Transfusion
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Multicenter Study Clinical Trial
Fresh frozen plasma prepared with amotosalen HCl (S-59) photochemical pathogen inactivation: transfusion of patients with congenital coagulation factor deficiencies.
Photochemical treatment (PCT) with amotosalen HCl (S-59) was developed to inactivate pathogens and white blood cells in plasma (PCT-FFP) used for transfusion support. ⋯ Replacement coagulation factors in PCT-FFP exhibited kinetics and therapeutic efficacy consistent with conventional FFP.
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The delayed bleeding associated with total knee arthroplasty (TKA) may be a result of a tourniquet-induced imbalance of the procoagulant and fibrinolytic systems. There are conflicting results in the literature about tranexamic acid (TA) infusion in reducing postoperative blood loss and the number of transfused red cells (RBC) units. A meta-analysis was performed to summarize the results of different research studies. ⋯ Our meta-analysis shows that the use of TA for patients undergoing TKA is effective in reducing the requirements of allogeneic blood transfusion.
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Multicenter Study
Hepatitis B virus (HBV) DNA screening of blood donations in minipools with the COBAS AmpliScreen HBV test.
The risk of hepatitis B virus (HBV) transmission by blood transfusion (estimated at 1 in 63,000-1 in 205,000 units in the United States) exceeds that of hepatitis C virus (HCV) or human immunodeficiency virus (HIV). Reduction of window-period HBV transmissions through detection of HBV DNA-positive units by minipool nucleic acid testing (MP NAT) would be expected to decrease this risk. ⋯ Implementation of HBV MP NAT will provide an increment in safety relative to HBV serologic screening, similar to that for HCV and in excess of that for HIV. Our data indicate that the implementation of HBV MP NAT would likely interdict 39 HBV window-period units and prevent 56 cases of transfusion-transmitted HBV infection annually. The current data indicate that HBV MP NAT should not lead to discontinuation of anti-HBc testing but that discontinuation of HBsAg testing with retention of anti-HBc testing may be possible.
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Extracellular potassium concentration [K(+)e] increases with duration of red blood cell storage. Sometimes red blood cells (RBC) are washed before transfusion to infants to reduce [K(+)e] of these components. AABB standards permit storage of washed RBCs at 4 degrees C for 24 hours. The [K(+)e] of washed RBCs during storage is not known. Experiments were performed to provide those data. ⋯ [K(+)e] increases after washing irradiated and nonirradiated packed RBCs. After irradiation and washing, the [K(+)e] for the initial 6 hours can be predicted from the [K(+)e] immediately after washing. There is a low probability that a unit of RBCs would have a [K(+)e] greater than 5 mEq per L during 6 hours of storage at 4 degrees C after washing if the cells are not irradiated and for 3 hours if the cells are irradiated.