The influence of CS-3000 plateletapheresis on blood donors and on platelet concentrates.

Platelet concentrates were prepared from blood of donors by means of Fenwal CS-3000, or by double centrifugation method. Platelets from CS-3000 were cryopreserved with 5% DMSO for 2-4 weeks. After thawing and washing platelets were stored in room temperature for 6 hours. Immediately after plateletapheresis the platelet count decreased by 24% and leukocyte count, Ht and Hb diminished on average 30%, 22% and 18% respectively. The efficiency of separation procedure was 45% and white cells contamination 5.8 +/-8.1 x 10(11). Significant morphological changes and the decrease in total ATP comparing to double centrifugation method were observed. Storage of platelets for 6 hours in room temperature didn't cause their quality changes. Single donor plateletapheresis method can prevent alloimmunization and diminish the risk of transmission of the viruses.

Donors leukapheresis on Fenwal CS-3000.

Leukocytes were collected from 24 donors using Fenwal CS-3000 cell separator. Two different sedimentation agents in citric acid were used. After collection donors hematologic data were evaluated. No significant differences in product yield and in donors blood test were observed when in product yield and in donors blood test were observed when Dextran 110 or HES were used. The average donor leukocyte count declined by 30% after the completion of the procedure. Mean donor platelet count decrease an average by 23% (from 203 to 156 x 10(3)/microliters). Other hematologic data were consistent with hemodilution due to anticoagulant and saline solutions.

Blood component therapy in open heart surgery.

Extensive bleeding still remains a major cause of morbidity and mortality in patients undergoing surgery despite the recent achievements in our understanding of hemostasis and availability of modern blood component therapy. In some surgical patients abnormally prolonged operative bleeding due to thrombocytopenia or thrombocytopathia may be corrected by the infusion of platelet concentrates. Evaluation of the requests for platelet transfusion therapy to prevent or to stop excessive thrombocytopenic bleeding should be based on clinical and laboratory data, underlying disease and availability of therapeutic products. In most instances of hemostatic alterations associated with cardiopulmonary bypass operations, the occasional bleeding episodes are related to platelet dysfunction rather than to plasma coagulation abnormalities. While the levels of coagulation factors are usually depleted, principally due to dilution with priming solutions for the oxygenator, only rarely the levels impairing hemostasis are reached. In the early days of open heart surgery, it was thought that freshly drawn whole blood was essential for these procedures but now a days, it seems that stored red blood cells are equally effective. Use of fresh frozen plasma (FFP) for replacement of coagulation factors during or after cardiopulmonary bypass only rarely is necessary, and mild to moderate abnormalities of coagulation factors can be tolerated without FFP transfusion. In the early stage of open heart surgery (late sixties) an average of 9 units of whole blood (freshly drawn) was used for each patient during and after cardiopulmonary bypass. Since that time, much attention has been focused on methods to reduce blood requirements for these patients. Hemodilution using a bloodless prime for the oxygenator is now widely used and has been found to be effective in reducing blood usage.(ABSTRACT TRUNCATED AT 250 WORDS)

[Studies of the possibility of preservation of leukocyte concentrates]. / Badania nad mozliwoscia przechowywania koncentratów leukocytarnych.

The authors tried to explain whether granulocytes obtained by sedimentation on dextran can be stored, under what conditions, and for how long time. For this purpose leukocyte concentrated were stored at 4-6 degrees C and 20-24 degrees C for up to 48 hours, and the count and percent proportions of leucocytes, granulocyte viability, their phagocytic index, chemotactic ability and ATP content were determined. The investigations demonstrated a progressing decrease of the biological viability of granulocytes after 24 hours, and a further decrease after 48 hours. Particularly pronounced and early changes were noted in the chemotactic activity and ATP content. A beneficial effect was noted of higher storage temperature (20-24 degrees C) on the maintenance of chemotactic activity. The other parameters were not temperature-dependent. It seems that under such conditions leucocyte concentrates should be transfused preferably immediately after their preparation.

[Plasmapheresis in the treatment of pemphigus]. / Plasmapheresebehandlung bei Pemphigus.

The results of small-volume plasmapheresis were favorable in cases of severe pemphigus vulgaris and foliaceus if applied simultaneously together with corticosteroids and cyclophosphamide, both on lowered doses. The patients went into long-lasting remission. A special indication for this therapy are cases that do not allow the application of large doses of prednison because of severe side-effects of steroids. The effect of plasmapheresis does not appear to depend on the removal large quantity of antibodies. Small-volume plasmapheresis as a supplementary therapy of the combined treatment with steroids and immuno-suppressors showed better effects than large-volume plasmapheresis.

[Peritoneal dialysis and leukopheresis in psoriasis: indications and contraindications]. / Peritonealdialyse und Leukopherese bei Psoriasis: Indikation und Kontraindikation.

Twenty-four patients with severe psoriasis were treated with continuous peritoneal dialysis and ten patients with repeated leukopheresis, with comparable clinical results: about 20%-30% of the patients had complete remission of the lesions during the therapy, about 40% showed spontaneous regression of above 50% of psoriatic lesions, and the remaining patients had some improvement. However, despite partial improvement during treatment, the psoriatic lesions of the patients that were previously unresponsive to any external and internal treatment disappeared within 2-3 weeks, after discontinuation of dialysis or leukopheresis, with the use of anthralin or tar ointments. Peritoneal dialysis and leukopheresis seem to be useful methods of treatment for especially resistent and widespread psoriasis in patients having contraindications to other methods, i.e., PUVA and/or aromatic retinoids.

Experimental investigations on the influence of stroma-free haemoglobin solution on kidney function in exchange transfusion models.

In the continuing search for promoting the bio-pharmacological characteristics of an excellent oxygen carrier, the Stroma-free Haemoglobin Solution (SFHS), in the presented work, the authors were investigating the composition changes of SFHS infused to dogs. In 10 mongrel dogs a total exchange of the circulating blood was done for replacing it with SFHS. For the observing the physico-chemical changes in circulating and excreted fluids electron spectroscopy was used in view of good spectral characteristics of haemoglobin, and a high sensitivity of this method to changes taking place in the analyzed molecule. Comparing the spectral curves characterizing the solution used for exchange transfusion with the spectral curves obtained from circulating SFHS samples and haemoglobin excreted in the urine, and from the ascites, during the 6 hours course of the experiment, no essential structural changes were observed in the hemin molecule, in the visible range.

Predictive value of lymphocytotoxic test and platelet aggregometry for the effect of transfused platelet concentrates.

Sera of patients with thrombocytopenic diathesis before platelet transfusion were evaluated using donor's platelets in the aggregometry test the donor's lymphocytes in the lymphocytotoxicity test. In most cases the results of both tests were in agreement, although sometimes, despite strongly positive results of LCTT, the Agr was negative. Both tests showed a similar value for the prediction of the effectiveness of platelet concentrates: Agr in 80% and LCTT in 71% of cases.

Plasmapheresis as a supplementary treatment in pemphigus.

Four cases with pemphigus 3 p. vulgaris and one p. foliaceus were treated with plasmapheresis. The volume of plasma exchange was 500-800 ml once a week for 6 weeks. In one patient the procedure was repeated four times, within 8 months. All patients were treated with prednisone and azathioprine or cyclophosphamide at the same time, but in lower dosages. The results were satisfactory and the remission after the treatment lasted for 11 months to 2 years.

Plasmapheresis in the treatment of systemic lupus erythematosus.

Plasmapheresis has been used as a supplementary method for the treatment of 11 cases of SLE (7 with lupus nephritis and 4 without renal changes). In 7 cases there was a marked improvement during the plasma exchanges which lasted from 2 months to 3 years of follow up. In one case the direct result was satisfactory but after 3 months there was a severe relapse and the patient died. In 3 cases (two without lupus nephritis) plasmapheresis was without any effect. We believe that plasmapheresis is chiefly indicated in severe cases with high levels of ds-DNA antibody titers.

Influence of stroma-free hemoglobin solution on renal function in dogs.

In the presented series of experiments, stroma-free hemoglobin solution (SFHS) was used as a perfusate for extracorporeal perfusion of kidneys and for exchange transfusion. It was shown that SFHS was adequatly oxygenated both as perfusate during the extracorporal perfusion and in the lungs after the blood exchange. Furthermore, there was provided evidence that oxygen was being transported and released in the tissues. Histologic examination of the kidneys demonstrated hemoglobin casts in the glomerules. Most of them were seen after extracorporal perfusion of isolated kidneys, less frequently after perfusion in situ and few casts were present after exchange transfusion. The cause of these depositions may be small remnants of stroma in the preparation. Furthermore it is possible, that at the beginning of the extracorporal perfusion of the kidneys the urine pH was below 6 and then a hemoglobin casts formation could occur. There were essential no changes in urine pH in the course of blood exchange. In this group were only few casts present in the kidneys.