Comparative assessment of single-donor plateletpheresis by Haemonetics® MCS® plus and Trima Accel®.

BACKGROUND: Single-donor platelets (SDPs) prepared by sophisticated automated equipment offer several advantages over random-donor platelets and are being increasingly used to support thrombocytopenic patients. Different apheresis machines working on the principle of centrifugation are being used worldwide to collect platelets. This retrospective study was done to compare plateletpheresis on two automated cell seperators - Haemonetics® MCS® Plus and Trima Accel®. MATERIALS AND METHODS: Data for 100 single-donor plateletpheresis procedures, fifty on each machine, were retrospectively collected and analyzed. Donor characteristics were analyzed by Student's t-test and no significant difference was found between the two groups. The parameters compared between the two machines were yield, collection efficiency, blood volume processed, procedure time, acid-citrate-dextrose (ACD) used, leukodepletion achieved, quality control of the products, and adverse donor reactions. RESULTS: Platelet yield (3.054 ± 0.14 vs. 3.120 ± 0.25), quality control of the platelets, leukodepletion achieved, and donor safety were comparable in both the machines. The blood volume processed (2230.74 ± 227.01 vs. 2452.90 ± 318.61), ACD used during procedure (265.48 ± 43.21 vs. 298.10 ± 53.32), procedural time (55.92 ± 13.00 vs. 68.86 ± 12.64), and the postprocedural decrease in donor count in Trima Accel® (183.10 ± 23.99 vs. 161.44 ± 63.47) were significantly less than those in Haemonetics® MCS® Plus. The median collection efficiency of Trima Accel® was found to be greater than Haemonetics® MCS® Plus (0.000649 vs. 0.000608, P = 0.020). CONCLUSION: Both Trima Accel® and Haemonetics® MCS® Plus can collect SDPs safely and efficiently. Trima Accel® has higher collection efficiency and reduced incidence of citrate-related adverse effects. It also has better potential to optimize productivity due to decreased procedural time.

Effect of FFP Transfusion on International Normalized Ratio in Liver Disease Patients.

Fresh frozen plasma (FFP) is widely used in liver diseases to rectify coagulation derangements. In this study we have analysed the pattern of FFP usage in liver diseases and its effect on International normalized ratio (INR). A retrospective study of liver disease patients who received FFP transfusions from January 2016 to June 2016 was done. FFP used for liver transplant surgeries and plasma exchange procedures were excluded from the study. A total of 1935 units of FFP were transfused to 576 patients. We found a high linear correlation between pre transfusion INR and change in INR per unit of FFP. Patients receiving 6 units or more FFP have shown significant INR improvement. Improvement was more in acute liver failure and acute on chronic liver failure cases compared to chronic liver disease. FFP is not effective in correcting mild to moderate coagulation defects in liver diseases. Large volumes are required to cause significant INR improvement. Considering the risks associated with FFP transfusion, decision of transfusion should be carefully weighed. Future prospective randomized control trails are required for understanding the risk benefit ratio better and formulating plasma transfusion guidelines in liver diseases.

Insertion/Insertion Genotype of Angiotensin I-Converting-Enzyme Gene Predicts Risk of Myocardial Infarction in North East India.

Myocardial infarction (MI) is common in India and the disease occurs at a relatively younger age. We wanted to look for association of Angiotensin I-converting enzyme (ACE) gene with MI in North East India. We also wanted to examine possible environmental interaction of ACE gene with established cardiovascular risk factors in causation of MI. In the study carried out in Assam Medical College, 200 consecutive confirmed cases of MI were recruited. Equal numbers of age- and sex-matched control subjects from hospital workers and patients attending the hospital for diseases unrelated to cardiovascular disease were enrolled. Structured questionnaires were used to note demographic and clinical factors. Cardiovascular risk factors were determined from history, physical examination and biochemical investigations. ACE insertion/deletion (I/D) polymorphism was determined by PCR method. Interaction of ACE gene with other risk factors was noted. The study identified ACE II genotype (odds ratio = 3.02; 95% CI 1.40-6.51), smoking, hypertension, diabetes and serum triglyceride > 150 mg/dl as independent risk factors for MI. ACE II genotype showed greater risk in non-smokers, non-hypertensives, non-diabetics and in subjects with LDL-C < 130 mg/dl. Low HDL cholesterol enhanced the genetic risk. Subjects with ACE II genotype have an independent risk of developing MI, specially in low cardiovascular risk subjects.

Crystal structure of tetra-kis-(µ-caproato-κ(2) O:O')bis-[(4-cyano-pyridine-κN (1))copper(II)].

The title dinuclear complex, [Cu2(C6H11O2)4(C6H4N2)2], has a paddle-wheel structure. The two crystallographically independent Cu(II) atoms are each in a distorted square-pyramidal environment, in which four O atoms from the four bridging caproate ligands form the basal plane and the pyridine N atom of the 4-cyano-pyridine ligand occupies the apical position. The Cu⋯Cu distance is 2.6055 (9) Å. One of the alkyl chains of the caproate ligands is disordered over two sets of sites, with occupancies of 0.725 (5) and 0.275 (5). In the crystal, two pairs of C-H⋯N hydrogen bonds connect the mol-ecules into chains along [11-1] and C-H⋯O hydrogen bonds link the chains into a three-dimensional network.