日本輸血学会雑誌
Online ISSN : 1883-8383
Print ISSN : 0546-1448
ISSN-L : 0546-1448
40 巻, 4 号
選択された号の論文の13件中1~13を表示しています
  • 吉田 久博, 万木 紀美子, 伊藤 和彦
    1994 年 40 巻 4 号 p. 589-592
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    In order to prevent adverse effects associated with the transfusion of platelet concentrates, the plasma in platelet concentrates was removed into another bag connected with a sterile connecting device and platelets were resuspended in the Seto solution. Average percentages of the plasma removal and the recovery of platelet were 94.4% and 93.8%, respectively. Platelets suspended in Seto solution were transfused 131 times into 22 patients who had showed adverse effects such as fever and urticarial rash and might exhibit hemolysis due to ABO-incompatible platelet transfusion. The average recovery of transfused platelets in vivo was 53% one day after platelet transfusion. This value was similar to that of the transfusion of platelet concentrates (55%). The adverse effects associated with platelet transfusions were remarkably decreased using Seto solution but developed in 2 cases. These results indicate that Seto solution is very useful to prevent the adverse effects due to plasma components.
  • 面川 進, 能登谷 武, 長井 郁子, 盛 直久, 吉岡 尚文, 三浦 亮
    1994 年 40 巻 4 号 p. 593-598
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    The objective of this study is to evaluate the blood ordering and usage in surgical procedures for 2 years after the revision of our maximum surgical blood order schedule (MSBOS) and type and screen (T & S) system.
    The number of surgical procedures ordered by T & S was increased to 38% of total number of procedures in 1993. Although T & S was not assigned for some procedures in pediatric and otolaryngology surgeries, the number of T & S procedures was increased in these surgeries. In lung lobectomy and brain tumor excision, for which 4 and 3 units of MSBOS were assigned, respectively, the volume of blood loss was less than 500ml and C/T ratios were increased. T & S should be assigned for these procedures. In radical mastectomy, C/T ratio was improved and the average number of cross-matched units was decreased after the change of assignment to T & S from MSBOS 3 units. Blood loss was approximately 1800ml in radical hysterectomy and radical resection of ovarial cancer because of the shift to more radical resection. Although C/T ratios were 1.4 and 1.9 in those procedures, MSBOS units should be increased to more than 5 in the both procedures. In surgical procedures with predeposit autologous blood, the number of T & S orders seemed to be increased, especially in cardiovascular surgery, instead of additional preoperative homologous blood preparation.
    MSBOS and T & S system should be re-evaluated after 6 months or 1 year period, thus, more effective blood utilization can be achieved.
  • 面川 進, 能登谷 武, 吉岡 尚文, 三浦 亮
    1994 年 40 巻 4 号 p. 599-605
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    This study evaluated the status of the use of platelet concentrate supplied from the Japan Red Cross blood center from April, 1989 to December, 1993. The units of platelet concentrate supplied were significantly increased in recent 2 years. The percentage of platelet concentrate products procured by apheresis was more supplied in 1993. The percentage of the patients who received only 1 or 2 unit product of platelet concentrate was approximately 40% until February, 1993, however, the number of patients receiving only more than 5 unit product of platelet concentrate was being increased since May, 1993. In addition, the number of donors transfused to the patient was significantly decreased to 2.13-3.71 donor number/patient in recent several months. Fifty four percent of the patients and 84% of the units transfused were for those with hematological diseases for which frequent platelet transfusion was performed. In hematological disease patients, an average platelet count was 20000-30000/μl before platelet transfusion. The levels of platelet counts were significantly lower in the patients with aplastic anemia and MDS compared with acute leukemia patients.
  • 権 吉源, 矢野 美佐子, 高橋 恒夫, 加藤 俊明, 池田 久實, 関口 定美
    1994 年 40 巻 4 号 p. 606-611
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    We investigated human T-cell leukemia virus type I (HTLV-I) transmission in married couples among a blood donor population. Retrospective or prospective studies were subjected to 172 couples either or both of whom was a HTLV-I carrier. Fifty-three seropositive donors (26 males and 27 females) were all positive on polymerase chain reaction (PCR) assay using primer pairs in the proviral genome pX region. None of 42 seronegative spouses (25 males and 17 females) among sero-discordant pairs was PCR-positive. Of 6 seroconverted cases, including 4 cases detected retrospectively, five were female donors with HTLV-I-seropositive husbands and showed the conversion of HTLV-I serostatus from gelatin-particle agglutination (PA) negative to PA/immunofluorescence (IF) double positive. The remaining one was a male donor with HTLV-I positive wife and converted from weakly PA positive/IF negative to PA/IF double positive. Western blot analyses demonstrated that 4 of the female seroconverters had anti-HTLV-I antibody in the IgM class as well as IgG. The other female donor had only IgM class anti-HTLV-I, which is a marker of recent primary infection. Our present results indicate that the transmission of HTLV-I is not rare among sexual partners who are voluntary blood donors. A pertinent notification system for the virus carriers may be mandatory in order to avoid the spread of HTLV-I infection.
  • 山下 万利子, 合志 博司, 能勢 義介, 阪田 宣彦, 瀧本 眞
    1994 年 40 巻 4 号 p. 612-617
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    The incident rate of post transfusion hepatitis (NANB-PTH) was reduced from 8.9% to 3.9% after the introduction of C100-3 antibody screening of blood for transfusion, and has become to 0% after the introduction of PHA screening.
    A retrospective study of 385 units of blood transfused to 75 patients from 1988 to 1991, however, revealed the presence of HCV transmission which had not been prevented by PHA screening. Therefore, a major task for the future is to develop a measuring system highly specific to other antigenic epitopes.
    Further, retrospective study indicated that the HCV infection did not occur even in some cases in which antibodies were present. This non-infectivity appears that the donors was infected in the past, and little of the HCV infective genome was present in the blood of the donors.
  • 瀬川 紀美子, 高橋 恒夫, 半田 誠, 片山 政彦, 池田 康夫, 関口 定美
    1994 年 40 巻 4 号 p. 618-624
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    The effect of prestorage filtration on platelet function and membrane surface glycoproteins was studied. Platelet concentrates (PC) prepared by apheresis (A-PC) or from whole blood and pooled (P-PC) were filtered with a leukocyte-removal filter, the Sepacell PL5N, and platelet functions and membrane glycoproteins were measured during 10 days of storage.
    Five pairs of filtered and non-filtered A-PCs or P-PCs were compared in this study. The average numbers of residual leukocytes in A-PC were 2.27±3.14×108/bag (non-filtered) and 8.60±11.0×106/bag (filtered), and those in P-PC were 1.46±0.92×107/bag (non-filtered) and 2.69±1.64×105/bag (filtered). No significant differences between the non-filtered and filtered PCs were observed during the storage in tests for the following: platelet functions such as aggregability and hypotonic shock response, levels of surface glycoproteins such as glycoprotein Ib and GMP-140 detected by flow cytometry, and the concentration of glycocalicin in plasma detected by enzyme immunoassay.
    These results indicate that prestorage filtration of PC does not effect platelet functions and it should be useful to further reduce the risks of side effects caused by the leukocytes contaminating PC.
  • 千葉 清司, 漆原 範子, 秋野 光明, 中條 聖子, 赤坂 淳一, 高橋 恒夫, 関口 定美
    1994 年 40 巻 4 号 p. 625-634
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    Since 1993 the Japanese Red Cross has adopted a new additive solution for red cell concentrate (RC), MAP (mannitol-adenine-phosphate), which is a modifided SAGM solution. However, frequent macroaggregate formation in MAP-additive RC (MAP-RC) has become a problem. We investigated the mechanism of macroaggregate formation in MAP-RC and sought method to reduce the frequency of such formation. During 3-week storage at 4°C, macroaggegates were formed in 30% of the buffy coat-poor RC (BP-RC) prepared by the conventional method without MAP, but in 100% of MAP-RC.
    Electron microscopic observation of the macroaggregates showed that red cells were trapped in a network structure, and enzyme treatments indicated that the network was made of DNA that leaked from granulocytes. The granulocytes stored in the MAP solution, however, formed macroaggregates only if plasma was added to the cell-suspension medium. Immunoblotting analysis indicated that fibrinogen and fibronectin were the constituents of the macroaggregate in addition to the DNA. Pre-storage filtration of MAP-RC with a leukocyte-removal filter (PALL BPF4) or preparation of BP-RC with the top & bottom system completely prevented the macroaggregate formation in the MAP-RC. These results indicated that reduction of leukocytes in MAP-RC to less than 1×108/bag is necessary to prevent macroaggregate formation.
  • 瀬川 紀美子, 高橋 恒夫, 半田 誠, 片山 政彦, 池田 康夫, 諸井 将明, 関口 定美
    1994 年 40 巻 4 号 p. 635-643
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    Although cryopreservation of platelets has been attempted for the last two decades, the results are not still satisfactory. To investigate the reasons for the functional loss of cryopreserved platelets, glycoproteins (GPs), such as GPIb, GPIb/IX, GPIa/IIa, GPIIb/IIIa, GPIIIa, GPIV and GMP-140 on the platelet membrane before and after cryopreservation were analyzed by monoclonal antibodies and flow cytometry (FCM). Platelets loaded with 5% dimethylsulfoxide (DMSO) were extracelluarly frozen at -5°C, cooled to -80°C at 0.5°C/min, and then thawed rapidly in a water bath (37°C). There was no change of expression of GPs except for GPIb. GPIb was lost from about half of the cell population after freezing and thawing. When platelets were extracellularly frozen without DMSO, GPIb was progressively lost from the population as temperature decreased. At -40°C or below, most of the platelets lost GPIb from the membrane. In contrast, the rapid cooling of platelets (-20°C/min) did not cause the loss of GPIb.
    To investigate the mechanism of GPIb loss due to freezing and thawing, platelets were osmotically stressed in hyperosmotic plasma made by addition of NaCl, resuspended in isosmotic plasma, and then GPs were analyzed by FCM. GPIb was lost at osmotic stresses greater than 1000mOsm/kg. An enzyme immunoassay to quantify GPIb as glycocalicin, which was released to the medium by freezing-thawing or osmotic stress (1500mOsm/kg), showed a good correlation with the loss of GPIb on the platelet membrane detected by FCM. SDS-gel electrophoresis and immunoblotting analysis indicated that GPIb was released to the suspending medium as glycocalicin. It is known that membrane GPIb is cleaved to glycocalicin by intracellular Ca2+-dependent proteinases. Platelets frozen with proteinase inhibitors, such as N-ethylmaleimide, EDTA or EGTA, did not show the loss of GPIb. These results indicated that the loss of GPIb from the platelet membrane can be explained by the cleavage of GPIb to glycocalicin by the intracellular Ca2+-dependent proteinases which leaked from the osmotically damaged platelets as a result of freezing and thawing.
  • 安田 広康, 大戸 斉, 遠山 ゆり子, 元木 良一, 七島 勉, 丸山 幸夫, 渡辺 岩雄
    1994 年 40 巻 4 号 p. 644-649
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    Two patients had platelet transfusion refractoriness accompanied with non-hemolytic-, and non-febrile-hypersensetivity reactions nevertheless HLA-, and HPA-matched platelets were used. Whether the development of hypersensitivity reactions and refractoriness were associated with HLA or ABO match grade between patient and donor, we estimated corrected count increment at 1-hour posttransfusion (CCI-1hr) after HLA-, and HPA-matched platelet transfusion. The CCI-1hr more than 0.75×104/μl was used to determine adequate transfusion response.
    Regardless of HLA or ABO match grade, hypersensitivity reactions following HLA-, and HPA-matched platelet transfusion were observed in 14 of 23 transfusions in case 1, and in 6 of 15 transfusions in case 2. When there were any hypersensitivity reactions, adequate transfusion responses were obtained in 4 (29%) of 14 transfusions in case 1, and in 2 (33%) of 6 transfusions in case 2. However, effective increments were observed in most of transfusions (78%, 89%, respectively) when hypersensetivity reactions were not found.
    Heal et al. hypothesized that antibodies to polymorphic plasma proteins could be involved in platelet transfusion refractoriness by an “innocent bystander” or “immune complex” mechanism, our findings were strongly suggestive of their possibility.
  • 林 律子, 青山 憲一, 小松 孝良, 鈴木 六郎, 高倉 清, 谷上 純子, 永尾 暢夫, 犬飼 和久, 柴田 洋一
    1994 年 40 巻 4 号 p. 650-654
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    We recently came across a case of neonatal alloimmune thrombocytopenic purpura (NAITP) in a set of triplets.
    The serum obtained from the mother of the child with NAITP contained platelet-specific alloantibody, anti HPA-4b. The antibody was of IgG class detected by anti-IgG indicator cells. The serum of the mother strongly reacted with the platelets of her husband (1:1, 024), but not with her own.
    After delivery, the platelet count of the triplet with NAITP was 1.2×104/μl. The platelet count of the other two infants were 29.5×104/μl, 29.7×104/μl each.
  • 山村 一, 宮原 正行, 佐藤 博正
    1994 年 40 巻 4 号 p. 655-660
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
    To find the optimal protocol for preparing leukocyte-reduced red cells (LRRC) with polyester filters, such as Sepacell R-500N and Pall BPF4, we studied the effects of filtration procedures and blood storage period on their efficiencies. Pre-filtration dilution had no effect on leukocyte removal, but caused about 5% increase in red cell recovery and almost 50% reduction in filtration time when Pall BPF4 was used. On the other hand, post-filtration rinse resulted in a decrease in leukocyte removal by about 10 times and an increase in red cell recovery by about 5%. These procedures had the almost same effects on the filtration efficiencies of Sepacell R-500N. There were no significant differences in leukocyte removal and red cell recovery between two groups of starting red cells stored for 2-10 days or 42 days in a mannitol-adenine-saline (MAP) solution. However, 21 day-old cells in CPD showed higher hemolysis after filtration than 2 to 14 day-old red cells in CPD. These data indicate that pre-dilution is required but post-rinse should be avoided for achieving the maximum efficiencies of the polyester filters. The storage limit of red cells as a starting material for LRRC can be extended up to 14 days in CPD or 42 days in MAP. Thus, the use of the optimal protocol for Pall BPF4 led to 4 log of leukocyte reduction, 92% of red cell recovery and 11min of filtration time.
  • 1994 年 40 巻 4 号 p. 679-680
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
  • 1994 年 40 巻 4 号 p. 681-684
    発行日: 1994/10/01
    公開日: 2010/03/12
    ジャーナル フリー
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