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  • 1.
    Aardal-Eriksson, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Mobäck, Caroline
    Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Jakobsson, Sandra
    Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry. Germany.
    Hoffmann, Johannes J. M. L.
    Abbott GmbH and Co KG, Germany.
    Iron depletion in blood donors - Have extended erythrocyte and reticulocyte parameters diagnostic utility?2015In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 53, no 1, p. 76-81Article in journal (Refereed)
    Abstract [en]

    Background: Blood donation is associated with iron depletion, but donor iron status is not usually investigated, as such tests are cumbersome and costly. It would therefore be desirable to have simple, fast and inexpensive tests that give information on a donors risk of developing iron depletion. In a pilot study we investigated whether novel erythrocyte and reticulocyte parameters can serve this goal. Methods: In regular blood donors extended red cell parameters were measured using the Abbott CELL-DYN Sapphire hematology analyzer and conventional biochemical tests of iron status. Donors were compared with a regionally matched group of non-donating controls. Results: In the controls, the reference ranges of extended RBC parameters were well comparable to published data. Donors had significantly more microcytic RBC than controls (median 0.9 vs 0.6%), lower serum ferritin concentration (median 43 vs 91 mg/L) and higher soluble transferrin receptor/ferritin index (median 1.60 vs 1.27). Overall 18-28% of the donors were iron depleted. Moreover, 3.3% of donors had iron-restricted erythropoiesis. Microcytic RBC and reticulocyte mean cell hemoglobin content predicted iron depletion with 70% and 64% sensitivities and specificities of 72% and 78%, respectively. When combined these two parameters increased the sensitivity to 82%. Conclusions: Our results in Swedish blood donors confirm a high prevalence of iron depletion, despite iron supplementation used by about half of the donors. Microcytic RBC and MCHr appeared to be helpful in identifying iron-depleted donors, who might benefit from iron supplementation. We recommend larger prospective investigations in order to confirm and extend the findings of this pilot study. (C) 2015 Elsevier Ltd. All rights reserved.

  • 2.
    Lappegård, Knut Tore
    et al.
    Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
    Kjellmo, Christian Abendstein
    Division of Internal Medicine, Nordland Hospital, Bodø, Norway.
    Ljunggren, Stefan A
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Cederbrant, Karin
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Marcusson-Ståhl, Maritha
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Mathisen, Monica
    Research Laboratory, Nordland Hospital, Bodø, Norway.
    Karlsson, Helen
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Hovland, Anders
    Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
    Lipoprotein apheresis affects lipoprotein particle subclasses more efficiently compared to the PCSK9 inhibitor evolocumab, a pilot study.2018In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 57, no 1, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Lipoprotein apheresis and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are last therapeutic resorts in patients with familial hypercholesterolemia (FH). We explored changes in lipoprotein subclasses and high-density lipoprotein (HDL) function when changing treatment from lipoprotein apheresis to PCSK9 inhibition. We measured the levels of low-density lipoprotein (LDL) and HDL particle subclasses, serum amyloid A1 (SAA1), paraoxonase-1 (PON1) activity and cholesterol efflux capacity (CEC) in three heterozygous FH patients. Concentrations of all LDL particle subclasses were reduced during apheresis (large 68.0 ± 17.5 to 16.3 ± 2.1 mg/dL, (p = 0.03), intermediate 38.3 ± 0.6 to 5.0 ± 3.5 mg/dL (p = 0.004) and small 5.0 ± 2.6 to 0.2 ± 0.1 mg/dL (p = 0.08)). There were non-significant reductions in the LDL subclasses during evolocumab treatment. There were non-significant reductions in subclasses of HDL particles during apheresis, and no changes during evolocumab treatment. CEC was unchanged throughout the study, while the SAA1/PON1 ratio was unchanged during apheresis but decreased during evolocumab treatment. In conclusion, there were significant reductions in large and intermediate size LDL particles during apheresis, and a non-significant reduction in small LDL particles. There were only non-significant reductions in the LDL subclasses during evolocumab treatment.

  • 3.
    Lindahl, Tomas L
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Ramström, Sofia
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Royal College of Surgeons in Ireland, Irland.
    Methods for evaluation of platelet function.2009In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 41, no 2, p. 121-125Article in journal (Refereed)
    Abstract [en]

    There are a multitude of platelet function tests available, reflecting the complex nature of the platelet in haemostasis. No simple single test will ever cover all aspects of platelet function. Some tests focus on the aggregation of platelets, for example aggregometry, other on the swelling in response to hypotonic solutions, i.e. the well-known hypotonic shock response, or adhesion or coagulation and clot retraction, for example thromboelastography. In general there is a lack of clinical studies showing a predictive value of analysis of platelet concentrates.

  • 4.
    Mortzell, M
    et al.
    Umeå University.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Nilsson, T
    University of Uppsala Hospital.
    Axelsson, C G
    University Hospital, Örebro.
    Efvergren, M
    University Hospital Karolinska.
    Audzijoni, J
    University Hospital, Vilnius.
    Griskevicius, A
    University Hospital, Vilnius.
    Ptak, J
    County Hospital, Czech Republic .
    Blaha, M
    University Hospital, Hradec Kralove.
    Tomsova, H
    University Hospital, Hradec Kralove.
    M Liumbruno, G
    San Giovanni Calibita Fatebenefratelli Hospital.
    Centoni, P
    University Hospital, Livorno.
    Newman, E
    Concord Repatriat General Hospital.
    Eloot, S
    Ghent University Hospital.
    Dhondt, A
    Ghent University Hospital.
    Tomaz, J
    University Hospital, Coimbra.
    Witt, V
    University Hospital, Vienna.
    Rock, G
    University Hospital, Ottawa.
    Stegmayr, B
    Umeå University.
    Analyses of data of patients with Thrombotic Microangiopathy in the WAA registry2011In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 45, no 2, p. 125-131Article in journal (Refereed)
    Abstract [en]

    Thrombotic Microangiopathy (TMA) is a histopathological feature of various diseases including thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. less thanbrgreater than less thanbrgreater thanThe aim of this study was to investigate the outcome and prognostic variables of TMA-patients. less thanbrgreater than less thanbrgreater thanMaterials and methods: Data were consecutively retrieved from the WAA-apheresis registry (www.waa-registry.org) during 2003-2009. Included were all 120 patients (1237 procedures) who suffered from various forms of TMA, as registered by the ICD-10 code M31.1. Besides registry data, more extensive information was retrieved from the latest 64 patients. Adverse events of the TMA patients were compared to those of the other patients in the registry. less thanbrgreater than less thanbrgreater thanResults: The mean age was 46 years (range 11-85 years, 57% women). In 72% therapeutic apheresis was due to an acute indication while a long-term indication was present in 28%. Plasma exchange was performed by centrifugation and filtration technique (95% and 4%, respectively), and immunoadsorption in 1% of the patients. Only fresh frozen plasma was used as replacement fluid in 69% of procedures. Adverse events were more frequent than in the general apheresis population (10% versus 5%, RR 1.9, CI 1.6-2.3). No death occurred due to apheresis treatment. Three percent of the procedures were interrupted. Bronchospasm and/or anaphylactic shock were present in two patients and one patient suffered from TRALI. At admission 26% were bedridden and needed to be fed. The risk of dying during the treatment period was significantly higher if the patient also suffered from a compromising disease, such as cancer. There was an inverse correlation between the ADAMTS13 level and the antibody titer (r = -0.47, p = 0.034). less thanbrgreater than less thanbrgreater thanConclusions: Patients with TMA have an increased risk for moderate and severe AE compared to the general apheresis population. Many patients were severely ill at admission. The prognosis is worse if the patient also has a severe chronic disease. Even slightly increased ADAMTS13-antibody titers seem to have a negative impact on the ADAMTS13 levels. (C) 2011 Elsevier Ltd. All rights reserved.

  • 5.
    Mortzell, M
    et al.
    Umeå University.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Nilsson, T
    University of Uppsala Hospital.
    Axelsson, C G
    University Hospital, Örebro.
    Efvergren, M
    University Hospital Karolinska.
    Audzijoni, J
    University Hospital, Vilnius.
    Griskevicius, A
    University Hospital, Vilnius.
    Ptak, J
    County Hospital, Frydek Mystek.
    Blaha, M
    University Hospital, Hradec Kralove.
    Tomsova, H
    University Hospital, Hradec Kralove.
    M Liumbruno, G
    San Giovanni Calibita Fatebenefratelli Hospital.
    Centoni, P
    University Hospital, Livorno.
    Newman, E
    Concord Repatriat General Hospital.
    Eloot, S
    Ghent University Hospital.
    Dhondt, A
    Ghent University Hospital.
    Tomaz, J
    University Hospital, Coimbra.
    Witt, V
    University Hospital, Vienna.
    Rock, G
    University Hospital, Ottawa.
    Stegmayr, B
    Umeå University.
    Thrombotic microangiopathy2011In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 45, no 2, p. 119-123Article in journal (Refereed)
    Abstract [en]

    Thrombotic microangiopathy (TMA) is a histopathological feature of various diseases including thrombotic thrombocytopenic purpura (UP) and hemolytic uremic syndrome (HUS). There are many secondary causes of TMA, many of them could mimic TTP or HUS. This article presents a short overview on TMA. In conclusion TMA is the result of various etiology reasons and pathologic reactions with various clinical entities. It is important to focus on a thorough history including family history when deciding on a diagnosis. Analysis of ADAMTS 13 and ADAMTS 13-antibodies may help to decide continued therapy.

  • 6.
    Mörtzell Henriksson, M.
    et al.
    Nephrol, Umeå, Sweden.
    Newman, E.
    Bone Marrow Transplant and Apheresis, New South Wales, Australia.
    Witt, V.
    St. Anna, Vienna, Austria.
    Derfler, K.
    AKH, Vienna, Austria.
    Leitner, G.
    AKH, Vienna, Austria.
    Eloot, S.
    Gent, Belgium.
    Dhondt, A.
    Gent, Belgium.
    Deeren, D.
    Roeselar, Belgium.
    Rock, G.
    Canada.
    Ptak, J.
    Frydek-Mistek, Czech Republic.
    Blaha, M.
    Hradec Kralove, Czech Republic.
    Lanska, M.
    Hradec Kralove, Czech Republic.
    Gasova, Z.
    Prague, Czech Republic.
    Hrdlickova, R.
    Ostrava, Czech Republic.
    Ramlow, W.
    Rostock, Germany.
    Prophet, H.
    Rostock, Germany.
    Liumbruno, G.
    Livorno, Italy.
    Mori, E.
    Livorno, Italy.
    Griskevicius, A.
    Vilnius, Lithuania.
    Audzijoniene, J.
    Vilnius, Lithuania.
    Vrielink, H.
    Amsterdam, The Netherlands.
    Rombout, S.
    Maastricht, The Netherlands.
    Aandahl, A.
    Oslo, Norway.
    Sikole, A.
    Skopje, Macedonia.
    Tomaz, J.
    Coimbra, Portugal.
    Lalic, K.
    Belgrade, Serbia.
    Mazic, S.
    Zagreb, Croatia.
    Strineholm, V.
    Orebro, Sweden.
    Brink, B.
    Huddinge, Sweden.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Dykes, J.
    Lund, Sweden.
    Toss, F.
    BC, Umeå, Sweden.
    Axelsson, C.G.
    BC, Umeå, Sweden.
    Stegmayr, B.
    Nephrol, Umeå, Sweden.
    Nilsson, T.
    Nephrol, Uppsala, Sweden.
    Norda, R.
    BC, Uppsala, Sweden.
    Knutson, F.
    BC, Uppsala, Sweden.
    Ramsauer, B.
    Nephrol., Skövde, Sweden.
    Wahlström,, A.
    Nephrol., Karlstad, Sweden.
    Adverse events in apheresis: An update of the WAA registry data2016In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 54, no 1, p. 14p. 2-15Article, review/survey (Refereed)
    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.

  • 7.
    Norda, R.
    et al.
    Department of Transfusion Medicine and Immunohemotherapy, Örebro Medical Center Hospital, SE 701 85 Örebro, Sweden.
    Berseus, O.
    Stegmayr, B.
    Department of Internal Medicine, Division of Nephrology, University Hospital, Umeå, Sweden.
    Adverse events and problems in therapeutic hemapheresis. A report from the Swedish registry2001In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 25, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Background: Since 1996 adverse events (AE) in therapeutic apheresis (TA) have been more extensively registered in Sweden. This report analyzes the extent and relation of AEs to procedures and diagnoses. Materials and methods: Reporting of TA performed in Sweden was centralized. A separate system for the registration of AE in TA was established and the data received were entered into a central database for registration and analyses. Fifteen of all 35 apheresis units reported both TA and AE during 1996-1999. These centers performed 75% of all TA procedures. Adverse events included medical symptoms, vascular access problems, technical and other problems. Results: More than 14,000 procedures were registered during the observation period. No fatalities occurred. AEs occurred in 3.7% (1996), 4.6% (1997), 4.2% (1998) and 4.4% (1999) of procedures. Interventions during the adverse event were performed in about 65% of the events. Apheresis procedures were interrupted due to an adverse event in about 1%. Adverse events occurred in 5.6% of plasma exchanges, 1.9% of plasma modulations and 6.8% of cytapheresis procedures. Paresthesia was registered in 22% and hypotensive events in 20.5%. Other more frequent symptoms were urticaria (14.4%), shivering (7.4%) and nausea (7.4%). AEs were most frequent in patients with Goodpasture's syndrome (12.5%), TTP/HUS (10.5%) and GuillainBarré syndrome (11.0%). Conclusion: AEs are few, often mild and less common in plasma modulation than plasma exchange. AEs are more frequent during TA of patients with certain diagnoses such as TTP/HUS. Copyright © 2001 Elsevier Science Ltd.

  • 8. Norda, Rut
    et al.
    Stegmayr, Bernd G
    Berlin, Gösta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Karkus, Jan
    Jonsson, Svante
    Söderström, Tommy
    Knutsson, Folke
    Wikström, Björn
    Berséus, Olle
    Therapeutic apheresis in Sweden: update of epidemiology and adverse events.2003In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 29, p. 159-166Article in journal (Refereed)
  • 9.
    Palfi, Miodrag
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Hildén, Jan-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Matthiesen, Leif
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Selbing, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Berlin, Gösta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    A case of severe Rh (D) alloimmunization treated by intensive plasma exchange and high-dose intravenous immunoglobulin2006In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 35, no 2, p. 131-136Article in journal (Refereed)
    Abstract [en]

    Background: In extremely severe Rh (D) alloimmunization, during pregnancy, early diagnosis and treatment is essential to avoid hydrops fetalis. Intrauterine transfusion (IUT) is of utmost importance in the prevention of fetal anemia but it is usually feasible only after 20 weeks of pregnancy. Therefore, additional treatment options in early pregnancy are needed. Study design and methods: A 27-year-old severely D + C immunized woman was admitted at 8 weeks of gestation in her fifth pregnancy with an extremely high concentration of anti-D. Her first pregnancy was uneventful but resulted in D + C alloimmunization. The next two pregnancies were unsuccessful, because of hydrops fetalis resulting in fetal death in pregnancy week 20 and 24, respectively, despite treatment with high-dose intravenous immunoglobulin (IVIG) and IUT treatment. A fourth pregnancy was terminated with legal abortion. The patient was eager and persistent to accomplish a successful pregnancy. Therefore, a combination of treatments consisting of plasma exchange (PE) three times/week and IVIG 100 g/week was started in pregnancy week 12. PE was performed 53 times and totally 159 L of plasma was exchanged. Results: The anti-D concentration was 12 μg/mL (IAT titer 2000) before start of treatment by PE and IVIG in pregnancy week 12. The concentration of anti-D was gradually reduced to approximately 3 μg/mL after only two weeks of treatment and was maintained at that level until pregnancy week 22. In pregnancy week 26 and 27, signs of hydrops were detected by ultrasonography and IUT were performed at each occasion. Sectio was inevitable at pregnancy week 28 + 1 and a male baby was born: Hb 58 g/L (cord sample) and 68 g/L (venous sample), weight 1385 g, Apgar score = 4-5-7, Bilirubin 56-150 mmol/L (4 h). Exchange transfusion was performed on day two and day five. Phototherapy was also implemented for eight days. The newborn's recovery thereafter was uneventful and complete. Conclusion: A combination of PE and IVIG may be an efficient treatment possible to start in early pregnancy in patients with extremely severe Rh (D) alloimmunization, with a history of hydrops fetalis in previous pregnancies. © 2006 Elsevier Ltd. All rights reserved.

  • 10.
    Palfi, Miodrag
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Lotta, Martinsson
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Kristina, Sundström
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Transfusion Medicine. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Hypocalcemic symptoms during plateletpheresis using the COBE Spectra: A comparison of oral combination of 600 mg calcium + 300 mg magnesium + 100 IU vitamin D3 vs. a 1000 mg calcium in symptomatic donors2007In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 36, no 3, p. 291-295Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to find an effective treatment for hypocalcemic symptoms during plateletpheresis and to evaluate if a combination of calcium, magnesium and vitamin D3 is more effective in comparison to routine calcium supplementation. Material and methods: A study group consisting of 10 donors, having a history of previous hypocalcemic symptoms during plateletpheresis, donated platelets twice in a one-month period. During the first donation combination tablets (600 mg Ca + 300 mg Mg + 100 IU vitamin D3) were used to treat hypocalcemic symptoms while routine treatment calcium carbonate tablets (1000 mg Ca) were used during the second donation. If symptoms persisted after 10 min the same dose was repeated. A control group, with no supplementation, consisting of five donors, with no history of hypocalcemic symptoms, were included. Donor subjective symptoms were graded and recorded on four occasions: at the start of plateletpheresis, when symptoms appeared, 10 min after the first tablet and at the end of donation. Samples for analysis of ionized calcium (iCa), magnesium and potassium were also taken at the same occasions. Results: All donors from the study group experienced minor or medium hypocalcemic symptoms and needed a second dose of supplementation. Calcium carbonate tablets completely relieved the hypocalcemic symptoms in six donors, it had no effect on three donors and one donor experienced aggravated symptoms. The combination tablets completely relieved the symptoms in three donors, one donor experienced a partial relief and six donors had no relief of symptoms. There were no significant differences in iCa, potassium and magnesium levels were noted in the study group irrespective of which tablets were used for treatment of hypocalcemic symptoms. After plateletpheresis the median iCa levels declined by 30% and potassium levels declined by 3-11% in all donors while the magnesium levels were not significantly affected. There was no correlation between the presence of symptoms and the changed levels of iCa or magnesium. Conclusion: Addition of magnesium and vitamin D3 to calcium seems to have no beneficial effect in the treatment of hypocalcemic symptoms in plateletpheresis donors. © 2007 Elsevier Ltd. All rights reserved.

  • 11.
    Stegmayr, B.
    et al.
    Umeå University, Sweden.
    Mortzell Henriksson, M.
    Umeå University, Sweden.
    Newman, E.
    Bone Marrow Transplant & Apheresis, New South Wales, Australia.
    Witt, V.
    St Anna, Austria.
    Derfler, K.
    AKH, Austria.
    Leitner, G.
    AKH, Austria.
    Eloot, S.
    University Hospital, Belgium.
    Dhondt, A.
    University Hospital, Belgium.
    Deeren, D.
    AZ Delta, Belgium.
    Rock, G.
    Canadian Apheresis Grp, Canada.
    Ptak, J.
    Transfusion Medicine, Frydek-Mistek, Czechia.
    Blaha, M.
    Transfusion Medicine, Hradec Kralove, Czechia.
    Lanska, M.
    Transfusion Medicine, Hradec Kralove, Czechia.
    Gasova, Z.
    Institute Hematol and Blood Transfus, Czech Republic.
    Bhuiyan-Ludvikova, Z.
    Institute Hematol and Blood Transfus, Czech Republic.
    Hrdlickova, R.
    University Hospital, Czech Republic.
    Ramlow, W.
    Apheresis Centre North, Germany.
    Prophet, H.
    Apheresis Centre North, Germany.
    Liumbruno, G.
    National Institute Heatlh, Italy.
    Mori, E.
    Centre Blood, Italy.
    Griskevicius, A.
    University Hospital, Lithuania.
    Audzijoniene, J.
    University Hospital, Lithuania.
    Vrielink, H.
    Sanquin, Netherlands.
    Rombout-Sestrienkova, E.
    Sanquin, Netherlands.
    Aandahl, A.
    Akers University Hospital, Norway.
    Sikole, A.
    University Hospital, Macedonia.
    Tomaz, J.
    Coimbra University Hospital, Portugal.
    Lalic, K.
    University Hospital, Serbia.
    Bojanic, I.
    University of Zagreb, Croatia.
    Strineholm, V.
    University Hospital, Sweden.
    Brink, B.
    Huddinge University Hospital, Sweden.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Dykes, J.
    University of Lund Hospital, Sweden.
    Toss, F.
    University Hospital, Sweden.
    Nilsson, T.
    University of Uppsala Hospital, Sweden.
    Knutson, F.
    Uppsala University, Sweden.
    Ramsauer, B.
    Skaraborg Hospital, Sweden.
    Wahlstrom, A.
    Department Nephrol, Sweden.
    Distribution of indications and procedures within the framework of centers participating in the WAA apheresis registry2017In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 56, no 1, p. 71-74Article in journal (Refereed)
    Abstract [en]

    The WAA apheresis registry was established in 2003 and an increasing number of centers have since then included their experience and data of their procedures. The registry now contains data of more than 74,000 apheresis procedures in more than 10,000 patients. This report shows that the indications for apheresis procedures are changing towards more ontological diagnoses and stem cell collections from patients and donors and less therapeutic apheresis procedures. In centers that continue to register, the total extent of apheresis procedures and patients treated have expanded during the latest years. (C) 2016 Elsevier Ltd. All rights reserved.

  • 12.
    Stegmayr, B
    et al.
    Umeå, Sweden.
    Ptak, J
    Frydek-Mistek, Czech Republic.
    Nilsson, T
    Uppsala, Sweden.
    Berlin, Gösta
    Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine. Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine.
    Mirea, V
    Örebro, Sweden.
    Axelsson, C G
    Örebro, Sweden.
    Griskevicius, A
    Vilnius, Lithuania.
    Centoni, P
    Livorno, Italy.
    Liumbruno, G
    Livorno, Italy.
    Audzijoniene, J
    Vilnius, Lithuania.
    Mokvist, K
    Uppsala, Sweden.
    Lassen, E
    Umeå, Sweden.
    Knutson, F
    Uppsala, Sweden.
    Norda, R
    Uppsala, Sweden.
    Mörtzell, M
    Umeå, Sweden.
    Prophet, H
    Rostock, Germany.
    Ramlow, W
    Rostock, Germany.
    Blaha, M
    Hradec Kralove, Czech Republic.
    Witt, V
    Vienne, Austria.
    Efvergren, M
    Huddinge, Sweden.
    Tomaz, J
    Coimbra, Portugal.
    Newman, E
    Concord, Australia.
    Eloot, S
    Ghent, Belgium.
    Dhondt, A
    Ghent, Belgium.
    Lalic, K
    Belgrade, Serbia.
    Sikole, A
    Skopje, Macedonia.
    Derfler, K
    Vienna, Austria.
    Hrdlickova, R
    Ostrava, Czech Republic.
    Tomsova, H
    Ostrava, Czech Republic.
    Gasova, Z
    Prague, Czech Republic.
    Bhuiyan-Ludvikova, Z
    Prague, Czech Republic.
    Ramsauer, B
    Skövde, Sweden.
    Vrielink, H
    Amsterdam, The Netherlands.
    Panorama of adverse events during cytapheresis2013In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 48, no 2, p. 155-156Article in journal (Refereed)
  • 13.
    Stegmayr, B
    et al.
    University Hospital, Umeå.
    Ptak, J
    Czech Republic .
    Wikstrom, B
    University Hospital, Uppsala.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    G Axelsson, C
    University Hospital, Örebro.
    Griskevicius, A
    University Hospital, Vilnius.
    Centoni, P
    Livorno, Italy .
    Liumbruno, G
    Livorno, Italy .
    Molfettini, P
    Livorno, Italy .
    Audzijoniene, J
    University Hospital, Vilnius.
    Mokvist, K
    University Hospital, Umeå.
    Norda, R
    University Hospital, Uppsala.
    Knutson, F
    University Hospital, Uppsala.
    Ramlow, W
    Rostock, Germany .
    Blaha, M
    Witt, V
    Vienna, Austria .
    Evergren, M
    University Hospital, Huddinge.
    Tomaz, J
    Coimbra University Hospital, Portugal.
    World apheresis registry 2003-2007 data2008In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 39, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Objectives: Seventy-five centers from many countries have applied for a login code to the WAA apheresis registry. Fifteen centers from 7 countries have been actively entering data at the internet site from 2003 until 2007. We report on data from the registry so far.

    Methods: This is a web-based registry. A link is available from the WAA homepage (www.worldapheresis.org). So far data from 2013 patients (12,448 procedures) have been included. A median of 6 treatments have been performed (range 1140). Mean age 51 years (range 1-94 years; 45% women). Seven percent of the patients were <= 21 years and 4% were <= 16 years.

    Results: The purpose of the apheresis procedure was therapeutic in 67% and retrieval of blood components in 33% Main indications: neurological and hematological diseases, lipid apheresis and stemcell collection (autologous, and some allogeneic). Blood access: peripheral vessels (71%), central dialysis catheter through jugular (6.5%) or subclavian veins (6.7%), femoral vein (8%) and AV fistula (4%). ACD was used for anticoagulation in 73% of the procedures. Albumin was mainly used as replacement fluid.

    Adverse events (AE) were registered in 5.7% of the procedures. AE was graded as mild (2.5%), moderate (2.7%) or severe (0.5%). No death occurred due to treatment. The procedures were interrupted in 2.6%. Most frequent AEs were blood access problems (29%), tingling around the mouth (20%), hypotension (18%), and urticaria (9%). There were significant differences between the centers regarding mild and moderate AEs. Data indicate that centers using continuous infusion of calcium had fewer AEs.

    Conclusion: There was a limited number of severe AEs. Centers use various standard procedures for apheresis. By learning from the experience of others the treatment quality will improve further. In the near future, an update of the registry will enable more extensive evaluation of the data.

  • 14.
    Tynngård, Nahreen
    Linköping University, Department of Clinical and Experimental Medicine, Transfusion Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Preparation, storage and quality control of platelet concentrates.2009In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 41, no 2, p. 97-104Article, review/survey (Refereed)
    Abstract [en]

    Patients with thrombocytopaenia need transfusions of platelet concentrates to prevent or stop bleeding. A platelet transfusion should provide platelets with good functionality. The quality of platelet concentrates (PCs) is affected by the preparation method and the storage conditions including duration of storage, type of storage container, and storage solution (plasma or an additive solution). Different in vivo and in vitro techniques can be used to analyse PCs. Platelets can be collected by apheresis technique, and from whole blood using either the buffy-coat or the platelet-rich plasma method. PCs can be gamma irradiated to prevent occurrence of graft-versus-host disease in the recipient. Pathogen inactivation procedures have been developed to prevent transmission of bacteraemia.

  • 15.
    Tynngård, Nahreen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Transfusion Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Johansson, Britt-Marie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lindahl, Tomas L
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Hansson, Mona
    Karolinska University Hospital and Karolinska Institute.
    Effects of intercept pathogen inactivation on platelet function as analysed by free oscillation rheometry2008In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 38, no 1, p. 85-88Article in journal (Refereed)
    Abstract [en]

    Introduction: The Intercept Blood System, using InterSol as additive solution, is used for inactivation of contaminating pathogens in PCs, thus reducing the risk for transfusion transmitted infection and making it possible to prolong the storage period. This study aimed at investigating the ability of Intercept treated platelets to induce clot formation, as measured by coagulation time using free oscillation rheometry (FOR), and to compare with that of platelets in concentrates with the additive solution T-Sol or plasma.

    Methods: Seventy-four single-donor platelet units were diluted in InterSol (n = 27) or T-Sol (n = 47) to a mean plasma concentration of 38%. The Intercept treatment was performed by addition of amotosalen HCl to the InterSol PCs followed by UVA irradiation and treatment with a compound adsorption device (CAD). Forty-six units were collected and stored in 100% plasma for comparison. Clotting time was measured by FOR in fresh PCs (within 26 h after collection) after stimulation by a platelet activator. Soluble P-selectin was analysed as a marker of platelet activation in the Intercept and T-Sol PCs.

    Results: The clotting time was shorter for Intercept treated platelets compared to platelets in T-Sol and plasma (p < 0.05). There was no difference in clotting time between T-Sol and plasma PCs. Soluble P-selectin was higher for Intercept platelets than platelets in T-Sol (p < 0.05).

    Conclusions: The platelets treated with the Intercept procedure had good clot promoting capacity.

  • 16.
    Witt, Volker
    et al.
    Vienna, Austria .
    Stegmayr, Bernd
    University Hospital, Umeå.
    Ptak, Jan
    University Hospital Ostrava.
    Wikstrom, Bjorn
    University Hospital, Uppsala.
    Berlin, Gösta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Immunology and Transfusion Medicine.
    Axelsson, C G
    Örebro Medical Centre .
    Griskevicius, A
    Vilnius University Hospital.
    Emilio Centoni, Paolo
    Hospital Livorno, Italy.
    Maria Liumbruno, Giancarlo
    Hospital Livorno, Italy.
    Molfettini, Pietra
    Hospital Livorno, Italy.
    Audzijoniene, Judita
    University Hospital, Umeå.
    Nilsson Sojka, B
    Umeå University Hospital.
    Norda, Rut
    University Hospital Uppsala .
    Ramlow, W
    Rostock, Germany .
    Blaha, Milan
    Hradec Kralove, Czech Republic .
    Evergren, M
    Karolinska University Hospital.
    Tomaz, J
    Karolinska University Hospital.
    World apheresis registry data from 2003 to 2007, the pediatric and adolescent side of the registry2008In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 39, no 3, p. 255-260Article in journal (Refereed)
    Abstract [en]

    Objectives: Paediatric patients are a special group in apheresis. It is general accepted to use adult indications in paediatric patients, but data in this age group are rare. In order to provide more information of apheresis practise in children and young adults (<21a) we will report of knowledge learnt by data from the registry from 2003 until 2007.

    Methods: This is a web-based registry. A link is available from the WAA homepage (www.worldapheresis.org). So far data from 12,448 procedures have been included. Six hundred and twelve procedures were performed in 135 children and young adults (308 procedures < 16a, 237 from 17 to 20a, and 67 with 21a) representing 5% of the total population. The median age was 14 years (range 1-21 years), 74 male and 61 female. These data were entered by 15 centres with a frequency of in median 18 aphereses in young patients per centre (range 1-287) from 2003 to 2007.

    Results: Main indications: haematological diseases and also nephrological, and neurological. The type of aphereses was mainly Leukapheresis (196, 33%), plasma exchange (149, 25%), photopheresis (127, 21%), and lipid aphereses (79, 13%). Blood access: peripheral vessels in 305 procedures (50 K, compared to 73% in adults), central venous catheter in 239 (38%), and AV-fistula in 2% and 0.3%, and in 8 (1.31%) procedures an arterial line was used. Anticoagulation was mostly by ACD (71%), heparin (18% or the combination of both (3%). 39 adverse events (AE) were registered in 22 (=3.59%) of the procedures. mostly graded as mild. Treatment was interrupted in 14 procedures (2.29%. AEs were abdominal pain, anaphylactic shock, flush, hyper- and hypotension, nausea, vertigo, cephalea and need for sedation and technical problems with the device and problems with the venous access. The rate of AEs was similar for stem cell harvesting and for plasma exchange (4%, and 4.7%). respectively).

    Conclusion: The paediatric data compared to the whole registry data set are showing that aphereses are performed as safe in paediatrics as in adults. Centres are mostly handling only a few cases younger than 21. Therefore more exchange of information and experience in paediatric apheresis is warranted.

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