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Red blood cell exchange

Daniel W Abbott, Kenneth D Friedman, Matthew S Karafin
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a microangiopathic hemolytic anemia that requires emergent treatment with plasma exchange and is one of the most important conditions for which apheresis service professionals are consulted. Careful interpretation of initial laboratory values and the peripheral blood smear is a critical first step to determining the need for plasma exchange because other conditions can show deceptively similar red cell morphology, and ADAMTS13 levels are often not rapidly available...
September 28, 2016: Transfusion and Apheresis Science
Shannon Kelly, Keith Quirolo, Anne Marsh, Lynne Neumayr, Alicia Garcia, Brian Custer
BACKGROUND: Chronic red blood cell (RBC) transfusion therapy (CTT) is an integral component of the management of severe sickle cell disease (SCD) and can prevent complications, such as stroke. RBC units can be administered via simple transfusion or exchange transfusion, and erythrocytapheresis (automated RBC exchange transfusion [aRBX]), is increasingly used for CTT. Comparisons of simple and aRBX transfusions are limited, and the current scope of aRBX use is not known. STUDY DESIGN AND METHODS: We administered a survey to define current transfusion practices for CTT and performed a review of the erythrocytapheresis literature...
October 19, 2016: Transfusion
Ravi Sarode, Samir K Ballas, Alicia Garcia, Haewon C Kim, Karen King, Bruce Sachais, Lance A Williams
The American Society for Apheresis (ASFA) conducted a one-day consensus conference on red blood cell exchange (RBCx) in sickle cell disease (SCD) during its annual meeting in San Antonio, TX, on May 5, 2015. The authors of this article, a subcommittee of ASFA's Clinical Applications Committee, developed several questions with regard to pathophysiology of SCD and use of RBCx in the management of various complications. These questions were provided to the seven invited speakers who are the experts in the field of SCD...
October 9, 2016: Journal of Clinical Apheresis
Nicolas Coudray, Sean L Seyler, Ralph Lasala, Zhening Zhang, Kathy M Clark, Mark E Dumont, Alexis Rohou, Oliver Beckstein, David L Stokes
Bor1p is a secondary transporter in yeast that is responsible for boron transport. Bor1p belongs to the SLC4 family which controls bicarbonate exchange and pH regulation in animals as well as borate uptake in plants. The SLC4 family is more distantly related to members of the Amino acid-Polyamine-organoCation (APC) superfamily, which includes well studied transporters such as LeuT, Mhp1, AdiC, vSGLT, UraA, SLC26Dg. Their mechanism generally involves relative movements of two domains: a core domain that binds substrate and a gate domain that in many cases mediates dimerization...
October 7, 2016: Protein Science: a Publication of the Protein Society
Rachel Bayley, Forhad Ahmed, Katie Glen, Mark McCall, Adrian Stacey, Robert Thomas
Manufacture of red blood cells (RBCs) from progenitors has been proposed as a method to reduce reliance on donors. Such a process would need to be extremely efficient for economic viability given a relatively low value product and high 2E12 cell dose. Therefore, the aim of these studies was to define the productivity of an industry standard stirred-tank bioreactor and determine engineering limitations of commercial RBC production. Cord blood derived CD34+ cells were cultured under erythroid differentiation conditions in a stirred micro-bioreactor (ambr™)...
October 1, 2016: Journal of Tissue Engineering and Regenerative Medicine
Sumaiya Adam, Hennie Lombaard
BACKGROUND: Minor red blood cell antibodies are becoming a more common cause of hemolytic disease of the newborn. Anti-U are a rare alloantibody found almost exclusively in people of black descent. There is limited experience to guide the management of pregnancies complicated by anti-U. Furthermore, there is often no suitable cross-matched blood available for transfusion of a patient with anti-U. CASE REPORT: A 21-year-old P0G1 presented at 25 weeks' gestation with D- disease in pregnancy...
September 23, 2016: Transfusion
Angela Scala, Silvana Ficarra, Annamaria Russo, Davide Barreca, Elena Giunta, Antonio Galtieri, Giovanni Grassi, Ester Tellone
We have recently proposed a new erythrocyte-based model of study to predict the antiproliferative effects of selected heterocyclic scaffolds. Starting from the metabolic similarity between erythrocytes and cancer cells, we have demonstrated how the metabolic derangement induced by an indolone-based compound (DPIT) could be related to its antiproliferative effects. In order to prove the validity of our biochemical approach, in the present study the effects on erythrocyte functionality of its chemical precursor (PID), whose synthesis we reported, were investigated...
2016: Oxidative Medicine and Cellular Longevity
Daniel Putensen, David Leverett, Bhavika Patel, Jasmin Rivera
BACKGROUND: The majority of reports regarding general vascular access choices for apheresis procedures argue that peripheral venous access should be considered first. However, the clinical reality appears to be different. While some procedures mandate central vascular access (e.g., therapeutic apheresis procedures in critically ill patients) and in some cases it is the patient's preference, we propose that the majority of elective procedures can be successfully performed peripherally...
September 15, 2016: Journal of Clinical Apheresis
Radhika Gangaraju, Vishnu V B Reddy, Marisa B Marques
Bone marrow necrosis with subsequent embolization of the fat and necrotic tissues into the systemic circulation causing fat embolism syndrome and multiorgan failure is a rare complication of patients with hemoglobinopathies. The exact etiology of this condition is not known. Because it occurs more often in patients with compound heterozygous conditions than in sickle cell disease, some patients are unaware of their predisposition. The initial symptoms are nonspecific, such as back and/or abdominal pain, fever, and fatigue, which may rapidly progress to respiratory failure and severe neurologic compromise...
September 2016: Southern Medical Journal
Caroline R Alquist, Zbigniew M Szczepiorkowski, Nancy Dunbar
Babesiosis is an increasingly recognized disease which may benefit from therapeutic apheresis (Category II/Grade 2C). Vulnerable populations include the splenectomized, those aged >50, those with malignancies, and the immunocompromised. In the setting of parasite levels > 10%, significant anemia, renal impairment, pulmonary compromise, or hepatic dysfunction, RBC exchange can rapidly reduce parasite burdens and decrease the bioavailability of proinflammatory cytokines. No previous report has shown such a rapid rebound in parasitemia despite adequate organism removal...
September 1, 2016: Journal of Clinical Apheresis
Saeed Dastgiri, Roya Dolatkhah
BACKGROUND: Sickle cell disease is an inherited autosomal recessive blood condition and is one of the most prevalent genetic blood diseases worldwide. Acute chest syndrome is a frequent complication of sickle cell disease, as well as a major cause of morbidity and the greatest single cause of mortality in children with sickle cell disease. Standard treatment may include intravenous hydration, oxygen as treatment for hypoxia, antibiotics to treat the infectious cause and blood transfusions may be given...
2016: Cochrane Database of Systematic Reviews
Dustin L Higashi, Nicolas Biais, Deborah L Donahue, Jeffrey A Mayfield, Charles R Tessier, Kevin Rodriguez, Brandon L Ashfeld, Jeffrey Luchetti, Victoria A Ploplis, Francis J Castellino, Shaun W Lee
Streptococcus pyogenes, or group A Streptococcus (GAS), is a human bacterial pathogen that can manifest as a range of diseases from pharyngitis and impetigo to severe outcomes such as necrotizing fasciitis and toxic shock syndrome. GAS disease remains a global health burden with cases estimated at over 700 million annually and over half a million deaths due to severe infections(1). For over 100 years, a clinical hallmark of diagnosis has been the appearance of complete (beta) haemolysis when grown in the presence of blood...
2016: Nature Microbiology
Elena Lazarova, Béatrice Gulbis, Brigitte van Oirschot, Richard van Wijk
BACKGROUND: Osmotic gradient ektacytometry is part of the laboratory diagnosis process of hereditary spherocytosis (HS) and other red blood cell (RBC) membrane disorders. We here present the experience of two independent institutions with a next-generation ektacytometer, the LoRRca MaxSis analyzer, in HS diagnostic settings. METHODS: Inter- and intra-assay variability and sample stability were analyzed. Samples from patients with HS (n=40), probable HS (n=21), auto-immune hemolytic anemia (n=7), and other pathologies (n=37) were studied...
August 25, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Ashok Tholpady, Arthur W Bracey, Kelty R Baker, Ross M Reul, Alice J Chen
Cold hemagglutinin disease with broad thermal amplitude and high titers presents challenges in treating cardiac-surgery patients. Careful planning is needed to prevent the activation of cold agglutinins and the agglutination of red blood cells as the patient's temperature drops during surgery. We describe our approach to mitigating cold agglutinin formation in a 77-year-old man with severe cold hemagglutinin disease who underwent off-pump coronary artery bypass surgery without the use of preoperative plasmapheresis...
August 2016: Texas Heart Institute Journal
Thordis Kristinsdottir, Sveinn Kjartansson, Hildur Hardardottir, Thorbjorn Jonsson, Anna Margret Halldorsdottir
INTRODUCTION: Hemolytic disease of the fetus and newborn (HDFN) is caused by the destruction of fetal red blood cells due to red cell antibodies produced by the mother. HDFN can cause fetal hydrops during pregnancy or neonatal jaundice after birth. Direct Antiglobulin Test (DAT) detects antibodies bound to red cells and is a valuable test aiding in the diagnosis of HDFN. In Iceland DAT is routinely performed on cord blood or newborn blood samples if the mother is Rhesus D negative or has non-A/B red cell alloantibodies...
July 2016: Læknablađiđ
Huy P Pham, Joseph Schwartz
PURPOSE OF REVIEW: Therapeutic apheresis can be used to treat many diseases. The American Society for Apheresis (ASFA) publishes Guidelines on the use of therapeutic apheresis every 3 years with the goal of providing the best available evidence for apheresis practice as well as clinical expertise. The 2016 (7th ed.) ASFA Guidelines contain 87 diseases (up from 78 in the 6th ed.) and 179 indications. This review outlines three new therapeutic apheresis indications for hematological disorders...
November 2016: Current Opinion in Hematology
Eric Salazar, Salvador Garcia, Robin Miguel, Francisco J Segura, Tina S Ipe, Christopher Leveque
Therapeutic and donor apheresis requires adequate vascular access to achieve inlet flow rates of ∼50-100 mL/min. While central dialysis-type venous catheters can usually provide such access, their use includes several associated risks. Some of these risks can be avoided or diminished if adequate peripheral venous access can be established. Some patients have adequate peripheral veins for apheresis that cannot be readily identified visually or by palpation. We hypothesized that ultrasound-guided peripheral venous access would benefit such patients and would lead to placement of fewer central venous catheters...
August 10, 2016: Journal of Clinical Apheresis
Cristina de Ramón, Joan Cid, Sergio Rodríguez-Tajes, Míriam J Álvarez-Martínez, Ma Eugenia Valls, Javier Fernández, Miguel Lozano
We report a severe Babesia microti infection in an immunocompetent patient diagnosed in Spain. A 66-year-old woman coming from USA presented with fever, thrombocytopenia, and multiorgan failure. Intraerythrocytic parasites were observed in Giemsa-stained peripheral blood smears and B. microti was first suspected by optical microscopy and afterward confirmed by specific polymerase chain reaction (PCR). Patient received antibiotic therapy, vital support measures and one red blood cell (RBC) exchange procedure...
October 2016: Transfusion and Apheresis Science
Adrian Najer, Dalin Wu, Martin G Nussbaumer, Geoffrey Schwertz, Anatol Schwab, Matthias C Witschel, Anja Schäfer, François Diederich, Matthias Rottmann, Cornelia G Palivan, Hans-Peter Beck, Wolfgang Meier
Medical applications of anticancer and antimalarial drugs often suffer from low aqueous solubility, high systemic toxicity, and metabolic instability. Smart nanocarrier-based drug delivery systems provide means of solving these problems at once. Herein, we present such a smart nanoparticle platform based on self-assembled, reduction-responsive amphiphilic graft copolymers, which were successfully synthesized through thiol-disulfide exchange reaction between thiolated hydrophilic block and pyridyl disulfide functionalized hydrophobic block...
August 21, 2016: Nanoscale
M Joshua Daniel, Prakash H Muddegowda, Chezhiansubash, Jyothi B Lingegowda, Niranjan Gopal, Krishna Prasad
INTRODUCTION: Red Cell Exchange (RCE) is removal of a patient's red blood cells while replacing with donor red blood cells either manually or using automated systems. RCE is beneficial in patients with Sickle Cell Disease (SCD) either during sickling crisis or prior to major surgical procedures to bring down the sickling percentage as high sickling percentage during prolonged anaesthesia may lead to vaso-occlusive crisis. It is also employed in patients infested with malaria and babesiosis where parasitic index remain high despite medical management...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
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