Double-blind, randomized controlled trial on the effect of leukocyte-depleted erythrocyte transfusions in cardiac valve surgery. (1/101)
BACKGROUND: Leukocytes in allogeneic blood transfusions are believed to be the cause of immunomodulatory events. A few trials on leukocyte removal from transfusions in cardiac surgery have been conducted, and they showed inconclusive results. We found in a previous study a decrease in mortality rates and number of infections in a subgroup of more heavily transfused patients. METHODS AND RESULTS: Patients (n=496) undergoing valve surgery (with or without CABG) were randomly assigned in a double-blind fashion to receive standard buffy coat-depleted (PC) or prestorage, by filtration, leukocyte-depleted erythrocytes (LD). The primary end point was mortality at 90 days, and secondary end points were in-hospital mortality, multiple organ dysfunction syndrome, infections, intensive care unit stay, and hospital stay. The difference in mortality at 90 days was not significant (PC 12.7% versus LD 8.4%; odds ratio [OR], 1.52; 95% confidence interval [CI], 0.84 to 2.73). The in-hospital mortality rate was almost twice as high in the PC group (10.1% versus 5.5% in the LD group; OR, 1.99; 95% CI, 0.99 to 4.00). The incidence of multiple organ dysfunction syndrome in both groups was similar, although more patients with multiple organ dysfunction syndrome died in the PC group. LD was associated with a significantly reduced infection rate (PC 31.6% versus LD 21.6%; OR, 1.64; 95% CI, 1.08 to 2.49). In both groups, intensive care unit stay and hospital stay were similar, and postoperative complications increased with the number of transfused units. CONCLUSIONS: Mortality at 90 days was not significantly different; however, a beneficial effect of LD in valve surgery was found for the secondary end points of in-hospital mortality and infections. (+info)To filter blood or universal leukoreduction: what is the answer? (2/101)
The safety of the blood supply has been a concern over the past 20-30 years because of the transmission of infectious diseases. Blood is still routinely tested for viruses, and leukoreduction is an effective strategy to reduce the transmission of cell-associated viruses. Clinically, the benefits of leukoreduction include decreases in transfusion reactions, HLA alloimmunization, infections, fever episodes, and antibiotic use. Although leukoreduction will add cost to a unit of blood, projections indicate that leukoreduced blood will become the standard of care. (+info)Could a simple surgical intervention eliminate HIV infection? (3/101)
BACKGROUND: Human Immunodeficiency Virus (HIV) infection is a dynamic interaction of the pathogen and the host uniquely defined by the preference of the pathogen for a major component of the immune defense of the host. Simple mathematical models of these interactions show that one of the possible outcomes is a chronic infection and much of the modelling work has focused on this state. BIFURCATION: However, the models also predict the existence of a virus-free equilibrium. Which one of the equilibrium states the system selects depends on its parameters. One of these is the net extinction rate of the preferred HIV target, the CD4+ lymphocyte. The theory predicts, somewhat counterintuitively, that above a critical extinction rate, the host could eliminate the virus. The question then is how to increase the extinction rate of lymphocytes over a period of several weeks to several months without affecting other parameters of the system. TESTING THE HYPOTHESIS: Proposed here is the use of drainage, or filtration, of the thoracic duct lymph, a well-established surgical technique developed as an alternative for drug immunosuppression for organ transplantation. The performance of clinically tested thoracic duct lymphocyte depletion schemes matches theoretically predicted requirements for HIV elimination. (+info)Gene expression analysis in platelets from a single donor: evaluation of a PCR-based amplification technique. (4/101)
BACKGROUND: Genetic analysis of platelet mRNA may facilitate the diagnosis of disorders affecting the megakaryocytic-platelet lineage. Its use, however, is limited by the exceptionally small yield of platelet mRNA and the risk of leukocyte contamination during platelet preparation. METHODS: We depleted platelet suspensions of leukocytes by filtration and used a PCR-based RNA amplification step [switching mechanism at the 5' end of RNA templates (SMART)]. We tested the reliability and precision of the RNA amplification procedure by use of real-time PCR to measure quantities of specific transcripts: von Willebrand factor (vWF), A-subunit of coagulation factor XIII (F13A), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Microarray analysis was performed on platelet RNA with and without amplification. RESULTS: Microgram quantities of platelet-specific cDNAs were produced from as little as 50 ng of total platelet RNA or 40 mL of whole blood. At cycle numbers <16, amplification of all transcripts tested was exponential with slightly more efficient amplification of low-abundance transcripts. Expression profiling of 9850 genes gave identical results for 9815 genes (1576 positive/8239 negative). Eight transcripts failed to be amplified by the SMART procedure. Expression of vWF, F13A, and GAPDH transcripts showed only minor day-to-day variations in three healthy individuals. CONCLUSION: The proposed protocol makes extremely small amounts of platelet RNA available for gene expression analysis in single patients. (+info)Remission of proliferative lupus nephritis following B cell depletion therapy is preceded by down-regulation of the T cell costimulatory molecule CD40 ligand: an open-label trial. (5/101)
OBJECTIVE: Autoreactive B cells play a key role in tissue injury in systemic autoimmune disease, and therefore a treatment resulting in B cell depletion could have benefit. This open-label study was undertaken to evaluate the efficacy of the anti-CD20 monoclonal antibody rituximab in the treatment of lupus nephritis. METHODS: Lupus patients with active proliferative nephritis (4 with focal disease and 6 with diffuse disease) received rituximab (4 weekly infusions of 375 mg/m(2)) combined with oral prednisolone. Clinical, laboratory, and immunologic responses, including peripheral lymphocyte subsets measured by flow cytometry, were prospectively assessed at monthly intervals for 12 months. Complete remission of nephritis was defined as normal serum creatinine and albumin levels, inactive urine sediment, and 24-hour urinary protein <500 mg. Partial remission was defined as >50% improvement in all renal parameters that were abnormal at baseline. RESULTS: B cell depletion lasted from 1 month to 7 months and was well tolerated. Partial remission was achieved in 8 of 10 patients within a median of 2 months (range 1-4 months); in 5 of them, complete remission was subsequently established (at a median of 3 months from baseline), and it was sustained at 12 months in 4. As early as 1 month from baseline, the expression of the costimulatory molecule CD40 ligand on CD4+ T cells was decreased by 4-fold, and it was almost blocked when partial remission was clinically evident. The expression of T cell activation markers CD69 and HLA-DR was significantly decreased at time points when partial remission was observed, and was further decreased during complete remission. In contrast, in patients who did not exhibit a response or when relapse was detected in patients in whom an initial remission had been achieved, such decreases were not prominent. Serum concentrations of double-stranded DNA autoantibodies were decreased in all patients, regardless of clinical outcome. CONCLUSION: Following B cell depletion, clinical remission of lupus nephritis is associated with a decrease in T helper cell activation, suggesting an additional role for B cells, independent of autoantibody production, in promoting disease. A controlled trial to confirm these promising clinical results is warranted. (+info)Can a leukocyte depletion filter (LDF) reduce the risk of reintroduction of hepatocellular carcinoma cells? (6/101)
During liver transplantation for hepatocellular carcinoma (HCC) patients, HCC could theoretically be introduced into the systemic circulation when salvaged blood is used with an autotransfusion device. Several reports have shown that some types of leukocyte depletion filters (LDFs) could completely reduce the risk for reintroducing some types of tumor cells. In this study, we tested the ability of the LDF (RCEZ1T, Pall Biomedical Co, NY, USA) to reduce the risk for reintroducing HCC cells in vitro by using a very sensitive detection method. We divided the test group into 6 groups: group I was 10 cells, group II was 20 cells, group III was 2 x 10(3) cells, group IV was 2 x 10(5) cells, group V was 2 x 10(6) cells, and group VI was 2 x 10(7) cells. The counted cells in 200 mL saline were passed through the RCEZ1T using the force of gravity. To identify the presence of cells, the pellet was resuspended, and polymerase chain reaction (PCR) was performed. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a housekeeping gene, was used as a primer. In groups I and II, the HCC cells were completely filtered in all experiments. However, in groups III, IV, and V, the HCC cells were not completely filtered in a few of the repeated experiments, with the unfiltered rate of tumor cells being between 8% and 20%. In group VI, the HCC cells were not completely filtered in all the repeated experiments. In conclusion, the RCEZ1T filter markedly reduced the risk for reintroduction of HCC cells. However, at high HCC cell load the filter cannot completely remove all the tumor cells. Further studies are required to assess the impact in clinical settings. (+info)Immunization to minor histocompatibility antigens on transfused RBCs through crosspriming into recipient MHC class I pathways. (7/101)
Increased rates of graft rejection after bone marrow transplantation (BMT) are observed in patients whose illnesses--such as sickle cell disease, thalassemia, and aplastic anemia--necessitate chronic transfusion before BMT. Because BM transplants in these patients are routinely HLA matched, any immunization responsible for increased rejection is likely against minor histocompatibility antigens (mHAs). It has been assumed that contaminating leukocytes in red blood cell (RBC) units are the main sources of immunization to mHAs. However, in this report, we demonstrate that antigens on donor RBCs are presented in the major histocompatibility complex (MHC) class I pathway of recipient antigen-presenting cells, resulting in activation and expansion of recipient CD8+ T cells specific for donor mHAs. Given that human hematopoietic progenitor cells express many of the known mHAs, this observation provides a mechanism by which chronic transfusion of even stringently leukoreduced RBCs may result in sufficient mHA immunization to increase the frequency of BMT rejection. (+info)Depletion of resident Chlamydia pneumoniae through leukoreduction by filtration of blood for transfusion. (8/101)
Current studies indicate that a significant percentage of healthy blood donors carry Chlamydia pneumoniae in their blood. Although the clinical significance of such findings is unknown, eradication of such bacteria from blood components may contribute to transfusion safety. Deletion of C. pneumoniae in Red Blood Cell (RBC) units was accomplished through leukoreduction by filtration. The presence of bacteria in RBC units before and after leukoreduction was assessed by real-time PCR using primers specific for C. pneumoniae 16S rRNA. The eluates of filters used for leukoreduction were also assessed by PCR and immunostaining with fluorescein isothiocyanate-conjugated chlamydial monoclonal antibodies specific for C. pneumoniae determination. Nineteen of 30 RBC units tested showed the presence of C. pneumoniae DNA. Leukofiltration resulted in a marked reduction of leukocytes as well as C. pneumoniae in terms of bacterial number and positive rate for the bacteria. The eluates of filters showed trapped bacteria determined by both PCR and immunostaining assays. Thus, leukoreduction with a filter is an effective method to significantly reduce resident C. pneumoniae levels in RBC components but may not be completely sufficient for total eradication of this pathogen. (+info)Leukocyte reduction procedures are medical processes that aim to decrease the number of white blood cells (leukocytes) in a unit of blood or blood component, such as red blood cells or platelets. These procedures are often used during transfusions for patients who have heightened reactions to leukocytes, or to lower the risk of complications like febrile non-hemolytic transfusion reactions, allergic reactions, and transmission of certain infectious agents.
The most common method for leukocyte reduction is filtration, where the blood component passes through a specialized filter that captures and removes the white blood cells. This process can reduce the leukocyte count to less than 1 x 10^6 per unit, which is significantly lower than the typical 5-10 x 10^6 leukocytes per unit found in unprocessed components.
Leukocyte reduction procedures are beneficial for specific patient populations, such as those undergoing chemotherapy or bone marrow transplantation, and help improve overall transfusion safety and efficacy.
Intrauterine transfusion
List of MeSH codes (E05)
American Red Cross
Pachydermoperiostosis
Autotransfusion
Ventricular assist device
Plasma frozen within 24 hours
Percutaneous umbilical cord blood sampling
Spent potlining
Erythrocytapheresis
Translocator protein
Campylobacteriosis
Histamine intolerance
Psoriasis
Postoperative wounds
B-cell activating factor
Oxcarbazepine
Prosthetic joint infection
Air embolism
Placental expulsion
Inflammatory bowel disease
Kidney stone disease
Bioremediation of radioactive waste
Platelet
Richard Peto
Bacillus subtilis
Chronic wound
Intracytoplasmic sperm injection
Healing of periapical lesions
Automated analyser
Intrauterine transfusion - Wikipedia
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MESH TREE NUMBER CHANGES - 2012 MeSH. August 19, 2011
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Human leukocy1
- Histocompatibility human leukocyte antigen (HLA)-B27 is identified in most patients with ulcerative colitis, though this finding is not associated with the condition. (medscape.com)
Irradiation1
- The selected blood then undergoes irradiation and leukocyte reduction. (wikipedia.org)
Antigens2
- The accumulation of leukocytes in retinal tissue soon after IR has become quantified by nonspecific staining procedures and qualitatively observed by immunohisto chemistry with antibodies to leukocyte antigens, but the qualities of this leukostasis have not been examined. (parp1inhibitor.com)
- and antibody formation against human leukocyte antigens (HLA). (msdmanuals.com)
Pancreatic2
- A surprise finding was that the patients had higher peritoneal levels of pancreatic secretory trypsin inhibitor (PSTI) after the lavage procedure. (nih.gov)
- The protease-antiprotease balance was studied by measuring immunoreactive anionic trypsin (irAT), cationic trypsin (irCT), complexes between cationic trypsin and alpha 1-protease inhibitor (irCT-alpha 1 PI), leukocyte elastase and neutrophil proteinase 4 (NP4), as well as the endogenous protease inhibitors, pancreatic secretory trypsin inhibitor (PSTI), alpha 2-macroglobulin (alpha 2M), alpha 1-protease inhibitor (alpha 1 PI), antichymotrypsin (ACHY), and secretory leukocyte protease inhibitor (SLPI). (nih.gov)
Accumulation2
- Rad51b c.92delT/c.92delT mice exhibited meiotic DNA repair defects due to RAD51 and HSF2BP/BMRE1 accumulation in the chromosome axes leading to a reduction in the number of crossovers. (nature.com)
- It is a chronic inflammatory disease of the arterial wall, which is characterized by lipid accumulation, leukocyte infiltration and smooth muscle cell proliferation. (spandidos-publications.com)
Antibodies1
- Antibodies One of the body's lines of defense ( immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and. (msdmanuals.com)
Arterial2
- Proximal femoral arterial ligation resulted in drastic reductions in LDP and Vrbc. (pcs.org.ph)
- 2. Use of the anti-inflammatory agent bindarit to control neointimal hyperplasia Chemokines are a family of proteins that regulate the migration of circulating leukocytes to sites of arterial injury as well as the activation of SMCs. (unina.it)
Protein3
- Results of lumbar puncture showed opening pressure of 15 cm H 2 O, 3 leukocytes/mm 3 , protein 35 mg/dL, and glucose 174 mg/dL. (cdc.gov)
- The present study identified that elevated values of ferritin, serum calcium, phosphorus, albumin, leukocyte, serum protein and serum iron values as a useful prognostic factor for the survival time. (biomedcentral.com)
- These effects were associated with a significant reduction of NF-κB activation and monocyte chemotactic protein-1 (MCP-1) expression in the carotid arteries of rats treated with the peptide. (unina.it)
Platelets1
- Results from his laboratory tests showed 7,000 leukocytes/mm 3 , 201,000 platelets/μL, serum creatinine 13.29 mg/dL, and serum urea 132 mg/dL. (cdc.gov)
Aseptic1
- The leukocyte reduced blood products may then be stored for the maximum allowable dating period.Instructions for UseCollection Procedure:Use aseptic technique.Notes: If Sample Diversion System is not used, donor samples may be collected using an alternate method following standard procedures. (drugcentral.org)
Significantly2
- There was immediate macromolecular tracer leakage and leukocyte activation was significantly increased in both ischemic and arterialized groups (15 cells vs 156 and 178 cells respectively). (pcs.org.ph)
- Parametric procedures used one way ANOVA using F distribution If significant differences were seen Dunnett's test was used to determine which treatment groups differed significantly from the control. (europa.eu)
Oxidative1
- There was a decrease in the phagocytotic ability of PMNs on days 1, 2, and 7 after completion of MPSS administration, with a reduction in the oxidative burst of PMNs detected on day 7. (avma.org)
Blood products2
- The leukocyte reduced blood products may then be stored for the maximum allowable dating period. (guidelinecentral.com)
- In this procedure, called pathogen reduction technology, certain blood products are treated with a chemical that reduces the risk of transmission of almost all microorganisms. (msdmanuals.com)
Immune system1
- During an examination of senior citizens, it was discovered that providing individuals with supplementary vitamin B6 resulted in a marked enhancement of their immune system and a simultaneous reduction in the likelihood they would experience periods of infection. (johnnyholland.org)
Antifungal1
- Prompt reduction of immunosuppression and initiation of antifungal therapy was required to successfully control the fungal infections and preserve engraftment. (cdc.gov)
Activation1
- Plasma levels of leukocyte proteases were high in all the patients, indicating leukocyte activation to be an important feature of the pathophysiology of severe acute pancreatitis. (nih.gov)
Dose4
- Many medications must be continued through the perioperative period, with the last dose taken with a sip of clear liquid up to 2 hours prior to the procedure, and resumed during recovery. (medscape.com)
- Objective -To evaluate effects of a high dose of methylprednisolone sodium succinate (MPSS) on function of polymorphonuclear neutrophilic leukocytes (PMNs) in dogs. (avma.org)
- Procedures -All dogs were treated by IV administration of a high dose of MPSS (30 mg/kg). (avma.org)
- High dose twice daily proanthocyanidin extract was not associated with a reduction in the number of symptomatic urinary tract infections when compared to a low dose proanthocyanidin extract. (biomedcentral.com)
Inflammatory4
- Specifically, the use of leukocyte-derived membrane proteins to functionalize nanovesicles (leukosomes) can enable their long circulation and target the inflamed endothelium present in many inflammatory pathologies and tumors, making them a promising and versatile drug delivery system. (frontiersin.org)
- Additionally, it plays a role in the generation of leukocytes and the management of inflammatory responses. (johnnyholland.org)
- Furthermore, CB treatment in a mouse model of collagen-induce arthritis resulted in a significant decrease in circulating inflammatory cytokine levels, immune cell infiltrates, joints erosion, and bone resorption, leading to a reduction in disease progression. (frontiersin.org)
- NQ contributes to DEP toxicity through the reduction of superoxide dismutase activity in vitro 26 , which raises the possibility that NQ may facilitate airway inflammatory conditions in vivo . (ersjournals.com)
Bone1
- The procedure is based on an autologous bone-marrow transplant (when patients receive a transplant of their own stem cells) and now constitutes a treatment option to cure an intestinal disease that sometimes does not successfully respond to drugs and requires highly complex surgery that does not provide a cure. (sciencedaily.com)
Filter3
- Integral filter unit intended for leukocyte reduction of whole blood up to 8 hours after blood collection when whole blood is stored at ambient temperature or up to 72 hours after blood collection when whole blood is refrigerated. (guidelinecentral.com)
- 4R3332E, 4R3327EFresenius KabiFenwal Blood-Pack Units Rx onlyUsing Anticoagulant Citrate Phosphate Dextrose Adenine Solution, USP (CPDA-1) with an Integral Sepacell RS-2000 Whole Blood Leukocyte Reduction Filter and Fenwal HighFlo Needle. (drugcentral.org)
- Also contains empty Transfer Pack containers for blood component aliquots.Integral filter unit intended for leukocyte reduction of Whole Blood up to hours after blood collection when Whole Blood is stored at ambient temperatures or up to 72 hours after blood collection when Whole Blood is refrigerated. (drugcentral.org)
Additionally1
- Additionally, blood transfusions alone constitute the most common inpatient procedure ( https://www.hcup-us.ahrq.gov/reports/statbriefs/sb165.jsp ). (healthit.gov)
Inflammation1
- Furthermore, this component assumes responsibility for contributing to the development procedure involving lymphatic units and supervising general inflammation protocols. (johnnyholland.org)
Donor2
Needle1
- Topical vapocoolant spray during minor procedures can be used to reduce needle penetration pain associated with digital nerve block and pain associated with local anesthetic infiltration. (medscape.com)
Function1
- On day 7 after the procedure, doctors performed a kidney biopsy after the patient experienced delayed graft function. (cdc.gov)
Cells7
- Almost 20 years later, the procedure was improved to a transfusion into the umbilical vein, which allowed for better absorption of red blood cells. (wikipedia.org)
- The leukocyte reduced red blood cells may then be stored for up to 42 days after collection. (nih.gov)
- Fluorescein-labeled red cells were used to measure red cell velocities (Vrbc) at the capillaries, and acridine orange injections used to stain endothelial cell nuclei to measure microcirculatory diameters, and leukocyte nuclei to measure leukocyte adhesion. (pcs.org.ph)
- Cell Permeabilization (Detergent Titration in Cultured Cells) Although more convenient than isolating coupled mitochondria, permeabiliza- tion procedures also require standardization. (banglaforexacademy.com)
- IR causes reduction of neuronal cells indicated by decreased thicknesses of ret inal layers, together with the ganglion cell layer, inner nuclear layer and inner plexiform layer. (parp1inhibitor.com)
- Eventually, ret inal IR damage to rats induced a reduction of vascular cells occurring seven to 14 days following reperfusion. (parp1inhibitor.com)
- Similar results were observed in apoE-/- mice in which bindarit administration resulted in a 42% reduction of the number of proliferating cells at day 7 after carotid injury and in a 47% inhibition of neointimal formation at day 28. (unina.it)
Patient1
- Although differences in care settings and test result for either nitrites or leukocyte patient populations have been proposed, the esterase in dipstick urinalysis has sufficient lack of adequate explanation for the hetero- predictive value to exclude disease, and geneity of dipstick results stimulates ongo- when both test results are positive there is ing debate. (who.int)
High2
- All patients had very high levels of leukocyte elastase and NP4 both in peritoneal exudate and in plasma. (nih.gov)
- nPOD recovers, processes, analyzes, and distributes high-quality biospecimens, collected using optimized standard operating procedures, and associated de-identified data/metadata to researchers around the world. (nature.com)
Collection1
- Integral Sepacell RS-2000 Whole Blood Leukocyte Reduction FilterFor Collection and Processing of 500 mL BloodFenwal Express System, Sample Diversion System, 16 ga. (drugcentral.org)
Significant1
- These effects were associated with a significant reduction of MCP-1 levels both in sera and in injured carotid arteries of rats treated with bindarit. (unina.it)
Results1
- These results suggest that mechanisms besides microcirculatory hemodynamics play a role in the overall picture of clinical effectivity of the procedure. (pcs.org.ph)
Researchers1
- Researchers have applied the idea of metabolic reduction to the cold storage of hearts. (gotomydoctor.com)
Method1
- related clinical problems, the objective of A dipstick test for proteinuria is also this study was to determine the reliabil- widely available, but no information on its ity of the dipstick method as a screening sensitivity or specificity is available when procedure for the detection of haematuria, implementing current guidelines [ 9 ]. (who.int)
Levels3
- Intraperitoneal levels were studied before and after the lavage procedure, and plasma levels were followed for 21 d. (nih.gov)
- The control group had lower plasma levels of SLPI and analysis of peritoneal fluid showed the reduction of irCT-alpha 1 PI to be more pronounced in the aprotinin group. (nih.gov)
- Peritoneal levels of PSTI were higher after the lavage procedure in contrast to the other measured variables that all showed lower peritoneal levels after the lavage. (nih.gov)
Units1
- Laser Doppler Perfusion (LDP) units at the distal limb were measured continuously throughout the procedure. (pcs.org.ph)
Treatment1
- Percutaneous coronary intervention (PCI) is the current procedure that allows the endovascular treatment of occlusive artery disease, without the need of bypass surgery. (unina.it)
Test1
- For non parametric procedures test of equality of means was performed using Kruskal-Wallis test. (europa.eu)
Days1
- Procedures -Racemic ketoprofen (0.25 mg/kg, PO) and gelatin capsules, as a drug-free placebo, were each administered to 7 dogs for 30 days. (avma.org)
Data1
- This study analysed the transcriptome derived from RNA-seq data of leukocytes obtained from Holstein cows in early lactation with respect to lactation number. (biomedcentral.com)
Health1
- Their immune systems are replete with leukocytes and humoral products that exert credible health benefits. (hindawi.com)
Guidelines1
- It's not a strictly difficult procedure, but there are many safety principles and guidelines that need to be followed. (sivethealth.com)
Recalled on day1
- She was discharged on day 8 after the procedure and was asymptomatic when recalled on day 10. (cdc.gov)