Transfusion and Apheresis Science - Articles in Press

Trends in hepatitis B and hepatitis C virus seropositivity among blood donors over 15years screened in the blood bank of a university hospital - Corrected Proof

Gunter Dilsiz, İdil Yenicesu, Fatma Burcu Belen, Bulent Celik, Gulyuz Ozturk — 2012-05-18

Abstract: Blood transfusion carries well defined risks including hepatitis B and hepatitis C virus transmission. In this study, records of blood donation candidates between the years 1996–2010 were retrospectively reviewed. A total of 220 841 apparently healthy adult donors were screened for hepatitis B surface antigen, anti-HCV with enzyme linked immunosorbent assay (ELISA) method. The overall prevalence of HbsAg and HCV were 1.07% and 0.39%, respectively. HBV seroprevelance decreased through years 1996–2010 but HCV seroprevelance showed a fluctuant course decreasing from 1996 to 2002. In order to decrease transfusion transmitted infections there should be centralized blood collection systems having qualified staff, equipment and non-remunerated voluntary blood donations must be strongly encouraged.

The effect of pneumatic tube system on complete blood count parameters and thrombocyte donation in healthy donors - Corrected Proof

2012-05-17

Abstract: This paper is the first report whether or not pneumatic tube system affects the selection of apheresis donors according to the results of complete blood count. According to the apheresis guidelines, hemoglobin level must be ⩾12.5g/dL and platelet level ⩾150/μL to be a donor. Paired blood samples of 26 healthy volunteers were transported by either hand delivered or a pneumatic tube system to the laboratory. No statistically significant differences were observed in order to mean values of routine complete blood cell count and white cell differential parameters that were send for selection of apheresis donor before the procedure. Therefore, all healthy volunteers decided as a donor according to the laboratory results independent from transport method.

Platelet usage trends in a tertiary care hospital – Could it be less and less expensive? - Corrected Proof

2012-05-16

Abstract: Major bleeding is a life threatening complication of severe thrombocytopenia. The aim of this study was to find out the indications and the threshold for platelet transfusions in the pediatric patients of our hospital throughout 1year. Records of the hospital’s blood bank and the files of the patients were retrospectively reviewed. One hundred and four patients, between ages 0–18years received 378 platelet units. Pretransfusion platelet counts were found to be significantly lower in hematology-oncology groups compared to other clinics (p<0.05). Single donor apheresis was found to be the major source of platelets in hematology (80.8%, n=147) and oncology (86.5%, n=45) clinics. There is a tendency for using apheresis products without proven superiority compared to platelet concentrates in terms of efficacy. This practice can be abandoned by continuous education.

The single center registry for therapeutic apheresis in Turkey: 11-year activity - Corrected Proof

2012-05-14

Abstract: Therapeutic apheresis (TA) is used as primary and adjunctive therapy in the treatment of several diseases and syndromes. We retrospectively evaluated the results of therapeutic apheresis (TA) including therapeutic plasma-exchange (TPE), double filtration plasmapheresis (DFPP), therapeutic thrombocytapheresis and leukocytapheresis as 11-year activity during 2000–2011. A total of 845 TA procedures were performed in 114 patients (67 male and 47 female, with mean age 51±17years). Adverse events (AE) were seen in 8.6% of procedures. None of the patients died from any complication. TA is safely carried out in our center in several diseases which are similar to previous reports.

The impact of donor selection on blood safety in Iran - Corrected Proof

Farhad Razjou, Mahtab Maghsudlu, Soheila Nasizadeh, Maryam Zadsar — 2012-04-23

Abstract: Introduction: Donor selection is a critical process to identify high risk volunteers and defer them from donating blood. Despite viral screening test on all donated blood, one cannot rely on screening tests alone to ensure a safe blood supply. Monitoring and assessment of the deferral procedure is of utmost importance to balance blood availability and safety. This study compares the prevalence of HIV, HCV, and HBV markers between deferred donors and accepted blood donors in order to evaluate the effectiveness of the current donor selection process in Iran.Materials and methods: This study was carried out on deferred blood donors throughout the country. A blood sample was collected from participants and tested for three viral markers: HbsAg, anti-HCV, and anti-HIV. Repeatedly reactive samples were retested with a confirmatory screening assay. The prevalence of viral markers among deferred donors was compared with national statistical data on blood donors.Results: The prevalence of HIV, Hepatitis B, and Hepatitis C was 120 (CI 95%; 90–150), 1280 (CI 95%; 1170–1390), and 580 (CI 95%; 510–650) in 100,000 deferred donors respectively. A significant increase exists in the prevalence of HBV (1.7 times), HIV (24 times) and HCV (15 times) in deferred donors as compared to accepted blood donors.Discussion: The effectiveness of donor selection in identifying high risk individuals is obvious upon comparing the prevalence of selected viral infections in deferred donors with those accepted for blood donation. This study showed the role and necessity of donor selection criteria.

Comparison of two leukocyte reduction filters for whole blood derived platelets - Corrected Proof

Jin-Hee Cho, Ju Hee Choi, Mina Hur, Hee-Won Moon, Chul Min Park, Yeo-Min Yun — 2012-04-11

Abstract: Background: Leukocyte reduction filters are widely used for platelet transfusion therapy, and effective leukocyte removal is mandatory for transfusion safety. We evaluated both the performance of leukocyte reduction filters for platelets and the effect of filtration on platelet function.Methods: A total of 100 pooled products (eight platelet concentrates were randomly pooled for each product) were used in this study: 50 were filtered by BioP-plus (Fresenius Kabi AG, Homburg, Germany) and 50 by PXL-8 (Pall Corporation, East Hills, NY, USA). Leukocyte reduction, platelet recovery, and filtration time were evaluated in each leukocyte reduction filter. Platelet aggregation responses to thrombin receptor activation peptide stimulation were compared in pre- and post-filtration products using impedance aggregometry (Multiplate Analyzer, Dynabyte Medical, Munich, Germany).Results: Leukocyte counts were uniformly less than 8.3×105 in all the post-filtration products, except one filtered by the PXL-8. Leukocyte reduction was 99.1% for BioP-plus and 99.7% for PXL-8, and platelet recovery was 84.2% for the BioP-plus and 86.7% for PXL-8. Filtration time of the BioP-plus was significantly shorter than that of PXL-8. Post-filtration platelet aggregation tended to decrease in both filters, showing no difference between them.Conclusions: Both BioP-plus and PXL-8 leukocyte reduction filters for platelets performed well with effective leukocyte reduction and satisfactory platelet recovery. Although platelet function was decreased after filtration procedures, its clinical relevance is uncertain.

The importance of transmission time in HIV infections and an epidemiological prospective follow-up study for 1year in the Marmara Region of Turkey - Corrected Proof

2012-04-09

Abstract: It is important to detect recent and new HIV/1 infections and to take preventative measures in order to prevent rapid disease progression in AIDS and to decrease the incidence of infection. We aimed to detect long standing or recent HIV infections by determining transmission times for the cases in which first-time HIV/1 seropositivity were detected. The serum samples of 323 cases which were found to be seropositive by ELISA and Western-blotting were included in this study. The discrimination between long-term and recent HIV/1 infection was made by determining transmission-time with the Aware BED-EIA, HIV-1 incidence test (IgG capture HIV-EIA) tests. Ninety-six healthy blood donors who did not have a positive anti-HIV test and a chronic infectious disease for at least 1year were included in this study as a negative healthy control group. In the discrimination of long-term and recent HIV/1 infections, only in vitro ODn values were used. The cases with normalized optical density (OD) (ODspecimen/ODcalibrator)<0.8 by commercial kit were accepted as recent HIV infection (155days history or seroconversion less than 6months). The cases with ODn >1.2 were accepted as long-term HIV/1 infections (more than 155days history or more than 6months). The cases with ODn between 0.8 and 1.2 were accepted as “additional tests needed” cases. We detected recent HIV/1 infections (<6months) in 60 (18.5%) out of 323 cases and long-term HIV/1 infections (>6months) in 263 (81.5%) out of 323 cases. The most frequently encountered transmission route in long-term and recent HIV/1 infections was heterosexual sexual intercourse as 54 (50%) and 257 (97%), respectively. 63.3% of newly infected patients were married females and 65.3% of recently infected patients were males.In conclusion, the detection of the high ratio of long-term HIV/1 infection cases (81.5%) compared to recent infections (18.5%) suggested to us, that the long standing cases may have some activities related with transmission of HIV/1 in the past. The detection of higher HIV/1-infections in individuals which had heterosexual sex and also in married males suggested that this situation poses a very great threat for the health of society.

Who should be really considered as a poor mobilizer in the plerixafor era? - Corrected Proof

2012-04-05

Abstract: Patients with a number of peripheral CD34+ cells ⩽20/μL have recently been defined in the literature as “poor mobilizers”. We retrospectively reviewed medical records from a total of 248 patients affected by hematological malignancies or solid tumors undergoing peripheral blood stem cell collection following chemotherapy plus G-CSF. On the basis of the CD34+ cell peak in peripheral blood following mobilization therapy, patients were defined as good mobilizers (group A, CD34+ cells ⩾20/μL), relative poor mobilizers (group B, CD34+ cells <20 and ⩾8/μL) and absolute poor mobilizers (group C, CD34+ cells <8/μL). One hundred and seventy-seven (71%) patients resulted good mobilizers, 35 (14%) patients relative poor mobilizers and 36 (15%) patients absolute poor mobilizers. Target of stem cell collection was ⩾2.0×106 CD34+cells/kg for each transplantation procedure. All patients in group A, 20 patients in group B (57%) and 1 patient in group C (2.7%) were able to collect ⩾2.0×106 CD34+cells/kg. The multivariate analysis confirmed that more than three lines of previous chemotherapy and a previous autologous PBSC transplantation negatively affect mobilization of CD34+ cells in peripheral blood. Our data suggest that a number of CD34+ cells ⩽20/μL does not always result in a failed stem cell collection and in fact in our patient series more than 70% of the patients defined as poor mobilizers have indeed collected the minimum number of 2.0×106 CD34+cells/kg required for a successful transplantation. The use of new agent such as CXCR4 antagonist plerixafor might further improve mobilization efficacy in such patients.

Maintenance of surface antigens and the absence of an apoptotic marker are observed during storage of granulocyte concentrates collected by bag separation method - Corrected Proof

2012-04-05

Abstract: Granulocytes were collected by the bag separation method and stored in whole blood for up to 72h. We evaluated the expressions of various surface antigens: CD62L, CD11b, CD18, CD64, CD16b, and CD95. Apoptosis was assessed both by flow cytometry and by light microscopy. Expression levels of all the surface antigens were shown to be maintained during storage for up to 72h. Approximately 80% of granulocytes were annexin V negative until 72h after collection. The storage of granulocyte concentrates collected by the bag separation method may maintain granulocyte surface antigens and lack an apoptotic marker.

Clinical efficacy of riboflavin and ultraviolet light inactivated fresh frozen plasma evaluated with INR-quantification - Corrected Proof

2012-04-05

Abstract: Treatment of blood products by riboflavin and ultraviolet (UV) light prevents of white blood cell (WBC) replication and inactivates of pathogens. The aim of this study was to determine the effects of the inactivation by riboflavin and UV light upon plasma clinical performance, based on effect on the pretransfusion international normalized ratio (INR).A prospective, controlled randomized study included 60 patients who received transfusion of plasma on the Clinic for hematology of Clinical Centre in Nis. Experimental group (EG; 30 patients) was treated with Mirasol-inactivated fresh frozen plasma (FFP) and control group (CG; 30 patients) was transfused with noninactivated FFP. Besides pretransfusion vs. posttransfusion INR, the improvement in INR patient’s plasma level per one FFP unit transfused was evaluated. Total of 68 units of FFP were transfused to patients of CG (2.24±0.83units per patient). Patients of EG received 84units of Mirasol-inactivated plasma (i.e. 2.80±1.19units per patient). There was significant increase in number of FFP transfusions that normalized coagulation parameters in EG compared to CG (p=0.039). Also, there was a significant improvement of INR after every FFP unit application (p=0.046). We found a linear relationship between pretransfusion INR and improvement of INR (r=0.97; p<0.001).Plasma treated with riboflavin and UV light retains hemostatic competence and can be used efficiently in the therapy of congenital or acquired coagulopathies, but in larger quantity as compared to noninactivated FFP volume.

Decreased soluble TGF-β1, Tie-2, and angiopoietins serum levels in bone marrow after treating healthy donors with granulocyte colony-stimulating factor - Corrected Proof

Jian-Zhu Yang, Li-Xia Sun — 2012-04-05

Abstract: The goal of this study was to investigate the effect of granulocyte colony-stimulating factor (G-CSF) on Tie-2, angiopoietins, VEGF, and TGF-β1 in bone marrow (BM) of healthy donors. Soluble Tie-2, angiopoietins, VEGF, and TGF-β1 levels in the BM were determined via ELISA in 25 healthy donors before and after G-CSF treatment. The results showed that treating healthy donors with G-CSF significantly decrease serum levels of Tie-2, angiopoietin-1, angiopoietin-2, and TGF-β1. In contrast, median VEGF level in the G-CSF-primed BM was significantly higher than steady-state BM. Our results suggest that decreased soluble TGF-β1, Tie-2, and angiopoietins levels in the BM could be related to stem cell mobilization.

The effect of cholesterol levels on hematopoietic stem cell mobilization - Corrected Proof

Ayhan Donmez, Ceyda Kabaroglu, Bahar Arik, Murat Tombuloglu — 2012-04-05

Abstract: Data regarding effects of cholesterol levels on hematopoietic stem cell mobilization are limited. We retrospectively reviewed the relationship between serum total cholesterol levels and peripheral blood CD34 (PBCD34) cell counts in 52 granulocyte colony stimulating factor (G-CSF) induced mobilization cycles with or without chemotherapy. The cholesterol levels between the poor and good mobilization groups (median 172mg/dl vs. 183.5mg/dl, respectively, p=0.18) were not different. No significant correlation was obtained between the cholesterol levels and PBCD34 counts (r=0.02, p=0.85). No significant correlation was obtained between cholesterol levels and PBCD34 counts in patients neither mobilized with G-CSF alone (r=−0.02, p=0.9) nor G-CSF plus chemotherapy (r=0.04, p=0.8). The results of the study indicate that there was no effect of cholesterol on hematopoietic stem cell mobilization. Prospective cohort studies are needed to demonstrate the effect of cholesterol on mobilization and its extent in humans.

Transfusion induced Graft versus host disease – Case report in a 2year child - Corrected Proof

2012-04-04

Abstract: Graft-versus-host disease (GVHD) is a rare, almost always fatal complication of a blood transfusion. It occurs much more commonly after bone marrow transplantation, a setting in which it is less severe—mortality rate of 20–25% following transplantation versus 80–90% when associated with a transfusion. Transfusion associated GVHD occurs in two settings: when the recipient is immunodeficient; and when there is a specific type of partial HLA matching between the donor and recipient. Here we present a case of transfusion associated GVHD which developed when a 2year old immunocompetent girl was given whole blood which was taken by his father. Inspite of very intense therapy with parental steroids and oral cyclosporine the child succumbed to death.