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Jeffrey McCullough

Publications and source records attributed to Jeffrey McCullough.

26 records · Page 2Linked to original sources
PubMed2003

Progress toward a pathogen-free blood supply.

Although the nation's blood supply is safer than ever, a small risk of transfusion-transmitted infection remains. Present strategies to further reduce the risk, such as the donor medical evaluation or laboratory testing, will not likely eliminate this risk. A different approach involves treating donated blood to eliminate its infectivity. A pathogen-inactivated plasma product was available for several years but was recently withdrawn. Several other methods are under development, but all of these prevent nucleic acids from replicating, thus inactivating any contaminating viruses or bacteria. Toxicity, mutagenicity, and safety margins seem to be adequate, and damage to blood proteins or cellular elements is minimal. Clinical trials of pathogen-inactivated platelets have been completed in Europe and in the United States, and phase III clinical trials of pathogen-inactivated red blood cells are underway in the United States. If these encouraging results are sustained, the risk of transfusion-transmitted disease may be nearly eliminated.

Anti-Bacterial Agents↗
PubMed2003

Short-term liquid storage of umbilical cord blood.

BACKGROUND: Processing and banking of umbilical cord blood requires the development of methods for short-term liquid storage. This study examines the conditions (temperature, time, and storage solution) for optimal storage of cord blood. STUDY DESIGN AND METHODS: Cord blood obtained from normal donors was collected and divided into aliquots. Some of the aliquots were supplemented with a storage solution and undiluted cord blood was used as a control. MNC counts, percentage of cells that are CD34+45+, frequency of CFU-GM, and solution pH were monitored for up to 72 hours in storage at 4 degrees C and room temperature. RESULTS: MNC counts, CD34+45+ cell recovery, and frequency of CFU-GM were all improved in samples diluted with a storage medium when compared to undiluted controls. MNC counts were higher when cells were stored at 4 degrees C. MNC counts and the frequency of CFU-GM were reduced at 72 hours when compared with 24 hours. CONCLUSIONS: These results indicate that the recovery of cells from cord blood can be improved if samples are stored using a storage solution for 24 hours without significant cell losses. Some of the solutions determined to be effective in maintaining viability are approved for human applications, although not specifically cord blood preservation.

Anticoagulants↗
PubMed2002

The role of the paternal health history in cord blood banking.

BACKGROUND: Umbilical cord blood (UCB) transplantation is becoming more widely used, yet ethical and policy issues regarding consent and health history persist. Whereas most UCB banks do not require paternal consent or paternal health history (PHH), both are obtained at this institution whenever possible. This study assessed the value of PHH in making UCB safer. STUDY DESIGN AND METHODS: A retrospective review was performed of all cord blood units (CBUs) collected by this bank between November 1999 and October 2000. All discarded CBUs were studied to identify those deferred based exclusively on PHH provided by the father in the PHH questionnaire. RESULTS: PHH was obtained for 301 of 655 (46%) CBUs collected. Of the 339 CBUs banked, 269 (79%) had PHH available. Three of the 301 CBUs in which PHH was available were discarded based solely on PHH, since maternal medical history and infectious disease testing were negative. Paternal high-risk factors in those three cases were: gave money or drugs for sex; traveled to an HIV high-risk area; and did not answer high-risk questions. CONCLUSION: Considerable time and effort is expended in the process and follow-up of obtaining PHH with an overall indistinct and unconvincing role in minimizing infectious disease transmission risk in UCB banking.

Adult↗
PubMed2002

Blood collection and transfusion in the United States in 1997.

BACKGROUND: Collections, processing, and transfusions of blood and blood components in the US in 1997 were measured and compared with 1994 and prior years. STUDY DESIGN AND METHODS: Questionnaires were returned by 2391 blood centers, AABB member hospitals, nonmember hospitals, and other facilities. Statistical procedures were used to verify that the sample was representative and to estimate national collections and utilization. RESULTS: The gross domestic blood supply in the US in 1997 was 12,602,000 units, 5.5 percent less than in 1994. It included 11,741,000 units of allogeneic community blood, 643,000 units of autologous blood, and 205,000 units of allogeneic-directed blood. Platelet transfusions amounted to 9,037,000 platelet concentrate equivalent units, of which 62.4 percent were apheresis packs. Compared with 1994, total platelet units transfused increased by 14.9 percent and single-donor platelet units transfused increased by 31.7 percent, whereas platelet concentrate transfusion declined by 3.8 percent. Transfusions of FFP increased by 26.6 percent compared with 1994. CONCLUSIONS: The margin of US allogeneic blood supply in excess of allogeneic transfusions in 1997 was 630,000 units, 5.4 percent of total allogeneic supply as compared with margins in prior years ranging between 9.3 and 10.9 percent. Although overall allogeneic available supply in 1994 was adequate to meet transfusion demand, the decrease in the margin between 1994 and 1997 is cause for concern. The rate of whole-blood collections in 1997 per 1000 members of the population aged 18 to 65 years was 12.6 percent lower than 1994. The RBC transfusion rate per 1000 members of the population in 1997 remained nearly the same as in 1994. However, the rates of platelet and of plasma transfusions both increased.

Adolescent↗
PubMed2002

A phased consent policy for cord blood donation.

This article focuses on ethical and policy questions concerning when consent may be sought for the collection and donation of cord blood. It reviews the advantages and disadvantages of alternative times for securing consent, challenges common objections to seeking consent during labor or after collection, and describes a phased consent process--a process that permits consent during early labor to the ex utero collection of cord blood followed by after-consent collection to donation. The phased consent policy attends to the unique characteristics of cord blood collection and donation, respects donors and their families, maximizes the number and diversity of cord blood units collected, preserves the relationship between providers and patients, and preserves public trust in cord blood and other types of tissue banking.

Adult↗
PubMed2002

Relationship between tick bites and the seroprevalence of Babesia microti and Anaplasma phagocytophila (previously Ehrlichia sp.) in blood donors.

BACKGROUND: Tick-borne diseases, particularly babesiosis and ehrlichiosis, represent recently emerging infections. Despite an increased recognition of the threat tick-borne agents pose to blood safety, our understanding of the prevalence and transmissibility of these agents in blood donors is limited. STUDY DESIGN AND METHODS: Babesia microti and Anaplasma phagocytophila (previously Ehrlichia sp.) seroprevalence was determined in random Connecticut and Wisconsin donors, and subsequently in Connecticut donors reporting tick bites. In the interim, a postcard survey regarding tick bites during the previous 6 months was sent to 6,000 random donors in six geographically distinct collection regions. RESULTS: In total, 3 of 999 Wisconsin donors (0.3%) and 6 of 1,007 Connecticut donors (0.6%) had antibodies to B. microti. Of 992 donors tested for A. phagocytophila, 5 Wisconsin donors (0.5%) and 35 Connecticut donors (3.5%) were seropositive. A total of 2,482 donors (41.4%) completed the survey; 103 (4.1%) reported a tick bite. Of 848 Connecticut donors (0.4%) reporting tick bites, 3 had B. microti antibodies, while 8 (0.9%) had A. phagocytophila antibodies. These rates were not significantly different from control donors. CONCLUSION: Blood donors seropositive for B. microti and A. phagocytophila are present in Connecticut and Wisconsin. Donors readily recall previous tick bites, but self-reported bites are not reliable indicators of serologic status. The exposure of blood donors to tick-borne pathogens does suggest a need to better understand the transfusion transmission potential of these agents.

Anaplasma phagocytophilum↗