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Clinical Significance of Antibodies Against Platelet HLA Class I in Children with Idiopathic Thrombocytopenic Purpura.

Hong Jun LEE ; Jung Sook YEOM ; Ji Sook PARK ; Eun Sil PARK ; Ji Hyun SEO ; Jae Young LIM ; Chan Hoo PARK ; Hyang Ok WOO ; Hee Shang YOUN

Korean Journal of Blood Transfusion.2013;24(3):233-240.

BACKGROUND: A previous history of transfusion has been known to be associated with production of anti-HLA class I antibodies. However, platelet glycoproteins are the main target of idiopathic thrombocytopenic purpura (ITP). The mechanism of antibody production is known to differ significantly between glycoproteins and anti-HLA class I. The aim of this study was to evaluate the clinical significance of anti-HLA class I antibodies in childhood ITP. METHODS: Enrollment for the normal control group targeted 48 people who visited Gyeongsang National University Hospital from 1990 to 2010, and 48 young children with ITP. Anti-glycoproteins and anti-HLA class I antibodies were tested using the Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit. RESULTS: The positive rate of anti-HLA antibodies was significantly different [36/39 (92.3%) vs 29/46 (63%)] [ITP group vs normal control group] (P=0.002). The mean positive S/C ratio of anti-HLA antibodies was also significantly different (3.55 vs 1.51) [ITP group vs normal control group] (P=0.0000). The positive rate of anti-HLA did not differ significantly between the transfused group and the non-transfused group [12/12 (100%) vs 24/27 (88%)] [transfused ITP vs non-transfused ITP]. The mean positive S/C ratio of anti-HLA antibodies did not differ significantly between the transfused ITP group and the non-transfused ITP group (4.30 vs 3.25) [transfused ITP vs non-transfused ITP]. Consecutive testing showed that positive rate and positive S/C ratio of anti-HLA antibodies did not change significantly between sampling times in both groups [transfused ITP vs non-transfused ITP] (P=1.00 and P=0.15). CONCLUSION: Anti-HLA class I antibodies may be involved in childhood ITP. Transfusion did not affect the course of childhood ITP.
Antibodies* ; Antibody Formation ; Blood Platelets* ; Child* ; Enzyme-Linked Immunosorbent Assay ; Glycoproteins ; Humans ; Platelet Membrane Glycoproteins ; Purpura, Thrombocytopenic, Idiopathic*

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Analysis of ABO Blood Discrepancies and Transfusion Experiences in Chonnam National University Hospital.

Min Seok HEO ; Duck CHO ; Hye Ryoen PARK ; Myung Geun SHIN ; Jong Hee SHIN ; Soon Pal SUH ; Dong Wook RYANG

Korean Journal of Blood Transfusion.2013;24(3):222-232.

BACKGROUND: ABO blood group discrepancy occurs when the results of red cell tests do not agree with those of the serum test. In order to select the proper blood units for transfusion, clarification of the cause of ABO discrepancies is essential. We analyzed the cases and recent actual transfusion experiences at Chonnam National University Hospital (CNUH). METHODS: In total, among pre-transfusion blood samples at CNUH between January 2012 and July 2013, 55 cases of ABO discrepancies were analyzed retrospectively. RESULTS: The discrepancy incidence was 0.14%. Problems with serum were the most common cause of ABO discrepancies, with 31 cases (56.4%), and extra serum reactivity due to cold allo-antibodies accounted for the highest frequency (n=7). There were three cases of non-specific aggregations caused by commercial RBC constituents and aggregation was not observed when a re-test was performed with other commercial RBCs or self-prepared human RBCs. Two of three cases with mix-field aggregations involved a pair of twins after in vitro fertilization - embryo transfer (IVF-ET). Among 55 patients, 20 were actually transfused, and all but four cases had weaker or identical RBC units and stronger or identical plasma units. CONCLUSION: There were newly revealed ABO discrepancies caused by non-specific aggregations of commercial RBCs and in twins after IVF-ET. In addition, investigation of actual transfusion experiences in patients with ABO blood group discrepancies would be helpful.
Chimerism ; Embryo Transfer ; Fertilization in Vitro ; Humans ; Incidence ; Jeollanam-do* ; Plasma ; Retrospective Studies ; Twins

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Blood Safety Management System in Foreign Countries.

Donghan LEE ; Jina OH ; Jeeyeon SHIN ; Jeongran KWON ; Kyoungyul LEE ; Minsun SONG ; Youngsill CHOI

Korean Journal of Blood Transfusion.2013;24(3):217-221.

In an effort to improve the blood safety management system, Korea Centers for Disease Control and Prevention visited the national agencies and blood centers of foreign countries. In Japan, the management system for Human T-lymphotropic virus positive donors is operated. In Germany, Red Cross Blood Centers provide 75~80% of national blood consumption, and hospital blood centers provided 15~20%. In addition, the Paul Ehrlich Institut is engaged in blood center management and blood product safety, and the Robert Koch Institut manages transfusion-transmitted infection. The standard temperature of RBC transport is 1~10degrees C. In Austria, haemovigilance is operated by the National Blood Authority and adverse reactions following transfusion are investigated by Blood Centers. In Britain, blood is provided by National Health Service Blood and Transplant, and the Serious Hazards of Transfusion, haemovigilance system is operated. Universal leukoreduction has been performed since 1999 in order to prevent transmission of variant Creutzfeldt-Jakob disease.
Austria ; Blood Safety* ; Centers for Disease Control and Prevention (U.S.) ; Creutzfeldt-Jakob Syndrome ; Germany ; Humans ; Japan ; Korea ; National Health Programs ; Red Cross ; Tissue Donors ; Viruses

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Platelet Additive Solutions.

Jin Hyuk YANG ; So Yong KWON ; Juyeon LEE ; Yong Hun JEE ; Myunghan KIM

Korean Journal of Blood Transfusion.2013;24(3):207-216.

Storage of platelet concentrates in platelet additive solution (PAS) with plasma removal has many advantages, including reduction of allergic reactions, contributing to the available plasma pool for fractionation or transfusion, and employment of pathogen reduction technology. In order to decrease platelet activation for improvement of in vivo viability, PAS should be designed for optimization of aerobic metabolism using compounds such as glucose, acetate, citrate, phosphate, and electrolytes. After a thorough discussion, particularly on the efficacy and regulations, use of the buffy coat method as well as application of a new generation of PAS may likely be the future direction of platelet storage in Korea.
Blood Platelets* ; Citric Acid ; Electrolytes ; Employment ; Glucose ; Hypersensitivity ; Korea ; Metabolism ; Plasma ; Platelet Activation ; Social Control, Formal

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A Case of Rifampin Induced Hemolytic Anemia Combined with Thrombocytopenia and Acute Renal Failure.

Chiseon KO ; Kye Chul KWON ; Jong Woo PARK ; Sun Hoe KOO ; So Yeon SHIN

Korean Journal of Blood Transfusion.2007;18(1):56-60.

A 35 year old woman was admitted to the hospital owing to her nausea, vomiting, oliguria and petechia with re-administration of rifampin. Laboratory tests were performed and they showed a hemoglobin level of 8.6 g/dL, a leukocyte count of 7,660/microliter, a platelet count of 1,000/microliter, a blood urea nitrogen level of 92.3 mg/dL and a creatinine level of 10.6 mg/dL. The Direct Coombs' test and anti-platelet antibody test were positive. Hemolytic anemia combined with thrombocytopenia and acute renal failure related to rifampin was suspected. We proved the formation of immune complex with anti-rifampin antibody and rifampin by in vitro testing. Hemolytic anemia combined with thrombocytopenia and acute renal failure after treatment with rifampin is a rare condition. We report here on such a case along with a brief review of the related literature.
Acute Kidney Injury* ; Adult ; Anemia, Hemolytic* ; Antigen-Antibody Complex ; Blood Urea Nitrogen ; Coombs Test ; Creatinine ; Female ; Humans ; Leukocyte Count ; Nausea ; Oliguria ; Platelet Count ; Rifampin* ; Thrombocytopenia* ; Vomiting

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Effect of Blood Ordering and Input with using the Blood Information Sharing System (BISS) of the Korean RedCross.

Young Jin LEE ; Do Sim PARK ; Ji Hyun CHO

Korean Journal of Blood Transfusion.2007;18(1):49-55.

BACKGROUND: Generally, a hospital blood bank orders blood components from the Korean RedCross with using a telephone. Persons in a blood bank are required to do lots of work and labor, and spend much time during handling, processing and storage of blood components, and this is irrespective of simple procedure. To improve blood bank work, we used the BISS at the Korean RedCross with using the internet. METHODS: The orders for the blood components were saved on an excel file with using BISS. After we got the blood components, we classified and counted the blood components and interfaced the data of the excel file to blood bank laboratory information system (LIS), and these components were stored at the proper sites. We compared the blood bank work before and after introducing the BISS. RESULTS: Using BISS saved 154.3 hour and it increased 5,607 irregular antibody screening tests per year. It also prevented bar code reading errors and reduced the workers' personal stress. CONCLUSION: The input process of blood and the blood bank work were effectively improved after introducing the BISS. Key words:
Automatic Data Processing ; Blood Banks ; Clinical Laboratory Information Systems ; Humans ; Information Dissemination* ; Internet ; Mass Screening ; Telephone

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The Effect of the Blood-donating Environment on Vasovagal Reaction.

Jai Ho WEE ; Eue Suk JOUNG ; Hyoun Sook SEO

Korean Journal of Blood Transfusion.2007;18(1):39-48.

BACKGROUND: Active re-donation is important for the whole blood donation program. Preparation of the blood-collection environment to minimize vasovagal reaction (VVR) is very important because VVR is the most common factor for stopping re-donation. METHODS: From the 1st of January to the 30th of November in 2005 at Busan Red Cross Blood Center, a total 195,247 donations from 138,093 donors were investigated for VVR. RESULTS: The total frequency of VVR was 0.14%. The frequency of VVR of the group donors who donated in indoor collecting places was the highest and the next highest VVR frequency was for the outdoor donors group. Unexpectedly, the frequency of VVR was the lowest in donors who donated in a blood bus. Teenage donations of blood were most frequent, and the next were people in their twenties. The frequency of VVR was the highest in first-time donor group. The more blood donated, the less the subjects experienced VVR. CONCLUSION: To recruit and retain the blood donors, the blood collection environment should be reconsidered for the group-donors in indoor- or outdoor places and not for those in the blood bus. In these places, it is important to educate the staff and prepare the blood-collecting environment where individual attention can be given to donors of the high-risk group for preventing VVR.
Blood Donors ; Busan ; Humans ; Red Cross ; Tissue Donors

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Evaluation of the DG Gel System using the Microtube Column Agglutination Technique for Antibody Screening and Identification.

Jee Yong KIM ; Ji Hoon HUH ; Sun Hyung KIM ; Myung Hyun NAM ; Kyoung Ho ROH ; Jang Su KIM ; Sook Young BAE ; Jin Hyuk YANG ; Soo Young YOON ; Chae Seung LIM ; Chang Kyu LEE ; Yoonjung CHO ; Young Kee KIM ; Kap No LEE

Korean Journal of Blood Transfusion.2007;18(1):32-38.

BACKGROUND: For the antibody screening test, the classical LISS tube indirect antiglobulin test has been replaced by the microtube column agglutination system in Korea. This system was first created in 1990 by Lapierre and it is distributed through DiaMed (DiaMed Ag, Cresssier, Morat, Switzerland) around the world. Similar systems, such as Ortho BioVue, have been developed and competed after that. We evaluated a newly developed microtube column agglutination system, DG Gel (Diagnostic Grifols, Barcelona, Spain), and we compare it with the other established systems. METHODS: In a comparative study, a total of 126 samples, including 76 antibody screening positive samples and 50 negative samples, were tested in parallel by the LISS/Coombs card (DiaMed Ag, Cresssier, Morat, Switzerland) and the DG Gel microtube column agglutination system. The positive samples that were proved by the LISS/Coombs card and the DG Gel system were identified by the ID-Dia panel (DiaMed Ag, Cresssier, Morat, Switzerland) and Identisera Diana (Diagnostic Grifols, Barcelona, Spain). Discrepant samples were rechecked with I, II and III cells that were supplied by the panel of the Korea Red Cross Blood Center. RESULTS: Among the 126 samples, the DG Gel antibody screening system showed 98.7% (75/76) sensitivity and 100% (50/50) specificity. We obtained concordant results in 75 samples (98.7%) and discrepant results in one sample (1.32%) between the DG Gel and DiaMed-ID for antibody identification. CONCLUSION: Both the microtube column agglutination systems work well and showed high estimated sensitivity and specificity with high concordance. Therefore, the DG gel microtube column agglutination system can be used with good results.
Agglutination* ; Coombs Test ; Korea ; Mass Screening* ; Red Cross ; Sensitivity and Specificity

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Detection Rate and Genetic Variability of Small Anellovirus DNA from Blood Donors at a Tertiary Hospital.

Ju Young CHUNG ; Tae Hee HAN ; Eung Soo HWANG ; Kyou Sup HAN

Korean Journal of Blood Transfusion.2007;18(1):23-31.

BACKGROUND: Small anellovirus (SAV) is a new member of the genus Anellovirus and this virus can infect humans. SAV could be transmissible by transfusion. However, there have been no studies about the genotypes of SAV among the blood donors in Korea. In this paper, the detection rate and genotypes of SAV were investigated among the blood donors at a tertiary hospital. METHODS: A total of 286 plasma samples from blood donors were tested. SAV DNA was amplified using primers derived from the open reading frame 1 (ORF1) region. Simultaneously, Torquetenovirus (TTV) and torquetenominivirus (TTMV) DNA were detected from the SAV DNA positive plasma samples by using nested PCR. Sequencing of amplicons (n=41) was carried out to investigate the SAV genotypes. RESULTS: SAV DNA was detected in 28.7% (82/286) of the blood donors. TTV or TTMV DNA was detected in 37.8% (31/82) of the SAV DNA positive blood donors. Twenty-four sequences were determined and compared with those deposited in the databases (GenBanK) and they revealed a high degree of genetic variability among the SAV DNA (nucleotide similarity: mean 69.3, range 61.2~99.3%). Phylogenetic analysis demonstrated the existence of three main clusters, which were tentatively assigned to genotype 1 (G1), genotype 2 (G2), and genotype 3 (G3), respectively. Genotype G1 was most prevalent and this was followed by G2 and G3. CONCLUSION: The detection rate of SAV DNA among Koreans seems to be higher than that stated in the previous reports from some other countries. Moreover, we determined the genotype distribution of SAV among Korean blood donors.
Anelloviridae* ; Blood Donors* ; DNA* ; Genotype ; Humans ; Korea ; Open Reading Frames ; Plasma ; Polymerase Chain Reaction ; Tertiary Care Centers*

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Characteristics and Follow-up Results of the Window Period Blood Donors for Hepatitis C Virus.

Jae Won KANG ; Jae Sook LEE ; Dong Hee SEO ; Kwang HUH ; Jai Ho WEE ; Quehn PARK

Korean Journal of Blood Transfusion.2007;18(1):15-22.

BACKGROUND: To improve the safety of the blood supply in Korea, nucleic acid amplification testing (NAT) for HCV and HIV-1 as a blood screening test has been used by the Korean Red Cross since February 1st, 2005. Until October 31st 2006, a total of 4,037,618 donor samples had been tested and 436 cases showed reactivity for HCV RNA. Only 10 of these cases showed serologically negative antibody results. METHODS: We investigated the characteristics and the follow-up results of the ten donors who showed HCV RNA reactivity and serologically negative results. RESULTS: All the ten donors were identified to be "window period" blood donors with confirmation of their seroconversion by follow-up testing. The average RNA titer of the donors was 9.21x106 IU/mL. Five donors showed high levels of ALT. One donor showed the reversed pattern on the test results for antibody and RNA. CONCLUSION: By detecting five cases of HCV "window period" infection, NAT has increased the safety of the Korean blood supply. But it is considered that NAT can not be a substitute serological test and an adequate follow-up strategy is required for verification of the accurate seroconversion time.
Blood Donors* ; Follow-Up Studies* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; HIV-1 ; Humans ; Korea ; Mass Screening ; Nucleic Acid Amplification Techniques ; Red Cross ; RNA ; Serologic Tests ; Tissue Donors

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