The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
William A. Blattner - One of the best experts on this subject based on the ideXlab platform.
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A prospective study of transmission by transfusion of HTLV-I and risk factors associated with seroconversion
International Journal of Cancer, 1992Co-Authors: Angela Manns, Rainford Wilks, Grace Haynes, J. Peter Figueroa, Marge Barnett, Barrie Hanchard, Edward L. Murphy, William A. BlattnerAbstract:To evaluate the risk of transfusion-related transmission of HTLV-I in Jamaica, a prospective study was initiated, prior to availability of a licensed HTLV-I serological screening assay. This information would prove useful in formulating strategies for blood-Donor screening. We followed 118 pre-transfusion HTLV-l-Negative transfusion recipients at monthly intervals posttransfusion for I year. Laboratory and questionnaire data were obtained at each visit to evaluate the clinical and immunological status of recipients. Cumulative incidence of HTLV-I seroconversion was estimated and risk-factor data associated with seroconversion among 66 HTLV-l-exposed transfusion recipients were analyzed. Seroconversion occurred in 24/54 (44%) of recipients of HTLV-l-positive cellular blood components, 0/12 recipients of positive non-cellular Donor units and 0/52 recipients of HTLV-l-Negative Donor units. Significant risk factors associated with recipient seroconversion were receipt of a seropositive cellular blood component stored for less than one week [odds ratio (OR) = 6.34, 95% confidence interval (CI) = 1.83 to 21.92], male sex (OR = 4.79, 95% CI = 1.15 to 20.0) or use of immunosuppressive therapy at time of transfusion (OR = 12.20, 95% CI = 0.95 to 156). Risk of blood-borne infection per person per year in Jamaica was estimated to be 0.009%. Our results confirm that blood transfusion carries a significant risk of HTLV-I transmission and that screening of Donor blood effectively prevents HTLV-I seroconversion. Recipients at greatest risk for seroconversion were those who required multiple transfusions or who were receiving immunosuppressive therapy at the time of transfusion. These patients should be given priority in receiving selectively screened blood components, if universal blood-Donor screening for HTLV-I is not possible.
Paul R Cieslak - One of the best experts on this subject based on the ideXlab platform.
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transmission of hepatitis c virus to several organ and tissue recipients from an antibody Negative Donor
Annals of Internal Medicine, 2005Co-Authors: Barna D Tugwell, Priti R Patel, Ian T Williams, Katrina Hedberg, Feng Chai, Omana V Nainan, Ann Thomas, Judith E Woll, Beth P Bell, Paul R CieslakAbstract:The authors used molecular techniques to prove that an organ and tissue Donor who was Negative for antibody to hepatitis C virus (HCV) transmitted HCV infection to 8 transplant recipients. Although...
Angela Manns - One of the best experts on this subject based on the ideXlab platform.
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A prospective study of transmission by transfusion of HTLV-I and risk factors associated with seroconversion
International Journal of Cancer, 1992Co-Authors: Angela Manns, Rainford Wilks, Grace Haynes, J. Peter Figueroa, Marge Barnett, Barrie Hanchard, Edward L. Murphy, William A. BlattnerAbstract:To evaluate the risk of transfusion-related transmission of HTLV-I in Jamaica, a prospective study was initiated, prior to availability of a licensed HTLV-I serological screening assay. This information would prove useful in formulating strategies for blood-Donor screening. We followed 118 pre-transfusion HTLV-l-Negative transfusion recipients at monthly intervals posttransfusion for I year. Laboratory and questionnaire data were obtained at each visit to evaluate the clinical and immunological status of recipients. Cumulative incidence of HTLV-I seroconversion was estimated and risk-factor data associated with seroconversion among 66 HTLV-l-exposed transfusion recipients were analyzed. Seroconversion occurred in 24/54 (44%) of recipients of HTLV-l-positive cellular blood components, 0/12 recipients of positive non-cellular Donor units and 0/52 recipients of HTLV-l-Negative Donor units. Significant risk factors associated with recipient seroconversion were receipt of a seropositive cellular blood component stored for less than one week [odds ratio (OR) = 6.34, 95% confidence interval (CI) = 1.83 to 21.92], male sex (OR = 4.79, 95% CI = 1.15 to 20.0) or use of immunosuppressive therapy at time of transfusion (OR = 12.20, 95% CI = 0.95 to 156). Risk of blood-borne infection per person per year in Jamaica was estimated to be 0.009%. Our results confirm that blood transfusion carries a significant risk of HTLV-I transmission and that screening of Donor blood effectively prevents HTLV-I seroconversion. Recipients at greatest risk for seroconversion were those who required multiple transfusions or who were receiving immunosuppressive therapy at the time of transfusion. These patients should be given priority in receiving selectively screened blood components, if universal blood-Donor screening for HTLV-I is not possible.
Jon Kobashigawa - One of the best experts on this subject based on the ideXlab platform.
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409 FLOW CYTOMETRY-POSITIVE, CYTOTOXICITY-Negative Donor-SPECIFIC CROSSMATCH: TO TRANSPLANT OR NOT TO TRANSPLANT, THAT IS THE QUESTION.: Table
Journal of Investigative Medicine, 2006Co-Authors: Jaideep Patel, M A Hamilton, Elaine F. Reed, David W. Gjertson, Jon KobashigawaAbstract:The phone rings at night. You are asked whether to proceed with heart transplant if the Donor-specific crossmatch is flow cytometry T cell positive, cytotoxicity Negative. What do you do? The importance of positive T-cell Donor-specific crossmatch by flow cytometry, yet cytotoxicity Negative, has not yet been established. Furthermore, outcome for these patients after heart transplant may be poor. To evaluate this, we reviewed 216 patients who underwent heart transplant (with noninduction immunosuppression) between June 2000 and August 2003 in our program. We found 13 heart transplant patients who were retrospectively tested and found to be flow T-cell positive yet cytotoxicity Negative. Results None of the flow cytometry-positive, cytotoxicity-Negative patients had hyperacute or delayed hyperacute rejection. Survival at 2 years was 100%. Only 1 of 13 patients had biopsy-proven rejection while 4 of 13 patients had any treated rejection (suggesting these patients had humoral rejection). No patients developed cardiac allograft vasculopathy within 2 years. For 203 control patients during the same time period, freedom from rejection was comparable (Table). Of these 13 study patients, 5 were also found to be B-cell positive by flow cytometry and cytotoxicity Negative. Only 1 patient was found to be B-cell flow cytometry positive and cytotoxicity positive. This had no impact on outcome. Conclusion T-cell flow cytometry-postive, cytotoxicity-Negative Donor-specific crossmatch appears safe to allow heart transplantation. A larger cohort of patients is needed to confirm this finding.
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pretransplant panel reactive antibody screens are they truly a marker for poor outcome after cardiac transplantation
Circulation, 1996Co-Authors: Jon Kobashigawa, J Moriguchi, Antoine Hage, Alejandro Sabad, G. A. Cogert, Davis C Drinkwater, Noboru Kawata, Paul I Terasaki, M A Hamilton, Hillel LaksAbstract:Background The effect of pretransplant sensitization on outcome after cardiac transplant has been controversial. Sensitization, defined as a positive panel-reactive antibody (PRA) screen in patients awaiting transplant, represents circulating antibodies to a random panel of Donor lymphocytes (usually T lymphocytes). The significance of pretransplant circulating antibodies to B lymphocytes has not been reported, and many centers disregard its use. Methods and Results We retrospectively reviewed the pretransplant PRA screens for 311 patients who underwent cardiac transplant at our institution. The PRA screen was performed by use of the lymphocytotoxic technique treated with dithiothreitol to remove IgM autoantibodies. Patients with PRA ≥11% against T or B lymphocytes had significantly lower 3-year survival (T lymphocytes, 39% ; B lymphocytes, 56%) than those patients with PRA=0% and PRA=1 % to 10% (T lymphocytes, 76% and 78% ; B lymphocytes, 78% and 74%, respectively) (P<.001). For this high-risk group, the rejection episode tended to occur earlier than in those patients with PRA=0% and PRA= 1 % to 10% (T lymphocytes, 2.3 versus 4.0 and 3.8 months ; B lymphocytes, 2.1 versus 4.1 and 3.4 months, respectively), and there were more clinically severe rejections that required OKT3 therapy. Conclusions Cardiac transplant patients with pretransplant T- and/or B-lymphocyte PRA ≥11% despite Negative Donor-specific crossmatch at the time of transplant appear to have earlier and more severe rejection with significantly lower survival after transplant surgery. Modification of immunosuppression in these high-risk patients may be warranted.
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Pretransplant panel reactive-antibody screens. Are they truly a marker for poor outcome after cardiac transplantation?
Circulation, 1996Co-Authors: Jon Kobashigawa, Antoine Hage, Alejandro Sabad, G. A. Cogert, J. D. Moriguchi, Davis C Drinkwater, Noboru Kawata, Paul I Terasaki, M A Hamilton, Hillel LaksAbstract:The effect of pretransplant sensitization on outcome after cardiac transplant has been controversial. Sensitization, defined as a positive panel-reactive antibody (PRA) screen in patients awaiting transplant, represents circulating antibodies to a random panel of Donor lymphocytes (usually T lymphocytes). The significance of pretransplant circulating antibodies to B lymphocytes has not been reported, and many centers disregard its use. We retrospectively reviewed the pretransplant PRA screens for 311 patients who underwent cardiac transplant at our institution. The PRA screen was performed by use of the lymphocytotoxic technique treated with dithiothreitol to remove IgM autoantibodies. Patients with PRA > or = 11% against T or B lymphocytes had significantly lower 3-year survival (T lymphocytes, 39%; B lymphocytes, 56%) than those patients with PRA = 0% and PRA = 1% to 10% (T lymphocytes, 76% and 78%; B lymphocytes, 78% and 74%, respectively) (P < .001). For this high-risk group, the rejection episode tended to occur earlier than in those patients with PRA = 0% and PRA = 1% to 10% (T lymphocytes, 2.3 versus 4.0 and 3.8 months; B lymphocytes, 2.1 versus 4.1 and 3.4 months, respectively), and there were more clinically severe rejections that required OKT3 therapy. Cardiac transplant patients with pretransplant T- and/or B-lymphocyte PRA > or = 11% despite Negative Donor-specific crossmatch at the time of transplant appear to have earlier and more severe rejection with significantly lower survival after transplant surgery. Modification of immunosuppression in these high-risk patients may be warranted.
Vincent Soriano - One of the best experts on this subject based on the ideXlab platform.
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Transmission of HIV type 1 through blood transfusion from an antibody-Negative/p24 antigen-Negative Donor.
AIDS research and human retroviruses, 2003Co-Authors: Carlos Toro, Berta Rodés, Félix Colino, Maria Del Valle Flores, Eva Poveda, Carmen De Mendoza, María Jesús Téllez, Vincent SorianoAbstract:Transmission of HIV through transfusion occurred in a 78-year-old male after receiving red blood cells from a 27-year-old woman, who was Negative for HIV antibodies and p24 antigen at the time of donation, but seroconverted thereafter. Plasma viral load at donation was 2538 HIV RNA copies/ml. Phylogenetic analyses demonstrated that viruses from both patients clustered tightly together, belonged to subtype B clade, and had no primary drug resistance mutations. This case highlights the residual risk of HIV transmission from Donors in the window period, and supports the implementation of nucleic acid testing in blood banks.
