We studied the pattern of use of platelets stored at 4 C. About half of 2,168 platelet concentrates were transfused to achieve hemostasis in 360 transfusion episodes. More than half of the platelet concentrates were given during the second and third day after collection. Of 164 prophylactic transfusion episodes including 44 plateletpheresis packs, 74 percent were given to patients with leukemia. Reactions to platelet transfusion occurred in about 4 per cent of the transfusion episodes. Considering our survey findings, the generally accepted properties of cold stored platelets and the capabilities and limitations of this blood bank, we plan to continue to store platelets at 4 C.

Blood Platelets↗

PubMedDate not supplied

Unacceptable variability of hemoglobin estimation on samples obtained from ear punctures.

Sampling techniques were studied for the determination of the hemoglobin in volunteer blood donors. First, finger, ear, and venous samples were collected from 50 volunteers. Then five volunteers were monitored for a three-day period and finger, ear, and venous samples were collected daily. Thirdly, microhematocrits were done on the postdonation EDTA samples of 500 donors who had been screened using ear puncture copper sulfate hemoglobin estimations. Fourth, 25,437 donations were followed up to see whether capillary sampling techniques affected the rate of donor deferral. And finally, the ear sampling technique was varied using vigorous rubbing and manipulation to see if there was abnormal circulation that would affect the hematocrit results from capillary blood from the ear. We found that the microhematocrits averaged 7 per cent higher from blood obtained from ear puncture than from either finger puncture or venous puncture. Microhematocrits obtained from blood obtained by ear puncture were less accurate and less precise than blood from finger punctures. Finger puncture samples exclude approximately 6 per cent more donors than does blood from ear punctures.

Blood Specimen Collection↗

PubMedDate not supplied

The effect of refreezing previously frozen-deglycerolized red blood cells.

Frozen red blood cells, once thawed and washed, must be used within 24 hours or discarded. In this study, three units of blood underwent two freeze-thaw cycles. It was shown that red blood cell survival, ATP, and 2,3-DPG were not adversely effected. The data suggest that previously frozen red blood cells should be refrozen, rather than discarded, if not used within 24 hours of deglycerolization.

Adenosine Triphosphate↗

PubMedDate not supplied

Utilization of nursing teams in the collection of blood.

The practice of nursing is group oriented. This was recognized in the past, but has only recently gained full acknowledgment by nursing managment. The concept of team assignment for the nursing staff was implemented in the blood program several years ago. The problems of the professional nurse in blood banking are not the same as in an acute or an extended care facility. Team assignments can improve both the delivery of care and the efficiency of the operation in the blood program. This paper describes many of the problems incurred under the system of conventional staffing and will show how these problems can be either eliminated or modified through the use of team assignment. Two centers experienced with permanent team assignments report these conclusions.

Blood Specimen Collection↗

PubMedDate not supplied

Relationship of physical symptoms, ECG, free calcium, and other blood chemistries in reinfusion with citrated blood.

Changes in ECG, free calcium (CaF), and other biochemical parameters were measured during reinfusion of citrate anticoagulated blood in 12 subjects undergoing plateletpheresis. Physical symptoms during the procedure were also monitored. The CaF was found to correlate best with the Q-oTc interval as compared to the Q-oT, Q-Tc, or Q-T interval. While the correlation was significant (r = 0.592, p less than .001), the Q-oTc could not predict the CaF. A number of other blood constituents were found to change during plateletpheresis, with most directly related to either citrate administration or hemodilution. Severe physical symptoms were found in one subject and no symptoms in three. In the subjects without symptoms the changes in Q-oTc, Pi, alkaline phosphatase, and glucose through the plateletpheresis procedure were different from changes in all subjects. The decrease in glucose level was the most striking single factor correlating with the lack of physical symptoms during the citrate-induced hypocalcemia associated with plateletpheresis. It is concluded that monitoring of the ECG cannot substitute for direct measurement of free calcium in citrate-induced hypocalcemia, that the physical symptoms associated with similar levels of hypocalcemia are variable, that glucose level may be a marker for the effects of citrate-induced hypocalcemia, and that lowered citrate loads during plateletpheresis appear warranted.

Adult↗

PubMedDate not supplied

Crossmatch compatible blood for patients with anti-P1.

Anti-P1 is a cold-reactive antibody often found in the serum of P2 individuals. For the past two years our reference laboratory has encouraged the use of crossmatch compatible blood for patients with Anti-P1 rather than the use of reagent-typed P1 negative units. The authors recently surveyed those hospitals that referred patient samples with anti-P1 to determine the safety of blood selected in this manner. Nineteen patients received 53 units without incident using this procedure. This report is a summary of the authors' findings.

Blood Group Antigens↗

PubMedDate not supplied

Recovery, lifespan, and function of CPD-Adenine (CPDA-1) platelet concentrates stored for up to 72 hours at 4 C.

We studied the in vivo recovery, lifespan, and hemostatic effectiveness of CPDA-1 platelet concentrates stored for up to 72 hours at 4 C. A total of 120 CPDA-1 concentrates containing an average (+/- 1 S.D.) of 6.6 +/- 2.0 x 10(10) platelets were prepared. The pH of the units following storage at 4 C was 6.8 +/- 0.2; no unit had a pH below 6.3. Autologous transfusion of six normal volunteers showed that platelets stored at 4 C for 72 hours had an in vivo recovery of 40 +/- 18 per cent and a lifespan of 5.1 +/- 1.5 days. The hemostatic effectiveness of CPDA-1 platelets was determined by platelet counts and template bleeding time measurements in 10 thrombocytopenic patients. Patients receiving 48-hour-stored platelets had a four- to six-hour posttranfusion corrected platelet increment averaging 15,300 +/- 3,200/microliter which was 67 +/- 34 per cent of expected recovery. Four of the five patients transfused with this preparation showed an improved bleeding time. In contrast, three patients receiving 72-hour-stored platelets had a four- to six-hour posttransfusion increment of 5,800 +/- 2,400/microliter that was only 26 +/- 13 per cent of the expected recovery; furthermore, only one of these patients showed any correction of the bleeding time. These data indicate that CPDA-1 platelets are hemostatically effective when stored at 4 C for up to 48 hours.

Adenine↗

PubMedDate not supplied

Impact of the anticoagulant-preservative citrate-phosphate-adenine (CPDA-1) on blood services.

The introduction of CPDA-1, as opposed to CPD, has allowed blood banks to store red blood cells for up to 35 days. The Missouri-Illinois Regional Blood Services studied the impact of CPDA-1 in three areas: reduction in blood outdating, change in distribution pattern, and the potential increase in the age of the products transfused. Our eighteen month study showed a reduction in blood outdating from 7.9 per cent to 3.9 per cent. Additionally, each unit of blood was distributed less frequently (from an average of 1.21 to 1.08 times from collection to transfusion). At the same time there was only a small increase in the mean age of the products transfused. It is our conclusion that the benefits of CPDA-1 can be attained with limited impact on the age of the products transfused.

Adenine↗

PubMedDate not supplied

Positive direct antiglobulin test due to anti-Fra in a newborn infant.

A positive direct antiglobulin test due to anti-Fra was found in a newborn infant whose mother previously had borne two other Fr(a+) children; all three were clinically unaffected. Family studies showed no evidence for close linkage between the Fr and HLA loci.

Blood Group Antigens↗

PubMedDate not supplied

Four crossmatch methods to select platelet donors.

We employed four crossmatch techniques to select platelet donors for refractory patients. Forty-four donor-recipient pairs were studied in 32 patients. Analysis of effectiveness of platelet transfusions revealed that only 18 percent of transfusions gave a borderline response; the remainder were either effective or not effective at all. The corrected predictive values of three crossmatch tests were as follows: enzyme-linked immuno-specific assay, 81 percent; platelet immunofluorescence test, 73 percent; and lymphocytotoxicity, 70 percent (p greater than 0.05). The predictive value of these tests did not differ in HLA-matched versus unmatched platelet transfusions. Donor selection by lymphocytotoxicity compatibility did not appear to be useful if donors were selected by either of the other two methods. The fourth test, antiglobulin-modified lymphocytotoxicity, offered no advantage over lymphocytotoxicity. Our data suggest that platelet crossmatching assays are a useful adjunct to the selection process for the platelet donor in addition to ABO, Rh, and HLA matching.

Adult↗

PubMedDate not supplied

AIDS, ethics, and the blood supply. A report of a conference of the American Blood Commission and the Hastings Center, Institute of Society, Ethics and the Life Sciences, January 29 and 30, 1985.

Although the conference was not held to determine policy, certain issues emerged which should be of interest to all involved with the initiation of anti-HTLV-III testing. First, there was a consensus that an implementation period during which donors will not be notified of the test results is essential. During this period, test proficiency, data confidentiality safeguards, and positive donor counseling procedures can be established. Also, during this period alternative test sites can be established; this was considered a critical step to maintain the safety of the blood supply. Second, there was a perceived need for legislation to protect the confidentiality of sensitive test data, whether in the laboratory or as part of a deferral list system, from subpoena. Third, there was not agreement about whether inventory should be tested; donors who provided that inventory did not know it was to be tested, and might not have consented if the implications of testing had been known. But, inventory testing is clearly in the interest of the recipient. Finally, there was an awareness in the blood banking community of their new role in monitoring a public health menace, and a beginning acceptance of this role emerged.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

The application of restriction fragment length polymorphism mapping to parentage testing.

Explore the source record for details and available documents.

DNA Probes↗