To analyse patients with chronic ocular graft-versus-host disease (GvHD) under treatment with 100% autologous serum eye drops from a sealed manufacturing system.
17 patients with chronic ocular GvHD ...received 100% autologous serum eye drops from single use vials manufactured in a sealed system. Retrospective analysis included visual acuity, corneal staining, frequency of artificial tears, ocular symptoms by means of a questionnaire and information on subjective side effects and cost compensation.
Data of prior to autologous serum eye drops therapy and at a 6-month follow-up were obtained. They demonstrated a significant increase in visual acuity (logMAR oculus dexter/right eye (OD) 0.5±0.32 to 0.4±0.3; oculus sinister/left eye (OS) 0.6±0.35 to 0.3±0.35; p=0.177/0.003) and significant improvement in corneal staining (Oxford grading scheme: OD from 3±1.03 to 2±1.43, OS from 4±1.0 to 2±1.09, p=0.004/0.001) and ocular symptoms (ocular surface disease index: 88±20.59 to 63±22.77; p=0.02). Frequency of artificial tears was reduced and no side effects were reported. Patient satisfaction was 100%, and cost compensation by health insurance reached 80%.
100% autologous serum eye drops using a sealed manufacturing system were efficient in improving the ocular surface, patient symptoms and visual acuity without side effects. It seems to be safe to use 100% autologous serum despite earlier suspicions regarding immune complex accumulations and exacerbation of ocular surface inflammation. The potential effects of serum levels of systemic immunosuppressives through readministration onto the ocular surface need to be elucidated.
BACKGROUND: New technologic developments enable automated collection and preparation of red blood cells (RBCs). This study's aim was to evaluate quality of apheresis‐derived RBCs (ARBCs) collected as ...single units along with platelets (RBC‐Ps) or double units (2‐RBCs) with four different apheresis systems.
STUDY DESIGN AND METHODS: Sixty‐six donors with similar baseline variables underwent RBC apheresis collection with various machines (Amicus 15 RBC‐Ps and Alyx 15 2‐RBCs, Baxter; the Trima Accel 9 RBC‐Ps, 8 2‐RBCs, Gambro, and the MCS+9 RBC‐Ps, 10 2‐RBCs, Haemonetics Corp.). In vitro properties were analyzed during 49 days of storage and compared to manual RBCs (MRBCs, n = 14).
RESULTS: All units but one, Alyx, demonstrated white blood cell counts of less than 1 × 106. ARBCs showed lower variability in volume compared to MRBCs. All units met international requirements (European, AABB) for hematocrit (50%‐70%), hemoglobin (>40 g/unit), and RBC mass (≥153 mL). pH values remained similar between study groups without reaching critical limits in any unit. MRBCs had slight advantages for hemolysis at the end of storage and were significantly superior in energy maintenance as indicated by less ATP degradation and potassium leak most likely due to more pronounced anoxidative glycolysis particularly during the first half of storage. Owing to more declining oxidative glucose metabolism, ARBCs demonstrated higher methemoglobin formation and subsequent oxygen release until the end of storage.
CONCLUSION: ARBCs exhibited better predictability in volume and absolute RBC mass than MRBCs and demonstrated sufficient in vitro quality throughout storage, even though lower ATP preservation and higher methemoglobin formation were observed compared to MRBCs probably due to differences in glucose metabolism.
BACKGROUND: To improve productivity of automated platelet (PLT) collection, the industry has introduced new instruments or modifications to existing equipment.
STUDY DESIGN AND METHODS: With the same ...8 donors for double (DDC) and triple‐dose PLT collection (TDC), the Baxter Amicus (AM), the Haemonetics MCS Plus (MCS+), and the Gambro Trima Accel (TA) were evaluated focusing on yield, duration, and citrate donor load. Target endpoints were set at 5.5 × 1011 to 6.0 × 1011 PLTs (DDC) and 7.5 × 1011 to 8.0 × 1011 PLTs (TDC) in up to 100 and 120 minutes’ donation time, respectively.
RESULTS: TA was the most efficient system (74.5 ± 3.9%) with significant differences from AM (71.1 ± 3.9%; p = 0.028) and MCS+ (64.0 ± 7.7%; p = 0.002). TA had advantages over AM for collection rate (10.9 × 109 ± 2.2 × 109 vs. 10.1 × 109 ± 1.5 × 109 PLTs/min; p = 0.382), whole blood processed (3928 ± 611 mL vs. 4219 ± 727 mL; p = 0.382), and time to obtain an established standard dose (TSD 2.5EU, 30.2 ± 5.6 vs. 37.7 ± 5.5 min; TSD 3.5US, 42.2 ± 7.8 min vs. 52.7 ± 7.7 min; p = 0.015), whereas AM was slightly superior in PLT yield (2.81 × 1011 ± 0.21 × 1011 vs. 2.76 × 1011 ± 0.31 × 1011/unit; p = 0.645). Owing to the lowest draw (42.3 ± 3.2 mL/min; p < 0.001) and collection rates (6.0 × 1011 ± 1.5 × 1011/min; p = 0.021), MCS+ was the slowest significantly (p < 0.001) but compensated with fewer citrate reactions owing to lower citrate infusion rates (0.78 ± 0.11 mL/min/L; p = 0.028).
CONCLUSION: High‐dose plateletpheresis was performed efficiently and safely with all three instruments. AM had advantages in PLT yield, and MCS+, in donor comfort. TA was the fastest in obtaining an established standard dose and, because of this advantage, the machine with the highest practical impact in routine use.
Background
To prevent phlebotomy of anemic individuals and to ensure hemoglobin (Hb) content of the blood units, Hb screening of blood donors before donation is essential. Hb values are mostly ...evaluated by measurement of capillary blood obtained from fingerstick. Rapid noninvasive methods have recently become available and may be preferred by donors and staff. The aim of this study was to evaluate for the first time all different noninvasive methods for Hb screening.
Study Design and Methods
Blood donors were screened for Hb levels in three different trials using three different noninvasive methods (Haemospect MBR Optical Systems GmbH & Co. KG, NBM 200 LMB Technology GmbH, Pronto‐7 Masimo Europe Ltd) in comparison to the established fingerstick method (CompoLab Hb Fresenius Kabi GmbH) and to levels obtained from venous samples on a cell counter (Sysmex Sysmex Europe GmbH) as reference. The usability of the noninvasive methods was assessed with an especially developed survey.
Results
Technical failures occurred by using the Pronto‐7 due to nail polish, skin color, or ambient light. The NBM 200 also showed a high sensitivity to ambient light and noticeably lower Hb levels for women than obtained from the Sysmex. The statistical analysis showed the following bias and standard deviation of differences of all methods in comparison to the venous results: Haemospect, −0.22 ± 1.24; NBM, 200 −0.12 ± 1.14; Pronto‐7, −0.50 ± 0.99; and CompoLab Hb, −0.53 ± 0.81.
Conclusion
Noninvasive Hb tests represent an attractive alternative by eliminating pain and reducing risks of blood contamination. The main problem for generating reliable results seems to be preanalytical variability in sampling. Despite the sensitivity to environmental stress, all methods are suitable for Hb measurement.
Between 2004 and 2013, 603 patients and their relatives (n = 1297) were typed as part of the search for a suitable HLA‐matched donor in their nuclear and extended families at the central service ...provider for transfusion medicine at the University Hospital of Cologne. The high success rate in finding donors over the years at our center (38.1%) led us to examine our database retrospectively in order to evaluate the donor search and haplotype frequencies (HFs) in the sample. Our goal was to identify the factors contributing to this high success rate and also to compare the HFs we observed with other reported haplotype frequency estimations (HFE) for the Cologne area. Probability estimations for a successful donor search were constructed based on the HFEs for the sample.
Automated component collection systems offer the possibility of increasing blood supply and improving transfusion safety.
30 blood donors were randomly assigned to double RBC collection with either ...the Baxter Alyx (AX), the Haemonetics MCS Plus (MCS+), or the Gambro Trima Accel (TA). Procedures were prospectively evaluated focussing on yield, time, efficiency, citrate donor load, and in vitro quality.
All units showed sufficient in vitro quality throughout 42 days of storage and complied with international requirements. Donor reactions were limited to mild citrate reactions. AX was the fastest and most efficient system
∗∗ (
∗∗
p
∼
0.001) attaining the highest yield
∗∗ from similar amounts of whole blood. The drawbacks were a higher RBC loss
∗ (
∗
p
<
0.05) and accelerated citrate infusion
∗∗. Due to lower collection rates
∗∗∗ (
∗∗∗
p
<
0.001), MCS+ was slower than TA
∗∗∗ but compensated with lower citrate load
∗∗∗.
Double RBC apheresis was performed safely and efficiently with all three instruments. AX had advantages for most parameters evaluated.
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