We evaluated the performance of four leukocyte removal filters under conditions simulating their use in bedside drip infusion of red cell concentrate (RCC; Sepacell RS-200A and Pall RC50) and platelet concentrate (PC; Sepacell PLS-10A and Pall PL100), and investigated their effects on the concentrates. The residual number of WBCs following filtration of ten RCC samples each containing ca. 2×109 WBCs was 3.62±5.10×105 with the RS-200A and 155.96±353.66×105 with the RC50, as compared with the American Association of Blood Banks standard of <5×106. The WBC removal rate (-log) was significantly higher with the RS-200A (4.2±0.6 vs. 2.7±0.6 with the RC50; p<0.001). Average F-Hb (free hemoglobin, mg/dl) increased by 21.9±21.8 (p<0.05) with the RS-200A and by 25.4±24.3 (p<0.01) with the RC50. In contrast, pH values were not significantly affected by either filter. Residual WBCs following filtration of six PC samples each containing ca. 7×107 WBCs with the PLS-10A and PL100 (0.30±0.22×105 and 0.84±0.48×105, respectively) all satisfied the Council of Europe standard of <1×106. pH was lowered by 0.068±0.011 with the PL100, but by significantly less (0.014±0.017) with the PLS-10A. Fractional analysis of three PC samples following passage at 5ml/min showed that platelet aggregability is lowered in relation to the decrease in pH of PC after filtration.
Predeposit autologous blood donation (PABD) with recombinant human erythropoietin (r-HuEPO) has recently come into widespread use. To determine the optimal route of r-HuEPO administration for PABD, we investigated the effects of r-HuEPO by different routes on predeposit autologous 1, 200ml blood donation courses in 71 patients undergoing elective orthopedic surgery. The patients were divided into three groups as follows: 36 patients were given r-HuEPO two or three times a week intravenously, 21 were given r-HuEPO once a week subcutaneously, and 14 without r-HuEPO served as controls. The increase in hemoglobin concentration in both r-HuEPO administration groups (3.46±1.16g/dl intravenous; 2.40±0.76g/dl subcutaneous) was significantly greater than that in the controls (1.47±1.04g/dl). To further compare the effects of r-HuEPO by both routes, regression analysis between increase in hemoglobin concentration per week period and total dose of r-HuEPO divided by body weight was done. The hemoglobin increase (y) demonstrated a significant positive linear correlation with r-HuEPO dose (x) in both groups (y=5.0×10-4+0.28, r=0.86 for the intravenous group, y=4.7×10-4+0.37, r=0.55 for the subcutaneous group), with the two lines revealing no significant difference from each other. In conclusion, both routes of r-HuEPO administration given under the same total dose are equally efficacious in raising hemoglobin concentration level.
Three apheresis systems (COBE Sprectra, Fenwal CS-3000 plus and Haemonetics MCS) were compared with regard to white cell (WBC) content (n=9 each) in the apheresis chamber on plateletpheresis of 10 units (range, 2-3×1011). Average WBC content in the residual blood in Sprectra, CS-3000 plus and MCS was 6.65×108 (70% of lymphocytes), 3.98×108 (77% of lymphocytes) and 2.21×108 (41% of lymphocytes) WBCs, respectively. Apheresis donors experiencing 12 plateletpheresis procedures per year, the maximum allowed, will sustain a 56.4×108 lymphocyte loss when Spectra, designoed to collect WBC-poor platelet concentrates, is used. The annual loss of lymphocytes in males and females would be 2.5 and 3.7 times, that by whole blood donation. Recently developed respectively, cell separators have been improved to decrease WBC contamination. However, close attention should be paid to WBC content in residual blood in the apheresis chamber.
We observed the occurrence of abnormal electrocardiogram (ECG) findings during the procedure of peripheral blood stem cell collection (PBSCC) in a 9-year-old child treated with chemotherapy for advanced rhabdomyosarcoma. Holter-electrocardiogram (Holter-ECG) recording over 23hrs at 7 weeks after PBSCC showed episodes of premature ventricular complexes (PVC). ECG findings were normal at the time of patient discharge. These findings indicate that the observation of ECG is necessary before and during PBSCC, and that the clinician is required during PBSCC.
X-ray irradiation is currently in wide use as a means of preventing Post-Transfusion Graft-Versus-Host Diease (PT-GVHD). In this study, we evaluated the effects of X-ray irradiation on RC-MAP pre-stored for various numbers of days, and assessed the length of time irradiated RC-MAP could be resued. RC-MAP was irradiated at a dosage of 15Gy at 1, 7, 14, 21 or 28 days after blood collection. These specimens were referred to as group I, II, III, IV and V (X-ray-irradiated groups), respectively. Non-irradiated RC-MAP was used as the control. Results showed that plasma K concentration increased following X-ray irradiation. It is therefore advisable that RC-MAPs be used immediately in infants and in renal failure. However, to maximize the efficiency of blood product use, it seemed possible that groups I and II could be used within two weeks after irradiation, and group III within one week. On the basis of this increase in K concentration, howerver, groups IV and V plasma should be used immediately after irradiation.