[Tests for donors of cord blood and bone marrow].

To date blood transfusion is considered to be one of tissue or organ transplantation. In the hematopoietic stem cell transplantation, donors of bone marrow, peripheral blood stem cells (PBSC) or cord blood should be tested to keep safety of donors and patients. Donors of PBSC, cord blood and bone marrow should be selected on the results of HLA class I and class II. Furthermore, donors of bone marrow should be tested for general anesthesia in order to keep safety of donors. In the present paper, we described the lists of tests for patients and donors of blood, PBSC, cord blood and bone marrow before and after stem cell transplantation.

Acute popliteal artery occlusion after total knee arthroplasty.

We describe the case of a 71-year-old man with calcium pyrophosphate dihydrate crystal deposition disease who developed acute popliteal artery occlusion immediately after total knee arthroplasty. Reperfusion was achieved thanks to the early diagnosis and thrombolytic therapy with urokinase. Arterial occlusion occurring after total knee arthroplasty is a rare but serious complication. Detailed preoperative evaluation of the peripheral arterial circulation and an early diagnosis seem to be important.

Anti-A and/or anti-B is not detectable in some patients who underwent ABO-incompatible bone marrow transplantation.

BACKGROUND: Recently, anti-A and/or anti-B produced by B cells from donor marrow could not be detected for more than 20 weeks in some patients who had undergone ABO-incompatible bone marrow transplantation (BMT). STUDY DESIGN AND METHODS: Twelve to 72 weeks after 11 patients underwent ABO-incompatible BMT, titers of anti-A and anti-B were assayed, A and B antigens were identified by routine methods and flow cytometry, direct and indirect antiglobulin tests were performed, and the red cell antibody was eluted. RESULTS: In some patients who underwent ABO-incompatible BMT, anti-A and/or anti-B produced by the B cells from the donor marrow could not be detected after BMT when red cells taken from the patients before BMT carried the corresponding antigen--that is, when hematopoiesis had already changed the cells to the donor's type according to ABO blood typing. Furthermore, some blood samples from those patients gave positive results in direct antiglobulin tests. Blood typing of patients after BMT showed mixed-field agglutination. In one patient, the half-life of red cells assayed with 51Cr was 22.4 days (30.0 +/- 4.0 days for normal controls). CONCLUSION: Although many hypotheses could be considered to explain the present data, the possibility is proposed that anti-A and/or anti-B in the sera must have been consumed in some patients who underwent ABO-incompatible BMT. This may lead to problems such as difficulty of ABO typing, positive direct antiglobulin tests, and a relatively short life span of red cells.

[Blood type and screen for crossmatch].

To reduce work and effectively use blood for transfusion, a type and screening system (T & S) has been adopted in many hospitals. A questionnaire survey on the system and tests for a transfusion was carried out on our hospital and 381 other hospitals. For 3 years in our hospital, 0.73% of the samples tested revealed the presence of antibodies to red cells which were 30% of the antibodies in Rh system, 30% in Le system, 38% in P1 M and N, and 3% of the other system such as Fyb, Jka and S. Forty percent of the positive samples were subjected to a crossmatch test. The tests were done in a laboratory for serum test in approximately half of the hospitals. A pharmaceutical division controlled the reservation of blood and blood components in 56% of the hospitals. In 45% of the hospitals, a crossmatch test was done using the methods of saline, enzyme treatment and Coombs test. In 10% of the hospitals. Coombs test was used for the test in the transfusion of red cells, platelets, and frozen plasma, and tests were done in 100, 67, and 52% of the hospitals, respectively. When the T & S system is adopted. Staff must have sufficient knowledge on blood transfusion and the system must be efficient to avoid transfusion troubles.