White blood cells (WBCs) and storage period are the main factors of transfusion reactions. In the present study, cytokine/chemokine concentrations after leukoreduction (LR) and irradiation (IR) in stored canine whole blood were measured. Red blood cell storage lesion caused by IR and LR were also compared. Blood samples from 10 healthy Beagles were divided into four groups (no treatment, LR-, IR-, and LR + IR-treated). Leukocytes were removed by filtration in the LR group and gamma radiation (25 Gy) was applied in the IR group. Immunologic factors (WBCs, interleukin-6 [IL-6], C-X-C motif chemokine ligand 8 [CXCL-8], and tumor necrosis factor-alpha) and storage lesion factors (blood pH, potassium, and hemolysis) were evaluated on storage days 0, 7, 14, 21, and 28. Compared to the treated groups, IL-6 and CXCL-8 concentrations during storage were significantly higher in the control (no treatment) group. LR did not show changes in cytokine/chemokine concentrations, and storage lesion presence was relatively mild. IR significantly increased CXCL-8 after 14 days of storage, but IR of leukoreduced blood did not increase CXCL-8 during 28 days of storage. Storage lesions such as hemolysis, increased potassium, and low pH were observed 7 days after IR and storage of blood, regardless of LR. IR of leukoreduced blood is beneficial to avoid immune reactions; however, storage lesions should be considered upon storage.
Blood Preservation ; Down-Regulation ; Erythrocytes ; Filtration ; Gamma Rays ; Hemolysis ; Hydrogen-Ion Concentration ; Immunologic Factors ; Interleukin-6 ; Leukocyte Reduction Procedures ; Leukocytes ; Necrosis ; Potassium ; Transfusion Reaction

BACKGROUND: Performing transarterial chemoembolization (TACE) is difficult with the occurrence of thrombocytopenia in cirrhotic patients with hepatocellular carcinoma (HCC). We aimed to evaluate the long-term efficacy and safety of partial splenic embolization (PSE) combined with TACE in patients with HCC with severe thrombocytopenia related to splenomegaly. METHODS: We conducted a case–control study consisting of 18 HCC patients with severe thrombocytopenia (< 50 × 109/L) who underwent PSE concurrently with TACE (PSE group) and 72 controls who underwent TACE alone (non-PSE group). RESULTS: Mean platelet counts at 1 month and 1, 3, and 5 years after concurrent PSE and TACE significantly increased compared with baseline (all P < 0.05), whereas the platelet count did not significantly increase after TACE alone. In addition, the platelet count at several time points after treatment in the PSE group was significantly higher than that in the non-PSE group, although the baseline platelet count in the PSE group was significantly lower than that in the non-PSE group. The platelet increase after PSE significantly reduced the need for platelet transfusions (P = 0.040) and enabled the subsequent TACE procedures in time (P = 0.046). The leukocyte counts and hemoglobin concentrations after concurrent PSE and TACE were also significantly increased, without deterioration of Child-Turcotte-Pugh score and unexpected side effects. CONCLUSION: PSE combined with TACE is effective in inducing and maintaining long-term thrombocytopenia improvement which reduces the need for the platelet transfusion and helps to perform initial and serial TACE, and is well-tolerated in patients with HCC and thrombocytopenia. PSE may be a promising treatment option for HCC patients with severe thrombocytopenia associated with splenomegaly who will undergo TACE.
Blood Platelets ; Carcinoma, Hepatocellular ; Humans ; Leukocyte Count ; Platelet Count ; Platelet Transfusion ; Splenomegaly ; Thrombocytopenia

BACKGROUND: A leukoreduction filter was recently developed in Korea to reduce various kinds of adverse transfusion reactions. The objective of this study was to propose a domestic evaluation system for leukoreduction filters and to apply this evaluation system to assess the newly developed leukoreduction filter. METHODS: We prepared packed red blood cells from 60 units of whole blood (400 mL) collected from 60 normal individuals and evaluated the efficacy of the newly developed filter (FINECELL, KOLON INDUSTRIES, Gumi, Korea) and a control filter (RCM1, Haemonetics, MA, USA). To verify the evaluation system, we assessed the filtration time, residual leukocyte count, RBC recovery, RBC hemolysis, hemoglobin concentration, and hematocrit using a control filter RCM1 and compared the results with those of an evaluation performed by the American Red Cross (ARC) in 2013. We then evaluated the efficacy of the test filter FINECELL using the methods established in this study and compared the results with those of the control filter RCM1. RESULTS: The results of the current study were similar to those of the ARC with the control filters. The test filters developed in Korea were not inferior to commonly used control filters regarding residual leukocyte count, RBC recovery, and RBC hemolysis at 35 days after filtration. All of the results in the evaluation satisfied the international standards. CONCLUSION: These results of this study showed that the efficacy of the newly developed domestic leukoreduction filter were satisfactory and will contribute to improvement of quality of blood components in Korea.
Erythrocytes ; Filtration ; Gyeongsangbuk-do ; Hematocrit ; Hemolysis ; Korea ; Leukocyte Count ; Methods* ; Red Cross ; Transfusion Reaction

BACKGROUND: Granulocyte transfusion therapy has been used as supportive care for patients with prolonged neutropenia after intensive chemotherapy or peripheral blood stem cell transplantation (PBSCT). Here, we investigated clinical factors of granulocyte transfusion therapy for neutropenic patients with infection to evaluate its efficacy and safety. METHODS: A retrospective analysis of 25 neutropenic patients treated with 99 granulocyte collection and granulocyte transfusion therapy from October 2011 to April 2016 at the National Cancer Center was conducted. Two groups, a count recovery group with a cut off of >1,000/µL and a no recovery group were compared and symptoms related with granulocyte transfusion were analyzed. RESULTS: Granulocyte collection and transfusions were performed in 99 procedures. After granulocyte transfusion therapy, 21 patients (84%) showed count recovery, whereas 4 patients (16%) had no response. Significant differences in pre-absolute neutrophil count (29/µL vs. 0/µL, P=0.048), duration of neutropenia before granulocyte transfusion (11 days vs. 26 days, P=0.011), and total number of granulocyte transfusion (2 times vs. 11 times, P=0.049) were observed between groups. Temporary symptoms related granulocyte transfusion were observed in seven patients (28%); however, all patients showed clinical improvement. The median of the single transfusion volume was 220 mL (200 to 397 mL) and the mean total granulocyte content was 4.92×10¹⁰. CONCLUSION: Granulocyte transfusion therapy is safe and effective for patient with life threatening neutropenia and infection, also considerable for early onset trial for granulocyte transfusion.
Drug Therapy ; Granulocytes* ; Humans ; Leukocyte Transfusion ; Neutropenia* ; Neutrophils ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies

OBJECTIVETo evaluate the short and long term therapeutic efficacy of the immunosuppressive therapy(IST) for adult severe aplastic anemia(SAA), and to analysis the relationship between the clinical factors(age, typing, lymphocyte percentage, reticulocyte percentage, neutrophil count) and the response to IST.

METHODSThe response rate of 39 patients received the IST between September 2009 and September 2013 in our hospital was assayed, the effective time in which all patients had hematologic response, and the survival rate at the first year were analyzed. The survival rates, the average amounts of the RBC and Plt transfusion per month in the first year were compared by using χ2 test between the IST group and the non-IST group; the multinomial logistic regression was used to analyze the relationship between the clinical factors and the response to IST.

RESULTSThe response rates of the 39 SAA patients at the first month, the third month, the sixth month and the first year were 29.73%, 70.27%, 75.68%, 86.49%, respectively. The median effective time of hematologic response in all patients had was 61.5 d(10 d-344 d). The survival rate of the IST group was 92.31%, which was much higher than that of the non-IST group (P<0.05). The average amounts of the RBC and Plt transfusion per month at the first year in the IST group were 1.04(0.13-2.78)×400 ml and 1.38(0.17-5.10)×200 ml, respectively, which were much lower than those in the non-IST group (P<0.01). Among the five clinical factors, the age, lymphocyte percentage and neutrophil count related to the response of IST (P<0.05).

CONCLUSIONThe response rate of the 39 SAA patients received IST is 86.49% at the first year, and their long term survival is better than that of non-IST group. The age, lymphocyte percentage and neutrophil count relate to the response of IST.

Adult ; Anemia, Aplastic ; Blood Transfusion ; Cyclosporine ; Humans ; Immunosuppressive Agents ; Leukocyte Count ; Logistic Models ; Neutrophils ; Reticulocytes ; Survival Rate

Aplastic anemia (AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes, resulting in the apoptosis of hematopoietic cells and bone marrow failure. Currently, hematopoietic stem cell transplantation (HSCT), immunosuppressive - therapy (IST), and supportive care (e.g. transfusion adjuvant therapy, hematopoietic growth factors, and prevention of infection) are the main treatments of AA. Granulocyte transfusion has recently been accepted as an useful adjuvant therapy of HSCT and intensive IST. This article reported a severe AA patient who failed to respond to IST, but achieved spontaneous remission three times after granulocyte transfusions from related donors. Such cases have rarely been reported. Existence of human leukocyte antigen (HLA) cross between the patient and his relatives may influence the T cell-mediated immunity, which might explain this patient's recovery.
Adult ; Anemia, Aplastic ; immunology ; physiopathology ; therapy ; Granulocytes ; transplantation ; Humans ; Leukocyte Transfusion ; Male ; Remission, Spontaneous

This study was aimed to explore the correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion. The outpatient and inpatient information of expectant lying-in women in our hospitals was collected, the route blood test, lever and kidney function and blood coagulation function tests were performed from the 4th to the 10th month of pregnancy. The pregnant women without underlying diseases and non-elderly pregnant women with single fetus were selected as the subjects of study. They were divided into postpartum blood transfusion group and non-blood transfusion group. The white blood cell (WBC) count, hemoglobin (Hb) level, platelet (Plt) count, plateletocrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) were compared in 2 groups. The results showed that 68 cases out of 450 expectant lying-in women received blood transfusion, among them 30 cases with complete data of puerperal transfusion were taken as blood transfusion group, the 28 cases of non transfusion puerperal as control group. There was no significant difference of hemogram changes between the two groups. However, there was a slight decline in Plt count and Hb level of late pregnant women. What is more, there was no correlation between Plt count change and the PCT, MPV and PDW. It is concluded that the changes of hemogram during pregnancy has no correlation with postpartum hemorrhage and blood transfusion in healthy pregnant women, the Plt count and Hb level of pregnant women slightly decline. Nevertheless, PCT, MPV and PDW are within the normal range.
Adult ; Blood Cell Count ; Blood Transfusion ; Erythrocytes ; Female ; Humans ; Leukocyte Count ; Middle Aged ; Platelet Count ; Postpartum Period ; Pregnancy ; blood ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Reference Values ; Young Adult

Spontaneous splenic rupture is a rare disease but can cause a life threatening situation. It can occur under a pathological spleen such as infection, neoplastic, infiltrative and inflammatory disease. Although splenectomy is the treatment of choice for splenic rupture, it is uncertain that the effectiveness of non- surgical treatment in the hemodynamically stable patient. We report a case of a 66-year-old male undergoing hemodialysis for 4 years who presented to the emergency department with abdominal pain and distention. Blood pressure was 130/80 mmHg, heart rate was 108 bpm. White blood cell count was 7,130/mm3, hemoglobin was 6.7 g/dL, platelet was 156,000/mm3. PT INR was elevated up to 2.01 because he had taken warfarin due to splenic infarction. Abdominal CT scan revealed hemoperitoneum due to splenic rupture. We performed angiography but there was no active bleeding. We decided conservative management without embolization because of stable condition and increased bleeding risk in operation. He received 6 pints of packed red blood cell transfusion during continuous renal replacement therapy for 24 hours on ICU. He was discharged with complete recovery on the 21st hospital day. We suggest that non-surgical treatment in splenic rupture also could be considered in hemodynamically stable patients with a high risk of postoperative complication.
Abdominal Pain ; Aged ; Angiography ; Blood Platelets ; Blood Pressure ; Emergencies ; Erythrocyte Transfusion ; Heart Rate ; Hemoglobins ; Hemoperitoneum ; Hemorrhage ; Humans ; International Normalized Ratio ; Leukocyte Count ; Male ; Mustard Compounds ; Rare Diseases ; Renal Dialysis ; Renal Replacement Therapy ; Spleen ; Splenectomy ; Splenic Infarction ; Splenic Rupture ; Warfarin

PURPOSE: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician's and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. METHODS: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. RESULTS: Of blunt trauma patients ,9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) < 14, Revised Trauma Score (RTS) < 11, white blood cell count (WBC) < 4000 or > 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS < 14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors. CONCLUSION: In our study, systolic blood pressure (SBP) < 90 mmHg, old age > 65 years, hemoglobin < 13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR > 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.
Blood Pressure ; Blood Transfusion ; Emergencies ; Erythrocytes ; Glasgow Coma Scale ; Heart Rate ; Hemoglobins ; Hemorrhage ; Humans ; Leukocyte Count ; Logistic Models ; Multiple Trauma ; Pelvis ; Respiratory Rate ; Retrospective Studies ; Shock ; Thorax

BACKGROUND: Knowing how the protein profile of platelet products changes with storage or leukoreduction may give us greater insight into cell physiology and the cause of transfusion reactions other than cytokines and chemokines. METHODS: We filtered four packs of platelet concentrates (PC) within 24 hr of blood collection and after 120 hrs of storage. Four aliquots of each supernatant in PC were obtained: pre-storage+prefiltration, pre-storage+post-filtration, post-storage+pre-filtration and post-storage+post-filtration. Routine chemistry tests and a two-dimensional electrophoresis (2-DE) were performed. The stained images were analyzed and the significant spots were identified using a peptide mass finger printing (PMF) with matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) analysis after trypsin digestion. RESULTS: The protein spots increased with storage and decreased after filtration (P<0.05, prestorage+post-filtration). The spot density of various proteins, including macrophage inflammatory protein-2 alpha, megakaryocyte colony stimulating factor and interleukin-22 changed with storage and leukoreduction. CONCLUSIONS: The database of identified protein spots and their changes produced in this study is a useful basic tool for future studies on the mechanism of transfusion reactions. Further studies should validate the significance of each protein spot.
Blood Platelets/*chemistry ; Blood Preservation ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Leukocyte Reduction Procedures ; *Platelet Transfusion ; Proteome/*analysis ; *Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Time Factors