A dose of 100 IU intravenous anti-D gammaglobulin is effective for the prevention of RhD immunisation after RhD-incompatible single donor platelet transfusion.
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Blood Donors↗
Biomedical subjects
V Weisbach
Publications and source records attributed to V Weisbach.
[18 months experience with a new single needle cytapheresis system (Fresenius AS 104 SN)].
BACKGROUND: Since October 1991 the third-generation cell separator Fresenius AS 104 offers a single-needle (SN) option for thrombocytapheresis. Here we present our first 18-month experience with this new single-needle system. MATERIALS AND METHODS: We performed 395 thrombocytaphereses in 225 donors. The influence of blood flow, cycle volume, and interface position on efficacy and leukocyte contamination was evaluated. RESULTS: 395 thrombocytaphereses were performed with an average thrombocyte yield of 3.00 +/- 0.69 x 10(11) platelets and a leukocyte contamination of 1.66 +/- 3.1 x 10(8) per concentrate. Blood flow rates of 50 ml/min (vs. 60 ml/min) and an interface position of 6:2 (vs. 7:1) resulted in a lower leukocyte contamination, but without statistical significance. CONCLUSION: The SN program of the AS 104 provides high thrombocyte yields and less leukocyte contamination than other SN systems, but 77% of the concentrates still contain more than 0.5 x 10(8) leukocytes.
Adult↗
Relation between leucocyte depletion and storage.
We intended to answer two questions: (1) Does storage time of platelet concentrates (PCs) influence the efficacy of leucocyte depletion by filtration? (2) Does pre-storage leucocyte depletion by filtration of PCs improve the post-storage quality? To this end we tested in parallel the halves of 10 double-sized PCs, one half stored after filtration through a polyester filter (PL 50, Pall), the other half filtered after a 5-day storage period. Efficacy of leucocyte depletion showed to be independent of the age of PCs, and pre-storage leucocyte depletion of PCs was not able to improve the quality of PCs stored for 5 days, as long as the leucocyte contamination of unfiltered PCs was lower than 0.5 x 10(8)/unit.
Adenosine Diphosphate↗
Are single-needle protocols equivalent to dual-needle protocols for platelet apheresis?
In light of the increasing demands being placed on cytapheresis donors and their occasional venous problems, it has become necessary to use 1-needle in addition to 2-needle separation techniques in thrombocytapheresis. We therefore compared five 1-needle and three 2-needle programs on four different cell separators and found that meanwhile both the platelet yields and the leukopenia (controlled by Nageotte chamber counting) of the products obtained with the 1-needle technique are equivalent to those obtained using the 2-needle technique, as long as the program is suitably adjusted.
Blood Cell Count↗
Automated bone marrow concentration using the Fresenius AS 104 blood cell separator.
We concentrated freshly taken bone marrow (BM) pooled from 21 patients from an original 1.265 ml (+/- 537 ml) down to 128 ml (+/- 36 ml) within 40-70 min with a modified version of the 'grancollect protocol' on the Fresenius AS 104 blood-cell separator using the P1-Y set. An average of 47% (+/- 21%) fo the initially present mononuclear cells and 68% (+/- 47%) of the colony-forming cells could be obtained in the concentrate. The erythrocyte concentration was reduced to 7% (+/- 4%) of the original amount. The technique described is very effective and makes is possible to obtain a BM cell population that is suitable for both immunomagnetic purging and cryopreservation or transplantation, e.g. in the case of blood group incompatibility.
Automation↗
[Various clusters of immunoreactivity in the aged and their relation to HLA antigens and erythrocyte antigens].
In blood samples of members of the Berliner Altersstudie (BASE) (n = 427, 204 males, 223 females; mean = 85.2 years, range = 76-96 years, SD = 3.3 years), red cell, HLA-A, -B, -Cw and -Dr antigens were determined by standard methods. Lymphocyte reactivity was measured by 3H-thymidine uptake into DNA of lymphoblastic cells stimulated by 12 different mitogens and antigens. Cluster analysis, confirmed by t and F tests, defined 3 distinct clusters of lymphocyte reactivity. Clusters showed significantly different cumulations of 3 or more increased characteristic red cell and HLA antigens, and trends toward a decreased overall immunoresponsiveness in elder people. Like in middle-aged individuals, immunoresponsiveness in elder individuals can be dissected into at least 3 functionally different clusters which are not influenced by lymphocyte subsets or in vivo cell activation but by the patterns of both red cell and HLA antigens.
Aged↗
[MLC reactivity demonstrates transfusion-induced immunosuppression].
The improved graft survival in preoperatively transfused renal transplant recipients led to the hypothesis that blood transfusions have an immunosuppressive effect. We examined 12 patients undergoing cardiac surgery, who received autologous red cells and one homologous HLA class-I-matched platelet concentrate. None of these patients produced red cell or lymphocytotoxic antibodies. Using the mixed lymphocyte culture (MLC) we observed a reduced lymphocyte responce to cells of the platelet donor during the first 4 days after transfusion. The MLC reactivity recovered on days 4-5 to the initial strength and reached over 200% of the initial strength from day 6 on. It must be assumed that these changes in MLC reactivity represent the early signs of the transfusion-induced immunosuppression. As intraoperative transfusions might correlate with cancer relapse, further studies must show whether this immunosuppressive effect can be avoided by the application of filtered leucocyte-depleted red cell transfusions.
Blood Transfusion↗
[Distinct lymphocyte reactivity in multivariate test systems and dependence on the HLA system].
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Antigens↗
[Flow cytometry quality control in stem cell separation].
Peripheral blood-derived haematopoietic stem cells (PBSC) are used as an alternative to bone marrow stem cells for autologous transplantation. One of the most important prerequisites for successful PBSC separation is the precise determination of the optimal separation days. As we previously demonstrated that neither PLT counts nor WBC counts in the peripheral blood (PB) are of predictive value for the amount of colony-forming cells (CFC) in the patients' PB, we started a daily monitoring of CD-34-positive cells to determine the beginning of the separation series. In addition to routine cell counts and CFU testing we assessed the number of CD 34+ in the PBSC concentrates to ascertain the number of separations needed for each patient. Due to the strong correlation of CD 34+ cells to CFC it is possible to predict the number of CFC collected within 2 h after finishing the PBSC separation and to calculate the efficiency of the separation for quality control.
Colony-Forming Units Assay↗
Automated processing of human bone marrow grafts for transplantation.
Prior to purging or cryopreservation, we concentrated 21 bone marrow (BM) harvests using a modification of the 'grancollect-protocol' of the Fresenius AS 104 cell separator with the P1-Y set. Within 40-70 min, the initial marrow volume of 1,265 ml (+/- 537 ml) was processed two to three times. A mean of 47% (+/- 21%) of the initial mononuclear cells was recovered in a mean volume of 128 ml (+36 ml). The recovery of clonogenic cells, measured by CFU-GM assays, was 68% (+/- 47%). Red blood cells in the BM concentrates were reduced to 7% (+/- 4%) of the initial number. The procedure was efficient and yielded a BM cell fraction suitable for purging, cryopreservation and transplantation. At this time, 10 of the 21 patients whose BM was processed using this technique have been transplanted. Seven of these 10 patients have been grafted using the BM alone. Three of the 10 patients showed reduced cell viability and colony growth in the thawed BM samples, and therefore obtained BM and peripheral blood-derived stem cells. All transplanted patients showed an evaluable engraftment, achieving 1,000 granulocytes per microliter of peripheral blood in a mean of 18 days.
Automation↗
[Initial experiences with routine use of the AS-104 cell separator in a single needle procedure].
Since 1992, the Fresenius cell separator AS-104 offers a single-needle option. The authors present data on their first experience with this new single-needle thrombocytapheresis system.
Adult↗
[Mobilization of hematopoietic stem cells in peripheral blood by leukapheresis].
To improve the separation results of peripheral blood stem cells (PBSC), cytokines (GM-CSF, G-CSF or IL3) can be administered to patients. The most important prerequisites for successful PBSC separation are daily monitoring of CD-34-positive cells to determine the separation days and the use of optimized separation programs. To improve the performance of the cell separation, we increased the process volume to more than patients' blood volume and obtained increased MNC and CFU recoveries. In most cases, we collected more cells than the preseparation number of circulating cells. We therefore conclude that large-volume PBSC separation itself mobilizes hematopoietic progenitor cells.
Antigens, CD↗
[Quality assurance in preoperative autologous blood collection from the viewpoint of the transfusion medicine physician].
The overall risk of autologous hemotherapy, consisting of the risks due to donation and transfusion, has to be lower than that of homologous hemotherapy. To maintain the advantage of autologous blood, for example preoperative blood deposit, it has to be collected and prepared according to the guidelines on the production of homologous blood, except some obvious deviations concerning donor criteria. In this paper we recommend measures for the quality assurance in autologous predeposits from the point of view of transfusion medicine.
AIDS Serodiagnosis↗
Bone marrow processing with the Fresenius AS 104: initial results.
Prior to purging, cryopreservation, or ABO-incompatible bone marrow (BM) transplantation, we have concentrated 23 BM harvests using a modification of the "grancollect-protocol" and the recently available bone marrow stem cell (BMSC) protocol of the Fresenius AS 104 cell separator with the P1-Y set. Within 40-70 minutes, the initial marrow volume of 922 ml (+/- 408 ml) was processed two to three times. A mean of 59% (+/- 20%) of the initial mononuclear cells was recovered in a mean volume of 119 ml (+/- 31 ml). The recovery of clonogenic cells, measured by CFU-GM assays, was 98% (+/- 80%). Red blood cells in the BM concentrates were reduced to 8% (+/- 4%) of the initial number. The procedure was efficient and yielded a BM cell fraction suitable for purging, cryopreservation, and transplantation. All transplanted patients showed fast and sustained engraftments after autologous or allogeneic BM transplantation.
Bone Marrow Cells↗
Bone marrow purging prior to autologous transplantation.
Our data suggest that ex vivo bone marrow purging using monoclonal antibodies (MoAbs) and sheep-anti-mouse immunobeads (SAM beads) prior to autologous bone marrow transplantation (ABMT) allows satisfactory tumor cell reduction without critical stem cell losses. Nevertheless, there is only a reduction but no elimination of tumor cells. The consequences will have to be clinically discussed.
Antibodies, Monoclonal↗
[Effect of leukocyte depleting polyester filters on thrombocytapheresis concentrates].
We studied platelet loss, leukocyte depletion, T/B cell ratio, platelet morphology and platelet function (aggregation, hypotonic shock reaction, retention and retraction) prior to and after filtration through two different polyester filters (Sepacell PL-5A, Pall PL100) as well as the posttransfusional platelet increment 1 h after transfusion in 8 pairs of single-donor platelet concentrates (Cobe Spectra, Fresenius AS 104). Leukocyte depletion was effective (>99.9%) and platelet loss acceptable in both filters, all tests showing no indication of a diminished platelet function by filtration.
Blood Component Transfusion↗
[Autologous blood donation and erythropoiesis].
Autologous blood donation before elective surgery has been widely endorsed as good transfusion practice. Although only 6% of patients undergoing elective orthopedic surgery are unable to donate 3 autologous units, 40% cannot donate 4 units because they become anemic. According to the results of our study this must be due to different problems of bone marrow dynamics, which cannot be overcome by unselected use of human recombinant erythropoietin.
Adult↗
[Hemoglobin follow-up of orthopedic autologous blood transfusion patients].
Patients undergoing autologous donation prior to elective orthopedic surgery show better Hb values during the perioperative period compared to those without autologous donation, all patients in both groups receiving no homologous transfusion. The widely assumed improvement of Hb regeneration during the postoperative period according to an erythropoiesis stimulated by preoperative autologous donation is not supported by our data.
Adult↗