Juhani Leikola

Weak Anti‐IgA Antibodies with Limited Specificity and Nonhemolytic Transfusion Reactions

Abstract. Anti‐IgA antibodies were studied in sera from patients with nonhemolytic transfusion reactions for which no serological reason had been found. Of the 158 sera that were studied by passive hemagglutination assay using twelve IgA myeloma proteins, 4 samples had class‐specific antibodies and 10 samples antibodies with limited specificity. Titers were 1:8 or less. 100 multitransfused hemophilia patients were studied with two IgA myeloma proteins. Four of the sera had anti‐IgA antibodies. Normal blood donor sera reacted with TgA only when antigens were first either digested with pepsin or stored for several months as dilute solutions in refrigerator. The results emphasize the need for fresh IgA proteins of good quality when human anti‐IgA antibodies are investigated.

Post-transfusion hepatitis C in Finland

Summary. Six of 11 (55%) non‐A, non‐B hepatitis (NANBH) patients seroconverted to hepatitis C virus antibody (anti‐HCV) positivity 8–16 weeks after transfusions in a prospective post‐transfusion hepatitis study on 685 open‐heart surgery patients in Finland. Five of them had a seropositive donor, and two of the five non‐converted NANBH patients had received an anti‐HCV positive unit. Among 36 studied donors who were positive in the anti‐HCV ELISA, reactivity of both the antigen bands in a recombinant immunoblot assay (RIBA) for anti‐HCV was significantly associated with NANBH (P < 0·00005) in the recipient. In addition, infective anti‐HCV positive donors had raised ALT values more often than seropositive donors which caused no seroconversion or infection in the recipients (P= 0·0001).

Antibodies to Hepatitis C Virus and Chronic Liver Disease among Finnish Patients with Haemophilia

Antibodies to hepatitis C virus, hepatitis B serology and liver enzymes were examined in 137 Finnish haemophiliac patients to detect signs of chronic viral hepatitis and its possible aetiological associations. The prevalence of raised alanine aminotransferase values was 37%. These were significantly associated with hepatitis C seropositivity but not with hepatitis B antibodies, severity of haemophilia or the type of clotting factor used in replacement therapy. The prevalence of hepatitis C seropositivity was 50%; it was significantly associated with severe haemophilia and with the use of large pool concentrates. The hepatitis C virus seems to be the major cause of chronic liver disease transmitted by clotting factors also in Finland, despite a somewhat lower seroprevalence than described elsewhere so far.

Achieving self sufficiency in blood across Europe.

When the development of blood component therapy was in its infancy countries were by and large self sufficient for whole blood. Large scale export and import of plasma started in the 1960s and early 1970s, when both albumin and coagulation factor VIII became commercially available. The industry needed more and more plasma, and the development of plastic bags made plasmapheresis feasible. Large plasma donation centres were established, primarily in the United States but also in countries such as Nicaragua and Haiti. Exploitation of donors gained wide publicity, and the trade in “red gold” became an important international media event. In Europe self sufficiency in blood production has again become an important concern, but the picture is now more complicated and self sufficiency is often confused with the issue of the source of the blood—paid or unpaid donors. Reacting to the bad publicity over exploited donors from developing countries, the assembly of the World Health Organisation in 1975 urged member states to “promote the development of national blood services based on voluntary non-remunerated donation of blood and enact effective legislation governing the operation of blood services and to take other actions necessary to protect and …

Self-sufficiency in blood products: Background and overview

Countries started looking at national self-sufficiency after large-scale importation of human plasma from developing countries was revealed in the early 1970s. Many international organizations have recommended national self-sufficiency. Several examples have shown that a country can be self-sufficient in practical terms by supplementing national blood supply with voluntary plasmapheresis programs. National or regional self-sufficiency should be one of the goals of a national policy.

Post-Transfusion Hepatitis

Prospective international studies have shown the incidence of post-transfusion hepatitis in the 1980s to vary between 2% and 31%. Rare cases of hepatitis B continue to occur despite donor screening for the hepatitis B surface antigen, but most are of the non-A, non-B type. Non-A, non-B hepatitis is typically mild and often subclinical in the acute phase but has a tendency to become chronic in about half the affected subjects. The recently characterised hepatitis C virus has been shown to cause most, if not all, transfusion associated non-A, non-B hepatitis. Hepatitis C seropositivity seems to be associated with viraemia and infectivity among blood donors, and donor screening for these antibodies has now been instituted in many countries. New assays now being developed are improving the sensitivity and specificity of this screening, which is estimated to prevent most cases perhaps 70 to 80% of post-transfusion hepatitis.

Lack of Evidence of HTLV-I Antibodies in the Finnish Population

5,287 serum samples from 2 different sources in Finland, people possibly at risk and healthy blood donors, were tested for the presence of HTLV-I antibodies. No positive cases were found. The result suggests that this virus is not endemic in Finland. 10 cases gave repeatedly a low positive value in the enzyme immune assay (EIA) test but were confirmed negative with other tests that included western blot, passive agglutination and immunofluorescence. Four of these samples originated from healthy blood donors, 6 from other categories. Several of them showed restricted reactivity in western blots. Five HIV-positive sera, discovered during the study from people with possible risk factors, were also tested for HTLV-I but showed no reactivity.

Application of the OCR-B Symbol in the Data-Processing System of the Finnish Red Cross Blood Transfusion Service

Abstract. We have used the Optical Character Recognition system B (OCR‐B) for automatic identification of blood samples on the Groupamatic 360 and in connection with computerized donor file management and control of blood product processing. For the Groupamatic system a device was constructed that lifts the samples, and during simultaneous rotation and downward movement, the OCR‐B identification number on the tube label ist read. The results indicate that with appropriate control and check digit design it is possible to achieve an economical and safe machine‐readable identification system.