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Biomedical subjects

R E Domen

Publications and source records attributed to R E Domen.

At least 37 records · Page 2Linked to original sources
PubMed1995

Paid-versus-volunteer blood donation in the United States: a historical review.

Several points are clear from this historical review. Over 50 years ago the first indications that hepatitis could be transmitted from the serum or plasma of one human to another became evident. This was confirmed in human transfer experiments although the agent causing hepatitis was not known and there was no specific test for what eventually was presumed to be a virus. It soon became clear that hepatitis was a complication of blood and plasma transfusion. Over the course of 10 to 20 years (the 1950s and 1960s) the connection was made between posttransfusion hepatitis and certain high-risk donors and behaviors. Despite the availability of scientific data to support the idea that not all commercial or paid blood donors were associated with higher rates of post-transfusion hepatitis, public opinion and emotions seemed to be a major driving force behind increased government regulation of blood banking. Because there were commercial blood banks that continued to recruit, collect, and pay blood donors from low-income, skid row areas, despite the mounting evidence that such donors clearly harbored higher rates of hepatitis, all commercial blood banks were reduced to that common denominator. Clearly economic factors were also being thrown into the equation. Political and philosophical differences between the major professional organizations involved in blood procurement and recruitment were important factors favoring more government control. The public pressured politicians and government agencies for more regulation and many scientific and medical professionals requested greater regulation. By the early 1970s the die was cast for increased regulation by the federal government.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Banks↗
PubMed1995

An analysis of autologous blood donor motivational factors.

Little is known about the patient's reasons for participating in an autologous blood (AUB) collection program. We surveyed 110 AUB donors in our hospital-based collection program. Although fear of infection from an allogeneic blood transfusion was cited by 20% of AUB donors, 68.2% indicated that their physician's recommendation was a motivating factor. For 18.2% self-initiated motivation was a factor in pursuing AUB. The overwhelming majority (97.1%) stated they would donate AUB even if the risk of getting AIDS from a blood transfusion was zero. Fear of infection does not appear to be the primary reason for patients to donate AUB. Recommendation by their personal physician is an important component in the patients' decision-making process to set aside their own blood for upcoming surgery.

Attitude to Health↗
PubMed1995

The confidential unit exclusion and allogeneic blood donation. Results from supplementary questions to the Donor Center and Viral Markers surveys of the College of American Pathologists.

OBJECTIVE: The confidential unit exclusion (CUE) is a mechanism for allogeneic blood donors to confidentially indicate whether they feel their blood is safe for transfusion to others. The purpose of this national survey was to determine the extent of use of the CUE procedure and its related policies. DESIGN: Supplementary questions related to the use of the CUE were asked of those 1994 DC-C, W1-C, and W2-C College of American Pathologists survey subscribers who collect allogeneic blood for transfusion. SETTING: National survey. PARTICIPANTS: Blood collection facilities who collect allogeneic blood components. MAIN OUTCOME MEASURES: Survey responses. RESULTS: There were a total of 2966 total participants in the 1994 DC-C, W1-C, and W2-C surveys. A potential total of 444 participants indicated that they collected allogeneic blood and were eligible to participate in the CUE survey. A variety of approaches are used concerning donor deferral, reinstatement, and follow-up in the use of the CUE. Documentation and donor counseling issues also show variation. CONCLUSIONS: Different approaches and procedures have been developed by collection facilities to address issues related to the use of the CUE. More data on the efficacy and cost-effectiveness of the CUE are needed.

Blood Donors↗
PubMed1995

Infectious disease marker testing of the autologous blood donor. A case study in clinical ethics.

OBJECTIVE: The Food and Drug Administration currently requires written authorization from the patient's physician before autologous units of blood that are positive or reactive for hepatitis B surface antigen or anti-human immunodeficiency virus can be shipped from a site of collection different from the site of transfusion. Additionally, the Blood Products Advisory Committee has recommended the universal testing of all autologous units of blood. DESIGN: The case of an autologous blood donor with positive infectious disease markers is presented. The ethics of infectious disease testing of patients who preoperatively donate their own blood is discussed. RESULTS: Many ethical issues are raised by policies requiring infectious disease testing of the autologous blood donor. Blood banking and transfusion medicine specialists should examine the ethical issues raised by regulatory mandates to perform infectious disease testing of the patient who desires to make a preoperative autologous blood donation. CONCLUSION: A policy that protects the rights of the patient as well as the rights and concerns of health care professionals should be pursued.

Blood Donors↗
PubMed1995

Multiple red cell transfusions and alloimmunization. Experience with 6996 antibodies detected in a total of 159,262 patients from 1985 to 1993.

This retrospective study of red cell antibodies covered the period from 1985 to 1993. A three-cell antibody screen, 22% albumin enhancement, and a polyspecific antiglobulin reagent assay were performed. From a total of 159,262 patients in the data set, 6996 antibodies were detected among the sera of 4700 patients (2.9%). Four thousand two hundred thirty-five (60.5%) alloantibodies of potential clinical significance were found. These included anti-K1 (23.0%), -E (17.6%), -D (12.4%), -Le(a) (7.3%), -C (6.3%), -Fya (5.7%), and -c (4.4%). Cold agglutinins were found in 1119 positive antibody screens, 261 had warm autoantibodies, and 554 had high-titered, low-avidity antibodies. Three hundred seven were clinically insignificant (eg, Sda and Bga). Five hundred seventeen were too weak to identify. Most patients' sera demonstrated only one antibody (69.3%), but there was a strong linear correlation between the total number of recorded red cell transfusions and the number of antibodies found (r = .976; P < .0001). There was a higher percentage of females with antibodies than the percentage of females in the total study population (59.2% versus 43.8%, P < .0001). Two hundred nine of 554 (37.7%) high-titered, low-avidity antibodies and 349 (31.2%) of 1119 of the cold agglutinins accompanied or obscured clinically significant antibodies.

Adult↗
PubMed1990

Vancomycin-induced neutropenia associated with anti-granulocyte antibodies.

Neutropenia is a rare complication associated with vancomycin, and the cause of this adverse reaction is not well understood. We report a case of vancomycin-induced neutropenia in which we were able to demonstrate anti-granulocyte antibodies. We also report the results of a hone marrow examination along with a brief review of the literature.

Journal Article↗
PubMed1990

Zeta potential and vancomycin-red blood cell interactions.

Vancomycin hydrochloride is a polycationic antibiotic that we have previously reported to cause spontaneous aggregation of red blood cells (RBCs) in vitro at concentrations of more than 3.0 mg/mL, and false-positive direct antiglobulin tests at concentrations of 2.0 and 2.5 mg/mL. These latter reactions were abolished when the RBCs were pretreated with the proteolytic enzyme ficin suggesting an interaction with sialoglycoproteins. In this study we show that prior addition of vancomycin did not block binding of antibodies to several blood group antigens, nor does vancomycin precipitate in an Ouchterlony assay with any of several sialic acid moieties. Finally, we show that vancomycin possesses fluorescent properties but fails to be detected on the RBC surface by flow cytometry. These data indicate that vancomycin may be acting through its polycationic properties. Our findings do not support protein binding of vancomycin to the RBC surface, but underline the importance of the zeta potential in RBC serologic reactions.

Erythrocyte Membrane↗
PubMed1989

Vancomycin-induced red cell aggregation.

Vancomycin, an antibiotic similar in structure to ristocetin, is used to treat staphylococcal infections. However, vancomycin-induced hemagglutination complicated red cell (RBC) serologic testing in the blood bank. At concentrations greater than 3.0 mg per ml, vancomycin caused spontaneous macroscopic red cell (RBC) aggregation; concentrations of 2.0 and 2.5 mg per ml were associated with weakly positive aggregation with anti-IgG and polyspecific antiglobulin reagents negative with anti-complement; and concentrations less than 1.5 mg per ml had no apparent effect. Ficin-treated RBCs demonstrated negative reactions with the antiglobulin reagents. Vancomycin-induced aggregation was reversed partially with 0.2 M trisodium citrate, and supernatant transfer studies showed that normal RBCs retained a significantly (p less than 0.025) greater percentage of vancomycin than did ficin-treated RBCs. Vancomycin causes the aggregation of RBCs, which can be a source of confusion in the blood bank. The mechanism(s) through which vancomycin enhances aggregation may be related to its polycationic properties and to its direct protein binding to the RBC membrane, although other nonimmunologic mechanisms may be operative.

Citrates↗
PubMed1989

Case report: ABO discrepancy due to vancomycin complicating a transfusion reaction investigation.

A 3-year-old patient with acute myelogenous leukemia developed fever and chills during transfusion of packed red cells. A preliminary workup suggested that a group AB donor unit had been issued to a Group A patient. However, a discrepancy between the ABO group of the original donor unit segment (A) and blood taken from the IV tubing (AB) and the patient's pre- and post-transfusion samples (A and AB, respectively) suggested mother reason for the weak reactivity of some samples with anti-8. The patient's chart revealed that vancomycin, reported to be a cause of non-immune agglutination of red cells, had been injected into the IV tubing one hour prior to transfusion. Further testing confirmed that the patient's febrile response to transfusion was consistent with a nonhemolytic transfusion reaction and was unrelated to the drug-induced, pseudo ABO problem.

Journal Article↗