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Biomedical subjects

J Nusbacher

Publications and source records attributed to J Nusbacher.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Granulocyte kinetics in donors undergoing filtration leukapheresis.

Normal blood donors undergoing filtration leukapheresis (FL) have a profound transient neutropenia early in the procedure which is followed by a "rebound" neutrophilia. This phenomenon occurs in unstimulated donors as well as in donors pretreated with either prednisone or dexamethasone. The mechanism for development of the neutropenia was investigated in volunteers throug a nylon filter at 37 C, a significant but transient neutropenia was observed. Plasma rendered cell and stroma-free achieved the same result indicating that plasma alone, when exposed to nylon fibers, is capable of producing neutropenia.

Blood Donors↗
PubMedDate not supplied

The acquisition of granylocytes by leukapheresis: a comparison of continuous flow centrifugation and filtration leukapheresis in normal and corticosteroid-stimulated donors.

Leukapheresis by continuous flow centrifugation (CFC) or filtration (FL) were compared in untreated and corticosteroid-treated donors. The administration of prednisone 60 mg orally 10 to 12 hours before leukapheresis increased significantly both the donor's prepheresis WBC counts and the total granulocyte yields by CFC or FL. Dexamethasone 6 mg iv at the start of FL did not increase granulocyte yields significantly. In untreated donors FL yielded 0.25 x 10(10) granulocytes per liter donor blood processed as compared with 0.05 x 10(10) per liter in CFC donors. Corticosteroid premedication has a greater relative effect in increasing yields by CFC than by FL. Donor reaction rates were between 4 and 6 per cent for both procedures.

Blood Donors↗
PubMedDate not supplied

Plateletpheresis residues: a source of large quantities of human blood lymphocytes.

The residue from single-donor plateletpheresis contains a large number of human mononuclear cells. We have been able to harvest more than 1 X 10(9) viable lymphocytes for laboratory study from the leukocyte-rich sediment that previously had been discarded. Prior to removal by adherence 5 X 10(8) monocytes were also available for future purification, if desired. The physical properties and response to phytohemagglutinin were very similar when lymphocytes isolated from plateletpheresis residues were compared with those obtained directly from veneous blood.

Blood Platelets↗
PubMedDate not supplied

Abdominal pain in donors during filtration leukapheresis.

An unusual donor reaction characterized primarily by lower abdominal and/or perineal pain occurs in 1.2 per cent of donors during filtration leukapheresis (FL). The reaction occurs almost exclusively in female donors. Corticosteroid pretreatment appears to be highly effective in preventing the reaction. The pathogenesis of this donor problem is speculative.

Abdomen↗
PubMedDate not supplied

One-year follow-up of plasma exchange therapy in 14 patients with idiopathic thrombocytopenic purpura.

Fourteen patients with idiopathic thrombocytopenic purpura (ITP) have been followed for one year after plasma exchange therapy. Exchange was performed prior to splenectomy in eight of nine patients with acute ITP and following splenectomy in five patients with chronic ITP. None with chronic ITP showed a response in platelet count as a result of exchange therapy. Four of the nine with acute ITP had poor responses and required splenectomy because of persistent severe thrombocytopenia. Three of these have responded completely and are in remission. One patient with acute ITP had an equivocal response, with a most recent platelet count of 93,000/microliter. The remaining four patients with acute ITP had prompt and complete responses and now have platelet counts above 100,000/microliter without steroid treatment. Although the good responses were temporally associated with the use of plasma but not albumin, the data are not sufficient to conclude that a plasma factor must be infused to obtain a satisfactory result. The overall response after one year was about that expected for acute ITP patients treated with prednisone and early splenectomy. Exchange plasmapheresis may be of value in decreasing the number of patients who require splenectomy, but a randomized, prospective study is needed to adequately assess this possibility.

Adult↗
PubMedDate not supplied

Red cell and platelet-bound IgG penicillin antibodies in a patient with thrombocytopenia.

A patient was found to have a positive direct antiglobulin test and thrombocytopenia while on a moderate dose of intravenous penicillin. Serological evaluation of the patient's red cells demonstrated that the positive antiglobulin test was due to antipenicillin antibody. This antibody also was demonstrated in the patient's serum. The patient's platelets had increased quantities of IgG; an eluate from her platelets gave positive test results with platelets treated with penicillin but not normal platelets. Her serum also reacted only with penicillin-treated platelets. Multiple absorptions of her serum with red cells treated with penicillin reduced reactivity against both fresh red cells and platelets treated with penicillin. This patient demonstrated the coexistence of drug-induced immune phenomena directed against both red cells and platelets.

Absorption↗
PubMedDate not supplied

Blood transfusion in liver transplantation.

Liver transplantation is a relatively new procedure in which unusually large quantities of blood are used. Blood use in 68 adult and 49 pediatric liver transplants was reviewed. The median (range) intraoperative red cell use for adults and children was 28.5 (3-251) and 11 (2-55), respectively. Blood use closely correlated with the patient's primary diagnosis. Adult patients with primary biliary cirrhosis and carcinoma used about one-half as much blood as those with a diagnosis of sclerosing cholangitis, hepatitis, or cirrhosis. Patients in the former diagnostic groups also had better survival rates. Total red cell use for the patient's entire hospitalization was about twice that used during surgery. Fresh-frozen plasma use paralleled red cell transfusions, but platelet use was modest. These data can serve as a baseline in helping other hospital transfusion services prepare for the advent of liver transplantation in their institutions.

Adult↗
PubMedDate not supplied

Evaluation of a confidential method of excluding blood donors exposed to human immunodeficiency virus.

A confidential self-administered questionnaire was given to all donors prior to blood donation (n = 95,917). The questionnaire describes acquired immunodeficiency syndrome (AIDS) high-risk groups and requires the donor to designate his blood for either laboratory purposes or for transfusion. Six-hundred and twenty-seven people (0.65%; 78% men) designated their blood for laboratory purposes. In addition to routine enzyme-linked immunoassay (EIA) screening for human immunodeficiency virus (HIV) antibody, all units from the latter group of donors were tested by Western blot (WB) irrespective of the EIA result. An equal number of donor units was selected from those designating their blood for transfusion (age, sex and clinic matched) and these too were tested by WB irrespective of the EIA result. We found that donors designating their blood for laboratory purposes had a 10 times (vs transfusion-designated controls) to 100 times (vs general donor population) greater exposure to HIV. In the laboratory-designated group, an EIA negative donor was WB positive, yielding an estimated EIA false-negative rate of 16 per million. A confidential questionnaire, as described, is a valuable adjunct in ascertaining high-risk blood donors.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Evaluation of a confidential method of excluding blood donors exposed to human immunodeficiency virus: studies on hepatitis and cytomegalovirus markers.

A confidential self-administered questionnaire was given to all blood donors prior to donation (n = 95,917). The questionnaire describes groups at increased risk of acquired immunodeficiency syndrome (AIDS) and requires the donor to designate his blood either for laboratory purposes or for transfusion. In a previous communication, we reported that donors in the former group had a much higher prevalence of antibody to human immunodeficiency virus (HIV) than age, sex and clinic matched controls or a group of "miscellaneous" donors who did not fill out the form properly. In this communication, we report results of tests for other viral markers performed on the three designation groups, namely laboratory-designated, miscellaneous and controls. We found that the former two groups had a higher prevalence of antibody to hepatitis B surface antigen (anti-HBs), hepatitis B core antigen (anti-HBc) and cytomegalovirus (anti-CMV) than controls, but there were no differences in alanine aminotransferase (ALT) levels among the groups. In addition, the laboratory-designated group had a higher prevalence of hepatitis B surface antigen (HBsAg) than the general donor population. These data indicate that a questionnaire designed to ascertain AIDS high-risk donors is valuable in excluding donors who may be carriers of other viruses as well.

Acquired Immunodeficiency Syndrome↗