Linda E. Pivacek

Anemia-induced increase in the bleeding time : implications for treatment of nonsurgical blood loss

BACKGROUND: Preoperative bleeding time (BT) does not correlate with postoperative bleeding in patients subjected to surgical procedures. A significant positive correlation has been reported between the BT 2 hours after cardiopulmonary bypass surgery and the nonsurgical blood loss during the first 4 hours after bypass surgery. This study was done to investigate the effect of Hct and platelet count on the BT measurement in normal, healthy men and women.

A multicenter study of in vitro and in vivo values in human RBCs frozen with 40-percent (wt/vol) glycerol and stored after deglycerolization for 15 days at 4°C in AS-3: assessment of RBC processing in the ACP 215

BACKGROUND: The FDA has approved the storage of frozen RBCs at –80°C for 10 years. After deglycerolization, the RBCs can be stored at 4°C for no more than 24 hours, because open systems are currently being used. Five laboratoris have been evaluating an automated, functionally closed system (ACP 215, Haemonetics) for both the glycerolization and deglycerolization processes.

An Experiment with Glycerol-Frozen Red Blood Cells Stored at –80°C for up to 37 Years

Background and Objectives: Red cells frozen using 40% W/V glycerol are currently FDA approved for frozen storage at –80°C for up to 10 years. Materials and Methods: Red cells frozen with 40% W/V glycerol and stored at –80°C for up to 37 years were thawed, deglycerolized, and stored at 4°C for 24 h. Results: Red cells frozen for up to 37 years had mean freeze-thaw-wash recovery values of 75%, less than 1% hemolysis, and normal ATP, 2,3-DPG and P50 levels, and 60% of normal RBC K+ levels. Conclusions: Red cells frozen with 40% W/V glycerol can be stored at –80°C for up to 37 years with acceptable in vitro results.

Fresh, liquid-preserved, and cryopreserved platelets: adhesive surface receptors and membrane procoagulant activity

BACKGROUND: A study in humans showed that the transfusion of previously frozen human platelets after cardiopulmonary bypass, despite decreased survival, resulted in better hemostatic function than that of liquid‐preserved platelets stored at 22°C for 3 to 4 days.

The safety and therapeutic effectiveness of human red cells stored at — 80°C for as long as 21 years

Human red cells frozen by various methods have been stored in the frozen state at —80°C for as long as 21 years. This report discusses: red cells frozen with 42 percent weight per volume (wt/vol) glycerol in an ionic medium in a polyvinylchloride (PVC) plastic bag using the Cohn method; red cells frozen with 45 percent wt/vol glycerol in a low ionic medium in a PVC plastic bag using the Huggins method; red cells frozen with 40 percent wt/vol glycerol in an ionic medium in a polyolefin plastic bag using the Meryman‐Hornblower method; and red cells frozen with 40 percent wt/vol glycerol in an ionic medium in a standard 600‐ml or an elongated 800‐ml PVC plastic primary collection bag with an adapter port using the Naval Blood Research Laboratory (NBRL) method. After frozen storage for as long as 21 years by the four methods described above, the thawed red cells were deglycerolized with 50 to 150 ml of 12 percent sodium chloride and 1.5 to 2.0 l of sodium chloride‐glucose or sodium chloride‐glucose‐phosphate solution. After washing and storage at 4°C for 24 hours, the red cells had a mean freeze‐thaw‐wash recovery value of 90 percent, a mean 24‐hour posttransfusion survival value of 85 percent, a mean index of therapeutic effectiveness of 75 percent, normal or slightly impaired oxygen transport function, and minimal hemolysis. When red cells frozen by the NBRL method in the standard 600‐ml or the elongated 800‐ml primary collection bag for as long as 5.7 years were stored after washing at 4°C for up to 3 days, these units had a mean freeze‐thaw‐wash recovery value of 90 percent, a mean 24‐hour posttransfusion survival value of 85 percent, a mean index of therapeutic effectiveness of 75 percent, normal or slightly impaired oxygen transport function, and minimal hemolysis. Cultures done after storage at 4°C for 1 week showed that the red cells remained sterile. The incidence of container breakage for red cells frozen in the standard 600‐ml or elongated 800‐ml primary collection bag was about 3 percent for units subjected to shipment and less than 1 percent for units that were not transported.

Process for the preparation of pathogen‐inactivated RBC concentrates by using PEN110 chemistry: preclinical studies

BACKGROUND: A pathogen‐inactivation process for RBC concentrates is being developed by using PEN110 chemistry (INACTINE, V.I. Technologies). The objective of this study was to characterize the quality of RBCs prepared by using the PEN110 process and to measure the virucidal effect achieved against two viruses.

In vivo survival of apheresis RBCs, frozen with 40-percent (wt/vol) glycerol, deglycerolized in the ACP 215, and stored at 4°C in AS-3 for up to 21 days

BACKGROUND: The FDA has approved the storage of frozen RBCs at –80°C for 10 years and the postwash storage at 4°C for no more than 24 hours. The 4°C postwash storage period is limited to 24 hours, because the current deglycerolization systems are functionally open systems.

Autologous platelet-rich plasma isolated using the Haemonetics Cell Saver 5 and Haemonetics MCS+ for the preparation of platelet gel

We compared three methods of isolating platelet‐rich plasma (PRP) using the Haemonetics Cell Saver 5 and one method of isolating PRP by plateletpheresis using the Haemonetics MCS+. PRP contains both platelets and fibrinogen, which are used in the preparation of haemostatic agents.

Therapeutic Effectiveness and Safety of Outdated Human Red Blood Cells Rejuvenated to Restore Oxygen Transport Function to Normal, Frozen for 3 to 4 Years at −80 C, Washed, and Stored at 4 C for 24 Hours Prior to Rapid Infusion

Human red blood cell concentrates with hematocrit values of 75 V% were prepared from citrate‐phosphate‐dextrose (CPD) blood, stored at 4 C for 20 to 28 days, and biochemically modified with a solution containing pyruvate, inosine, glucose, phosphate, and adenine (PIGPA Solution A). The rejuvenated red blood cells were frozen with 40% W/V glycerol in a polyolefin plastic bag and were stored at −80 C. After three to four years of frozen storage, the units were thawed, washed, and stored at 4 C in a sodium chloride‐glucose‐phosphate solution for 24 hours prior to transfusion. Red blood cell recovery was 97 per cent after thawing and 90 per cent after washing. An automated differential agglutination procedure (ADA) showed 24‐hour survival values of about 80 per cent, and long‐term survival values of about 85 days depending on the disease state of the recipient. The red blood cells had normal affinity for oxygen on the day of transfusion. Plasma hemoglobin levels measured immediately after transfusion indicated extravascular removal of nonviable donor red blood cells. There was no increase in the uric acid level during the 24‐hour posttransfusion period. A pool of three to ten units of rejuvenated washed previously frozen red blood cells was transfused rapidly to each of 19 anemic elderly patients. The red blood cells which had normal oxygen delivery capacity immediately upon transfusion increased the recipients red blood cell mass and produced no untoward effects.

A comparison of methods of determining the 100 percent survival of preserved red cells

Studies were done to compare three methods to determine the 100 percent survival value from which to estimate the 24‐hour posttransfusion survival of preserved red cells. The following methods using small aliquots of 51Cr‐labeled autologous preserved red cells were evaluated: First, the 125I‐albumin method, which is an indirect measurement of the recipients red cell volume derived from the plasma volume measured using 125I‐labeled albumin and the total body hematocrit. Second, the body surface area method (BSA) in which the recipients red cell volume is derived from a body surface area nomogram. Third, an extrapolation method, which extrapolates to zero time the radioactivity associated with the red cells in the recipients circulation from 10 to 20 or 15 to 30 minutes after transfusion. The three methods gave similar results in all studies in which less than 20 percent of the transfused red cells were nonviable (24‐hour posttransfusion survival values of between 80–100%), but not when more than 20 percent of the red cells were nonviable. When 21 to 35 percent of the transfused red cells were nonviable (24‐hour posttransfusion survivals of 65 to 79%), values with the 125I‐albumin method and the body surface area method were about 5 percent lower (p less than 0.001) than values with the extrapolation method. When greater than 35 percent of the red cells were nonviable (24‐hour posttransfusion survival values of less than 65%), values with the 125I‐albumin method and the body surface area method were about 10 percent lower (p less than 0.001) than those obtained by the extrapolation method.(ABSTRACT TRUNCATED AT 250 WORDS)