Thawing fresh frozen plasma(FFP) by waterbath(WB) requires about 30 minutes, which is too slow in emergency situations and carries the risk of bacterial contamination of FFP. To solve these problems, a new thawing method using a microwave oven(MWO) has been developed. Twenty units of equally divided plasma from 10 units of plasma were frozen, stored at -55 degrees C, and thawed in parallel using microwave oven or waterbath. Coagulation factors, plasma proteins and thawing time were measured. Except for antithrombin III(MWO: 85.2+/-6.94%, WB : 90.8+/-9.14%, p<0.05), no significant differences were observed in the 18 other coagulation parameters and the plasma proteins studied. Mean thawing time by MWO was 5.9 minutes per 1 unit, 10.4 minutes per 2 units and 12.5 minutes per 3 units; by WB, it was 19.0, 20.0 and 22.0 minutes, respectively. In conclusion, FFP can be thawed faster using a microwave oven than using 37 degrees C waterbath and the thawed plasma proteins were generally equivalent to those of FFP thawed by waterbath.
Blood Coagulation Factors ; Blood Proteins ; Emergencies ; Microwaves* ; Plasma*

Bedside filtration for white celI(WBC) reduction of red cell concentrates(RBCs) has been performed to reduce the workload of blood bank personnel. However, a high incidence of filtration failure with bedside filters was recognized by several investigators. We therefore evaluated the efficiency of the bedside filter under various conditions that might be important variables such as temperature of the blood units, flow rate and possibly, filtration techniques performed. We used 29 bedside filters(RCXL2, Pall Corporation, USA) and total of 58 units of CPDA-1 RBCs for this study. Thirty eight refrigerated RBCs were filtered at fast flow with or without mixing the blood cells in a bag to resuspend the possible blood cell aggregates. And another 20 units were filtered at slow flow(2 hours) with or without mixing after 1 hour incubation at room temperature. Pre-, intra-, and post-filtration blood samples were collected and residual white cells were counted using Nageotte hemocytometer. A higher contamination of white cells was found in the units filtered after mixing at slow flow(mean 2.99 x 105/unit) than at fast flow(mean 1.31 x 10S/unit) and in the units filtered at slow flow without mixing(mean 6.11 x 10S/unit) than with mixing(mean 2.46x 10S/unit). Our data suggested that filtration at slow flow decrease the efficiency of WBC reduction, especially after omitting the mixing process before filtration.
Blood Banks ; Blood Cells ; Filtration* ; Humans ; Incidence ; Leukocytes* ; Research Personnel

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.
Antibodies ; Female ; Fetal Death ; Haplotypes ; Homozygote ; Humans ; Hydrops Fetalis ; Incidence ; Infant, Newborn* ; Korea ; Phenotype* ; Pregnancy ; Siblings

Isoimmune hemolytic disease of the newborn due to anti-E is a disease characterized by the progressive neonatal hyperbilimbinemia and anemia which is caused by the IgG antibody transmitted from the mother to the ferns. Authors have experienced two cases of isoimmune hemolytic disease due to anti-E, who presented with jaundice on the first and the second day of life, respectively. The ABO and Rh blood types of their mother and father were B, CcDee and O, ccDEE, respectively. Both babies showed positive direct Coombs test and the mother showed strong positive indirect Coombs test. Antibody identification tests were made only in the first case and the mother, both of which revealed anti-E antibody. The first case was treated with phototherapy for 3 days and two blood transfusions. The second case was treated with phototherapy for 6 days and two exchange transfusions.
Anemia ; Blood Transfusion ; Coombs Test ; Fathers ; Ferns ; Humans ; Immunoglobulin G ; Infant, Newborn ; Jaundice ; Mothers ; Phototherapy ; Siblings*

Authors experienced a case of A3B in a 46-year-old patient with liver cirrhosis and two cases of A3 in her children by family study. A3 subgroups were confirmed by delayed and weak positive with anti-A and anti-A,B, negative in anti-A1 lectin, adsorption-elution test, and family study. We report a family case of A3B and A3 with brief review of literatures.
Child ; Humans ; Liver Cirrhosis ; Middle Aged

We reported a case of hemolytic transfusion reaction that was related to multiple RBC antibodies such as anti-E, anti-M, anti-Jkb and anti-Lea after serial RBC transfusions. A forty-nine year old female visited the emergency room (ER) with hematochezia. She had previously received 16 units of packed RBCs from 2003 to Jan 2007 for her intermittent esophageal varix bleeding. No specific antibodies were identified before this visiting. At the ER, under the request for packed RBCs, we identified anti-E antibody within her serum. Her blood type was AB, RhD+ with the phenotype of CcDe. She received 5 units of E antigen negative RBCs. However, she showed hemolytic transfusion reactions such as mild fever with a decrease of hemoglobin from 11.4 g/dL to 6.8 g/dL after the transfusion. From the 8th to the 10th hospital day, another 3 units of E-antigen negative with the least incompatible RBCs were transfused to the patient, but the level of hemoglobin was not definitely increased. At the 14th hospital day, she received a final 2 units of leuko-reduced RBCs without E, M and Jkb antigens. Her hemoglobin was increased right after the final transfusion. We found that the patient's serum reacted with multiple RBC antibodies such as anti-E, anti-M, anti-Jkb and anti-Lea antibodies. She finally recovered from acute varix bleeding and was discharged on the 26th hospital day with the level of hemoglobin being 8.3 g/dL.
Antibodies ; Blood Group Incompatibility ; Emergencies ; Esophageal and Gastric Varices ; Female ; Fever ; Gastrointestinal Hemorrhage ; Hemoglobins ; Hemorrhage ; Humans ; Phenotype ; Varicose Veins

No abstract available.
Blood Group Incompatibility

Authors found a case of anti-Yka antibody in a 66-year-old female patient with acute peritonitis due to colon cancer perforation. Although anti-Yka antibody has no clinical significance, its high-titer, low-avidity (HTLA) characteristics with weak and variable reactivity to Yk(a+) RBC in the indirect antiglobulin test can cause confusion and difficulties in identifying coexisting clinically significant antibodies. Titration studies could be used to determine such reactions due to HTLA antibodies. Since anti-Yka antibody has not been shown to cause significant destruction of transfused Yk(a+) RBC, Yk(a+) units can be safely transfused to patients with anti-Yka antibody unless clinically significant antibodies coexist in their sera. This is the first case report of anti-Yka antibody as an high-titer, low-avidity antibody in Korea.
Aged ; Antibodies ; Blood Transfusion ; Colonic Neoplasms ; Coombs Test ; Female ; Humans ; Korea ; Peritonitis

BACKGROUND: There is a recent trend of increased use of the gel test for detecting unexpected antibodies because of its simplicity and the ease with which a definitive interpretation can be made. The aim of the present study was to evaluate the diagnostic performance of newly developed DG Gel microtube column agglutination system as compared with the tube method and other two microtube column agglutination systems (DiaMed-ID, Ortho BioVue). METHODS: We collected 305 patients who were screened for unexpected antibody from February to July 2007. These samples were screened and we identified the unexpected antibody with the tube method and three microtube column agglutination systems. RESULTS: The highest estimated sensitivity of the screening test was 97.4% for DiaMed-ID. The highest estimated specificity of the screening test was 100% for DG Gel. The least number of discordant identification results was seven for the DG Gel. CONCLUSION: DG Gel has good diagnostic efficacy and accuracy for identifying unexpected antibody. DG Gel might be used as a replacement or supplement for the previous tests.
Agglutination ; Antibodies ; Humans ; Mass Screening ; Sensitivity and Specificity

BACKGROUND: The AutoVue Innova (Ortho Clinical Diagnostic, Raritan, NJ, USA) is an automatic instrument for blood bank tests, and it has recently been introduced in Korea for the first time at our hospital. This instrument employs column agglutination technology and it performs blood bank tests automatically. We evaluated this instrument and we report on the results. METHODS: We performed ABO/RhD typing and antibody screening for 250 randomly selected samples, and crossmatching for 261 samples with using the AutoVue Innova in parallel with the conventional manual methods. For a sensitivity test, we added 3 samples of A(2)B(3) and 2 samples of weak-D and serially diluted reagent antisera to the test pool and we measured turnaround time (TAT) for the antibody screening test. RESULTS: The concordance rates between AutoVue Innova and the manual methods for ABO/RhD blood typing, antibody screening and crossmatching tests were 99.6%, 100% and 98.9%, respectively. The overall retest rate was 0.5% and the main cause of the discrepancy was revealed to be hemolysis or an inadequate amount of the samples. The overall sensitivity of AutoVue Innova seems to be same as or better than the manual methods. The TAT for the antibody screening test was significantly shorter for the AutoVue Innova (64+/-43 min, n=512) than for the tube method (89+/-57 min, n=99) (P<0.001). CONCLUSION: The test results of AutoVue Innova were accurate and sensitive for the ABO/RhD typing, crossmatching and antibody screening tests. The TAT for the antibody screening test was remarkably shortened up to five times more samples could be tested without an increase of manpower.
Agglutination ; Blood Banks ; Blood Grouping and Crossmatching ; Hemolysis ; Immune Sera ; Korea ; Mass Screening