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Berlin, Gösta
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Publications (10 of 52) Show all publications
Berlin, G., Cherif, H., Knutson, F., Mattsson, J. & Axdorph Nygell, U. (2018). Granulocyttransfusion bör övervägas vid neutropeni och allvarlig infektion [Granulocyte transfusion – when and how should it be used?]. Läkartidningen, 115, Article ID EXUU.
Open this publication in new window or tab >>Granulocyttransfusion bör övervägas vid neutropeni och allvarlig infektion [Granulocyte transfusion – when and how should it be used?]
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2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, article id EXUUArticle, review/survey (Refereed) Published
Abstract [en]

There are no randomized controlled trials proving the clinical benefit of granulocyte transfusions. However, clinical experience and a number of case studies suggest that granulocyte transfusions may be life-saving in certain situations. In our opinion granulocyte transfusions should be considered for patients with profound neutropenia and severe, life-threatening infection not responding to antibiotic or antifungal therapy. Since the clinical effect seems to be dose-dependent, the granulocyte concentrate should contain a large number of cells, which usually means that the donor should be mobilized with steroids and G-CSF. Regular blood donors as well as relatives to the patient can be used for granulocyte donations with apheresis technique after information of the process. Granulocyte transfusion should be given daily as long as the indication remains. The clinical efficacy of the transfusions should be evaluated daily.

Abstract [sv]

Granulocyttransfusion bör övervägas till patient med uttalad neutropeni och allvarlig infektion som inte svarat på antibiotika eller antimykotisk behandling.

Man bör transfundera en hög dos granulocyter, vilket normalt innebär att granulocytgivaren stimuleras med steroider och granulocytkolonistimulerande faktor (G-CSF).

Både blodgivare och anhöriga kan användas som granulocytgivare efter information om processen.

Granulocyttransfusion ges dagligen så länge indikationen kvarstår.

Daglig bedömning av transfusionseffekten ska göras.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag, 2018
National Category
Hematology
Identifiers
urn:nbn:se:liu:diva-154949 (URN)29558012 (PubMedID)
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-10-10Bibliographically approved
Berlin, G., Cherif, H., Knutson, F., Mattsson, J. & Axdorph Nygell, U. (2018). Replik gällande granulocyttransfusion: Rekommendationerna är väl underbyggda. Läkartidningen, 115
Open this publication in new window or tab >>Replik gällande granulocyttransfusion: Rekommendationerna är väl underbyggda
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2018 (English)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2018
National Category
Hematology
Identifiers
urn:nbn:se:liu:diva-155850 (URN)29634070 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-04-03Bibliographically approved
Mörtzell Henriksson, M., Newman, E., Witt, V., Derfler, K., Leitner, G., Eloot, S., . . . Wahlström,, A. (2016). Adverse events in apheresis: An update of the WAA registry data. Transfusion and apheresis science, 54(1), 2-15
Open this publication in new window or tab >>Adverse events in apheresis: An update of the WAA registry data
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2016 (English)In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 54, no 1, p. 14p. 2-15Article, review/survey (Refereed) Published
Abstract [en]

Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.

Place, publisher, year, edition, pages
Elsevier, 2016. p. 14
National Category
Hematology
Identifiers
urn:nbn:se:liu:diva-135128 (URN)10.1016/j.transci.2016.01.003 (DOI)000374614700002 ()26776481 (PubMedID)
Available from: 2017-03-09 Created: 2017-03-09 Last updated: 2017-11-29Bibliographically approved
Södergren, A., Tynngård, N., Berlin, G. & Ramström, S. (2016). Responsiveness of platelets during storage studied with flow cytometry - formation of platelet subpopulations and LAMP-1 as new markers for the platelet storage lesion. Vox Sanguinis, 110(2), 116-125
Open this publication in new window or tab >>Responsiveness of platelets during storage studied with flow cytometry - formation of platelet subpopulations and LAMP-1 as new markers for the platelet storage lesion
2016 (English)In: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 110, no 2, p. 116-125Article in journal (Refereed) Published
Abstract [en]

Background and ObjectivesStorage lesions may prevent transfused platelets to respond to agonists and arrest bleeding. The aim of this study was to evaluate and quantify the capacity of platelet activation during storage using flow cytometry and new markers of platelet activation. Materials and MethodsActivation responses of platelets prepared by apheresis were measured on days 1, 5, 7 and 12. In addition, comparisons were made for platelet concentrates stored until swirling was affected. Lysosome-associated membrane protein-1 (LAMP-1), P-selectin and phosphatidylserine (PS) exposure were assessed by flow cytometry on platelets in different subpopulations in resting state or following stimulation with platelet agonists (cross-linked collagen-related peptide (CRP-XL), PAR1- and PAR4-activating peptides). ResultsThe ability to form subpopulations upon activation was significantly decreased already at day 5 for some agonist combinations. The agonist-induced exposure of PS and LAMP-1 also gradually decreased with time. Spontaneous exposure of P-selectin and PS increased with time, while spontaneous LAMP-1 exposure was unchanged. In addition, agonist-induced LAMP-1 expression clearly discriminated platelet concentrates with reduced swirling from those with retained swirling. This suggests that LAMP-1 could be a good marker to capture changes in activation capacity in stored platelets. ConclusionThe platelet activation potential seen as LAMP-1 exposure and fragmentation into platelet subpopulations is potential sensitive markers for the platelet storage lesion.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keywords
apheresis; haemostasis; platelet concentrates; platelet function; platelet transfusion
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-126141 (URN)10.1111/vox.12324 (DOI)000370657500002 ()26389538 (PubMedID)
Note

Funding Agencies|Region Ostergotland; Linkoping University through the LiU Research Fellows program

Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2018-10-25
Sandgren, P., Berlin, G. & Tynngård, N. (2016). Treatment of platelet concentrates with ultraviolet C light for pathogen reduction increases cytokine accumulation. Transfusion, 56(6), 1377-1383
Open this publication in new window or tab >>Treatment of platelet concentrates with ultraviolet C light for pathogen reduction increases cytokine accumulation
2016 (English)In: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 56, no 6, p. 1377-1383Article in journal (Refereed) Published
Abstract [en]

BACKGROUNDPathogen reduction technologies use photoactive substances in combination with ultraviolet (UV) light to inactivate pathogens. A new method uses only UVC light for pathogen reduction. This study assesses the effects of UVC light treatment on cytokine release in platelet (PLT) concentrates (PCs). STUDY DESIGN AND METHODSA PC with 35% plasma and 65% PLT additive solution (SSP+) was prepared from five buffy coats. Three such PCs were pooled and divided into 3 units. One unit was used as a nonirradiated control, the second was a gamma-irradiated control, and the third unit was treated with UVC light technology. Ten units of each type were investigated. Cytokine release was analyzed on Days 1, 5, and 7 of storage. Correlation between cytokines, PLT surface markers, and hemostatic properties was investigated. RESULTSSwirling was well preserved and pH was above the reference limit of 6.4 during storage of PLTs in all groups. Cytokine levels increased during storage in all groups but to a larger degree in PCs treated with UVC light. Only weak correlation was found between cytokines and PLT surface markers (ramp;lt;0.5). However, several cytokines showed strong correlation (ramp;gt;0.6) with the PLTs ability to promote clot retraction. CONCLUSIONUVC treatment resulted in increased release from PLT alpha granules as evident by a higher cytokine release compared to nonirradiated and gamma-irradiated PCs. The clinical relevance of these findings needs to be further evaluated.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:liu:diva-130296 (URN)10.1111/trf.13601 (DOI)000378553200048 ()27080102 (PubMedID)
Note

Funding Agencies|Region Ostergotland; Linkoping Medical Society; MacoPharma

Available from: 2016-07-31 Created: 2016-07-28 Last updated: 2018-01-10
Tynngård, N., Trinks, M. & Berlin, G. (2015). In vitro function of platelets treated with ultraviolet C light for pathogen inactivation: a comparative study with nonirradiated and gamma-irradiated platelets. Transfusion, 55(6), 1169-1177
Open this publication in new window or tab >>In vitro function of platelets treated with ultraviolet C light for pathogen inactivation: a comparative study with nonirradiated and gamma-irradiated platelets
2015 (English)In: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 55, no 6, p. 1169-1177Article in journal (Refereed) Published
Abstract [en]

BackgroundDuring storage of platelet concentrates (PCs) replication of contaminating pathogens might occur, which can be prevented by various pathogen inactivation (PI) methods using photoactive substances in combination with ultraviolet (UV) light. A new method uses only UVC light for PI without photoactive substances. This study evaluates the in vitro function, including hemostatic properties (clot formation and elasticity), of platelets (PLTs) treated with UVC light. Study Design and MethodsA PC with 35% plasma and 65% PLT additive solution (SSP+) was prepared from five buffy coats. Three PCs were pooled and divided into 3units. One unit was used as a nonirradiated control, the second was a gamma-irradiated control, and the third unit was treated with UVC light. In vitro variables including analysis of coagulation by free oscillation rheometry were analyzed on Days 1, 5, and 7 of storage. Ten units in each group were investigated. ResultsSwirling was well preserved, and the pH level was higher than the reference limit (6.4) during storage of PLTs in all groups. Glycolysis and PLT activation were higher for UVC-treated PLTs but the clot-forming capacity was unaffected. However, immediately after UVC treatment, the clot elastic properties were slightly affected. Hypotonic shock response decreased immediately after UVC treatment but recovered partly during the storage period. ConclusionUVC treatment affected the in vitro properties, but PLT quality and storage stability were well preserved for up to 7 days, and the in vitro hemostatic capacity of UVC-treated PLTs was only minimally altered. The clinical relevance of these changes needs to be evaluated in controlled trials.

Place, publisher, year, edition, pages
Wiley: 12 months, 2015
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:liu:diva-120238 (URN)10.1111/trf.12963 (DOI)000356366300024 ()25524519 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland; Linkoping Medical Society

Available from: 2015-07-21 Created: 2015-07-20 Last updated: 2018-01-11
Knobler, R., Berlin, G., Calzavara-Pinton, P., Greinix, H., Jaksch, P., Laroche, L., . . . Hillen, U. (2014). Guidelines on the use of extracorporeal photopheresis. Journal of the European Academy of Dermatology and Venereology, 28(s1), 1-37
Open this publication in new window or tab >>Guidelines on the use of extracorporeal photopheresis
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2014 (English)In: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 28, no s1, p. 1-37Article in journal (Refereed) Published
Abstract [en]

BackgroundAfter the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma was published in 1983 with its subsequent recognition by the FDA for its refractory forms, the technology has shown significant promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. Among the major studied conditions are graft versus host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection and inflammatory bowel disease. Materials and methodsIn order to provide recognized expert practical guidelines for the use of this technology for all indications the European Dermatology Forum (EDF) proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. Results and conclusionThese guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103282 (URN)10.1111/jdv.12311 (DOI)000328586600001 ()
Available from: 2014-01-17 Created: 2014-01-16 Last updated: 2017-12-06
Tynngård, N., Trinks, M. & Berlin, G. (2014). In vitro properties of platelets stored in a small container for pediatric transfusion. Transfusion, 54(6), 1562-1568
Open this publication in new window or tab >>In vitro properties of platelets stored in a small container for pediatric transfusion
2014 (English)In: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 54, no 6, p. 1562-1568Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The quality of a platelet (PLT) concentrate (PC) is affected by the number of PLTs in relation to the size and gas permeability of the container. This study evaluates the in vitro function, including hemostatic properties (clot formation and elasticity), of PLTs stored in a container of standard or small size.

STUDY DESIGN AND METHODS:

PCs with 30% plasma and 70% PLT additive solution were prepared from buffy coats. Two PCs were pooled and divided into the following containers: 1 unit and ½ a unit into a 1.8-L container (reference container) and ½ a unit into a 0.45-L container (test container). In a second set of experiments ¼ of a unit was stored in the reference and test containers. Swirling, PLT count, blood gases, metabolic variables, PLT activation markers, hypotonic shock response (HSR), and coagulation by free oscillation rheometry were analyzed during 7 days of storage.

RESULTS:

Swirling was well preserved and pH was acceptable (6.4-7.4) during storage of PLTs in both containers. Glycolysis and PLT activation were higher when storing ½ and ¼ of a unit in the reference container and storage of ¼ of a unit in the reference container resulted in the largest decrease in HSR. The clotting time was similar whereas the clot elasticity was slightly lower for PLTs when stored as ½ and ¼ of a unit in the reference container.

CONCLUSION:

Storage of a low number of PLTs benefits by storage in a small container in terms of better maintained in vitro properties.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-109144 (URN)10.1111/trf.12482 (DOI)000337591200019 ()24224557 (PubMedID)
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2018-01-11Bibliographically approved
Tynngård, N., Berlin, G., Samuelsson, A. & Berg, S. (2014). Low dose of hydroxyethyl starch impairs clot formation as assessed by viscoelastic devices. Scandinavian Journal of Clinical and Laboratory Investigation, 74(4), 344-350
Open this publication in new window or tab >>Low dose of hydroxyethyl starch impairs clot formation as assessed by viscoelastic devices
2014 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 74, no 4, p. 344-350Article in journal (Refereed) Published
Abstract [en]

Objective. High doses of the synthetic colloid hydroxyethyl starch (HES) used for plasma expansion have been associated with impaired haemostasis and hypocoagulation. Less is known about effects on clot formation in the low haemodilutional range (less than 40%). This study evaluated the effects of low haemodilution with HES and albumin on coagulation using two different viscoelastic methods. Methods. Clot formation was studied in vitro in healthy donor blood after 10% and 30% haemodilution with 60 g/L HES 130/0.4 or 50 g/L albumin with free oscillation rheometry (FOR) and rotational thromboelastography. Results. Clotting time was not significantly affected at 10% haemodilution but was prolonged with both substances at 30% dilution (p less than 0.01-0.001). The effect was significantly more pronounced with HES than with albumin. The elasticity of the clot was slightly reduced at 10% dilution with albumin, more pronounced at 10% dilution with HES (p less than 0.05), further reduced at 30% dilution with albumin and to a still greater extent at 30% dilution with HES (p less than 0.05). With albumin the functional activity of fibrinogen was not reduced in excess of the dilutional effect. HES in contrast produced a further reduction in clot elasticity than caused by mere dilution at both 10% and 30% dilutions (p less than 0.001). Conclusions. There is an adverse effect on clot formation even at low grade haemodilution with both albumin and HES. The effect on coagulation is significantly more pronounced with HES than with albumin.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Coagulation; colloids; fibrinogen; haemodilution; platelets
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-108934 (URN)10.3109/00365513.2014.891259 (DOI)000337084600011 ()
Available from: 2014-07-15 Created: 2014-07-13 Last updated: 2018-01-11
Panzer, S., Engelbrecht, S., Cole-Sinclair, M. F., Wood, E. M., Wendel, S., Biagini, S., . . . Reesink, H. W. (2013). Education in transfusion medicine for medical students and doctors. Vox Sanguinis, 104(3), 250-272
Open this publication in new window or tab >>Education in transfusion medicine for medical students and doctors
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2013 (English)In: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 104, no 3, p. 250-272Article in journal (Refereed) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91536 (URN)10.1111/j.1423-0410.2012.1661.x (DOI)000316680300010 ()
Available from: 2013-04-26 Created: 2013-04-26 Last updated: 2017-12-06
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