Automation in Blood Banking

Abstract. During the past decade, automation took a major place in blood transfusion laboratories. Now many centers have purchased automated equipment and subsequently undertaken the computerization of their activities. The aim of this paper is to review the state of the art in the field of automation and to try to estimate future tendencies.     

The Preservation of Human Red Blood Cell Agglutinogens in Liquid Nitrogen: Study of a Technic Suitable for Routine Blood Banking

A simple method for the preservation of red blood cells in liquid nitrogensuitable for routine laboratory use is described. With this method, erythrocyteantigens retain their integrity for at least six months and, after thawing, remainactive for at least two weeks in Alsever’s Solution. A panel of cells preservedin liquid nitrogen is as satisfactory as fresh cells in defining irregular antibodies encountered in patient sera. The advantages of this technic over othermethods of red blood cell preservation is discussed.

Submitted on April 9, 1962 Accepted on April 27, 1962     

Application of Robotics in Blood Banking1,2

Abstract. To demonstrate the feasibility of using robots in blood banking applications several prototype systems were developed. Activities associated with sample testing and component preparation were examined. In one project, a general-purpose laboratory robot (Zymate Laboratory Automation System, Zymark, Inc., Hopkinton, Mass.) was configured to prepare samples for microplate-based ABO/Rh testing. In a second project, this same robot was configured to carry out specific steps in evaluating bar-coded labels, as part of a quality control procedure. A fluid-handling robot (Sampler 505, Tecan AG, Hombrechtikon, Switzerland) was used to prepare the dilution of serum samples for the evaluation of an anti-HTLV-III test kit. It was then configured to aspirate, dilute and dispense samples for anti-HTLV-III and HBsAg testing. This robotic system is now in field trial. The use of large industrial robots for automating component production was also considered. The key element in this design was the development of a fixture that would hold the blood bag set during the balancing, centrifugation and expressing steps. However, a fixture which was capable of performing these operations and that was equivalent in size and adaptable to a standard centrifuge bucket could not be fabricated.     

Cord Blood Banking and Transplant in Europe

The number of cord blood transplants has been increasing very quickly with more than 250 cases reported to Eurocord Registry and more than 500 patients transplanted via the New York Cord Blood Bank. Cord blood transplants have been performed either with related or unrelated cord blood. Several cord blood banks established a group called Netcord whose goal is the standardization of the procedures, the organization of internal audits for accreditation and qualification, and the communication and exchange by internet of donor search on an international basis. More than 15000 units of frozen cord blood are currently available and this number is increasing rapidly worldwide. Analysis of the clinical results has shown that related cord blood transplants give better results than unrelated cord blood transplants. Factors associated with better survival in related and unrelated cord blood transplants were lower age, diagnosis, with better results in inborn errors and in good risk children with acute leukemia. A larger number of nucleated cells in the transplant and the recipient being negative for CMV serology were also favourable risk factors for survival. Engraftment was improved with higher numbers of cells and HLA identity. Graft versus Host disease was reduced when compared to transplants of adult allogeneic bone marrow or peripheral blood progenitor cells. HLA disparities did not influence GVH; the only factor associated with increased GVH was positive CMV serology in the recipient. This study shows that cord blood is an alternative source of hematopoietic stem cells for allogeneic transplantation in children and in some adults. HLA disparity is not a limiting factor but the number of cells infused is important; currently the use of a number of nucleated cells inferior to lx10⁷/kg is not recommended. Several questions remain including the criteria of choice of the donor, the indications in children and in adults, the comparison of cord blood transplants to other sources of hematopoietic stem cells and the role of growth factors and expansion for improving the speed of engraftment.     

A Monolayer Coagglutination Microplate Technique for Typing Red Blood Cells

Background and objectives: Serologic agglutination tests have the disadvantage of lack of an objective endpoint that can be easily read and quantitated. We have developed a new method for ABO and Rh typing based on producing a red blood cell (RBC) monolayer on microplates and the mixed hemagglutination reaction. Materials and methods: We have employed a new red cell fixation buffer to prepare the RBC monolayer. As the technique for grouping, we used a mixed agglutination reaction between the RBC monolayer and the RBCs to be typed. Results: Compared with an automated hemagglutination system in 34,519 samples, the method is shown to be more sensitive, free of false positive reactions, and cost-effective. Conclusions: The microplate coagglutination method is accurate and lower in cost than conventional methods.     

Ex Vivo Expansion of Human Hematopoietic Stem Cells: Implications for The Modern Blood Bank

Pluripotent hematopoietic stem cells (PHSC) are rare cells within the marrow that are capable of self-renewal and differentiation into multiple hematopoietic lineages. Following myeloablative chemotherapy and radiation therapy and marrow transplantation, hematological reconstitution occurs after a period of 2- 3 weeks. Recently, a number of laboratories have shown that both early and delayed phases of engraftment are mediated by PHSC within a graft and that engraftment can be accelerated by transplanting greater numbers of PHSC. Increasing efforts have been directed, therefore, towards developing methods to expand PHSC ex vivo. In this report, we describe an endothelial cell-based culture system to which exogenous cytokines are added which appears to permit the ex vivo expansion of PHSC. Refinement of these technologies will potentially have a major impact on the ability of blood banks to improve the quality of hematopoietic stem cell grafts.     

代谢综合征患者血压变异性和心率变异性的临床研究

目的 通过观察代谢综合征(MS)患者血压变异性(BPV)和心率变异性(HRV),探讨MS对心血管系统自主神经功能的影响.方法 入选MS患者(MS组)110例及对照组46例,分别进行24h动态血压和动态心电图监测,对比分析两组的BPV和HRV的指标.结果 (1)MS组的一般资料(性别比、年龄)及HDL-C与对照组比较,差异均无统计学意义(P＞0.05);MS组的体质指数(BMI)、腰围(WC)、腰臀比(WHR)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、体脂含量(FATc)及体脂比例(FATp)与对照组比较,差异均有统计学意义(P＜0.05).(2)MS组BPV中9项指标均较对照组显著性增高(P＜0.05);其余3项(dDBPSD、nSBPSD及nDBPSD)指标升高,但无统计学意义(P＞0.05).(3)MS组HRV各项指标与对照组比较,差异均有统计学意义(P＜0.05).(4)MS与性别、吸烟、心血管病早发家族史、高血压、糖尿病、TG、FBG及MBI具有相关性(P＜0.05);与饮酒、TC、HDL-C及LDL-C无相关性(P＞0.05).结论 MS患者存在心血管系统自主神经功能紊乱,表现为BPV的显著升高和HRV的显著降低,其与性别、吸烟、心血管病早发家族史、高血压病、糖尿病、TG、FBG及MBI相关.     

Role of the Blood Transfusion Service in Tissue Banking

Tissue transplantation and banking are rapidly growing services throughout the world reflecting the widening availability of transplantable cadaver tissue and the mounting clinical indications particularly in orthopaedic, plastic and cardiovascular surgery. In the US tissue banking is more established, yet continues to show a rapid growth profile. In the UK it is currently organised in a variety of different ways and by a number of different organisations. The risks of disease transmission by tissue transplantation are similar to those for blood transfusion and the majority of tissues are grafted during procedures that are not life saving. The danger of disease transmission has resulted in the introduction of legislation in the US which allows the FDA to inspect tissue banks and to recall and destroy tissues. In the UK, there is currently no regulation or inspection of tissue banks to demonstrate that donor selection, tissue processing and tracking are conducted to acceptable standards. Blood transfusion services in the UK, US, New Zealand, Australia and possibly other countries have extended their roles to include organ and tissue donation to varying degrees, with the collection, processing and distribution of bone and tendon allografts most commonly undertaken. They have readily available special capabilities and experience with an established infrastructure, compliant with Good Manufacturing Practice, placing them in an ideal position to provide this service safely and cost-effectively.     

血压变异的研究进展

血压变异是人类血压的最基本的生理特征之一。高血压患者血压变异异常,机制复杂。遗传与许多环境因素都影响血压变异。当前,对血压变异及高血压相关基因研究日益深入。血压变异和血压水平一样决定高血压患者靶器官的损害及总体预后。异常血压变异应尽早发现及恰当治疗。     

血压变异的临床意义

血压是重要的生命指标。尽管我们可以根据多次重复测量的血压的均值判断一个人的血压是否正常,但血压的确是在不断变化的。根据血压变异发生的时间,可分为：心动周期间变异（beat-to-beat）、1 d内的短时变异和日间的长期变异。根据血压变异发生的原因,又可分为：生理变异、病理变异和使用药物所导致的变异。尽管心动周期间变异和生理变异也很重要,     

Blood Pressure Variability in Patients on Beta-Blockers

Summary: Blood pressure variability in patients on beta-blockers.
The direct arterial blood pressure was monitored over 24 hours in unrestricted untreated patients in order to obtain the average pressure and standard deviation over 24 hours. The standard deviation was taken as the index of variability of pressure. In eight subjects the study was repeated three months after commencement of treatment with a beta-adrenergic blocking agent (tolamolol, 300 mg/day). In these subjects tolamolol resulted in a fall in mean blood pressure from 107 to 92 mmHg (P < 0.05) and a fall in heart rate from 82 to 70 beats per minute (P ≤ 0.01). The variability in blood pressure, however, was unaffected by treatment.