Because plasma is in much demand but very short in selfsufficiency in Japan, it is not enough to get source plasma derived only from 200ml or 400ml donations of whole blood. As a less expensive process whereby plasma is collected from a single voluntary donor, membrane plasmapheresis has been initiated.
We investigated the safety of donating plasma and the efficacy of collected plasma by using a membrane plasmapheresis apparatus, KM8700 Kuraray. There were no complaints from 20 voluntary donors and no abnormal vital signs observed. And there was no activation of platelet, coagulation, fibrinolysis, and complement systems.
The components in collected plasma showed little difference from fresh frozen plasma supplied by the Japanese Red Cross, except for a slightly low level of factor IX.
We concluded that donor membrane plasmapheresis by using KM8700 Kuraray was safe and clinically useful.

抄録全体を表示

ACD-A solution, anticoagulant for preserved blood, has been used for donor plasmapheresis (DP), howerver it has some undesirable problems for the puropose.
This time, we examined usefulness of SCS-4 (4% sodium citrate solution, USP XXI) as an anticoagulant for DP in 85 healthy volunteers, 75 cases by membrane method and 10 cases by centrifugal method.
SCS-4 was safely used as an anticoagulant for DP in both methods, in less volume than the conventional ACD-A solution because of the higher citrate concentration. The blood picture, biochemistry, coagulation factors and immunoglobulin of the donors returned normal promptly in both methods. We could obtain plasma with high concentration of total protein, albumin, immunoglobulin and coagulation factors.
These results indicate that SCS-4 is useful as an anticoagulant for DP.

抄録全体を表示

With a view to making proper and effective use of blood products, we prepared our own criteria for use of blood products for surgical hemorrhage and examined their clinical effectiveness.
For group I, whole blood or concentrated blood cells (CRC) and fresh frozen plasma (FFP), equivalent to the bleeding volume, were transfused. For group II, on the contrary, CRC were used from a bleeding volume of more than 500ml; 2, 4, 4 and 4U were used for bleeding volumes of 1, 000, 2, 000, 3, 000 and 4, 000ml respectively. FFP was used only at a dose of 1U for a bleeding volume of 2, 000ml; 2 and 2U were used for bleeding volumes of 3, 000 and 4, 000ml respectively. For group III, CRC was used from a bleeding volume of 800ml. One additional unit of CRC was used additionally for each 400ml of bleeding volume up to 3, 200ml and for each 200ml of that up to 4, 000ml. FFP was used only at a dose of 1U for a bleeding volume of 3, 200ml. Only one additional unit of FFP was used for a bleeding volume of 4, 000ml.
Employing the above criteria for use of blood products, we examined the clinical course of our patietns to determine the requirement for the maintenance of circulating blood volume and blood coagulability.
The results revealed that all physiological factors recovered spontaneously to their preoperative values in 7 postoperative days except for persistent slight anemia in both group II and group III.

抄録全体を表示

To clarify the possibility to introduce the type and screen into the blood transfusion business in hospitals, the present status of blood transfusion tests was investigated in the four large hospital in Kyoto. Although the techniques used at the institutions were almost the same, each percentage of identification of unexpected antibodies was from 80.1 to 98.8%. Moreover, each percentage of incompatible specimens, in which the screening test was negative but the cross-match was positive (S(-) & C(+)), was from 0.04 to 1.09%, and each percentage of clarification of their reasons was from 0 to 100%. From these results, the introduction of the type and screen may be possible in the institution, in which the percentage of identification of unexpected antibodies is high and that of S(-) & C(+) specimens is low. But in the other institutions, it is necessary to investigate why the former is low and/or the latter is high, before the type and screen is introduced.

抄録全体を表示

Membrane plasmapheresis is partially applied to separate plasma from whole blood. However it is evidenced that membrane plasmapheresis can be complicated by activated complementary system. It is suggested that activation of some complementary components occurs during the exposure of whole donor blood to the membrane surface and also during the filtration of plasma through the membrane pores. Activation of complementary system occurs predominantly through the alternative pathway and activated complementary components play a role of endogenous chemotactic factor, resulting in a transient segregation in the pulmonary vascular bed. In the recent years it has been pointed out that polysulfone (PS) membrane does not so influence on the complementary system during membrane dialysis in human.
Using PS membrane we performed plasma collection from 10 adult healthy donors. Donor's blood samples and collected plasma were examined haemotologically and biochemically before, during and after plasma collection. Coagulant-anticoagulant and complememtary system were also included. PS membrane filter has 0.8 and more than 0.8 of filtration coefficient for TP, Alb, immunoglobulin and coagulant factors. But filtration coefficient for fibrinogen was 0.75.
Mean values of anafiratoxin C3a in the donors' blood and separated plasma were always in the normal range, a C5a in the donors' blood also was always stable. C5a in the separated plasma was increased to 17 times of pre-level, but it was corresponded to 3.2 times of the maximum value of the normal range.
Activation of complementary system by PS membrane filter was minimum relative to those of other membranes used in the past.

抄録全体を表示

Before HBsAg screening of plasma was instituted, the preventive effect of immunoglobulin preparations (ISG) against Hepatitis B was not clearly defined. Since HBsAg screening became a requirement, all ISG has shown Anti-HBs and it further became clear that such preparations are effective in preventing Hepatitis B.
Recently, cases of Hepatitis NANB associated with administration of intravenous immunoglobulin (IVIG) were reported. Since there is no NANB screening test presently available and IVIG tends to be administered in a large volume, a virus inactivation treatment should be performed on IVIG.
Now that heat treatment at 60°C for 10 hours, which had previously been considered to be impossible or unnecessary for immunoglobulin, has become possible, an intravenous immunoglobulin preparation which is more ideal in stability and safety is available.

抄録全体を表示

The Bemberg Microporous Membrane (BMM) is composed of microporous regenerated cellulose hollow fiber and has been developed for virus removal from plasma. When fresh plasma was appiled on the BMM-30 (average pore size 30nm), 93 percent of albumin was passed through. However, more than 50 percent of IgM and Factor VIII were trapped in the hollow fiber. On the other hand with the BMM-50 filtration, 70 percent of IgM and Factor VIII were recovered in the filtrate. The double filtration by BMM-50 modules was carried out for HB virus positive fresh frozen plasma. Trapping of plasma components occurred only at the first BMM filtration and there was virtually no trapping at the second BMM filtration. HBV-DNA in Dane particles could be effectively removed by the double BMM-50 filtration. The residual amount of HBV-DNA in the first filtrate became under the detectable level after the second filtration. Thus, HBV-free plasma with sufficient amounts of plasma components could be obtained by the double filtration with the BMM-50 modules.

抄録全体を表示

We performed to prepare white-cell-poor blood components using automatic device, which was made up a optic sensor detecting the interface of red cells and plasma, a sensor weighing the plasma and huffy coat fraction, and three clamps connecting these sensors. This device was enable to separate 400ml whole blood into packed red cells, plasma and huffy coat fraction involved the platelets within about 3 minutes. White cell contamination in packed red cells was 59±19×10⁷ with recovery of 24±4% of the original value, and the lymphocytes in the white cells were only 3±1×10⁷ (2±1% of the original value).
White cell contamination of platelet concentrate was below the threshold of white cell detection by the microscopic observation (less than 100 cells per μl of concentrate). These results suggest that this automatic device was enable to introduce the procedure for preparation of white-cell poor blood components as a routine operation in blood center.

抄録全体を表示

We developed a new filter “Sepacell-PL” which was composed of blood administration set for the preparation of leukocyte-poor platelet concentrates at the patient's bedside. This filter is packed with 1.8μm polyester fibers coated with a new polymer (copolymer of hydroxyethyl methacrylate and diethylaminoethyl methacrylate), and has a small volume of 14ml. Sepacell-PL removed over 99% of the leukocytes and recovered approximately 93% of platelets from 10 units of platelet concentrates which contained 5×10⁸ leukocytes and 3×10¹¹ platelets. The functions of pre- and post-filtrated platelets showed no differences. The procedure of the filtration is very simple without priming with saline to remove air and to wet the filter. Moreover, platelet concentrates can be applied to the filter at a lower flow rate of 4ml/min as well as at a higher flow rate of 54ml/min by gravity.

抄録全体を表示

Previously, we found that inosine elevated the ATP level and enhanced the blastformation of PHA-stimulated lymphocytes. The effectiveness of inosine on lymphocytes, seemed to invite further investigation. In this study, the effects of inosine on the induction of lymphokine activated killer (LAK) cells from peripheral blood lymphocytes (PBL) were tested. PBL were cultured in the medium (RPMI 1640+10% human AB serum), supplemented with recombinant interleukin-2. When inosine was added to the medium at concentrations of 0.12-3.2mmol/l during the periods from 10th day to 15th day of the culture, inosine enhanced the proliferation of LAK cells and increased the killer activity of them. By using inosine at a adequated time of culture, it may be able to induce very high killer activity of LAK cells.

抄録全体を表示

In the last seven years, 216 medical staffs had accidental exposures to hepatitis virus. 190 cases out of them were exposed to HBV and 26 were to NANBV. They were serologically and biochemically followed up for six months after exposure. Five male surgeons developed acute hepatitis (3 with hepatitis B and 2 with hepatitis NANB). One of hepatitis NANB cases progressed to chronic state.
All of them had either needle or surgical knife stick injuries a few months before the development of clinical hepatitis. Accidental exposure to NANBV as well as HBV should be carefully followed up.

抄録全体を表示

Our reference laboratory recently investigated a case in which a patient had transient depression of the LW antigen and also produced anti-LW. Reported here are the methods which we employed in the identification of the antibody along with an outline of the LW blood group system.

抄録全体を表示