Blood Transfusion Sets Research Articles

White particulate matter found in blood collection bags consist of platelets and leukocytes.

In late January 2003, some blood centers and hospitals throughout the US voluntarily sus-pended the use of some RBC and plasma units for trans-fusion due to the presence of unknown white particulate matter (WPM) in these units. To better understand the WPM phenomena, a number of technologies were used to establish the nature of the particulates observed in Terumo Collection sets. All AS-5 nonleuko-reduced RBCs and plasma units were visually inspected for WPM by placing the bags on a flat counter, undisturbed, for approximately 10 minutes and then perform-ing a visual examination for particles. Particles were isolated and placed on microscope slides or in plastic tubes for further analysis. Electron microscopy, bright field microscopy, differential interference contrast microscopy, infrared spectroscopy, and flow cytometry procedures were performed to establish the nature of the particulate matter. In addition, leukoreduction filters and blood transfusion sets were used on RBCs units with WPM. The particles were mostly composed of PLTs and WBCs, and fragments of these cells. All macroscopic WPM was removed from RBCs with leukoeduction and transfusion filters. WPM originated from PLTs and WBCs. Foreign matter (e.g., plastic) was not observed in any of the units. Leukoreduction and transfusion filters can be used to remove macroscopic WPM.

The dermatopathologic manifestations of hepatitis C infection: a clinical, histological, and molecular assessment of 35 cases

Cutaneous eruptions related to hepatitis C virus (HCV), a major cause of hepatitis in the setting of blood transfusion, intravenous drug abuse, organ transplantation, and hemodialysis, are typically reported as isolated cases. We encountered 35 cases of HCV infection associated with cutaneous eruptions. The present study evaluates paraffin-embedded, formalin-fixed tissue sections stained with hematoxylin and eosin from biopsy specimens of skin lesions from 35 patients seropositive for HCV. In 20 cases, reverse transcriptase polymerase chain reaction (RT-PCR) was performed using a probe for HCV RNA; the RNA was detected through the action of alkaline phosphatase on the chromogen nitroblue tetrazolium and bromochloroindolyl phosphate. The clinical spectrum comprised dermatomyositis-like photodistributed eruptions, palpable purpura, folliculitis, violaceous and perniotic acral lesions, ulcers, nodules, and urticaria. Lesions were also classified histopathologically by the dominant reaction pattern: vasculopathies of neutrophilic, lymphocytic, and granulomatous vasculitis and pauci-inflammatory subtypes (15 patients); palisading granulomatous inflammation (3 patients); sterile neutrophilic folliculitis (5 patients); dermatitis herpetiformis (1 patient); lobular panniculitis composed of neutrophilic lobular panniculitis in 2 patients and benign cutaneous polyarteritis nodosa in 1 patient; neutrophilic dermatoses, including neutrophilic urticaria, neutrophilic eccrine hidradenitis, and pyoderma gangrenosum (3 patients); interface dermatitis (3 patients); and low-grade lymphoproliferative disease of B-cell lineage representing marginal zone lymphoma in 1 patient and a clonal plasmacellular infiltrate in another patient. In most cases, whereas 1 of the aforementioned disorders defined the dominant reaction pattern, there was an accompanying secondary reaction pattern, defining a hybrid picture. Endothelial changes including endothelial cell enlargement and effaced heterochromatin with margination of the chromatin to the nuclear membrane were seen in several cases; in some cases similar cytopathic changes also involved the supporting pericytes, eccrine ductular cells, or keratinocytes. The RT-PCR analyses in 8 of 20 cases examined revealed HCV RNA expression in a focal, weak fashion in endothelia and perivascular inflammatory cells in those cases showing vasculopathic changes. Viral parasitism of endothelia may be important in cutaneous lesional propagation in the setting of HCV infection. Cross-reactivity between endogenous and viral antigens, leading to cellular and/or type II immune reactions; viral tropism to B lymphocytes, resulting in B cell expansion with resultant autoantibody production; and circulating immune complexes containing monoclonal cryoglobulins may also be of pathogenetic importance. Tropism of the virus to B lymphocytes provides a mechanism for the development of low-grade clonal B cell lymphoproliferative disease in this setting.

Adherence of Serratia marcescens, Serratia liquefaciens, Pseudomonas aeruginosa and Staphylococcus epidermidis to Blood Transfusion Bags (CPD-SAGMAN Sets)

The adherence of 4 isolates of Serratia marcescens, 1 isolate of Serratia liquefaciens, 1 of Pseudomonas aeruginosa, and 2 of Staphylococcus epidermidis to blood transfusion sets (CPD-SAGMAN) consisting of bags and connecting tubing was tested. All strains adhered well to the connecting tubes (polyvinyl chloride) from the transfusion sets from 3 manufacturers. Three isolates from a Swedish outbreak of septicaemia associated with contaminated blood bags showed greater adherence than an isolate from a urinary tract infection. There was no significant adherence of S. marcescens to the blood bags. In general, there were no significant differences in the adherence of a given isolate to the plastics from different manufacturers. Appropriate hygienic procedures for the production of transfusion sets appear to be of greater importance than differences in the plastic material as regards the incidence of transfusion-related bacteremia.

Clinical evaluation of commonly used blood administration sets

Five commonly available blood transfusion sets, the Fenwall Blood Recipient set, the Abbott HEMA R Y-type Blood Set, the Bentley Infusion Blood Set (PFF-100), the Medex Hi-Flo Tlrauma R Quad Set (MX 884) and the Pall Ultipor Transfusion Set with Filter are compared. Flow rates and lifespan are evaluated by measuring the time required for 150 mL aliquots of homogeneous units of human red blood cells to pass through the devices under 300 mmHg constant pressure. Microfiltration of blood is briefly reviewed.

Evaluation of a volumetric intravenous fluid infusion pump for transfusion of blood components containing red cells.

A method was devised to evaluate the suitability of an infusion pump for transfusing components containing red cells. With simulated transfusions of units of whole blood tested before or after the expiration date there was no increase in the plasma hemoglobin level in pumped blood compared with blood that was put through a standard blood transfusion set. With outdated units of red cells there was an increased level of plasma hemoglobin after pumping. The increases were greatest at maximum pump rates, but were not statistically or clinically significant. The authors' evaluation indicates that this pump causes minimal damage to the red cells, although care should be exercised when rapidly transfusing red cells with high hematocrit values.

Use of a urologic set for improved fluid administration rates.

This study was designed to compare flow rates of three sets of tubings: a large bore (8 mm) Y-urologic set (Y-URO); a Y-URO with an added in-line blood filter (Y-URO + BF); and a currently used (3.5 mm diameter) blood transfusion set (Y-TRANSFUSION). The time required to empty a one litre bag of Ringer's Lactate from a 1.0 meter vertical drop was measured while using four different IV catheters (9.5, 10, 14 and 16 gauge), and the flow rates calculated. When a 9.5-gauge catheter was used, the flow rates obtained by the Y-URO and the Y-URO + BF were respectively 269 and 162 per cent higher than those achieved by the Y-TRANSFUSION. This wide margin was decreased to 41 and 39 per cent with a 16-gauge catheter. A 9.5-gauge catheter, when compared to a 16-gauge, allowed a 346 per cent improvement in flow rates with the Y-URO, a 225 per cent with the Y-URO + BF and only a 71 per cent increase with the Y-TRANSFUSION. The urologic set allows better fluid flow because of the larger diameter of its tubing. This adaptation of a large bore urologic irrigation set can be very useful when rapid fluid administration is imperative.

STUDIES ON EXPERIMENTAL THERAPY OF ANAPHYLACTIC SHOCK IN DOGS.

Abstract1. Treatment with blood transfusion or arterenol perfusion set up 3-6 min. after induction of anaphylactic shock in dogs, protected animals from dying in acute phase, but did not decrease total mortality rate, since a significant number of the treated animals died in the following hours.2. Arterenol perfusion applied in the same way in animals treated with phenergan before challenge, as well as perfusion with arterenol, adrenaline, and phenergan in animals not previously treated with the antihistaminic, prevented animals from dying in acute phase and increased significantly the number of survivors.3. Treatment with adrenaline and phenergan by intramuscular route, as well as perfusion with hypertensin, only or in association with phenergan, did not not, always prevent animals form dying in acute phase and did not significantly increase the number of survivors.4. Death in anaphylactic shock in dogs does not represent a direct, effect, to the biochemical lesions induced in cells by the antigen-antibo...

A Note on Testing Filters in Blood Transfusion Sets

SummaryA test for the efficiency of filters in transfusion sets which entails testing whole sets is unsatisfactory. An alternative test was devised which makes it possible to test small circles of filter material and to obtain reasonably reproducible results.This test shows that there is an inverse relationship between poresize and the weight of solid matter removed from stored blood. Until more is known about the possible harmful effect of infusing the solid matter which can be removed by filtration from stored blood, the choice of any particular pore‐size must remain arbitrary.RésuméUn test servant à déterminer l'efficacité du filtre des nécessaires à transfusion qui impose à la pratique du test l'utilisation du nécessaire en entier est insuffisant. Les auteurs ont imaginé un autre test qui permet de pratiquer des essais avec de petites quantités de matière à filtre et qui permet d'obtenir des résultats suffisamment reproductibles.Ce test montre que la masse des substances solides retenues par filtration du sang conservé est inversément proportionnelle à la dimension des pores du filtre.Le choix d'une dimension des pores d'un filtre ne peut être qu'arbitraire tant qu'on ne connaît pas l'effet nocif possible des matières solides infusées qui peuvent être retenues par filtration du sang conservé.ZusammenfassungDie Prüfung der Leistungsfähigkeit des Filternetzes von Transfusionsfiltern ist bei Verwendung des gesamten Transfusionsbesteckes unbefriedigend. Es wurde deshalb eine Methode entwickelt, bei welcher kleine Kreisabschnitte des Filternetzes gepriift werden. Die Versuchsergebnisse mit dieser Methode waren befriedigend. Es gelang zu zeigen, daß eine umgekehrte Beziehung zwischen der Porenweite des Filters und dem Gewicht der zurückgehaltenen Anteile besteht. Da die Frage allfälliger Schäden durch Infusion geformter Teilchen noch nicht restlos geklärt ist, läßt sich über die günstigste Porenweite von Transfusionsfiltern nichts Endgültiges aussagen

A Note on Testing Filters in Blood Transfusion Sets

A Note on Testing Filters in Blood Transfusion Sets