Scott A. Kirkley

A cost analysis of autologous and allogeneic transfusions in hip-replacement surgery.

PURPOSE To analyze the cost consequences of autologous versus allogeneic transfusions. METHODS Costs were determined when allogeneic transfusions were given in addition to, or instead of, autologous transfusions. Hospital charges were used to estimate costs for hip-replacement surgery. The main outcome measure was estimated incremental hospital costs per unit transfused. RESULTS Among donors of autologous blood, mean total charges were

Citrate Toxicity During Massive Blood Transfusion

7,200 greater for recipients of both autologous and allogeneic transfusions than for recipients of autologous transfusion only (P=0.0001). Each allogeneic transfusion was associated with additional costs of

An association between decreased cardiopulmonary complications (transfusion-related acute lung injury and transfusion-associated circulatory overload) and implementation of universal leukoreduction of blood transfusions.

1,480. In a second cohort of patients receiving identical amounts of either allogeneic or autologous blood (mean=2.3 units), total hospital charges were a mean of

Current Research on the Immunomodulatory Effect of Allogeneic Blood Transfusion

4,800 greater (P=0.0001) for allogeneic recipients. The per unit excess costs associated with each unit of allogeneic blood cohort were

A cost comparison of allogeneic and preoperatively or intraoperatively donated autologous blood.

1,043. CONCLUSIONS Allogeneic transfusions are associated with incremental hospital costs of about

Leukocyte-Reduced Transfusions in Cardiac Surgery Results of an Implementation Trial

1,000 to

Providing ABO‐identical platelets and cryoprecipitate to (almost) all patients: approach, logistics, and associated decreases in transfusion reaction and red blood cell alloimmunization incidence

1,500 per unit transfused when compared with costs for similar patients receiving no transfusions or 1 to 5 units of autologous blood.

Use of single donor platelets

THE USE OF sodium citrate as the blood anticoagulant for transfusion science dates from 1914 to 1915 and the almost simultaneous publication of the work of four independent investigators. Articles from Hustin,l Agote,2 Weil,3 and Lewisohn,4 published between May 1914 and January 1915, each reported the successful use of citrated blood for human transfusion. Because citrate was known to be toxic to animals, Lewisohn carefully titrated the minimum concentration of citrate required to prevent clotting. Despite the demonstration by Weil that citrated blood could be stored for several days and still be effective,3 and the discovery by Rous and TurnerS that citrated blood supplemented by dextrose was capable of more prolonged storage, citrated blood was not quickly accepted by the general medical community. Though used with success in limited trials on the battlefield in World War 1,6 transfusions with citrated blood were often associated with chills and fever which were incorrectly attributed to the citrate. Febrile reactions were so common with citrated blood that during the 1920s most transfusions consisted of the rapid transfers of nonanticoagulated whole blood, and the use of stored citrated blood did not become commonplace until the mid-1930s. 7 While improvements in transfusion technology and the establishment of blood banks made the administration of blood a standard procedure in the operating room, blood usage was generally limited to a few units for any given patient. Advances in knowledge of the biochemistry of citrate and calcium led to an improved understanding of their interaction as well as the relationship of serum ionized Ca + + to total serum calcium. The development of citrate toxicity due to acute hypocalcemia was demonstrated in dogs as early as 1944. After Wodd War II surgical techniques of increas-

An alternative method to dithiothreitol treatment for antibody screening in patients receiving daratumumab.

BACKGROUND: Cardiopulmonary adverse events after transfusion include transfusion‐related acute lung injury (TRALI) and transfusion‐associated circulatory overload (TACO), which are potentially lethal and incompletely understood.

Efficacy of preoperative autologous blood donation in free TRAM flap breast reconstruction.

This review summarizes three aspects of current research on the immunomodulatory effect of allogeneic transfusion. Representatives of three laboratories ‐ each of which is actively engaged in research on transfusion‐induced immunomodulation ‐ summarize their current investigative approach. First, current animal models of transfusion‐induced immunomodulation are presented and research on the tumor growth‐promoting effect of allogeneic transfusion is described. Second, mechanisms underlying an immunomodulatory effect of transfusion are summarized and experiments on the induction of transplant tolerance by selective introduction of donor‐type MHC antigens is presented. Third, the potential clinical impact of increased infection and tumor recurrence resulting from transfusion‐induced immunomodulation is assessed. The potential role of donor‐derived hematopoietic stem cells is presented as an area of future investigation in the area of transfusion‐induced immunomodulation.