ABSTRACT
BACKGROUND: Cryoprecipitate depleted plasma(CDP) that is selectively used for therapeutic plasma exchange for the thrombotic thrombocytopenic purpura(TTP). We evaluated coagulation factor activities of CDP prepared by two different methods to use CDP as a blood component and induce a new guideline. METHODS: We studied 32 units of CDP were made from FFP collected from 16 donors. To prepare CDP, units of FFP were thawed in a 4degrees C water bath for 1 to 2 hours(rapid thawing) or thawed in a 1 to 6degrees C refrigerator for 14 to 16 hours(overnight thawing). Then CDP were refrozen within 1 hours, stored at -45degrees C and re-thawed in three weeks later. We measured prothrombin time(PT), activated partial prothrombin time(aPTT), fibrinogen, coagulation factor V, VIII, von willebrend factor(vWF) and vWF multimer of CDP at the time of preparation, after re-freezing and re-thawing. And we compared them with the results of platelet poor plasma(PPP). RESULTS: The mean volume of CDP was 129+/-12mL. We found all measured factors of CDP except factor V were significantly lower or longer than those of PPP. In the comparision of thawing method, rapid thawing CDP showed longer PT, higher activities of fibrinogen and factor VIII, lower activities of vWF than those of overnight thawing with no significant change of factor V. No significant changes were notified in all factors between the results of CDP within 1 hour of preparation and those of after re-freezing and re-thawing. CONCLUSIONS: CDP prepared by rapid thawing is more recommendable for therapeutic plasma exchange for TTP. CDP prepared by re-freezing and re-thawing can be used as a CDP just prepared from FFP.
Subject(s)
Humans , Baths , Blood Coagulation Factors , Blood Platelets , Cytidine Diphosphate , Factor V , Factor VIII , Fibrinogen , Plasma Exchange , Prothrombin , Tissue DonorsABSTRACT
We report here the results of surveys for external quality assessment of blood bank tests performed in 2003. Response rates for the 1st, 2nd and 3rd trial were 93.1%, 91.7%, and 90.1%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.7-100% and 99.7-100%, respectively. In crossmatching test, the accuracy rates were 97.4-100% for the compatible samples, 83.4-100% for the incompatible samples, 87.2-92.4% for the samples which were incompatible in albumin phase, and 83.4-88.8% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 97.9-99.6% for negative samples and 93.8-95.0% for positive samples. The correct results were reported from 95.9-100% of the surveyed institutions for antibody screening test and 98.8-100% for identification test. Forty six institutions gave repeatedly incorrect answers for crossmatching. Nine out of 46 institutions gave incorrect answers for all the test specimens sent out 3 times last year.
Subject(s)
Blood Banks , Coombs Test , Korea , Mass ScreeningABSTRACT
BACKGROUND: Since the genes encoding glycosyltransferases synthesizing ABO antigens were cloned and sequenced in 1990, genetic polymorphisms and phenotype-genotype correlations have been reported by several investigators, but the genetic basis remains unclear for many subgroups. The Ael phenotype is one of the important A subgroups having very weak A antigen, and recent studies suggested that different alleles can result in this phenotype. METHODS: Three unrelated Ael subgroup samples from Korean blood donors were studied. Exons 6 and 7 of the ABO gene, 91% of the catalytic active part of the glycosyltransferase, were amplified and subjected to direct sequencing. RESULTS: Only C467T substitution in comparison with the consensus sequence of A gene was found in one Ael sample, but this mutation pattern was very commonly observed in normal A1 phenotype of Orientals. The other two samples had T646A (Phe216Ile) and G681A (silent) substitutions beside C467T substitution, reported first from a Japanese Ael individual. CONCLUSIONS: These results indicate that molecular genetic heterogeneity within the Ael subgroup was also seen.
Subject(s)
Humans , ABO Blood-Group System , Alleles , Asian People , Blood Donors , Clone Cells , Consensus Sequence , Exons , Genes, vif , Glycosyltransferases , Molecular Biology , Phenotype , Polymorphism, Genetic , Population Characteristics , Research PersonnelABSTRACT
BACKGROUND: As the number of malaria patients has increased in Korea, the number of blood donors who are diagnosed as malaria after donation has also increased. And during 1997~2001, ten cases of transfusion-transmitted malaria were reported. We investigated the transfusion safety of blood that was donated by malaria patients before diagnosis. METHODS: For a total of 2,552 malaria patients diagnosed in 2001, blood donation history of past one year before diagnosis was inquired at the beginning of 2002. Then we inquired informations about recipients of the hospitals through the regional Red Cross blood centers. we also inquired development of malaria after transfusion for the recipients in the August of 2002. Malaria antibody test results of donated blood were also analyzed to determine the status of immunity of donors in Seoul, Gyeonggi and Gangwon area. RESULTS: Among 2,552 malaria patients, 162 (6.3%) patients had donated within one year before diagnosis and they were all man. Their blood was processed into 292 units of blood components and supplied to 90 hospitals, where it was transfused 286 patients. Among these 286 patients, no one was diagnosed as malaria until time of database retrieving. Among 162 malaria patient, enzyme immunoassay malaria antibody test results of 107 (66.0%) patients were available, and all were negative. CONCLUSION: No one has developed malaria among the recipients transfused with blood that was donated by malaria patients before diagnosis. Therefore, the infectivity of blood donated before malaria diagnosis is thought to be very low. As antibody to malaria was not produced in some of malaria patients before diagnosis, this finding could be useful for the study of immunology of malaria infection.
Subject(s)
Humans , Allergy and Immunology , Blood Donors , Diagnosis , Immunoenzyme Techniques , Korea , Malaria , Red Cross , Seoul , Tissue DonorsABSTRACT
We report here the results of surveys for external quality assessment of blood bank tests performed in 2002. Response rates for the 1st, 2nd and 3rd trial were 91.0%, 91.6%, and 91.8%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.4-100% and 97.4-100%, respectively. In crossmatching test, the accuracy rates were 92.5-98.3% for the compatible samples, 73.7-99.7% for the incompatible samples, 88.0% for the samples which were incompatible in albumin phase, and 73.7% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 96.3-98.4% for negative samples and 95.9-97.0% for positive samples. The correct results were reported by 98.6-100% of the surveyed institutions for antibody screening test and 100% for identification test. Forty six institutions gave repeatedly incorrect answers for crossmatching. Nine institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Subject(s)
Blood Banks , Coombs Test , Korea , Mass ScreeningABSTRACT
Concha bullosa is defined as the pneumatization of intranasal turbinates (superior, middle, or inferior). Inferior concha bullosa (ICB) is a very rare condition and it can cause nasal obstruction that needs surgery. In the English-Language literature, there are 3 reported unilateral ICB and 2 bilateral ICB. We experienced a case of unilateral ICB which was associated with septal deviation, chronic rhinosinusitis and nasophryngeal inverted papilloma. ICB was diagnosed by computed tomography (CT) showing pneumatization of inferior and middle turbinate on the right side in the coronal and axial plane. There have not been any reports of inferior concha bullosa in the last ten years in Korea. We report this case with a review of literature.
Subject(s)
Korea , Nasal Obstruction , Papilloma, Inverted , TurbinatesABSTRACT
BACKGROUND: Antiplatelet antibody test is the most important tool for the diagnosis of immune mediated thrombocytopenia. But antiplatelet antibody can occur in various diseases and the detection rates of antiplatelet antibody differ among investigators. In this study we investigated the prevalence of antiplatelet antibody in thrombocytopenic patients with various clinical conditions and analyzed the clinical significance of antiplatelet antibody in thrombocytopenia. METHODS: We tested 130 thrombocytopenic patients from 1999 January to 2000 October. The clinical diagnosis of the patients were 30 idiopathic thrombocytopenic purpura (ITP), 12 hematological diseases, 29 sepsis, 17 liver diseases, 11 pregnancy, 8 solid tumor, 2 malaria and 21 unclassified disorders. Antiplatelet antibody was detected by means of indirect immunofluorescence test. RESULTS: Antiplatelet antibody was detected in 6.2% of total patients (8/130) ; ITP 10% (3/30), malaria infection 50%(1/2), sepsis 3.5%(1/29), liver diseases 5.9%(1/17), solid tumors 12.5%(1/8), other unclassified disorders 4.8%(1/21). Antiplatelet antibody was negative in three drug induced thrombocytopenic patients. CONCLUSIONS: The positive rate of indirect immunofluorescent antiplatelet antibody was unexpectedly low in immune mediated thrombocytopenia. The positive results of non-immune mediated thrombocytopenia may be related to various conditions such as past platelet transfusions.
Subject(s)
Humans , Pregnancy , Diagnosis , Fluorescent Antibody Technique, Indirect , Hematologic Diseases , Liver Diseases , Malaria , Platelet Transfusion , Prevalence , Purpura, Thrombocytopenic, Idiopathic , Research Personnel , Sepsis , ThrombocytopeniaABSTRACT
It is very important to prevent hemolytic transfusion reaction. We experienced 1 case of transfusion in liver transplantation patient with multiple unexpected antibodies. On crossmatching for 20 pRBC (packed red blood cells), weak reactions were observed in room temperature, but strong reactions were observed in 37 , and AHG (antihuman globulin) phase. The patient had unexpected antibodies of anti-C, anti-Jka, anti-Dia. The probabilitis of compatible blood of anti-C, anti-Jka, anti-Dia in Koreans had been reported to be 14.2%, 32.8%, and 90%, respectively. We received 217 units of C antigen-negative pRBCs prepared by typing of 2679 type B pRBCs from Central, Eastern and Southern Blood Center of the Korean Red Cross. From the 217 units, 60 units of pRBCs compatible with patient's serum in AHG phase were prepared in our laboratory. The hemolytic tranfusion reaction can be successfully prevented by aid of Blood Center of Korean Red Cross and it should be emphasized that performing crossmatching including AHG phase is very important.
Subject(s)
Humans , Antibodies , Blood Group Incompatibility , Liver Transplantation , Liver , Red Cross , TransplantationABSTRACT
BACKGROUND: Blood utilization review in medical facilities is necessary for predicting blood demand and maintaining an efficient blood program. We investigated the use of blood components and discard rate of blood components in eight university hospitals in Korea. METHODS: Blood component utilization including autologous blood collection in eight university hospitals on 1999 was analyzed with the co-work of its department of laboratory medicine. RESULTS: 700,686 blood component units were used at eight university hospitals investigated. Among a total of 601,262 units analyzed, the department of internal medicine used 303,843(50.5%) units and ranked first among clinical department for blood use, followed by general surgery 91,450 units, thoracic surgery 45,038 units. The cumulative number of autologous blood collected until 1999 was 6,232 units. Seven hospitals experienced rejection of reimbursement for health insurance payments and the rejection rate ranged from one to 28%. CONCLUSIONS: This survey provides information on blood component usage in eight Korean university hospitals. A successive nationwide survey on blood utilization like this study is required for estimation of blood demand.
Subject(s)
Hospitals, University , Insurance, Health , Internal Medicine , Korea , Thoracic Surgery , Utilization ReviewABSTRACT
BACKGROUND AND OBJECTIVES: Sialolithiasis occurs in the submandibular gland rather than in the parotid or sublingual gland. It was manifested by several biochemical and anatomical factors inducing saliva retension. There have been various clinical reports about sialolith, but only a few analytical reports. MATERIALS AND METHODS: A retrospective review was carried out for the period of July, 1998 to July, 2000 of 25 cases of the submandibular sialolithes, which was diagnosed and removed . We performed clinical and component analysis of sialolithes with a new method that uses the absorption band of an infrared spectrometer analysis. RESULTS: Calcium phosphate (16 cases) showed a strong band at 1000cm-1 and calcium phosphate and albumin (9 cases) showed a strong double band at 1700cm-1 and 1000cm-1. The incidence of submandibular sialolithiasis was predominant in females, accounting for the male to female ratio of 8:17. The age distribution of sialolithes was 15 to 62 years. Sialolithes were removed by the transoral approach under local anesthesia and external approach (submandibular gland resection) under general anesthesia. For most patients, sialolithes were brown in color (12 cases), 2~14mm in size, 2.1~1636.8ng in weight and located on the Wharton's duct orifice (17 cases). CONCLUSION: The most common types of sialolithes were calcium phosphate (16 cases, 64%). The rest of sialolithes (9 cases, 36%) were mixed calcium phosphate and albumin. Compared to all the other methods used in the sialolithes analysis, the infrared analysis furnished the permanent record in the shortest time. It was also ideal for qualitative identification and semiquantitative estimation of small fractions of calcium.
Subject(s)
Female , Humans , Male , Absorption , Age Distribution , Anesthesia, General , Anesthesia, Local , Calcium , Incidence , Retrospective Studies , Saliva , Salivary Ducts , Salivary Gland Calculi , Sublingual Gland , Submandibular GlandABSTRACT
BACKGROUND: Identification of blood use characteristics in medical facilities is essential for predicting blood demand and maintaining an efficient blood programme. We investigated the use of blood components and discard rate of blood in hospitals. METHOD: Blood component utilization of hospitals in 1998 and 1999 was analyzed by mail survey and co-work with eight university hospitals. RESULTS: A total of 1,510,862 blood component units in 1998 and 1,646,346 units in 1999 meaning an increase of 8.97 % percent were used by 59 hospitals investigated. Use of irradiated blood and single-donor platelets increased. Blood discard rate was less than five percent in most hospitals and many hospitals experienced improper cut in health insurance reimbursement. CONCLUSION: Use of blood components in hospitals is increasing and national guideline for transfusion is needed. A successive investigation on National wide blood utilization like this study is required for estimation of blood demand.
Subject(s)
Hospitals, University , Insurance, Health, Reimbursement , Korea , Postal ServiceABSTRACT
BACKGROUND: Serologic test for syphilis(STS) is an old traditional donor screening test for preventing transfusion-transmitted syphilis. By conducting STS, history taking for donors and refrigeration of blood, transfusion associated syphilis is very rare at present. This study evaluated the usefulness of the STS as a surrogate marker for preventing the transfusion of human immunodeficiency virus(HIV) via the transfusion of infectious window-period blood in Korean blood donors. METHODS: Demographic and laboratory information on blood donations made between January 1997 and December 1998 in 16 Korean Red Cross Blood Centers was analyzed. STS positive rate of 239 HIV-infected people and blood donors in 1999 were investigated. RESULTS: Of 4,808,297 donations over 2-year period, 3,956 (0.08%) were positive in STS and 40 (0.0008%) were anti-HIV confirmed positive. Of those, two were simultaneously positive for STS and anti-HIV. Among donations, Anti-HIV positive donations were 64 times more likely to be STS positive(odds ratio=63.9) and positive predictive value (PPV) of STS for anti-HIV was 0.05%. Fourteen of 239 HIV-infected people were STS positive. CONCLUSION: STS positivity was higher in anti-HIV positive donors, but the PPV of STS for anti-HIV was low. STS as a donor screening test is considered as a poor marker for preventing post-screening HIV infections and the usefulness of STS must be evaluated in its own value.
Subject(s)
Humans , Biomarkers , Blood Donors , Donor Selection , HIV Infections , HIV , Red Cross , Refrigeration , Serologic Tests , Syphilis , Tissue DonorsABSTRACT
A large aggregate was found in a plasma unit collected by plasmapheresis at the Chungbuk Blood Center. The result of the screening test for the donor was normal. The aggregate was dissolved in 1N NaOH and 10% SDS and this aggregate was analyzed with UV spectrometer and NMR spectrometer. Most of the component of it was proved to be protein. The informations about this aggregate in plasmapheresis unit were asked to other institutes. Osaka Blood Center of Japanese Red Cross gave an information that the aggregate could be made by anticoagulant. When the aggregate was treated with the plasmin, the aggregate was dissolved completely. And the band regarded as fibrin was found in SDS-PAGE. An aggregate like this could be formed when the amount of anticoagulant is deficient in the collection of blood. To prevent the formation of the fibrin clot, the addition of the proper amount of anticoagulant has to be inspected.
Subject(s)
Humans , Academies and Institutes , Asian People , Electrophoresis, Polyacrylamide Gel , Fibrin , Fibrinolysin , Mass Screening , Plasma , Plasmapheresis , Red Cross , Tissue DonorsABSTRACT
BACKGROUND: The non-remunerated blood programme in Korea was delegated to the Korean Red Cross by the government since 1982 and 98% of blood for transfusion in medical facilities was supplied by KRC in 1999. This study was conducted to analyze the activities of recent ten years. METHODS: The quantities and trends of blood collection and transfusion were analyzed on the basis of annual report of Korean Red Cross. RESLUTS: Between 1990 and 1999, the number of annual blood donation increased from 1.1 million to 2.5 million units reaching 5.4 percent of total population in 1999. About 20 percent of total donation were plasmapheresis in 1999. The total number of whole blood transfusion decreased from 249,239 in 1990 to 47,814 units in 1999. The component transfusion of RBCs and Platelets increased from 0.7 million to 1.5 million and from 0.2 million to 1.1 million units, respectively. The stational donation rooms were opened actively from 1993 and more than 90 donation rooms were established in 1999. CONCLUSIONS: The total number of blood collected and transfused increased greatly. The component donation and individual voluntary donation are increasing. The quality control on blood programme conducted by Korean Red Cross was enforced.
Subject(s)
Humans , Blood Donors , Blood Transfusion , Korea , Plasmapheresis , Quality Control , Red CrossABSTRACT
BACKGROUND: There is still risk of acquiring HCV and HIV by transfusion due to window phase. Screening for HCV and HIV-1 by nucleic acid amplification testing (NAT) may improve blood safety allowing detection during the preseroconversion window in donors. METHODS: We investigated NAT usefulness using COBAS AMPLICOR analyzer (Roche). The following sample population were tested:1) 15,552 HCV/HIV-1 seronegative random blood donor samples for HCV and HIV-1 NAT;2) 696 high ALT and 271 HCV EIA positive samples for HCV NAT;3) 1,152 HIV-1 EIA reactive samples for HIV-1 NAT. NAT was performed on pools of 24 donations according to the assay protocol. RESLUTS: Six pools showed initial reactive reactions in HCV NAT and one pool showed initial reactive reaction in HIV-1 NAT. But no donor sample was found repeatedly reactive by this assay. CONCLUSIONS: Although there were false positive reactions, specificity of the NAT assay was high enough for the assay to be applied as a blood screening test and implementation of this assay is expected to improve blood safety and be useful for blood products use.
Subject(s)
Humans , Blood Donors , Blood Safety , False Positive Reactions , HIV , HIV-1 , Mass Screening , Nucleic Acid Amplification Techniques , Sensitivity and Specificity , Tissue DonorsABSTRACT
Screening test of Human Immunodeficiency Virus(HIV) infection was introduced on Korean Blood Donor Test Program in July 1987, and the test results between July 1987 and December 1990 were reported on the Korean Journal of Blood Transfusion on May 1992. Moreover, we assessed anti-HIV ELISA screening test result of 3,905,986 blood donors donated at Korean Red Cross Blood Centers between January 1991 and December 1993. The seropositivity of anti-HIV ELISA screening test was 0.26% in 1991, 0.30% in 1992 and 0.18% in 1993.0.15% of all donors in 1991 was reactive repeatedly, and 0.15% in 1992 and 0.08% in 1993. The prevalence of HIV infected donors confirmed by Western Blot Assay was 0.0003% in 1991, 0.0015% in 1992, and 0.0009% in 1993. The sero-positivities of anti-HIV screening tests with AIDSDIA reagent and HIVIRO reagent were 0.32% and 0.17% and the difference was significantly(p<0.05). The sero-positivities of ELISA screening and Western Blot. Assay detecting anti-HIV were lower in soldier group than in non-soldier donor group (p< 0.05).