Sangre最新文献

Purpose: We present a retrospective study about the transfusional needs and the results of the preoperative autologous donation programme in our centre during 1996, in the Orthopaedic and Traumatologic Surgery Service's patients (SOT).

Patients and methods: During 1996 the SOT Service carried out 592 major programmed surgical procedures with implants: hip prostheses (HP), knee prostheses (KP) and spinal column fixings (SCF). We've reviewed transfusion forms of the Blood Bank and the preoperative autologous donation forms of the patients sent to us. We've analysed the data with the EpiInfo 6.04 of CDC. Atlanta and SSPS programmes, using the chi 2 of Pearson's Test for qualitative variables and T-Student's test for 2 quantitative variables.

Results: The put 387 HP, 118 KP and 87 SCF. 1399 units of blood were administered to 437 patients: 310 HP, 64 KP and 63 SCF. The units/patient (U/P) mean was: 3.3 in HP, 2.3 in PTR and 3.5 in SCF. They sent 99 patients to be programmed for autotransfusion, of which 15 were excluded. The patients' number and the surgical procedures were: 39 HP, 7 KP and 38 SCF. They solicited 247 units (2.9 U/P) and we took out 91.4% of these and the programme was finished in the 73.8% of patients. They transfused 311 U, autologous 176, to 91.6% of programmed patients. Only autologous blood was received by 48% of transfused patients without any statistically significant differences (SSD) (p > 0.05) between the different prostheses. The difference among the transfusion needs of HP and SCF and over KP is SSD (p < 0.001), being non significant between HP and SCF. The probability of getting an autotransfusion programme is bigger in SCF, with a SSD (p < 0.001) of SCF over the HP and the KP and non significant between the last two. The probability of being transfused is greater in the programmed autotransfusion group, this being SSD (p < 0.001), as much of global form as comparing separately each type of prostheses. In the programmed autotranfusion group there are no SSD (p > 0.05) between the type of prostheses and the probability of being transfused, finding the same SSD when we compare the U/P mean and each type of prostheses. The opposite occurred to the patients programmed, it is SSD (p < 0.001) as much of global form as comparing the U/P means in each type of prostheses. Finally, between the global U/P transfused global in the patients that we did an autotransfusion on and those we didn't the difference is SSD (p < 0.001), seeing the same SSD comparing the U/P means in each type of prostheses between both groups.

Conclusions: Given that the autotransfusion is safer than the homologous transfusion and the high percentage of this type of patients that need transfusion, 80% of HP, 54% of KP and 73% of SCF 72%, it would be desirable to enlarge the autotransfusion preoperative programme because it is only carried out on 14.18% of this type of proc

Purpose: To determine whether anti neutrophil cytoplasmic antibodies (ANCA): anti myeloperoxidase (anti MPO) and anti proteinase 3 (anti PR3), are present in patients with sickle cell anaemia (SCA) during painful crisis.

Patients and methods: 55 patients with SCA were included in this study, 35 of them had painful crisis and the rest were in steady state. We determined levels of anti MPO and anti PR3 by two enzyme immunoassays commercially available (Progen Biotechnik GMBH).

Results: A significant increase of anti MPO in the group of patients with painful crisis was found in comparison with steady state patients and controls.

Conclusions: Our results suggest the possibility that anti MPO interacting with MPO on primed neutrophils lead to neutrophil activation, enhanced neutrophil adhesion and amplification of endothelial cell damage.

Purpose: The implementation of an in vivo assay to determine the biological activity of human recombinant erythropoietin (Hu-r EPO) is essential. The purpose of this study was to perform and optimize the conditions of an easy in vivo bioassay suitable for routine testing of quality control of Hu-r EPO preparations.

Material and methods: Normocythemic 8 weeks female mice treated with different Hu-r EPO doses were employed. The reticulocyte response was measured by flow cytometry and by visual count in a Neubauer cell count chamber, after selective red blood cell haemolysis. A unique subcutaneous injection with blood extraction 96 hours later was the schedule employed. The reticulocyte count measured by both methods was plotted against the log dose of Hu-r EPO.

Results: The dose-response curve obtained was linear between 5 and 160 UI/mouse and the doses chosen for future assays were 10, 30 and 90 UI/mouse. The use of at least 6 animals per dose and not less than 3 assays to obtain reliable limits according to international regulations is convenient. Thirty assays were performed in four different samples and were analyzed by parallel lines (3 + 3) relating the response with the log dose. The coefficient of correlation between both methods was 0.989, so they are equivalent.

Conclusions: This method is suitable because fewer animals and bioassays are necessary to obtain fiducial limits according to international requirements. It is in agreement with the tendency to reduce the number of animals used for bioassay because ethical and economic reasons.

Purpose: To measure the capability of heat (60 degrees C for 10 hr) and low pH to inactivate BVDV (a model of HCV) in human intravenous immunoglobulins.

Materials and methods: The study was carried out on three batches of immunoglobulins produced by the Cohn method and contaminated with a known amount of BVDV. These mixtures, with and without 33% sorbitol, were submitted to heat treatment at 60 degrees C for 10 hours. The same immunoglobulin batches were manufactured at pH 4.25 and 4.5 and stored at 4 degrees C and 4 degrees C and 21 degrees C for 28 days. Samples of the two experiments were taken at the beginning and the end. The viral infectiousness was calculated by the standard microtiration method in 96-well plates, using the CPE, and the reduction factor was measured for each experiment.

Results: Complete viral inactivation was achieved with the heat treatment after 4 hours, and the 33% sorbitol decreased the formation of aggregates. Treatment by pH 4.5, at 21 degrees C for 28 days, decreased the viral load by approximately 2 log; no viral inactivation was achieved in samples stored at 4 degrees C.

Conclusion: Heat is an effective method for inactivating HCV in final batches of human intravenous immunoglobulins when 33% sorbitol is added. The use of low pH at 21 degrees C as a method of viral inactivation must be evaluated case by case, since, according to the present results, it only achieved a 2 log inactivation.