Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation

We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000 mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.     

ABO血型与肝炎病毒感染关系的探讨

目的：探讨ABO血型与肝炎病毒感染的关系，方法：应用疾病关联分析方法对HBsAg和,抗－HCV阳性献血者与同期健康献血者的ABO血型资料进行比较分析。结果：ABO血型与HBsAg和抗－HCV阳性率之间无显著性相关关系（P＞0．05），结论：乙型肝炎和丙型肝炎病毒感染与ABO血型无显著性相关。     

新生儿Rh溶血病不同血源换血疗法的疗效观察

目的:探讨新生儿 Rh溶血病实行换血疗法时的血源选择和换血量的确定。方法 :选取在我院接受换血治疗的 6 3例 Rh溶血病患儿 ,其中用 Rh阳性血换血 32例 ,Rh阴性血换血 31例 ,分析其换血前后血清总胆红素(TB)和血红蛋白 (Hb)变化以判断疗效。 结果 :两种换血术均获得满意疗效 ,换血后胆红素值明显下降 ,所有患儿均痊愈出院。 结论 :在紧急情况下 ,若无法及时得到 Rh阴性血 ,可用 Rh阳性血换血 ,换血量至少应 >2 0 0 m l/ kg(为 Rh阴性血的 2倍 ) ,若应用得当 ,是一项安全有效的替代疗法     

Rh血型不合新生儿溶血病检测方法及应用

产前检测Ｒｈ，Ｄ因子及抗人球蛋白（ｃｏｏｍｂｓ）试验是必要的。测定Ｒｈ，Ｄ因子及抗Ｄ滴度使用木瓜酶方法。通过对１１２６１例孕妇常规检查Ｒｈ，Ｄ因子，发现Ｄ阴性７４例。Ｒｈ，Ｄ阴性妇女占６．５‰。２２例Ｒｈ，Ｄ阴性的孕妇所分娩的新生儿均为Ｒｈ，Ｄ阳性。其中２例孕妇血清抗Ｄ滴度为１∶３２，病情严重，宫内输血无效，胎死宫内。初产妇１３例，占５９％。活产２０例，存活率９０％。Ｒｈ因子及抗人球蛋白试验方法简便、易行，一般医院均可进行。对有流产史、输血史的孕妇检查Ｒｈ因子是十分必要的。在有条件的医院，对Ｒｈ，Ｄ阴性的产妇分娩Ｒｈ，Ｄ阳性的新生儿之后，产妇应预防性注射抗Ｄ免疫球蛋白     

IL-6 and G-CSF levels in amniotic fluid during the second trimester in normal and abnormal pregnancies

Activity levels of cytokines were measured by stimulation of the cell lines NFS-60, 7TD1, and TF-1. In 39 samples of amniotic fluid, levels of Granulocyte-Stimulating Factor (G-CSF) were 1434±2063 (mean±SD) and of Interleukin (IL-6) 546±1071 pg/ml; Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) was not detectable. IL-6 was correlated to G-CSF (r=0.3; p=0.003). G-CSF (p=0.0002) and IL-6 (p=0.006) were influenced by Alpha-Fetoprotein (AFP) and G-CSF by rhesus-incompatibility (p=0.0004). These findings suggest that cytokines such as IL-6 and G-CSF play some role in physiological and pathological pregnancy.Abbreviations G-CSF granulocyte-colony stimulating factor - GM-CSF granulocyte-macrophage colony stimulating factor - M-CSF macrophage-colony stimulating factor - CSF colonystimulating factor - IL-6 interleukin-6 - IL-11 interleukin-11 - AFP alpha-fetoprotein - NFS-60 cell line - 7TD1 cell line - TF-l cell line - rh recombinant human - MTT 3-(4,5-dimethylthiazol2-yl)-2,5-diphenyl tetrazolium bromide - FCS fetal calf serum - RPMI 1640 nutrient solution - ATCC American Tissue Culture Collection Correspondence to: E. Weimann     

Histologic Findings One Year After Positive Crossmatch or ABO Blood Group Incompatible Living Donor Kidney Transplantation

Recent protocols have allowed successful positive crossmatch (+XM) and ABO incompatible (ABOI) kidney transplantation, although their long-term outcome is not clear. To begin to assess this issue we compared protocol biopsies performed 12 months posttransplant in 37 +XM, 24 ABOI and 198 conventional allografts. Although the majority in all three groups had only minimal histologic changes, transplant glomerulopathy (TG) was significantly increased in +XM (22% vs. 13% ABOI vs. 8% conventional, p = 0.015), and correlated with prior humoral rejection (HR) by multivariate analysis (odds ratio 17.5, p < or = 0.0001). Patients with a prior history of HR also had a significant increase in interstitial fibrosis (No HR 54% vs. HR 86%, p = 0.045). In the absence of HR no difference in histologic changes was seen between groups, although all three groups had a demonstrable mild increase in interstitial fibrosis from biopsies performed at the time of transplant. Thus, although HR is associated with an increase in TG, in its absence allograft histology is similar in +XM, ABOI and conventional allografts 1 year posttransplant.     

母婴ABO血型不合与新生儿溶血病的关系

目的　探讨O型孕妇血清IgG抗体效价与新生儿溶血病的关系。 方法　对丈夫血型为A型 ,B型或AB型的 75 4例O型孕妇进行血清IgG抗A(B)抗体水平检测 ,同时对IgG抗A(B)≥ 6 4的孕妇所生的新生儿做HDN免疫血清学检查。 结果　 75 4例O型孕妇中产前IgG抗A(B)≥ 6 4的有 2 87例 ,其所生新生儿发生新生儿溶血病的例数为 31例。结论　新生儿溶血病发病率与孕妇血清IgG抗A(B)效价的高低成正相关。     

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.     

基因分型技术首次应用于类孟买型家系ABO基因的研究

目的 探计将基因分型技术用于解决临床输注中血型血清学难题。方法 报告首次在国内用基因分型技术用于一个类孟买型家系5口人ABO基因多态性的研究。在吸收放散试验、唾液血型物质凝集抑制等血清学试验基础上，采用快速盐析法提取外周血中的DNA，用PCR—SSP法扩增ABO血型等位基因。结果 一家5人中，兄弟3人均为类孟买型，ABO基因分型分别为A102B、A102B、Al20O1，而其父母血型基因与血清学血型相符合。结论 ABO PCR—SSP基因分型是一种方便、快速、可靠的技术，与血型血清学相比有着显优势。     

母婴ABO血型不合母体高效价IgG的低温分离与纯化

目的 分离和纯化母婴血型不合母体的特异性高效价的IgG抗体。方法 采用半饱和硫酸铵低温沉淀法分离IgG抗体，SephedexA50层析柱纯化，然后用B型红细胞(RBC)吸收放散IgG，用聚乙二醇(PEG)沉淀，真空泵脱水回收IgO。结果 200ml血浆经半饱和硫酸铵低温沉淀后得IgG粗制品2．26g，Sephedex A50层析柱纯化后得纯制品1．84g，经B型RBC吸收放散后得特异性IgG 0．55g，回收率达29．89％(0．55／1．84)。结论 采用半饱和硫酸铵低温沉淀法分离高效价IgG抗体，可以获得高纯度的IgG。