Comparison of Blood Donor Reactions in Whole Blood Donations, Plasmapheresis and Plateletpheresis / 대한수혈학회지

BACKGROUND: Several kinds of adverse reactions can occur during blood donation such as vasovagal reaction (VVR), hematoma, citrate toxicity, etc. These adverse reactions are not common, but they are important because they cause a decrease in re-donation. The cost for maintaining a repeat donation is very low compared to that for securing first-time donors. Whole blood donation differs from apheresis in some aspects, and this could have an influence on blood donor reactions. We compared whole blood donation with apheresis for blood donor reactions. METHODS: From January to December in 2007 at Busan Red Cross Blood Center, 109,004 donations were investigated for blood donor reactions. 76,098 (69.8%) donations were from male donors and 32,906 (30.2%) were from females. 77,813 (71.3%) donations were for whole blood, 25,224 (23.2%) were for plasmapheresis and 5,967 (5.5%) were for plateletpheresis. RESULTS: The frequencies of VVR were 0.10% (75/77,813) for the whole blood donations, 0.15% (37/25,224) for plasmapheresis and 0.03% (2/5,967) for plateletpheresis (P<0.05). The frequency of hematoma was 0.05% (37/77,813) for whole blood donation, 0.25% (62/25,224) for plasmapheresis and 0.27% (16/5,967) for plateletpheresis (P<0.05). Citrate toxicity was extremely rare. VVR was most common in plasmapheresis, and it was rare in plateletpheresis. CONCLUSION: The kinds of donated blood components had an influence on blood donor reactions. Understanding these characteristics helps to prevent adverse reaction. Having people re-donate is essential for keeping a large sized donor pool. So, appropriate management to prevent donor reactions is very important.

Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates / 대한진단검사의학회지

BACKGROUND: This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs' effectiveness during the storage period. METHODS: Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO3-, pO2, pCO2, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period. RESULTS: Starting from the Day 4, the pH and HCO3- of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non- LRCA group (P<0.01). An increase in pO2 level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4. CONCLUSIONS: The interruption of agitation reduced the platelet's capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer.

A Case of Group O Losing Anti-B Selectively / 대한수혈학회지

We report a case of group O losing anti-B selectively. A 25-year-old male donated blood; on the donor test an ABO discrepancy was noted, and a further evaluation study was performed. ABO genotyping with an allele specific polymerase chain reaction assay revealed O/O and DNA sequencing of exons 6 and 7 of the ABO gene showed O01/O02. The serum gammaglobulin level was decreased and only 0.2% CD19 pan-B positive lymphocytes were present in a subset of lymphocytes. In a previous donor study, anti-B of the patient was lost from a third donor study and was still not detected.

Characteristics and Follow-up Results of the Window Period Blood Donors for Hepatitis C Virus / 대한수혈학회지

BACKGROUND: To improve the safety of the blood supply in Korea, nucleic acid amplification testing (NAT) for HCV and HIV-1 as a blood screening test has been used by the Korean Red Cross since February 1st, 2005. Until October 31st 2006, a total of 4,037,618 donor samples had been tested and 436 cases showed reactivity for HCV RNA. Only 10 of these cases showed serologically negative antibody results. METHODS: We investigated the characteristics and the follow-up results of the ten donors who showed HCV RNA reactivity and serologically negative results. RESULTS: All the ten donors were identified to be "window period" blood donors with confirmation of their seroconversion by follow-up testing. The average RNA titer of the donors was 9.21x106 IU/mL. Five donors showed high levels of ALT. One donor showed the reversed pattern on the test results for antibody and RNA. CONCLUSION: By detecting five cases of HCV "window period" infection, NAT has increased the safety of the Korean blood supply. But it is considered that NAT can not be a substitute serological test and an adequate follow-up strategy is required for verification of the accurate seroconversion time.

The Effect of the Blood-donating Environment on Vasovagal Reaction / 대한수혈학회지

BACKGROUND: Active re-donation is important for the whole blood donation program. Preparation of the blood-collection environment to minimize vasovagal reaction (VVR) is very important because VVR is the most common factor for stopping re-donation. METHODS: From the 1st of January to the 30th of November in 2005 at Busan Red Cross Blood Center, a total 195,247 donations from 138,093 donors were investigated for VVR. RESULTS: The total frequency of VVR was 0.14%. The frequency of VVR of the group donors who donated in indoor collecting places was the highest and the next highest VVR frequency was for the outdoor donors group. Unexpectedly, the frequency of VVR was the lowest in donors who donated in a blood bus. Teenage donations of blood were most frequent, and the next were people in their twenties. The frequency of VVR was the highest in first-time donor group. The more blood donated, the less the subjects experienced VVR. CONCLUSION: To recruit and retain the blood donors, the blood collection environment should be reconsidered for the group-donors in indoor- or outdoor places and not for those in the blood bus. In these places, it is important to educate the staff and prepare the blood-collecting environment where individual attention can be given to donors of the high-risk group for preventing VVR.

Platelet Activation of Stored Platelets with Storage / 대한수혈학회지

BACKGROUND: Effects of storage period on platelet activation of random-donor platelets (RDP) prepared from whole blood units and single-donor platelets (SDP) prepared from single-donor apheresis collections have been investigated in this study. We also analyzed the correlation between amount of blood cells and platelet activation in random-donor platelets. METHODS: RDP and SDP were collected at 1 day, 3 day, or 5 day during storage. In case of SDP, whole blood was also collected just before apheresis. The platelet activation in RDP and SDP was measured by flowcytometry using monoclonal antibodies against CD41a, CD61 and CD62p. RESULTS: In SDP, MCFI against CD62p has been significantly increased during storage and any significant differences are not found according to the kinds of pheresis machines. In RDP, no significant differences in MCFI against CD62p were found with storage period and showed a increased MCFI dependent only on the number of platelets. CONCLUSION: Single-donor platelets should be used as soon as possible for transfusion due to progressive platelet activation with storage period. On the other hand, a proper number of platelets should be maintained under strict quality control system to minimize platelet activation in RDP.

Factors Affecting pH Changes in Preserving Platelet Concentrates / 대한수혈학회지

BACKGROUND: The purpose of this study is to examine whether the blood cells in the platelet concentrate (PC) and the PC arrangement method can affect the pH which is one of the important factors influencing the survival and function of the preserved PCs. METHOD: Two groups of CPDA-1 added PC were preserved at 20 ~ 24degrees C for 7 days. The PCs in group I were overlapped one another while those in group II were not overlapped and arranged separately during the preservation period. The number of RBC, WBC and platelets were measured at the first day of the preservation period while the pH was measured at the 1st, 3rd, 5th and 7th day. RESULTS: The number of blood cells in the PC was 0.6x109 for WBC, 1.6x109 for RBC and 800x109 for platelet. As for the average pH, the 1st day's average pH was 7.4 for group I and 7.3 for group II, while at the 7th day, both decreased by 0.6. According to the correlation analysis between the blood cells and the pH changes, as for group I, the more the number of platelets were, the lower the pH decreased, and as for group II, the more the WBC and platelets were, the lower the pH decreased. (p<0.01) CONCLUSION: This study indicates that the major parameter affecting the pH of the preserved PCs is the number of platelets. In addition to platelet, the number of WBCs affected the pH when PCs were overlapped during storage. Conclusionally the key factor which affects pH of stored PCs was the number of platelets. And the number of contaminated WBCs also were thought to be an important factor.

Affecting Factors on the Willingness to Platelet Apheresis / 대한수혈학회지

BACKGROUND: The purpose of this study is to empirically find out the affecting factors on the willingness to platelet apheresis. METHODS: Data were collected from 505 platelet apheresis donors and college students of major cities in Korea using the self-administered questionnaire. RESULTS: First, the level of positive cognition and affectivity to platelet apheresis donation and satisfaction for service during donation process among platelet apheresis donors were significantly higher than that among students only experiencing whole blood donation and students never experiencing blood donation. Second, valence for external and internal reward and knowledge of platelet apheresis among platelet apheresis donors were significantly higher than that among students only experiencing whole blood donation and students never experiencing blood donation. Third, platelet apheresis donors and students experiencing whole blood donation were more sound in character and more active in volunteer works, and had healthier behavior than students never experiencing blood donation. Fourth, the results of multiple regression analysis showed a statistically significant positive relationship between the willingness to platelet apheresis and valence for internal and external reward, satisfaction for service during donation process, and health behavior. CONCLUSIONS: These findings suggest that strategy for effective public relation and improvement of blood donor satisfaction should be developed in order to enhance willingness to platelet apheresis.

Qualitative and Quantitative Measurements of Anti-HCV Positive Blood Donor Group / 대한수혈학회지

BACKGROUND: To determine the positivity of hepatitis C virus-ribonucleic acid (HCV-RNA), we tested blood specimens of donor both positive in enzyme immunoassay (EIA) and in immunoblot assay, and those positive in EIA but indeterminate in immunoblot assay by nucleic acid amplification test (NAT). After quantifying HCV-RNA of specimens positive in NAT, we compared the titers of HCV-RNA between blood donor group and patient group. METHOD: One hundred twenty blood specimens positive both in screening test and in confirmative test, and 20 specimens positive in screening test but indeterminate were tested by qualifying NAT. After testing the specimens positive in this test by quantifying NAT, we classified specimens into 3 groups, normal group whose ALT values were within 45 IU/L, abnormal group whose values were higher than 45 IU/L and patient group who admitted into hospital to treat chronic hepatitis C and then compared HCV-RNA among groups. RESULTS: 81% of specimens both positive in screening test and in confirmative test was positive in NAT. Only 10% of specimens positive in screening test but indeterminate in confirmative test was positive in NAT. Ages of patient group were highest among groups and titers of HCV-RNA of patient group were lower than any other group. Correlation of AST/ALT values with the titers of HCV-RNA was not shown. CONCLUSION: It is concluded that the study groups show no difference of HCV-RNA titers whether they have symptoms of liver disease or not. The titer of HCV-RNA has no correlation with AST/ALT values.

Detection of platelet specific antigens by flow cytometry and genotyping method / 대한수혈학회지

BACKGROUND: To identify the human platelet antigens (HPA) associated with neonatal alloimmune thrombocytopenia (NATP), posttransfusion purpura (PTP), and platelet refractoriness, polymerase chain reaction-sequence specific primer (PCR-SSP) method and immunofluorescent method by flow cytometry were used. The frequencies of the genonotypes of HPA systems by PCR-SSP method and those of phenotypes by flow cytometry were determined. Then both types were compared each other and each types were compared with those of established reports. METHOD: Platelet suspensions were prepared from peripheral blood specimens of 200 blood donors and DNA specimens were extracted from those of 160 donors among them. Phenotypes of 200 specimens and genotypes of 160 ones were tested by flow cytometry and PCR-SSP method, respectively. RESLUTS: Frequencies of penotypes of HPA-1a, -3a, -4a, -4b and NaKa were 100.0%, 88.0, 100.0%, 0.5% and 94.0%, respectively. HPA-5 system could not be identified due to a few antigenic sites of HPA-5 systems. The genotype fequencies are of HPA-2 were a+b- 63.75%, a+b+ 35.00%, a-b+ 1.25%; HPA-3, a+b- 38.12%, a+b+ 48.13%, a-b+ 13.75%; HPA-4, a+b- 100.00%, a+b+ 0.00%, a-b+ 0.00%; HPA-5, a+b- 98.12%, a+b+ 1.88%, a-b+ 0.00%. The frequencies of HPA-4 and -5 were almost same as those of other reports but the frequencies of HPA-2 and -3 were somewhat different from others. Concordant rate between phenotype and genotype of HPA-3a,-4a and -4b were 95.6%, 100% and 99.4%, respectively. CONCLUSION: Phenotyping method by flow cytometry was rapid and objective for identifying HPA systems except HPA-5 system which has a few antigenic sites on platelet membrane. Especially it will be useful method for screening HPA-4b as possible cause of NATP in Koreans. But like other serologic methods, phenotyping by flow cytometry also require the highly qualified antiserum and appropriate amount of platelet. PCR-SSP method was also rapid and simple to test of genotypes of HPA-2~5 systems. Because PCR-SSP method is thought to be one of the most simple and economic genotyping methods to overcome the shortages of serologic methods, it is suggested to be the efficient screening method of HPA systems substituting the serologic methods in the cases which HPA sytems can not be identified by flow cytometry.

A study on vasovagal reaction of high school students participating in group blood donation / 대한수혈학회지

BACKGROUND: Vasovagal reaction(VVR) is the most common side reaction of blood donor reactions. The frequencies of VVR have not been yet reported among blood donors in Korea. This study was carried out to investigate VVR among high school students who participated in blood donation. The frequencies of VVR were compared according to sex, experience of blood donation and season. Symptoms, manifesting time and recovery time of VVR were evaluated with the rates and causes of deferral for blood donation. METHODS: 11,607 male and 7,442 female high school students residing in Pusan area who participated in group blood donation were evaluated on their VVR from November, 1996 to July, 1997. RESULTS: The rates of deferral for blood donation were 1.9% and 20.7% in male and female candidates for blood donation, respectively. The most common cause of deferral was low specific gravity of blood in both sexes. Frequencies of VVR were 0.39% and 2.0% in male and female donors, respectively. 2.86% of females and 0.42% of males who gave first blood donation experienced VVR. The frequency of VVR in female donors was higher in summer than in autumn and winter season. 60.5% of male donors and 77.3% of female donors manifested VVR within 5 minutes from blood donation. Dizziness and pale were the most common symptoms in male donors but dizziness, pale and nausea were the most common symtoms in female. 95.4% of male donors and 95.3% of female donors were recoverd from VVR within 10 minutes. CONCLUSION: VVR frequency of female donors was higher than that of male donors and it showed higher in females who gave first blood donation than in any other donors. Because the frequency of VVR in female donors showed higher in summer than in autumn and winter season, attention should be given to group blood donation of female high school students in summer season for the prevention of accidents from blood donation.

Comparison Between HLA-DR Serological Typing and O1igotyping / 대한임상병리학회지

BACKGROUND: In renal transplantation, a good HLA-DR match Is associated with successive graft outcome. But due to a number of technical problems, reliable serological DR typing cannot always be obtained. To compare the serological DR typing with DRBI DNA typing, we tested 103 specimens that had been frozen after serological typing, by PCR-SSOP typing method. METHODS: Serological DR typing was performed by complement-dependent microlymphocytotoxicity technique using commercial antisera kits, and DNA gyp ins was performed by PCR-SSOP, using one of the methods recommended by 12th International Histocompatibility Workshop. DNA amplification was done by DRBAMP-A and DRBAMP-B primers, and hybridization by 18 oligonucleotides labelled with digoxigenin.. RESULTS: The concordance rate between serologic typing and DNA typing was 76.7%. Most (79.0%) of discordant results were due to serological blanks turning out to be definable antigens by DNA typing and these antigens consisted of mainly DR5 splits but none of DR1, DR2, or DR7. CONCLUSIONS: In spite of technical improvement, serological typing method often can not define the accurate HLA-DR type. It is thought that combining serological typing with DNA typing Is necessary to achieve a higher success rate of graft outcome.