Massive Immune Hemolysis Caused by Anti-D After Dual Kidney Transplantation

Massive immune hemolysis due to passenger lymphocyte-derived anti-D has not been reported in renal transplantation. A 50-year-old (B-positive) male received a dual deceased-donor kidney transplant (B-negative) for diabetic renal failure. Two weeks post-transplant, the patient developed severe hemolytic anemia. The donor anti-D titer was 1:8. The recipient anti-D titer (zero pre-transplant) increased from 1:4 to 1:16 over 4 days. Rapid hemolysis caused severe anemia, minimum Hb = 4.2 g/dL, while selectively lysing the patient's autologous red cells during this time. The hemolytic anemia did not impair the allografts and subsided without monoclonal B-cell pharmacotherapy or apheresis. The anti-D titer decreased to barely detectable levels at four months and had cleared when checked 2 years post-transplant. Transfusion support subsided after two months. If complications of anemia can be avoided, the deleterious effects of hemolysis may be well tolerated by renal allografts using antigen negative transfusion alone.     

Combination of ABO blood group incompatibility and glucose-6-phosphate dehydrogenase deficiency: effect on hemolysis and neonatal hyperbilirubinemia

The incidence (%) of hyperbilirubinemia (serum bilirubin ≥257 μmol/l) was similar in neonates with a combination of ABO incompatibility and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency (45%), with ABO incompatibility (54%) or G-6-PD deficiency (37%), alone (ns). Carboxyhemoglobin values, corrected for inspired CO, were similarly elevated in all three groups (0.87 ± 0.32%, 0.82 ± 0.29%, 0.76 ± 0.18%, respectively, ns), but correlated with bilirubin only in those with ABO incompatibility alone. ABO-incompatible/G-6-PD-deficient neonates, compared with those with either condition alone, are not at increased risk for hemolysis or hyperbilirubinemia.     

人参总皂甙溶血作用的研究

本实验研究了人参总皂甙在体外对人红细胞及在体内对狗红细胞的溶血作用。结果表明：人参总皂甙在体外对人的红细胞有溶血作用，表现为游离血红蛋白升高，人参总皂甙在体内对狗的红细胞有溶血作用，表现为游离血红蛋白升高，结合珠蛋白下降，网织红细胞升高等。同时，人参总皂甙对肾脏有一定毒性，表现为血尿及蛋白尿，但这种损伤可能为可逆性的。     

An enzyme-linked immunosorbent assay (ELISA) for the measurement of antibodies to different parts of the gram-negative lipopolysaccharide core region

Bovine serum albumin was complexed with the core antigens of either Escherichia coli J5 LPS, Salmonella minnesota R595 LPS or E. coli lipid A. These core-BSA complexes were used for solid-phase coating in ELISAs for anti-core antibodies. Antibodies, binding to various parts of the core region were easily quantified in a single experimental set-up, which was hitherto not possible. The ELISA has only 3 incubation steps and is not costly as only moderate amounts of the core antigens (i.e., 1 microgram per test) were needed for coating. The sensitivity proved to be excellent and the complexes were biologically fully active (compared to native, smooth LPS), which make them suitable for the screening (after fusion) of monoclonal anti-core antibodies. Another possible application is the large-scale screening of blood-bank sera in order to find samples with a high anti-core antibody content.     

产前血型IgG抗体水平的检测及其临床意义

目的探讨ABO血型不合孕妇的产前IgG抗体水平,了解IgG抗体效价异常在孕妇中所占比率及临床意义,为预防及诊治新生儿溶血病（HDN）采取有效的防治措施。方法用抗人球蛋白试管凝集法进行IgG抗A或抗B的ABO血型抗体效价检测。结果910例孕妇中,血清效价大于64者有108例,异常检出率为11.9%。IgG抗A效价大于64者有64例,检测率为11.8%;检测IgG抗B效价大于64者有54例,检测率为14.1%。讨论妊娠中IgG抗体效价与新生儿溶血密切相关,ABO血型不合的孕妇应及时作产前血清学的检测,可预防新生儿溶血病的发生及减轻胎儿受害的程度。     

螺旋血泵的CFD分析

溶血和血栓是目前国内心室辅助装置不能应用于临床的主要原因。血泵的不良血液动力学特性是导致溶血和血栓的主要因数。计算流体力学（CFD）方法目前被广泛应用于血泵设计,它可以准确有效地反映血泵内部流场状态、血泵压力流量曲线以及血泵内部流场剪切力分布状态等。本研究采用CFD方法对自制螺旋血泵的泵腔、出入流口进行流场分析,内部流场采用三维彩图显示。结果显示CFD分析结果很好的与体外实验结果吻合。血泵血液动力学特性,以及内部血流状态采用CFD方法分析,可以有效地分析血泵血液相溶性方面的问题。     

Normal and homogeneous red blood cell populations over a wide range of hyper-iso-hypotonic media

The volumes of human erythrocytes after rapid and gradual swelling in hypotonic NaCl media were measured using a Coulter Counter Z_B at temperatures of +4°C and +20°C together with potassium leakage, the degree of hemolysis and the ‘returning volume’, i. e., the volume in an isotonic solution to which the cells will return from that in a hypotonic solution. The methodological and systematic errors in the volume measurements were corrected by taking into account the shape dependence of the Coulter Counter and the change in cell population during hemolysis, whereafter the measured cell volume values and the comparison between them become more reliable. The curves for cell volume as an inverse function of osmotic pressure appeared to be non-linear. The slopes were small at first but shoed a rapid increase as the cells approached their maximal volume. The critical hemolytic volume was approx.8% higher at +20°C after both rapid and gradual swelling than at +4°C and approx.4% higher after a gradual swelling as compared with a rapid swelling both at +4°C and +20°C.A decrease in temperature resulted in an increase in the critical osmotic pressure both in rapid and gradual hemolysis, but did not greatly affect the amount of prelytic K⁺ leakage. The critical osmotic pressure was smaller in gradual hemolysis than in rapid hemolysis and the prelytic K⁺ leakage was doubled at both +4°C and +20°C.The shifts in osmotic fragility as a function of temperature may be due to differences in the visco-elastic properties of the cell membrane, but the shifts in osmotic fragility as a function of swelling rate may be connected with differences in potassium leakage and membrane stretch.