Shigeru Takamoto

Impact of fresh-frozen plasma from male-only donors versus mixed-sex donors on postoperative respiratory function in surgical patients: a prospective case-controlled study

BACKGROUND: To reduce the risk of transfusion‐related acute lung injury (TRALI), plasma products are mainly made from male donors in some countries because of the lower possibility of alloimmunization; other countries are considering this policy. The advantage of male‐only fresh‐frozen plasma (FFP) should be examined in a prospective case‐control study.

Incidence of transfusion-related adverse reactions per patient reflects the potential risk of transfusion therapy in Japan

OBJECTIVES To describe the frequency of adverse reactions (ARs) after transfusion on both per transfused patient and per transfused unit bases. METHODS We performed a retrospective analysis of data available from records of 6 hospitals on the total number of transfusions and documented ARs between January 2008 and December 2009 for RBCs, fresh-frozen plasma (FFP), and platelet concentrates (PCs). RESULTS The incidence of ARs to RBCs, FFP, and PCs per transfused unit was 0.6%, 1.3%, and 3.8%, respectively. The incidence of ARs to RBCs, FFP, and PCs per patient was 2.6%, 4.3%, and 13.2%, respectively-almost 3-fold higher. Most RBC-ARs were febrile nonhemolytic transfusion reactions and allergic reactions, whereas most FFP-ARs and PC-ARs were allergic reactions. CONCLUSIONS The incidence of ARs per transfused patient may reflect better the potential risk of transfusion with blood components, taking into account the characteristics of the transfused patient.

Aggregates in platelet concentrates

P. F. van der Meer, L. J. Dumont, M. Lozano, N. Bondar, J. Wong, S. Ismay, J. Pink, W. Nussbaumer, J. Coene, H. B. Feys, V. Compernolle, D. V. Devine, D. Howe, C. K. Lin, J. Sun, J. Ringwald, E. F. Strasser, R. Eckstein, A. Seltsam, P. Perseghin, P. Proserpio, S. Wakamoto, M. Akino, S. Takamoto, K. Tadokoro, D. Teo, P. H. Shu, S. S. Chua, T. Jimenez-Marco, J. Cid, E. Castro, I. Mu~ noz, H. Gulliksson, P. Sandgren, S. Thomas, J. Petrik, K. McColl, H. Kamel, J. Dugger, J. D. Sweeney, J. B. Gorlin, L. J. Sutor, D. Heath & M. H. Sayers.

Impact of chemiluminescent enzyme immunoassay screening for human parvovirus B19 antigen in Japanese blood donors

To reduce the risk of human parvovirus B19 (B19V) transmission through contaminated blood for transfusion and plasma‐derived products, the Japanese Red Cross (JRC) Blood Centers introduced B19V antigen screening by chemiluminescent enzyme immunoassay (CLEIA‐B19V) in 2008.

A retrospective observational study to assess adverse transfusion reactions of patients with and without prior transfusion history

This study compares the frequency of adverse transfusion reactions (ATRs) after first transfusions with the frequency of ATRs for subsequent (non‐first) transfusions.

Anti-M Antibody Induced Prolonged Anemia Following Hemolytic Disease of the Newborn Due to Erythropoietic Suppression in 2 Siblings.

Hemolytic disease of the newborn (HDN) arising from MNSs incompatibility is rare, with few reports of prolonged anemia and reticulocytopenia following HDN. We report the younger of 2 male siblings, both of whom had anti-M-induced HDN and anemia persisting for over a month. Peripheral reticulocytes remained inappropriately low for the degree of anemia, and they needed multiple red cell transfusions. Viral infections were ruled out. Corticosteroids were given for suspected pure red cell aplasia. Anemia and reticulocytopenia subsequently improved. Colony-forming unit erythroid assay revealed erythropoietic suppression of M antigen-positive erythroid precursor cells cultured with maternal or infant sera containing anti-M. In conclusion, maternal anti-M caused HDN and prolonged anemia by erythropoietic suppression in 2 siblings.

Storage of volume-reduced washed platelets in M-sol additive solution for 7 days

Volume‐reduced washed platelets (VR‐wPLTs), which are prepared by concentrating platelets (PLTs) into a smaller volume of additive solution (AS), may prevent not only circulatory overload, but also adverse reactions caused by plasma components. Although VR‐wPLTs may be quickly degraded due to high PLT concentrations, few studies have examined the effects of storage on VR‐wPLTs. We examined here the in vitro properties of VR‐wPLTs prepared with M‐sol AS during their storage for 7 days.

Repeated exposure rather than the total volume of transfused components may influence the incidence of allergic transfusion reactions.

The plasma fraction of blood components has an essential role in the etiology of allergic transfusion reactions (ATRs). The difference of incidences of ATRs between fresh‐frozen plasma (FFP) and platelet concentrates (PCs), in which plasma is the main component, is not clearly understood. This study compares the frequency of ATRs to FFP versus PCs on both first and subsequent (nonfirst) transfusions and considers the factors influencing the risk of ATRs.

Comparison between in vitro properties of washed platelet concentrates suspended in M-sol and those in BRS-A, both of which were prepared with an automated cell processor

BACKGROUND Washed platelet concentrate (WPC) is prepared manually in general, but automated preparation is desirable to minimize variation in the WPC quality and enhance WPC production. Recently, the software was improved for an automated cell processor (ACP) to control all processes of WPC preparation. M-sol and BRS-A, which are mixtures of medical solutions, are widely used for WPC preparation with a manual method in Japan. In this study, we prepared WPC suspended in M-sol (WPC-M) or BRS-A (WPC-B) with the ACP, and compared their in vitro properties during 7-day storage. STUDY DESIGN AND METHODS PC was divided into two equal aliquots for WPC-M and WPC-B. A divided PC, medical solutions and disposable materials were set in the ACP, and it was started to prepare WPC-M or WPC-B on Day 0. Prepared WPC was stored on a flatbed shaker until Day 7. RESULTS The pH of WPC-M and WPC-B was maintained above 6.8 during the 7-day storage. The differences in aggregation (%), HSR (%), P-selectin expression, GPIbα expression, and phosphatidylserine expression between WPC-M and WPC-B were minimal until Day 3. CONCLUSION The in vitro properties of WPC-B are not markedly different from those of WPC-M until Day 3.

Evaluation of ADAM-rWBC for counting residual leucocytes in leucocyte-reduced whole blood and apheresis platelet concentrates

Dear Sir, Universal leucocyte reduction of blood components has been widely implemented to reduce the risk of transfusion reactions (Beckman et al., 2004). The residual numbers of leucocytes are required to be <1× 106 cells per blood product and <5× 106 cells per blood product in the European and American guidelines, respectively (U.S. Food and Drug Administration, 2012, Council of Europe Publishing, 2013). In Japan, 1% of manufactured leucocyte-reduced (LR) products are quality control (QC) tested and residual leucocytes in ≥95% of those blood products should be ≤1× 106 cells bag−1. The leucocyte concentrations in LR-blood products tend to be <1 cells μL−1 (Seghatchian et al., 2001; Strobel et al., 2014). Therefore, accurate and easy methods of counting low concentrations of leucocytes are essential for QC of LR-blood products to ensure compliance with the guidelines. The flow cytometry method (FCM) has the advantages of good reproducibility and high throughput for counting the low concentration of leucocytes in LR-blood products (Dzik et al., 2000; van der Meer et al., 2001). Recently, ADAM-rWBC (NanoEnTek, Seoul, Korea), a new system to count residual leucocytes in blood components for transfusion was introduced (Bae et al., 2007; Strobel et al., 2014). ADAM-rWBC uses fluorescence microscopy for cell counting. The blood sample is stained with a solution containing fluorescent dye (propidium iodide, PI) and detergent. PI only stains cells containing DNA. Because PI can permeate through cell membranes due to the detergent, both viable and dead cells are stained. The stained sample is applied onto a disposable plastic slide and inserted into the ADAM-rWBC device. The light source for the sample excitation is a green light emission diode (LED). The emission images of the cells are detected by charge coupled device (CCD) camera. The pictures of 203 fields on the slide taken by the camera are recorded and the fluorescence spots are counted as cells using analysis software. The concentration of the cell is calculated by the analysis software and displayed. ADAM-rWBC is thought to be more convenient than FCM (Kline et al., 2012; Strobel et al., 2014). In the study by Kline et al., counting the number of leucocytes in red blood cell (RBC) products and platelet concentrate (PC)s, obtained values