日本輸血学会雑誌
Online ISSN : 1883-8383
Print ISSN : 0546-1448
ISSN-L : 0546-1448
36 巻, 6 号
選択された号の論文の16件中1~16を表示しています
  • 小林 芳夫, 豊田 尚志, 大國 典子, 松本 一夫
    1990 年 36 巻 6 号 p. 679-686
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    The initial report of the New Blood Program Advisory Committee stated that the quantity of donated blood needed to meet domestic requirements for manufacturing blood coagulation factor preparations is currently estimated to be 480, 000 liters.
    We collected blood components (each 400ml PPP or PRP) from 1, 552 donors during 59 sessions at facilities other than blood center between May 10, 1988 and March 31, 1990 in the area of the Kitaosaka Red Cross Blood Center. We also were able to obtain blood components (each 400ml PPP) from 368 donors during another 28 collection campaign sessions, using blood collection vehicles, between February 16, 1989 and March 31, 1990 in the area of the Kitaosaka Red Cross Blood Center. Donor apheresis outside blood center is conducted at companies, health centers, city offices, churches or in blood collection vehicles. Therefore, in comparison to blood center or donation room, space is limited in many cases and the auditory and visual atmosphere is generally less pleasing. In addition, we need to work toward converting former whole blood donors into donors from whom we can collect blood components. However, in order to promote blood donation campaigns, we must expand donor apheresis outside the blood center program.
    Comparing donor apheresis in collection vehicles with that in facilities other than blood center and donation room, although the level of donor relaxation and nurse mainpulation suffers in the vehicles, the moving of equipment, shipping and moving the collection site are much easier.
    These experiences have led to the following conclusion regarding future blood component collection campaigns. In addition to the use of blood collection vehicles to collect whole blood, a more effective procedure would be to obtain blood components from donors at as many facilities as possible outside blood center and donation room.
    In conducting blood component collection campaigns at facilities other than blood center and donation room, we should strive to improve the environment (TV, VTR, music, bodysonics, magazines etc.) and devote further study to better equipment transport (special purpose vehicles), even though this setup is already better than blood collection vehicles.
    It is also important to improve the blood collection environment (TV, VTR, bodysonics, magazines etc.) in blood collection vehicles.
  • 輸血後GVHDの発症を防止するために
    田中 成憲, 杉本 昭子, 福森 泰雄, 大軒 子郎, 山口 英夫
    1990 年 36 巻 6 号 p. 687-694
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    Irradiation of blood products can minimize the induction of graft-versus-host disease (GVHD) in recipients by eliminating the mitotic capacity from lymphocytes. We investigated the mitotic activity of lymphocytes with the aid of 3H-thymidine uptake after irradiation with various doses of X-ray in the range of 0 to 50Gy. This study showed that the mitotic activity of lymphocytes assessed by Mixed Lymphocyte Culture (MLC response) was completely inhibited by irradiation with 5Gy to each of blood products derived from 400ml of whole blood, including whole blood (WB), concentrated red cells (CRC) and platelet concentrates (PC). Irradiation of these blood products with 15Gy resulted in a 68-85% reduction in mitogen-stimulated 3H-thymidine uptake (mitogen response), and irradiation with 50Gy decreased the mitogen response by 96-99%. No differences were found in both morphology and viability between lymphocytes derived from 50Gy-irradiated and unirradiated CRC.
    Since MLC response of lymphocytes seems to reflect closely the capability of lymphocytes to induce GVHD in patients, the risk of GVHD following transfusion of blood products would be eliminated by irradiation with X-ray of 15 Gy, which is three times minimal dose sufficient to abolish MLC response of lymphocytes.
  • 大塚 小百合, 大沼 みき, 三谷 孝子, 新保 雅之, 池田 久實, 関口 定美
    1990 年 36 巻 6 号 p. 695-700
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    A recently developed monoclonal antibody-specific immobilization of platelet antigens (MAIPA) was evaluated as a method to detect platelet specific antibodies. Antisera to Siba and Koza which were responsible for the refractoriness to platelet transfusion were reactive only with immobilized GPIb. They were not reactive to MoAb-immobilized HLA-classI, GPIIb/IIIa or IV. Therefore, the Siba/Koza epitopes appeared to be on GPIb molecule. Besides anti Siba and anti Koza, alloantibodies to GPIIb/IIIa or Ib were detected in the sera of patients who were refractory to HLA-matched platelet transfusion by the MAIPA method. In several cases, the specificities of such antibodies did not correspond to the known platelet antigens.
  • 飯島 雅子, 重田 勝義, 川田 典子, 月本 一郎, Fumiko Funane
    1990 年 36 巻 6 号 p. 701-704
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    A micro-aggregating method using a U-bottom Terasaki Plate was evaluated with blood from 252 patients during the 12-month period from January to December, 1989.
    Specimens could be to read with consistency at patient's serum volume and reagent volume of 8-10μl. Correlation of the Terasaki Plate method and the Micro Plate method were shown to be 99% for the PA test (HTLV-I antibody), and 100% for the RPHA (HBs antigen) and PHA tests (HBc antibody).
    Antibody titer determination revealed a correlation rate of 82%, without diurnal variation. Determination was possible at a reaction time of 90 minutes; moreover, reagent costs could be reduced to one third.
    This method was deemed to be useful for saving serum samples, and was shown to offer reductions in cost and reaction time.
  • 西野 主真, 多葉田 祥代, 道野 淳子, 樋口 清博, 藤巻 雅夫, 小湊 慶彦, 藤倉 隆, 滝沢 久夫, 井上 恭一
    1990 年 36 巻 6 号 p. 705-708
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    Expression of A or B antigen on human red cells of ABO variants including A2, A3, A2B3 and B2 were analyzed using flow cytometry (FCM). Profiles of the variants were different from those of A1 or B red cells; proportions of anti-A positive cells in A2 and A3 red cells were 49.5% and 7.2%, respectively whereas that in A1 was 81.4%. These results seemed to be associated with A antigen amounts of the corresponding red cells. Therefore, a quantitative analysis of A or B antigen on red cells with FCM would be helpful in characterization of variant red cells.
  • 神林 裕行, 松田 信, 安田 広康, 大戸 斉
    1990 年 36 巻 6 号 p. 709-712
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    For the purpose of decreasing anti-HLA antibody titer, three patients with the platelet transfusion refractoriness were treated with the bolus of methyl-prednisolone (m-PSL).
    In the first and second case, an anti-HLA titer of 128 decreased to 8 after the treatment, but the reactivity and specificity of antibody did not significantly change. In the third case, an anti-HLA titer 4 became negative after the treatment, and the reactivity of antibody deminished with the decreasing of titer, but the specificity did not change. In the addition, when the titer of anti-HLA antibody became negative, corrected platelets increment (CPI) significantly increased by the platelet transfusion from random multiple donors.
    m-PSL pulse therapy may be the useful method against the platelet transfusion refractoriness.
  • 石田 文宏, 緒方 洪之, 古田 精市, 降旗 謙一
    1990 年 36 巻 6 号 p. 713-716
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    A platelet alloantigen system, Bra/Brb, is defined recently and is implicated in several cases of neonatal alloimmune thrombocytopenic purpura (NATP) in Europe. Since each platelet has only 1, 000-2, 000 molecules of BraBrb antigens, it is very hard to phenotype platelets by methods in which whole platelets are used as antigens. In this study, we employed modified antigen-capture ELISA (MACE) to phenotype platelets for Bra/Brb. Platelets were easily phenotyped qualitatively and semiquantitatively by MACE in which a murine monoclonal anti-glycoprotein (GP) IIa (4B4; CD29) was used to capture GP Ia-IIa complex. Phenotypic frequencies of Bra and Brb among 67 Japanese were 11.7% and over 98.3%, respectively. Their frequencies among Japanese were significantly differed from those among Caucasians and chilean Indians. Bra/Brb antigen system would be responsible for some cases of NATP and platelet transfusion refractoriness in Japan. MACE would be extremely useful to identify Bra/Brb incompatibility in those cases.
  • 永峰 啓丞, 青地 寛, 押田 眞知子, 林 悟, 倉田 義之
    1990 年 36 巻 6 号 p. 717-721
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    A new solid phase system (Capture-R) for the detection of irregular IgG red cell antibodies was evaluated.
    In this system, test sera were added to the wells coated with reagent red cells and incubated. After washing plates, anti-IgG coated indicator red cells were added, and the plates centrifuged.
    In the case of a positive test, indicator cells adhered to the entire surface of the well. In contrast, in the case of a negative test, the indicator cells formed a compact bottom in the bottom of the well.
    Warm type IgG antibodies considered to be clinically important were completely detected by Capture-R, but a part of IgM antibodies such as anti-Lea, anti-Leb, anti-P1 and anti-M were not detected.
    We consider that Capture-R is suitable for pre-transfusion tests since it is objective, sensitive and easy to perform compared with conventional antiglobulin test.
  • 伊藤 和彦, 則岡 美保子, 吉田 久博, 藤田 真弘, 丸屋 悦子, 佐治 博夫, 細井 武光
    1990 年 36 巻 6 号 p. 722-725
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    The change of HLA phenotype from heterozygous to homozygous one occurred in two postoperative patients developing posttransfusion GVHD. One haplotype was shared in the homozygous and heterozygous phenotype. A blood donor whose HLA phenotype was identical to the homozygous phenotype of the patient was found.
    For preventing posttransf usion GVHD, blood preparations to be transfused within 10 days after collection were irradiated in a dose more than 15Gy. The two patient described above developed GVHD after the tranfsuion with non-irradiated fresh blood. On the other hand, no patients developed GVHD after the transfusion with irradiated blood.
  • 西田 一雄, 木村 秀子, 松田 利夫
    1990 年 36 巻 6 号 p. 726-730
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    The Japanese Red Cross Blood Center routinely uses the copper sulfate (CS) method to exclude anemic blood donors, because of its simplicity, speed and minimal expense. With this method the level at which a drop of donor blood becomes stationary varies according to its specific gravity (SG). The CS method procedure is described in the AABB's technical Manual and in many papers, but the manner of interpretation of the stationary level is not specified.
    The drop is delivered from about 1cm above the CS solution in a 100ml glass bottle (6cm high, 46mm in diameter) from an SG needle (Kawasumi, Japan). Momentum carries the drop 1 or 2cm below the surface, and it will then rise, become stationary, or continue to fall. We studied the method using stationary drops at only 4 levels: level A, 3.0cm below the surface; B, 1.5cm below; C, 1.0cm below; and D, 0.5cm below. The SG of these 4 blood samples were measured by pycnometer. The samples were of whole blood containing citrate-phosphate-dextrose (SG approximately 1.052). In Japan, the minimum condition for donors giving 200ml whole blood or undergoing plasmapheresis is hemoglobin (Hb)≥12.0g/dl or SG≥1.052. Temperature affects SG, which was measured at 30-32°C with an SG needle in a catheter probe (Terumo, Japan), and blood drop tests were done after incubation at 30°C. The CS solution (d2020=1.0521) was warmed from 15 to 35°C.
    Pycnometer values for blood SG varied according to the drop level in the CS solution and to the solution temperature, the average difference between positions A and D at 20°C being 0.0014. At 20°C, a drop in the D position, 5mm below the surface, had the same SG as the solution (1.0522±0.0002, n=3). Routine screening of position D showed that only 5 percent of eligible donors would have been rejected for low Hb. Although the CS method has a higher donor rejection rate than the Hb procedure, its rejection rate varied with the drop stationary level.
  • 吉田 久博, 万木 紀美子, 伊藤 和彦
    1990 年 36 巻 6 号 p. 731-733
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    To promote economization of blood transfusion test, the utility of Robotic Sample Processor 5052 (RSP) for blood grouping, irregular antibody screening, etc. of patients' specimens was compared with manual operation. Processing was little faster with RSP than that with manual operation. The results with both procedures were correlated well in each experiment. Although RSP requires improvement in the programing process, it is very useful with respect to economy of labor of blood transfusion test.
  • 稲葉 頌一, 坂口 嘉郎, 高橋 成輔, 吉武 潤一
    1990 年 36 巻 6 号 p. 734-737
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
    To understand the strategy of anesthesiologists regarding intra-operative transfusion, we analyzed cases at Kyushu University Hospital. During the last four months, intra-operative blood transfusions were performed in 172 out of 1, 525 (11.3%) surgical operations done in our operating room. Among these 172 cases, as many as 30% (55 cases) were managed by autologous transfusions, either preoperative deposition or intra-operative cell saving. For red cell transfusion, red cell concentrates derived from 400ml of donated blood were used in most cases (224/236, 95%). The critical hematocrit level at which anesthesiologists introduced blood transfusion was 25%, instead of 30%, the generally accepted level. All platelet transfusions were done with platelet concentrates obtained by single donor apheresis. These results indicate that adverse reactions of homologous blood transfusions such as post-transfusion hepatitis or post-transfusion graft-versus-host disease are well understood by anesthesiologists, and efforts to reduce transfused blood units were made. Only 15% of all transfused blood units were of fresh frozen plasma. This means that anesthesiologists recognized that fresh frozen plasma should be used to supplement coagulation factors. However, one of the problems to be settled is the overuse of albumin solutions. In the present series, 5% albumin solutions were administered in over 60% of transfused cases to maintain colloid osmotic pressure, but many cases could have been managed by alternative measures.
  • 1990 年 36 巻 6 号 p. 738-779
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
  • 1990 年 36 巻 6 号 p. 780-794
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
  • 1990 年 36 巻 6 号 p. 795-817
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
  • 1990 年 36 巻 6 号 p. 823-825
    発行日: 1990/12/30
    公開日: 2010/03/12
    ジャーナル フリー
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