) and were able to lyse erythrocytes and leukocytes. The results obtained indicate that polymerization and pore formation are involved in the molecular events that participate in the cytotoxic effects of E. cloacae toxin. Immunization of rabbits with 13.3kDa toxin generated antibody response capable of inhibiting oxidative stress as well as hemolytic and leukotoxic effects. Immunoblotting indicated that monomer and polymer reacted with antihemolysin serum. The importance of E. cloacae toxin "in vivo" was studied in animals by means of assays performed in peritoneum of rats, inoculated with the hemolytic strain (C1) and a non-hemolytic variant (C4). Both strains stimulated infiltration of leukocytes in peritoneum, but C1 caused cell death and lysis wheras assays with C4 maintained the viability of leukocytes even within 5 h after extraction of samples. PMID:15881838

Paraje, María Gabriela; Eraso, Alberto Jorge; Albesa, Inés

2005-01-01

404

The in vitro hemolytic effect of diltiazem on erythrocytes exposed to varying osmolarity.  

PubMed

The hemolytic effect of diltiazem (a calcium channel blocker) on red blood cells (RBCs) exposed to varying osmolarity was investigated. Previous work on the in vitro hemolytic effect of verapamil shed some light on the potential for some drugs to induce hemolysis at moderate-to-high doses and in pre-existing osmotic stress. The current experimental approach used a modified red cell hemolysis assay with concentrations of diltiazem ranging from 50-1500 ?M compared to drug free controls. The time-course of hemolytic effects was also investigated. In conditions representing decreasing osmolarity (dilution from 140 to 0 mM NaCl) there was a significant increase in erythrocyte hemolysis that was also dependent on diltiazem concentration (ANOVA, p<0.05). The red cells also showed a significantly increased rate of hemolysis over 5 h with increasing concentration of diltiazem (ANOVA, p<0.05). Overall the data suggested that diltiazem can cause hemolysis of RBCs in a predictable time- and concentration-dependent manner, and that diltiazem increases the fragility of the erythrocytes further during hypotonic osmotic stress. The mechanism of diltiazem-dependent hemolysis could involve various ion transport pathways (i.e. Ca pump, Ca Channels) and subsequent effects on cell volume control or membrane fragility. PMID:20486888

Watts, T J

2010-10-01

405

Hematologic characterization and chromosomal localization of the novel dominantly inherited mouse hemolytic anemia, neonatal anemia (Nan).  

PubMed

One of the most commonly inherited anemias in man is Hereditary Spherocytosis (HS) with an incidence of 1 in 2000 for persons of Northern European descent. Mouse models of HS include spontaneous inherited hemolytic anemias and those generated by gene targeting. The Neonatal anemia (Nan) mouse is a novel model of HS generated by N-ethyl-N-nitrosurea mutagenesis and suffers from a severe neonatal anemia. Adult Nan mice have a lifelong hemolytic anemia with decreased red blood cell numbers, hematocrit, and hemoglobin, but elevated zinc protoporphyrin levels. Blood smears taken from Nan mice show a hypochromic anemia characterized by poikilocytosis, anisocytosis and polychromasia. The Nan phenotype can be transferred by bone marrow transplantation indicating that the defect is intrinsic to bone marrow. The hemolytic anemia in adult Nan mice can be identified by osmotic fragility testing. Examination of the erythrocyte membrane skeleton proteins (EMS) reveals a global deficiency of these proteins with protein 4.1a being completely absent. The Nan locus maps to mouse Chromosome 8 and does not co-localize with any known EMS genes. The identification of the Nan gene will likely uncover a novel protein that contributes to the stability of the EMS and may identify a new mutation for HS. PMID:19409822

White, Robert A; Sokolovsky, Inna V; Britt, Margaret I; Nsumu, Ndona N; Logsdon, Derek P; McNulty, Steven G; Wilmes, Leigh A; Brewer, Brandon P; Wirtz, Eric; Joyce, Heather R; Fegley, Barbara; Smith, Ann; Heruth, Daniel P

2009-01-01

406

Impact of Respiratory Viral Infections on Alpha Hemolytic Streptococci and Otopathogens in the Nasopharynx of Young Children  

PubMed Central

Background We studied nasopharyngeal (NP) colonization in a cohort of children to determine the impact of viral upper respiratory infections (URI) on non-pneumococcal alpha hemolytic streptococci (AHS) and otopathogen colonization in association with acute otitis media (AOM). Methods NP samples were collected routinely when children were aged 6, 9, 12, 15, 18, 24, and 30 months and during episodes of AOM. NP samples were prospectively obtained from 248 children during a 5-year time span; 1,018 during routine visits, 161 at the time of AOM and 59 at follow-up visits 3 weeks after AOM. Results The overall NP colonization rate of AHS was 50.8% during a non-AOM visit but declined to 38.3% during a viral URI with concurrent AOM (p=0.0006). Of 56 AOM visits with paired follow-ups, 6 (10.7%) had AHS in the NP at the time of viral URI and concurrent AOM whereas 29 (51.8%) had AHS at the follow-up (p<0.001). Lower NP colonization rates with AHS were associated with significant increases in Streptococcus pneumoniae carriage during non-AOM visits (p<0.001) and during viral URI and concurrent AOM visits (p=0.003). AHS NP colonization rates were not different when children had a viral URI without AOM versus when they were URI negative, but NP colonization with non-typeable Haemophilus influenzae rates increased (p<0.001) and Moraxella catarrhalis decreased (p<0.001) during viral URI. Conclusion Respiratory viral infections alter NP carriage rates of commensal AHS and otopathogens, including prior to AOM. PMID:23241988

Friedel, Victoria; Chang, Arthur; Wills, Jennifer; Vargas, Roberto; Xu, Qingfu; Pichichero, Michael

2012-01-01

407

Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trials  

PubMed Central

Objectives To evaluate the efficacy and safety of intravenous iron, focusing primarily on its effects on haemoglobin, requirement for transfusion, and risk of infection. Design Systematic review and meta-analysis of randomised controlled trials investigating the safety and efficacy of intravenous iron therapy. Data sources Randomised controlled trials from Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1966 to June 2013, with no language restrictions. Eligibility criteria for selecting studies Eligible trials were randomised controlled trials of intravenous iron compared with either no iron or oral iron. Crossover and observational studies were excluded. Main outcome measures Change in haemoglobin concentration and risk of allogeneic red blood cell transfusion (efficacy) and risk of infection (safety). Results Of the 75 trials meeting the inclusion criteria, 72 studies including 10 605 patients provided quantitative outcome data for meta-analysis. Intravenous iron was associated with an increase in haemoglobin concentration (standardised mean difference 6.5 g/L, 95% confidence interval 5.1 g/L to 7.9 g/L) and a reduced risk of requirement for red blood cell transfusion (risk ratio 0.74, 95% confidence interval 0.62 to 0.88), especially when intravenous iron was used with erythroid stimulating agents (ESAs) or in patients with a lower baseline plasma ferritin concentration. There were no significant interactions between the efficacy of intravenous iron and type or dose administered. Intravenous iron was, however, associated with a significant increase in risk of infection (relative risk 1.33, 95% confidence interval 1.10 to 1.64) compared with oral or no iron supplementation. The results remained similar when only high quality trials were analysed. Conclusions Intravenous iron therapy is effective in increasing haemoglobin concentration and reducing the risk of allogeneic red blood cell transfusion and could have broad applicability to a range of acute care settings. This potential benefit is counterbalanced by a potential increased risk of infection. PMID:23950195

2013-01-01

408

Hemodynamic effects of exchange transfusions with liposome-encapsulated hemoglobin.  

PubMed

The ability of liposome-encapsulated hemoglobin (LEH) to sustain life in rats at hematocrits 45% below lethal levels was demonstrated by virtually total exchange transfusions. All control animals (transfused with 7% albumin in Erilyte) died at a mean hematocrit of 5.35%, with corresponding oxygen-carrying capacity of 2.65 ml/100 ml. All LEH animals survived with a final RBC hematocrit of 2.96% and an oxygen-carrying capacity of 7.05 ml/100 ml. LEH animals maintained normal blood pressures and essentially normal cardiac output, while control animals failed to do so. Systemic vascular resistance of control animals at 78% exchange was reduced to 33% of baseline, while of LEH animals at 92% exchange, to 80% of baseline. In-vitro measurements were made of LEH and RBC suspension viscosity as a function of shear rate, suspension concentration, and lipid membrane composition. The viscous behavior of the LEH suspensions was non-Newtonian and nearly the same as suspensions of natural RBC prepared similarly, though LEH suspensions had slightly higher viscosity. PMID:3140919

Miller, I F; Mayoral, J; Djordjevich, L; Kashani, A

1988-01-01

409

Blood work. Canadian nursing and blood transfusion, 1942-1990.  

PubMed

The extension of blood transfusion to civilian populations was contingent on the availability of a nursing workforce capable of taking on increasingly responsible roles. Nurses assumed a variety of roles as they incorporated blood work into patient care and, in the process, enabled, embodied, and engendered it as nurses' and women's work. Initially, the student workforce facilitated transfusion through roles that were congruent with nursing's domestic roots. Later, it constrained the expansion of blood work because of its perpetually novice nature. Delegation constituted one strategy by which a limited number of persons could become experienced and autonomous in a particular role. As long as the skill remained limited, nurses shared its associated power and status, which differentiated them within the work culture. A few women were able to shape blood work to their advantage, using their expertise either as job security or as a bargaining point to negotiate better working conditions. However, when the skill was routinized and dispersed among many nurses, it became dirty work. The examination of one specific technology that shifted from medicine into nursing contributes insights to current issues of expanded roles and delegated skills. Nurses need to question seriously what is gained and lost as they take on and let go of technologies. They need to consider what kinds of knowledge will be needed and how best to develop it. Finally, they need to reflect how changes might complicate care giving and nurses' work. PMID:11200321

Toman, C

2001-01-01

410

Transfusion Strategy: Impact of Haemodynamics and the Challenge of Haemodilution  

PubMed Central

Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is further enhanced by the continued antiplatelet therapy policy. Another important issue is that cardiopulmonary bypass leads to haemodilution and a potential blood loss. The basic role of blood is oxygen transport to the organs. The determining factors of oxygen delivery are cardiac output, haemoglobin, and saturation. If oxygen delivery/consumption is out of balance, the compensation mechanisms are simple, as a decrease in one factor results in an increase in one or two other factors. Patients with coexisting cardiac diseases may be of particular risk, but studies indicate that patients with coexisting cardiac diseases tolerate moderate anaemia and may even benefit from a restrictive transfusion regimen. Further it has been shown that patients with reduced left ventricular function are able to compensate with increased cardiac output in response to bleeding and haemodilution if normovolaemia is maintained. In conclusion the evidence supports that each institution establishes its own patient blood management strategy to both conserve blood products and maximise outcome. PMID:25177515

Jakobsen, Carl-Johan

2014-01-01

411

Hepatitis C virus and blood transfusion: past and present risks.  

PubMed

The risk of HCV transmission by blood and blood products has been greatly reduced since the early 1980's. Selection of non-remunerated donors, donor selection to prevent HIV transmission, initial surrogate testing in some regions, and introduction of anti-HCV testing have all contributed to this. ALT surrogate testing has become obsolete since the introduction of anti-HCV testing. The residual risk of HCV transmission due to donations in the anti-HCV window period at present is about 1 in 100 000 transfusions of cellular products, and transmission of HCV by plasma products treated with modern inactivation methods such as solvent-detergent treatment, has not been reported. Hemovigilance programmes, which are presently being installed, will provide more data on the safety of blood transfusion. Introduction of HCV nucleic amplification technology (NAT) as a quality control of manufacturing pools for plasma products or as a form of blood donor screening by minipools is anticipated in many European countries for the coming year. Given industrial developments, NAT testing of individual blood donations may become available within the next 2 years. HCV NAT testing will further annihilate the residual risk, and the cost-effectiveness will become relatively low in comparison with other public health measures. PMID:10622570

van der Poel, C L

1999-01-01

412

[Blood transfusion and adjunctive therapy in the bleeding trauma patient].  

PubMed

Uncontrolled hemorrhage is the most common cause of potentially preventable death in massive trauma. In addition to the early identification of potential bleeding sources and angiographic embolisation or surgical bleeding control, in-hospital management will aim at maintain tissue oxygenation with volume replacement using crystalloids, colloids and RBC. In general, RBC transfusion is recommended to maintain hemoglobin between 7-10g/dL. The complex combination of clotting factors and platelets consumption, loss and dilution, shock, hypothermia, acidosis and colloid-induced hemostatic alterations leads to coagulopathic bleeding. Most guidelines recommend the use of FFP in significant bleeding complicated by coagulopathy (PT, aPTT >1.5 times control). Platelets should be administered to maintain a platelet count above 50 x 10(9)/L (100 x 10(9)/L in patients with traumatic brain injury). However, standard laboratory tests have poor correlation with in vivo coagulopathy and the test results are not rapidly available. Empiric guidelines derived from mathematical hemodilution models developed in elective surgery settings may not be appropriate for trauma settings where significant bleeding may have already occurred. Moreover, coagulopathy is frequently present on admission in severely injured patients. Recent litterature suggests that FFP and platelets should be given early and more often to injured patients requiring massive transfusion. The place of adjunctive hemostatic therapy is discussed. PMID:18930423

Ozier, Y

2008-11-01

413

Coagulopathy associated with cell salvage transfusion following cerebrovascular surgery  

PubMed Central

A 35-year-old man was scheduled for dural arteriovenous fistula resection for vascular malformation under general anesthesia and a cell saver device was employed. The patient suffered from massive bleeding for the rupture of arteriovenous malformations from the beginning of the operation and 1000 mL cell-saved blood was transfused. After autologous blood transfusion and fluid resuscitation, blood oozed significantly from the surgical wounds, and the administration of cryoprecipitate and fibrinogen has no effect. The value of the activated coagulation time (ACT) increased to 999s. Considering the residual heparin in the autologous blood, ninety mg of protamine was intravenously injected, then 5 minutes later the ACT dropped to 147s. After the therapy, the surgical procedure was performed smoothly. The activated partial thromboplastin time (APTT) and the thrombin time (TT) of the postoperative venous blood was 18.9 s and 53.6 s respectively. Two days later, the APTT and the TT decreased to 12.1 s and 32.7 s without special treatment. The patient was discharged home without complications and well follow-up. PMID:24550976

Zheng, Jianqiao; Du, Li; Du, Guizhi; Liu, Bin

2013-01-01

414

Impact of rapid antigen detection testing on antibiotic prescription in acute pharyngitis in adults. FARINGOCAT STUDY: a multicentric randomized controlled trial  

Microsoft Academic Search

BACKGROUND: Acute pharyngitis is one of the most frequent consultations to the general practitioner and in most of the cases an antibiotic is prescribed in primary care in Spain. Bacterial etiology, mainly by group A beta-hemolytic streptococcus (GABHS), accounts for 10-20% of all these infections in adults. The purpose of this study is to assess the impact of rapid antigen

Jordi Madurell; Montse Balagué; Mónica Gómez; Josep M Cots; Carl Llor

2010-01-01

415

THE ONGOING CHARITY OF ORGAN DONATION. CONTEMPORARY ENGLISH SUNNI FATWAS ON ORGAN DONATION AND BLOOD TRANSFUSION  

Microsoft Academic Search

ABSTRACTBackground: Empirical studies in Muslim communities on organ donation and blood transfusion show that Muslim counsellors play an important role in the decision process. Despite the emerging importance of online English Sunni fatwas, these fatwas on organ donation and blood transfusion have hardly been studied, thus creating a gap in our knowledge of contemporary Islamic views on the subject.Method: We

STEF VAN DEN BRANDEN; BERT BROECKAERT

2011-01-01

416

[Surgery without blood transfusion for pheocromocytoma in a Jehovah's Witness patient: a case report].  

PubMed

A 59-year-old woman who identified as a Jehovah's Witness was diagnosed with pheochromocytoma in the left adrenal gland, measuring 11 cm in diameter, during treatment for hypertension. Given her desire to undergo transfusion-less surgery for religious reasons, we obtained fully informed consent and had the patient sign both a transfusion refusal and exemption-from-responsibility certificate and received consent to instead use plasma derivatives, preoperative diluted autologous transfusion and intraoperative salvaged autologous transfusion. To manage anemia and maintain total blood volume, we preoperatively administered erythropoiesis-stimulating agents and alpha 1 blocker, respectively. During the left adrenalectomy, the patient underwent a transfusion of 400 mL of preoperative diluted autologous blood, ultimately receiving no intraoperative salvaged autologous blood. The operation took 4 hours 42 minutes, and the total volume of blood lost was 335 mL. In conclusion, to complete transfusion-less surgery for pheochromocytoma, it is necessary to have the patient sign a generic refusal form for transfusion and exemption-from-responsibility certificate as well as outline via another consent form exactly what sort of transfusion is permitted on a more specific basis. And doctors should become skilled in perioperative management and operative technique for pheochromocytoma and make the best effort by all alternative medical treatment in order to build trust confidence with a patient. PMID:23819364

Ito, Toshiki; Kurita, Yutaka; Shinbo, Hitoshi; Yasumi, Yasuhiro; Ushiyama, Tomomi

2013-05-01

417

NOTE: Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion  

NASA Astrophysics Data System (ADS)

Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others.

van Gemert, Martin J. C.; van den Wijngaard, Jeroen P. H. M.; Lopriore, Enrico; Pasman, Suzanne A.; Vandenbussche, Frank P. H. A.

2008-04-01

418

Targeting Continuing Medical Education on Decision Makers: Who Decides to Transfuse Blood?  

ERIC Educational Resources Information Center

Staff communication patterns were observed during 13 open-heart surgeries to identify the transfusion decision makers. It was determined that targeting decision makers for continuing medical education would improve the quality of transfusion practice and increase the efficiency of continuing education. (SK)

Goodnough, Lawrence T.; And Others

1992-01-01

419

Blood transfusion in Ireland: Perceptions of risk, a question of trust  

Microsoft Academic Search

In Ireland over 1,000 people were infected with Human Immunodeficiency Virus (HIV) and hepatitis C from blood transfusions and blood products they received between the late 1970s and early 1990s. This review discusses how these events have affected perceptions of blood transfusion with reference to theoretical perspectives on risk. This paper uses Douglas' cultural approach, Beck's ‘Risk Society’ approach and

Rachel Barrett; Ronald G. Moore; Anthony Staines

2007-01-01

420