Vox Sang

Leukocyte filtration does not affect lymphocyte subpopulations and NK cell function in recipients of blood transfusions.

Mathiesen O. Lund L. Brodthagen U. Gandrup P. Grunnet N. Balslev I. Jersild C.
Regional Center of Blood Transfusion and Clinical Immunology, Aalborg Hospital, Denmark.
BACKGROUND AND OBJECTIVES: The possible immunosuppressive action of blood transfusion has aroused great interest recently, particularly with respect to its effects on tumor growth and recurrence rate of malignant disease. MATERIALS AND METHODS: The effect of blood transfusion on lymphocyte subpopulations and NK cell function preoperatively and 6 months postoperatively was studied in 129 patients treated with elective surgery for colorectal malignancy. Forty-two patients (33%) received blood transfusions, 21 of them randomly allocated to receive leukocyte-depleted blood products. Investigation was by means of conventional laboratory methods. RESULTS: In 21 patients receiving a median of 3 units of non-leukocyte-depleted blood products (NLD), a significant reduction in CD4+ lymphocytes (44% vs. 40%, p < 0.01) occurred. In contrast, no significant changes in CD4+ lymphocytes were observed in the 21 patients transfused with leukocyte-depleted blood products (LD). However, with respect to lymphocyte subpopulations and NK cell function, differences between the NLD and LD groups were not significant. There was a marginal decrease in HLA-DR+ lymphocytes in the NLD patients without a history of previous transfusion. CONCLUSIONS: There seems to be no major change in lymphocyte subpopulations and NK cell function 6 months after blood transfusion. Thus we cannot confirm our previous findings of a reduced number of CD20+ cells after blood transfusion.

Hepatitis G virus infection in screened Chinese blood donors.

Ren FR. Wang Y. Li H. Chen HS. Zhao HY.
Beijing Red Cross Blood Center, China.
BACKGROUND AND OBJECTIVES: To determine the prevalence of the recently identified hepatitis G virus (HGV)/GBV-C in screened Chinese paid blood donors. MATERIALS AND METHODS: Two hundred and seventy-nine plasma samples were tested for HGV RNA by RT-PCR with nested primers from the 5'-noncoding region of GBV-C. All samples were obtained from plasma or blood bags that had been screened twice by routine selection tests (ALT, HBsAg, Anti-HCV, anti-HIV, and syphilis) and were available for clinical use. RESULTS: HGV RNA was detected in 2 (4%) of 50 paid plasma donors from the Beijing Red Cross Blood Center, 1 (2%) of 50 paid blood donors from Taiyuan, and 9 (5%) of 179 paid blood donors from Hebei, a total HGV detection rate of 4.3% (12/279). CONCLUSIONS: Our data suggest that HGV infection is relatively frequent even in screened donors, at least in paid screened donors, although larger-scale studies are required.

Benefit of dynamic over static incubation in the detection of a low-level HBsAg (chronic carrier) bone donor.

Raafat A. Yates P. Sellers F. Munro H. Dow B.
Aberdeen and North East Scotland Blood Transfusion Service, UK.
BACKGROUND: Hepatitis B infection can be transmitted by organ or tissue transplantation. CASE REPORT: A 40-year-old man received a bone graft from a donor who tested negative for HbsAg with a static-mode assay. The same donor, on a subsequent donation, was found to be HbsAg-positive with a dynamic mode assay. The archival sample from the initial donation also tested HbsAg-positive with the dynamic-mode assay. The recipient of the bone, who had received HBV vaccine in the past, did not develop clinical or laboratory evidence of HBV infection. CONCLUSIONS: This case highlights the importance of sensitive microbiological test protocols in the context of tissue banking.

Hepatitis G virus: prevalence and sequence analysis in blood donors of Sao Paulo, Brazil.

Year 1998
Bassit L. Kleter B. Ribeiro-dos-Santos G. Maertens G. Sabino E. Chamone D. Quint W. Saez-Alquezar A.
Fundacao Pro-Sangue Hemocentro de Sao Paulo, Brazil.
BACKGROUND AND OBJECTIVES: Hepatitis G virus (HGV) is a recently discovered viral agent transmitted by blood, which was firstly identified in patients with acute or chronic liver disease. HGV prevalence in US blood donors was recently found to average 1-2%. We report a much higher HGV frequency among blood donors of Sao Paulo, Brazil. MATERIALS AND METHODS: 200 serum samples were submitted to RT-PCR using primers directed to the 5' untranslated region and nonstructural 5A (NS5A) region. PCR products were analyzed by gel electrophoresis and Southern blot hybridization. RESULTS: Of the 200 specimens, 18 (9%; 95% CI 5.4-13.8%) were positive by both sets of primers. Sequence analysis of the NS5A PCR products revealed a homology of 96.3%. Of the 18 HGV-positive samples, only one was positive for anti-HBc and all were anti-HCV- and HCV-RNA-negative. CONCLUSION: Such a high prevalence of HGV in a nonsymptomatic population suggests that this is a benign agent.

Review of counselling in a transfusion service: the London (UK) experience.

Year 1998
Miller R. Hewitt PE. Warwick R. Moore MC. Vincent B.
Royal Free Hospital and School of Medicine, London, UK.
Donor (and recipient) counselling within the Transfusion Service in the UK has grown in volume and complexity over the last 10 years. The addition of new tests for donated blood and the growth of bone marrow transplantation have increased the demands on counselling staff. New initiatives, such as the HCV look-back programme, have required an extension of the skills and knowledge of staff involved in counselling.

Application of the human hepatitis B virus core antigen from transgenic tobacco plants for serological diagnosis.

Year 1998
Tsuda S. Yoshioka K. Tanaka T. Iwata A. Yoshikawa A. Watanabe Y. Okada Y.
Plant Biotechnology Institute, Ibaraki Agricultural Center, Iwama, Japan. stsuda@mxj.meshnet.or.jp
BACKGROUND AND OBJECTIVES: The aim was to produce HBcAg from plants more cheaply than can be done by other currently available means, and to apply such antigen to immunoassay procedures for pretransfusion testing of donor blood. MATERIALS AND METHODS: Transgenic Nicotiana tabacum cv. SR-1 plants expressing the human hepatitis B virus (HBV) core antigen (HBcAg) gene were generated by Agrobacterium-mediated transformation. The recombinant product, called tHBcAg, can assemble itself into a spherical particle with a diameter of 25 to 30 nm, and can maintain two antigenic determinants of HBcAg, namely HBc/alpha and HBc/beta. Partly purified tHBcAg was used in the hemagglutination-inhibition (HI) test, as routinely used by the Japanese Blood Center, to test a panel of 524 blood units taken from HBV-positive donors. RESULTS: In the HI test, tHBcAg showed serologic properties comparable to that from Escherichia coli, the standard antigen used in the Japanese Blood Center. CONCLUSIONS: Transgenic plants can produce reagents for serologic testing and perhaps even such medical materials as oral vaccines.

Epidemiological and clinical aspects of hepatitis G virus infection in blood donors and immunocompromised recipients of HGV-contaminated blood.

Year 1998
Heuft HG. Berg T. Schreier E. Kunkel U. Tacke M. Schwella N. Hopf U. Salama A. Huhn D.
Virchow-Clinic, Department of Internal Medicine, Hematology/Oncology, Humboldt University, Germany.
BACKGROUND AND OBJECTIVES: The infectiousness and clinical relevance of the newly discovered blood-borne Flaviviridae-like agent, termed hepatitis G virus (HGV), are not well understood. MATERIALS AND METHODS: Twenty-three transfusion recipients of two HGV-affected long-term blood donors were studied for HGV genome and antibodies to the putative envelope 2 glycoprotein (anti-E2) of HGV. Nine recipients had nonhematological disorders and 14 suffered from severe hematological diseases and 7 of them received allogeneic bone marrow or blood stem cell transplantation. The molecular epidemiology of the observed HGV infection was studied by direct sequencing of parts of the 5'-noncoding region, NS3, and NS5 region of HGV in the 2 long-term donors and in their 6 recipients who became HGV RNA positive. Additionally, 549 individuals-homologous (n = 254) and autologous blood donors (n = 202), and medical staff (n = 89)--were investigated for the presence of HGV RNA. RESULTS: HGV RNA in serum was found in 15 of the 23 (65%) transfusion recipients with known exposure of HGV-contaminated blood. Seven of the remaining 8 recipients showed only an anti-E2 response, indicating previous HGV infection with spontaneous clearance of the virus. In one recipient neither HGV RNA nor anti-E2 could be detected. Molecular evidence for HGV transmission by the 2 donors was found in 3 of the 6 recipients studied. The alanine aminotransferase levels were not significantly different in the HGV RNA positive and negative recipients, and none of the 23 recipients developed posttransfusion hepatitis. Persistent HGV infection was observed especially in recipients with severe hematological disorders or in those in whom intensive immunosuppressive treatment was necessary. Of the 549 individuals studied, 10 (1.8%) were healthy carriers of HGV RNA. CONCLUSION: The persistence of transfusion-acquired HGV infection is not associated with acute or chronic hepatitis, but may be influenced by the recipient's underlying disease.

Outcome of transfusion of K:11 erythrocytes in a patient with anti-K11 antibody.

Year 1998
Kelley CM. Karwal MW. Schlueter AJ. Olson JD.
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, USA.
BACKGROUND AND OBJECTIVES: The clinical significance of anti-K11 in red cell transfusion therapy is unknown. We report the outcome of transfusion of K:11 erythrocytes into a patient with a known anti-K11 antibody. MATERIALS AND METHODS: The patient was monitored clinically following transfusion of 11 units of K:11 erythrocytes. A red cell survival study with K:11 erythrocytes and a monocyte monolayer assay (MMA) were performed. RESULTS: No adverse clinical outcome was detected. The red cell survival study showed normal survival of K:11 erythrocytes, and the MMA showed no increase in reactive monocytes. CONCLUSION: These findings suggest that K:11 red cells can safely be transfused to individuals with anti-K11 antibody.