Transfusion
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The use of fresh red blood cells (RBCs) is recommended for critically ill patients and patients undergoing surgery, although there is no conclusive evidence that this is beneficial. In this follow-up study, the short-term and the long-term recovery of irradiated, leukoreduced RBCs transfused after either a short storage (SS) or a long storage (LS) period were compared. By consecutive transfusion of RBCs with a SS and LS period, a direct comparison of their survival within the same patient was possible. ⋯ The mean 24-hour PTR of both SS and LS RBCs complies with the guidelines, even in a compromised patient population. The 24-hour PTR of SS RBCs, however, is significantly higher than that of LS RBCs. The remaining population of SS and LS RBCs has a nearly identical long-term survival. Therefore, depletion of the removal-prone RBCs before transfusion may be an efficient approach for product improvement.
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Pediatric patients may require small-volume transfusions necessitating splitting of red cell (RBC) units. This process usually involves temporary storage of aliquots in pediatric blood bags or, in some cases, plastic syringes, until they are transfused. While many studies have been published on the efficacy of storage in blood bags, there is little evidence to show that RBCs are safe and effective for transfusion after separation into plastic syringe aliquots. ⋯ Irradiation and storage of aliquoted RBCs demonstrated expected but not significant changes in the in vitro variables. Storage for up to 24 hours in syringes does not have a greater detrimental effect on RBCs than storage in transfer bags, making products stored in either container safe for transfusion to pediatric patients.
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Hemolytic disease of the fetus and newborn (HDFN) is a severe disease, resulting from maternal red cell (RBC) alloantibodies directed against fetal RBCs. The effect of a first-trimester antibody screening program on the timely detection of HDFN caused by antibodies other than anti-D was evaluated. ⋯ First-trimester screening enables timely treatment of HDFN caused by antibodies other than anti-D, however, with a sensitivity of only 75 percent. A second screening at Week 30 of c- women will enhance the screening program. Severe HDFN, caused by antibodies other than anti-D, is associated with anti-K, anti-c, and to a lesser extent with other Rh-alloantibodies.
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Pegylated filgrastim (PEG-f), a long-lasting granulocyte-colony-stimulating factor, has been used in different hematologic conditions to shorten chemotherapy-induced neutropenia and to mobilize peripheral blood stem cells. Data on mobilization efficacy in patients with multiple myeloma are, however, still limited. ⋯ These results, compared with those previously reported for the DCEP-filgrastim combination, suggest that DCEP chemotherapy followed by PEG-f is a promising combination to mobilize peripheral blood stem cells in myeloma patients.