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Biomedical subjects

R J Sassetti

Publications and source records attributed to R J Sassetti.

14 recordsLinked to original sources
PubMed1990

Computerization of plateletpheresis quality control records with a commercially available spreadsheet program.

Many apheresis units lack the resources to acquire customized computer software for record keeping. We have adapted a commercially available "spreadsheet" program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis. Data are entered in a grid pattern wherein each donation occupies one row and successive columns contain numerical data derived from the donation. The last two columns contain formulas that calculate yield and collection efficiency from values entered in preceding columns. The program runs on an IBM PC or equivalent with 512 K RAM; the combined cost of a computer and software is currently under $2,000.00. Data entry requires fewer keystrokes per record than computation of yield and efficiency with a calculator, and creates an inclusive permanent record for future analysis. Data sorting and statistical functions allow rapid identification of incomplete records, and derivation of average platelet yield and/or collection efficiency for any time period of interest. The program also facilitates determining the proportion of donations that fall below any chosen cutoff. Performance characteristics of a particular instrument or operator can be assessed easily by isolating the pertinent records and analyzing them separately. The system will thus accomplish a variety of quality control activities, including those mandated by licensing agencies. It can be implemented by apheresis personnel with limited "computer literacy" and is superior to manual tabulation of quality control data in both ease of data entry and facility of analysis.

Data Interpretation, Statistical↗
PubMed1990

Alloimmunization to RhD by platelet transfusions in autologous bone marrow transplant recipients.

Platelet transfusions from RhD-positive (D-positive) donors are often given to RhD-negative (D-negative) cancer patients. The low observed rate of alloimmunization has been attributed to disease and therapy-related immunosuppression. We have studied the occurrence of alloimmunization in 16 D-negative patients who did not have detectable anti-D prior to autologous bone marrow transplantation for malignant disease. All received D-positive platelets, but no other D-positive blood product. Three patients (19%) developed anti-D at 13, 24 and 83 days, respectively, after first receiving D-positive platelets, and after a total dose of 53, 65 and 119 D-positive platelet unit equivalents, respectively. Two of them also developed anti-C. The 13 patients in whom anti-D was not detected were also heavily transfused with D-positive platelets (mean +/- SD = 136 +/- 82 platelet unit equivalents). In 6 of them, the last recorded antibody screen was less than 3 months after the first D-positive platelets, and may not exclude a primary immune response. Thus, despite profound immunosuppression associated with autologous marrow transplantation, alloimmune responses to D-positive red cells in platelet concentrates can occur in some D-negative recipients.

Adolescent↗
PubMed1989

Treatment of von Willebrand's disease and hypofibrinogenemia with single donor cryoprecipitate from plasma exchange donation.

Conventional replacement therapy for hypofibrinogenemia and von Willebrand's disease requires multiple donor exposures and a correspondingly high risk of blood-borne infection. We describe the collection and successful use of cryoprecipitate derived from a single donor by plasma exchange donation to support such patients through major hemostatic stresses. The father of an epileptic patient with von Willebrand's disease produced cryoprecipitate containing 23,546 units of von Willebrand factor (vWF) in nine desmopressin-stimulated donations; this provided total factor replacement for neurosurgery to remove a seizure focus. The average yield was 2,616 units per donation and the average VWF concentration in cryoprecipitate was 17.7 units/ml. The husband of a hypofibrinogenemic patient with a history of postpartum hemorrhage provided cryoprecipitate containing 13.4 g of fibrinogen in five donations; this supported his wife through parturition without recourse to other blood products. The average yield was 2.7 g per donation, and the average fibrinogen concentration was 15.3 g/liter. Plasma exchange donation is a practical alternative source for cryoprecipitate. It can provide vWF and fibrinogen that carry a reduced risk of infectious disease transmission.

Adult↗
PubMed1989

Simultaneous collection of platelets and cryoprecipitate by plasma-exchange donation.

To increase cost efficiency, the simultaneous collection of platelets during plasma-exchange donation of cryoprecipitate was investigated. Sixteen desmopressin (DDAVP)-stimulated donors underwent 90 simultaneous donations. Permanent donor plasma loss for each donation averaged 150 ml in cryoprecipitate and 151 ml in platelet concentrates. Mean factor VIII (FVIII) yield was 4699 +/- 2754 IU per donation. The mean yield in the platelet products was 4.63 X 10(11) platelets; aggregation properties and posttransfusion increments were satisfactory. White cell contamination averaged 4.05 X 10(9) but could be lowered by a secondary centrifugation. The direct cost for a single-donor platelet transfusion produced in this way is estimated at $102.19 and that for FVIII at $0.055 per IU. Simultaneous donation is technically feasible and safe for donors, and it provides functional products that are more cost-effective than apheresis platelets or cryoprecipitate donated separately.

Blood Donors↗
PubMed1987

A high-potency, single-donor cryoprecipitate of known factor VIII content dispensed in vials.

Current factor VIII products expose recipients to many donors and hence to a high risk of acquiring blood-borne infections. Plasma-exchange donation of cryoprecipitate can reduce donor exposure by repeatedly obtaining large yields of factor VIII from individual donors. In this study, donor factor VIII levels were stimulated with desmopressin before donation. Mean yield per donation increased from 1399 +/- 425 IU in controls to 3818 +/- 1350 IU in stimulated donations (p less than 0.001), and mean factor VIII concentration in the cryoprecipitate increased from 8.2 +/- 3 IU/mL to 24 +/- 12 IU/mL (p less than 0.001). A new packaging system dispenses assayed aliquots of stimulated cryoprecipitate in plastic vials. The direct cost of production for this material is $.065 per unit. The cryoprecipitate is hemostatically active and convenient to use, and the aggregate yields from sequential donations by stimulated persons are high enough to allow long-term, single-donor support of many adults with hemophilia.

Blood Component Removal↗
PubMed1987

Le(s)t reason prevail.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Hematologic emergencies.

Hematologic emergencies require thorough but prompt evaluation of the patient, availability of relatively routine laboratory tests, and immediate decisions. This article discusses the emergencies associated with red blood cell disorders, white blood cell disorders, hemostatic disorders, and transfusion reactions.

Anaphylaxis↗
PubMed1976

IgE myeloma presenting with classical myeloma features.

A patient with IgE myeloma, presenting with bone lesions and modest anemia without plasma cell leukemia or hepatosplenomegaly, is described. The findings are compared with those of other patients with this and the more common forms of multiple myeloma.

Aged↗
PubMedDate not supplied

An overview of a hierarchy of planning models for Regional Blood Bank Management.

Optimal regionalization of a blood banking system requires a hierarchical structure based on an analysis of preexisting elements in the region to determine at what level of activity economics of scale, cost effectiveness and efficiency will be greatest. We have applied operations research techniques to segments of the blood service complex. This paper is an overview of the general results of this research. From analysis of the data in each segment, a mathematical response function is developed for such managerial processes as demand forecasting, requirements computation, crossmatch and recycle control at each level of the hierarchy in a regional system. These processes in independent hospital blood banks are contrasted with those in hospital blood banks and transfusion services which are dependent on central blood banks for their supply. An example is presented of a model which is useful in the planning of a regional system. Implementation of these hierarchical models in hospital blood banks can reduce outdating, size of inventories and shortage. In central blood banks, these models can minimize shipment quantities, determine optimal transshipments and the most efficient routing.

Blood Banks↗
PubMedDate not supplied

Long-term frequent plasma exchange donation of cryoprecipitate.

Plasma exchange donation accomplishes the selective donation of cryoprecipitate. It facilitates the repeated donation of large quantities of factor VIII by individual donors and reduces donor exposure for recipients. A highly motivated donor is described who has undergone 103 donations between May 1983 and March 1987, producing 359,460 IU of factor VIII and supplying all the factor VIII needed since August 1983 by his severely affected hemophiliac son, now age 14. The donor has remained in good health, and no significant abnormalities have been noted in hematologic, biochemical, immunologic, coagulation, and serum protein testing. Extensive experience with this donor suggests that repeated plasma-exchange donation is safe and can sometimes allow single-donor support of severe hemophiliacs.

Adolescent↗