BACKGROUND: Lewis antigens are not intrinsic to red cells, but are adsorbed from plasma to the red cell membranes. It is known that Lewis blood antigen is altered according to pregnancy, alcoholic cirrhosis, pancreatitis, and malignant tumor. The aim of this study was to investigate the alteration of RBC Lewis antigen expression and the correlation of Lewis genotype with serum CA19-9 and DUPAN-2 levels in gastric cancer patients. METHODS: Fifty-seven gastric cancer patients and forty five healthy controls were examined and compared in regard to Lewis blood phenotype and genotype. Serum levels of sialyl Lea(CA19-9) and sialyl Lea-b-(DUPAN-2) were measured by EIA to evaluate the relationshop between Le and Se genotype. RESLUTS: In heathy controls, the percentage of blood phenotype of Le(a+b-), Le(a-b+), and Le(a-b-) were 15.6%, 71.1%, and 13.3%, respectively; and in gastric cancer patients, 15.8%, 57.9%, and 26.3%, respectively. Le(a-b-) phenotype was more frequent in gastric cancer patients than in healthy controls. In gastric cancer patients, the percentage of Lewis genotype of (Le/-, se/se), (Le/-, Se/-), and (le/le, -/-) were 21.1%, 68.4%, and 10.5%, respectively. The Lewis gene frequency was not different between gastric cancer patients (Le 0.623, le 0.377) and healthy controls (Le 0.635, le 0.365). Many of Le gene negative patients (le/le) with gastric cancer exhibited high positive DUPAN-2 levels in serum, and many of Le gene positive patients showed high CA19-9 levels. CONCLUSIONS: This result showed that a loss of Lewis antigen in red blood cell in gastric cancer patients occurs during the adsorption of Lewis antigen to the red blood cell rather than the alteration of gene structure. And in using CA19-9 or DUPAN-2 as a tumor marker, a test of Lewis blood phenotype should be performed.
Adsorption ; Cell Membrane ; Erythrocytes ; Gene Frequency ; Genotype* ; Humans ; Liver Cirrhosis, Alcoholic ; Pancreatitis ; Phenotype* ; Plasma ; Pregnancy ; Stomach Neoplasms*

BACKGROUND: Platelet refractoriness has been reported to occur in 30-70% of multitransfused patients. This can result by either immune or nonimmune mechanisms. The predominant immune cause of platelet refractoriness is alloimmunization to HLA class I antigens. Recently, acid-treated platelets have been used in a few patients with platelet refractoriness due to HLA alloantibodies. However, the effect of acid-treated platelets has not been consistent. The aim of this study was to evaluate the in vivo survival of acid-treated, HLA-eluted platelets in HLA-immunized rabbits. METHODS: For in vivo survival test, 14 New Zealand White rabbits were studied. Four rabbits were in the nonimmunized control and 10 were immunized by weekly transfusions of human pooled platelets for six weeks. The HLA-immunized group was separated into two groups with transfusion of acid-treated platelets and untreated platelets. The survival of transfused platelets in rabbits with immunization and control group was estimated by a flow cytometer using FITC-labeled anti-CD42a. We also examined the HLA re-expression in acid-treated platelets due to regeneration and adsorption of HLA from human plasma. RESLUTS: The half-life of untreated platelets in nonimmunized rabbits was 11.8 +/- 3.7 hr. The half-life of acid-treated platelets in rabbits with HLA antibodies was 9.5 +/- 5.5 hr and the half-life of untreated platelets in rabbits with HLA antibodies was 5.9 +/- 2.9 hr. The difference between untreated platelets in the nonimmunized control group and acid-treated platelets in rabbits with HLA antibodies was statistically insignificant (p=0.221). Re-expression of HLA-A,B,C by endogenous resynthesis occurred continuously, and after 24 hrs it reached 84% of pre-elution level. Adsorption of HLA antigens from human plasma was completed within four hrs. CONCLUSIONS: Acid-treated, HLA-eluted platelets may be applicable for the patients with refractoriness to platelet transfusion, especially, in case of unavailability of HLA-compatible donors and fatal bleeding such as intracranial hemorrhage and pulmonary hemorrhage. However, the post-transfusion increment of the platelet count could not be maintained over 24 hrs because of the endogenous resynthesis of HLA antigens.
Adsorption ; Antibodies ; Blood Platelets ; Half-Life ; Hemorrhage ; Histocompatibility Antigens Class I ; HLA Antigens ; Humans ; Immunization ; Intracranial Hemorrhages ; Isoantibodies ; Plasma ; Platelet Count ; Platelet Transfusion ; Rabbits* ; Regeneration ; Tissue Donors

BACKGROUND: Some investigators have done several studies on the frequency and distribution of unexpected antibodies in Korea. But more studies are necessary to estimate the precise frequency of unexpected antibodies. METHOD: In order to determine the frequency of unexpected antibodies, we analyzed the results from 23,735 antibody-screening tests performed for transfusion candidates at Yonsei University Severance Hospital during a recent two-year period (March 1998~ Feb 2000). Screening and identification of unexpected antibodies were carried out using a gel agglutination technique with DiaMed-ID system (DiaMed, Murten, Switzerland). RESLUT: Out of all 23,735 serum samples, positive results were obtained from 109 sera (0.46%). Clinically significant antibodies were found from 0.29% of all the population. Antibodies that were detected most frequently were anti-E+c (33 sera), followed by anti-E (19 sera) and anti-Lea (12 sera). CONCLUSION: We found that Rh antibodies, clinically significant unexpected antibodies, are detected frequently in Korea, too. So we consider that unexpected antibody screening test must be included in pre-transfusion test in Korea and this information is reassuring in assessing the risk associated with blood transfusion in many hospitals of Korea.
Agglutination ; Antibodies* ; Blood Transfusion ; Humans ; Incidence* ; Korea ; Mass Screening ; Research Personnel

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.
Blood Donors* ; Blood Safety ; False Positive Reactions ; HIV ; HIV-1* ; Humans ; Mass Screening ; Nucleic Acid Amplification Techniques ; Sensitivity and Specificity ; Tissue Donors

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.
Blood Donors ; Blood Transfusion ; Humans ; Korea ; Plasmapheresis ; Quality Control ; Red Cross*

Alloantibodies against RBCs after transfusion of only platelet products are rarely reported except for RhD mismatched platelet transfusion. We report a case of anti-E antibody developed after transfusion of platelet concentrates. The patient was a 27- month male infant with idiopathic thrombocytopenic purpura and was treated with IV immunoglobulin and IV Rh immunoglobulin. Anti-E antibody was detected after transfusion of 18 units of platelet concentrates for about 40 days. RBC alloimmunization was developed after transfusion of platelet products, which suggests platelet transfusion may be cause of RBC alloimmunization in childhood.
Blood Platelets* ; Humans ; Immunoglobulins ; Infant ; Isoantibodies ; Male ; Platelet Transfusion ; Purpura, Thrombocytopenic, Idiopathic*

Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury that occurs during or within 6 hours of a completed transfusion, which has been the leading cause of transfusion-related death. We report a case of TRALI in a 63-year old man with alcoholic liver disease. He developed hypoxemia and non-cardiogenic pulmonary edema after red blood cell transfusion. Given an oxygen support, he recovered after 4 days.
Acute Lung Injury* ; Anoxia ; Blood Group Incompatibility ; Erythrocyte Transfusion ; Humans ; Liver Diseases, Alcoholic ; Middle Aged ; Oxygen ; Pulmonary Edema

Authors found a case of anti-Wr(a) with anti-E antibody in 67 years old female patient. Anti-Wr(a) in Korea was reported for the first time in 2005. Anti-Wr(a) has been associated with hemolytic transfusion reaction (HTR) and hemolytic disease of the newborn (HDN). It is necessary to study the incidence of Wr(a) antigen and anti-Wr(a) in Korea.
Aged ; Blood Group Incompatibility ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea

Febrile nonhemolytic transfusion reaction (FNHTR) is one of the most common adverse reactions to the transfusion of blood products. It is caused by antigen-antibody reactions between patient's plasma and transfused cellular components (or the reverse) or bioactive substances such as cytokines generated by leukocytes during storage of cellular blood components. Most of the antibodies involved in FNHTR are anti-HLA antibodies. However, platelet-specific antibodies and rarely granulocyte-specific antibodies may be involved in FNHTR, We found a granulocyte antibody from a 53-year-old male with FNHTR for the first time in Korea. Fever developed during transfusion of a unit of packed RBC after partial cystectomy, and subsided after the adminstration of acetaminophen. The hemolytic transfusion reaction and sepsis were excluded after investigations. Mixed passive hemagglutination test revealed that the patient had antibody against human neutrophil antigen-1b (HNA-1b), and granulocyte antigen genotyping showed granulocyte antigen mismatches between the patient (HNA-1a homozygote) and the unit of transfused RBC (HNA-1a/HNA-1b heterozygote).
Acetaminophen ; Antibodies ; Antigen-Antibody Reactions ; Blood Group Incompatibility* ; Cystectomy ; Cytokines ; Fever ; Granulocytes ; Hemagglutination Tests ; Humans ; Korea* ; Leukocytes ; Male ; Middle Aged ; Neutrophils ; Plasma ; Sepsis

BACKGROUND: The blood processing works are composed of phlebotomy, donor testing, manufacturing, storage, transportation, and quality control. Among these, storage, transportation and quality control are done partially at the blood collection centers and finally accomplished at the hospital blood banks. We tried to analyze blood processing costs in hospital blood banks. METHODS: Blood processing costs are divided into physician works, practice expenses, and professional liability insurance according to RBRVS (Resource-Based Relative Value Scale). Physician works were analyzed according to the study of the 'Physician work RBRVS committee of the Korean society for laboratory medicine'. For the practice expenses, three university hospital blood banks data were analyzed. The costs for the blood supply of small clinics or hospitals without blood banks were investigated by questionnaire. RESULTS: Comprehensive works of physician were such as laboratory administration, quality control, preparation of procedure manual, education, quality improvement control. Specific works of physician were such as supervision over technologists, analysis of quality control data, management of blood inventory, storage and issue, blood utilization review, management of adverse transfusion reaction, blood return and disposal. As for one unit of blood, the standard labor time of technologists was 28.8 minutes (which is equivalent of 7,680 won) and the mean equipment cost was 592 won. The mean cost of small clinics or hospitals for blood supply was 12,150 won. CONCLUSION: The reimbursement of blood processing cost for the hospital blood bank would contribute to stable blood bank administration, stable blood supply and safe transfusion.
Blood Banks* ; Blood Group Incompatibility ; Education ; Humans ; Insurance ; Liability, Legal ; Organization and Administration ; Phlebotomy ; Quality Control ; Quality Improvement ; Tissue Donors ; Transportation ; Utilization Review ; Surveys and Questionnaires