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  • 1.
    Almroth, Gabriel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Njurmedicinska kliniken US.
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Åkerlind, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk mikrobiologi.
    Månsson, Ann-Sofie
    Malmö University Hospital.
    Widell, Anders
    Malmö University Hospital.
    Monitoring hepatitis C infection in a major Swedish nephrology unit and molecular resolution of a new case of nosocomial transmission.2010Inngår i: Journal of medical virology, ISSN 1096-9071, Vol. 82, nr 2, s. 249-256Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hepatitis C virus (HCV) infection is a frequent problem in hemodialysis units. The prevalence and incidence of HCV infection over a decade were studied in a nephrology unit affected by previous nosocomial HCV transmission. The HCV non-structural 5B protein gene was sequenced to achieve phylogenetic analysis of a new (incident) case of infection. Proportions of patients who were and were not infected with HCV remained similar over the period, as did the inflow and outflow of patients infected previously. In 1997, 12/157 (8%) of patients at the unit (treatment: hemodialysis, peritoneal dialysis, and renal transplant recipients) were positive in HCV RNA, whereas in 2007 the overall number was 9/239 (4%). One patient acquired an HCV infection, and the NS5B sequence in that case clustered with genotype 2b sequences found in patients from an earlier outbreak. Comparing the HCV from the incident patient with several stored longitudinal samples and cloned PCR products from the most likely source patient revealed close phylogenetic relationship with an HCV quasispecies member from the possible source. The source patient and the incident newly infected patient were not scheduled on the same dialysis shift, although the records showed that simultaneous treatment occurred on two occasions during the months preceding transmission. In conclusion, over the 10-year period, the proportion of HCV-infected patients at the unit was unchanged. Only one new infection occurred, which originated from a fellow patient's quasispecies. This establishes phylogenetic analysis as a valuable tool for tracing patient sources of HCV transmission.

  • 2.
    Benjamin, R J
    et al.
    American Red Cross.
    Bianco, C
    Canadian Blood Service.
    Seed, C R
    Australian Red Cross Blood Service.
    Yang, H
    Australian Red Cross Blood Service.
    Lee, J
    Australian Red Cross Blood Service.
    Keller, A J
    Australian Red Cross Blood Service.
    Wendel, S
    Hospital Sirio Libanes.
    Biagini, S
    Hospital Sirio Libanes.
    Murray, J
    Shanghai Blood Centre.
    Turek, P
    Thomayer Teaching Hospital.
    Moftah, F M
    National Blood Transfus Service.
    Kullaste, R
    North Estonia Medical Centre.
    Pillonel, J
    French Institute Public Health Surveillance.
    Danic, B
    Etab Francais Sang.
    Bigey, F
    Etab Francais Sang.
    Follea, G
    Etab Francais Sang.
    Seifried, E
    Goethe University of Frankfurt.
    M Mueller, M
    Goethe University of Frankfurt.
    Lin, C K
    Hong Kong Red Cross Blood Transfus Service.
    Makroo, R N
    Indraprastha Apollo Hospital.
    Grazzini, G
    Italian National Blood Centre.
    Pupella, S
    Italian National Blood Centre.
    Velati, C
    Italian National Blood Centre.
    Tadokoro, K
    Japanese Red Cross Society.
    Bravo Lindoro, A
    Institute Nacl Pediat.
    DArtote Gonzalez, A
    Banco Central Sangre Siglo XXI.
    Giner, V T
    Centre Nacl Transfus Sanguinea.
    Flanagan, P
    New Zealand Blood Service.
    Olaussen, R W
    Oslo University of Hospital.
    Letowska, M
    Institute Hematol and Transfus Med, Warsaw.
    Rosiek, A
    Institute Hematol and Transfus Med, Warsaw.
    Poglod, R
    Institute Hematol and Transfus Med, Warsaw.
    Zhiburt, E
    Pirogov Russian National Medical Surg Centre.
    Mali, P
    Blood Transfus Centre Slovenia.
    Rozman, P
    Blood Transfus Centre Slovenia.
    Gulube, S
    S African National Blood Service.
    Castro Izaguirre, E
    Centre Transfus Cruz Roja Espanola Madrid.
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Barnes, S M
    NHS Blood and Transplant.
    McLaughlin, L
    University of Vienna.
    Reesink, H W
    University of Amsterdam.
    Deferral of males who had sex with other males2011Inngår i: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 101, nr 4, s. 339-367Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    n/a

  • 3.
    Berlin, Gösta
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Östergötland satsar på klinisk forskning2011Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, nr 3, s. 81-84Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [sv]

    Flera rapporter har visat att svensk klinisk forskning under senare år har tappat mark i förhållande till omvärlden.Inom Östergötland har landstinget och den medicinska fakulteten vid Linköpings universitet (Hälsouniversitet) tagit gemensamma initiativ för att ge bättre förutsättningar för klinisk forskning kombinerat med sjukvårdsarbete.

    Åtgärdsplanen »FoU i befattningsutvecklingen« slår fast sjukvårdens uppdrag och roll inom klinisk forskning.

    Årliga FoU-bokslut görs för sjukvårdsenheterna.

    Projektet »Från student till docent« syftar till att rekrytera studenter från de olika utbildningarna i vård och medicin till forskning redan under studietiden och därefter ge möjligheter att bedriva forskarutbildning och fortsatt forskning kombinerat med klinisk karriär.

    Tidsbegränsade forskningsbefattningar inom sjukvården har inrättats för medarbetare med legitimationsyrken.

    Infrastrukturen kring klinisk forskning med olika typer av kompetensstöd för den enskilda forskaren har stärkts.

  • 4.
    Davidson, Thomas
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Gaines, Hans
    Lesko, Birgitta
    Akerlind, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk mikrobiologi.
    The cost-effectiveness of introducing nucleic acid testing to test for hepatitis B, hepatitis C, and human immunodeficiency virus among blood donors in Sweden2011Inngår i: TRANSFUSION, ISSN 0041-1132, Vol. 51, nr 2, s. 421-429Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The purpose of this study was to estimate the cost-effectiveness of using individual-donor nucleic acid testing (ID-NAT) in addition to serologic tests compared with the sole use of serologic tests for the identification of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in Sweden. STUDY DESIGN AND METHODS: The two strategies analyzed were serologic tests and ID-NAT plus serologic tests. A health-economic model was used to estimate the lifetime costs and effects. The effects were measured as infections avoided and quality-adjusted life-years (QALYs) gained. A societal perspective was used. RESULTS: The largest number of viral transmissions occurred with serologic testing only. However, the risks for viral transmissions were very low with both strategies. The total cost was mainly influenced by the cost of the test carried out. The cost of using ID-NAT plus serologic tests compared to serologic tests alone was estimated at Swedish Krona (SEK) 101 million (USD 12.7 million) per avoided viral transmission. The cost per QALY gained was SEK 22 million (USD 2.7 million). CONCLUSION: Using ID-NAT for testing against HBV, HCV, and HIV among blood donors leads to cost-effectiveness ratios that are far beyond what is usually considered cost-effective. The main reason for this is that with current methods, the risks for virus transmission are very low in Sweden.

  • 5.
    Flegel, Willy A
    et al.
    University Hospital, Ulm.
    von Zabern, Inge
    Doescher, Andrea
    Wagner, Franz F
    Strathmann, Klaus P
    Geisen, Christof
    Plafi, Miodrag
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Pisacka, Martin
    Poole, Joyce
    Polin, Helene
    Gabriel, Christian
    Avent, Neil D
    D variants at the RhD vestibule in the weak D type 4 and Eurasian D clusters2009Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 49, nr 6, s. 1059-1069Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: One branch of the RHD phylogenetic tree is represented by the weak D type 4 cluster of alleles with F223V as the primordial amino acid substitution. F223V as well as a large number of further substitutions causing D variants are located at the extracellular RhD protein vestibule, which represents the entrance to the transmembraneous channel of the RhD protein.

    STUDY DESIGN AND METHODS: RHD and RHCE nucleotide sequences were determined from genomic DNA and cDNA. D epitope patterns were established with commercial monoclonal anti-D panels.

    RESULTS: The RHD alleles DOL-1 and DOL-2 had the two amino acid substitutions M170T (509T>C) and F223V (667T>G) in common. DOL-2 harbored the additional substitution L378V (1132C>G). Both alleles were observed in Africans and are probably evolutionary related. DMI carried M170I (510G>A), which differed from the DOL-typical substitution. DFW and DFL harbored the substitutions H166P (497A>C) and Y165C (494A>G). The antigen densities of DOL-1, DFL, and DFW were only moderately reduced.

    CONCLUSION: DOL-1 and DOL-2 belong to the weak D type 4 cluster of RHD alleles. Together with DMI, DFL, and DFW they represent D variants with amino acid substitutions located at extracellular loops 3 or 4 lining the RhD protein vestibule. These substitutions were of minor influence on antigen density while adjacent substitutions in the transmembraneous section caused weak D antigen expression. All these D variants were partial D and alloanti-D immunizations have been observed in DOL-1, DMI, and DFL carriers. The substitution at position 170 causes partial D although located deep in the vestibule.

  • 6.
    Malm, Kerstin
    et al.
    Örebro University Hospital, Sweden .
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Hillgren, Kristina
    Maria Beroendecentrum, Centre for Dependency Disorders, Stockholm, Sweden.
    Britton, Sven
    Karolinska University Hospital, Sweden .
    Fredlund, Hans
    Örebro University Hospital, Sweden .
    Andersson, Soren
    Örebro University Hospital, Sweden .
    Prevalence of human T-lymphotropic virus type 1 and 2 infection in Sweden2012Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 11, s. 852-859Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Prevalence data on human T-lymphotropic virus types 1 and 2 (HTLV-1/2) in Sweden have not been updated since 1995. The seroprevalence among blood donors at that time was 0.2/10,000. A few years earlier, a high prevalence of HTLV-2 was found in intravenous drug users (IDUs) in Stockholm (3.4%). The objective of this study was to update information on the seroprevalence of HTLV in several study groups. Methods: Serum samples from pregnant women, hepatitis C virus (HCV)-positive individuals, and IDUs in Stockholm were investigated for HTLV-1/2 antibodies. Data from the mandatory HTLV-1/2 screening (2003-2006) of in vitro fertilization (IVF) clients were compiled, as well as data from new blood donors. Results: Eight out of 35,000 IVF patients were positive for anti-HTLV-1/2 (seroprevalence 2.3 per 10,000). Of the anti-HCV-positive individuals (n = 355), 1 sample was HTLV-1-positive (28.2 per 10,000). From 1995 to 2007, 18 HTLV-positive new blood donors were identified out of approximately 550,000 individuals tested (0.3 per 10,000). Thirty-five of 1079 tested IDUs were screening reactive. Conclusions: Since the start of screening in 1994, there has been no increased seroprevalence of HTLV-1/2 among blood donors in Sweden. Seroprevalence among Swedish IVF patients is 10 times higher than among blood donors. This finding is comparable to a 2003 European seroprevalence study of pregnant women in 7 countries. However, the possibility that the IVF group includes individuals with a higher risk of acquiring sexually transmitted infections, including HTLV, than the general population cannot be ruled out.

  • 7.
    Nilsson, Caroline U.
    et al.
    Lund University, Sweden .
    Tynngård, Nahreen
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Reinstrup, Peter
    Lund University, Sweden .
    Engstrom, Martin
    Lund University, Sweden .
    Monitoring fibrinolysis in whole blood by viscoelastic instruments: A comparison of ROTEM and ReoRox2013Inngår i: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 73, nr 6, s. 457-465Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. Increased fibrinolysis with the risk of bleeding is a consequence of thrombolytic therapy and can also be seen in clinical situations such as acute trauma. Thrombelastography and thrombelastometry are viscoelastic coagulation instruments that can detect higher degrees of fibrinolysis; hyperfibrinolysis. A newer viscoelastic instrument is the ReoRox, which uses free oscillation rheometry to detect clot formation, strength and fibrinolysis. The ReoRox has a new test for detection of fibrinolysis, called ReoLyse. The aim of this study was to compare ReoRox with its new ReoLyse test with rotational thrombelastometry (ROTEM) in the monitoring of in vitro-induced fibrinolysis. Methods. Whole blood from 10 healthy volunteers was mixed with tissue plasminogen activator (t-PA) to obtain seven different plasma concentrations (0, 0.25, 0.5, 0.75, 1, 3 and 5 mu g/mL). Whole blood samples with the different t-PA plasma concentrations were analyzed with ROTEM EXTEM and FIBTEM tests, ReoRox standard test Fib1 (clot formation/strength) and ReoLyse (fibrinolysis) tests. Results. The fibrinolysis variables with the best dose-response effect were the ReoRox ReoLyse lysis variables and ROTEM EXTEM Time to complete lysis. However, these variables only detected high t-PA levels (andgt;1 mu g/mL). Conclusions. The new ReoRox ReoLyse test provides more information on fibrinolysis compared to the ReoRox Fib1 program. Neither ReoRox nor ROTEM could detect lower degrees of fibrinolysis. ReoRox is a valuable alternative to ROTEM to study high degrees of fibrinolysis and should be evaluated in clinical situations with increased fibrinolysis and during therapeutic thrombolysis.

  • 8.
    Reesink, H W
    et al.
    University of Amsterdam, Netherlands .
    Lee, J
    Australian Red Cross Blood Serv, Australia .
    Keller, A
    Australian Red Cross Blood Serv, Australia .
    Dennington, P
    Australian Red Cross Blood Serv, Australia .
    Pink, J
    Australian Red Cross Blood Serv, Australia .
    Holdsworth, R
    Australian Red Cross Blood Serv, Australia .
    Schennach, H
    TILAK University of Clin Regional Hospital, Austria .
    Goldman, M
    Canadian Blood Serv, Canada .
    Petraszko, T
    Canadian Blood Serv, Canada .
    Sun, J
    Shanghai Blood Centre, Peoples R China .
    Meng, Y
    Shanghai Blood Centre, Peoples R China .
    Qian, K
    Shanghai Blood Centre, Peoples R China .
    Rehacek, V
    University Hospital, Czech Republic .
    Turek, P
    Thomayer Hospital, Czech Republic .
    Krusius, T
    Finnish Red Cross Blood Serv, Finland .
    Juvonen, E
    Finnish Red Cross Blood Serv, Finland .
    Tiberghien, P
    Etab Francais Sang, France .
    Legrand, D
    Etab Francais Sang, France .
    Semana, G
    Etab Francais Sang Bretagne, France .
    Muller, J Y
    Etab Francais Sang, France .
    Bux, J
    German Red Cross Blood Serv W, Germany .
    Reil, A
    German Red Cross Blood Serv W, Germany .
    Lin, C K
    Hong Kong Red Cross Blood Transfus Serv, Peoples R China .
    Daly, H
    National Blood Centre, Ireland .
    McSweeney, E
    National Blood Centre, Ireland .
    Porretti, L
    Fdn Ca Granda Osped Maggiore Policlin, Italy .
    Greppi, N
    Fdn Ca Granda Osped Maggiore Policlin, Italy .
    Rebulla, P
    Fdn Ca Granda Osped Maggiore Policlin, Italy .
    Okazaki, H
    Blood Serv Headquarters, Japan .
    Sanchez-Guerrero, S A
    National Institute Cancerol, Mexico .
    Baptista-Gonzalez, H A
    Medical Hospital, Mexico .
    Martinez-Murillo, C
    Siglo XXI National Medical Centre Mexican Social Secur, Mexico .
    Guerra-Marquez, A
    La Raza National Medical Centre Mexican Social Secur, Mexico .
    Rodriguez-Moyado, H
    Consejo Mexicano Hematol, Mexico .
    Middelburg, R A
    Sanquin JJ van Rood Centre, Netherlands TRIP, Netherlands .
    Wiersum-Osselton, J C
    Sanquin JJ van Rood Centre, Netherlands TRIP, Netherlands .
    Brand, A
    Sanquin JJ van Rood Centre, Netherlands TRIP, Netherlands .
    van Tilburg, C
    New Zealand Blood Serv, New Zealand .
    Dinesh, D
    New Zealand Blood Serv, New Zealand .
    Dagger, J
    New Zealand Blood Serv, New Zealand .
    Dunn, P
    New Zealand Blood Serv, New Zealand .
    Brojer, E
    Institute Hematol and Transfus Med, Poland .
    Letowska, M
    Institute Hematol and Transfus Med, Poland .
    Maslanka, K
    Institute Hematol and Transfus Med, Poland .
    Lachert, E
    Institute Hematol and Transfus Med, Poland .
    Uhrynowska, M
    Institute Hematol and Transfus Med, Poland .
    Zhiburt, E
    Russian Transfusionist Assoc, Russia .
    Palfi, Miodrag
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Frey, B M
    Blood Transfus Serv SRC, Switzerland .
    Puig Rovira, L
    Banc Sang and Teixits Catalonia, Spain .
    Muniz-Diaz, E
    Crus Roja Espanola, Spain .
    Chapman, C
    NHSBT Newcastle Centre, England .
    Green, A
    NHSBT, England .
    Massey, E
    NHSBT, England .
    Win, N
    NHSBT Tooting Centre, England .
    Williamson, L
    NHSBT, England .
    Silliman, C C
    Bonfils Blood Centre, CO 80230 USA .
    Chaffin, D J
    University of Rochester, NY 14642 USA .
    Tomasulo, P
    Blood Syst, AZ USA .
    Land, K J
    Blood Syst, TX USA Blood Syst, CA USA .
    Norris, P J
    Blood Syst, TX USA Blood Syst, CA USA .
    Illoh, O C
    US FDA, MD 20852 USA .
    Davey, R J
    US FDA, MD 20852 USA .
    Benjamin, R J
    Amer Red Cross, MD 20855 USA .
    Eder, A F
    Amer Red Cross, MD 20855 USA .
    McLaughlin, L
    Amer Red Cross, MD 20855 USA .
    Kleinman, S
    University of Vienna, Austria .
    Measures to prevent transfusion-related acute lung injury (TRALI)2012Inngår i: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 103, nr 3, s. 231-259Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    n/a

  • 9.
    Reesink, H W
    et al.
    University of Amsterdam.
    Panzer, S
    Medical University of Vienna.
    Wendel, S
    Hospital Sirio Libanes.
    Levi, J E
    Centre Imunol and Imunogenet, Brazil.
    Ullum, H
    Copenhagen University Hospital.
    Ekblom-Kullberg, S
    Finnish Red Cross Blood Service.
    Seifried, E
    German Red Cross.
    Schmidt, M
    German Red Cross.
    Shinar, E
    Osped A Manzoni.
    Berzuini, A
    Osped A Manzoni.
    Ghosh, S
    New Zealand Blood Service.
    Flesland, O
    Asker and Baerum Hospital.
    Jeansson, S
    Oslo University Hospital Ulleval.
    Zhiburt, E
    Pirogov Russian National Medical Surgery Centre.
    Piron, M
    Blood and Tissue Bank Catalonia.
    Sauleda, S
    Blood and Tissue Bank Catalonia.
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Eglin, R
    NHSBT.
    Kitchen, A
    NHSBT.
    Dodd, R Y
    American Red Cross.
    Leiby, D A
    American Red Cross.
    Katz, L M
    Mississippi Valley Reg Blood Centre.
    Kleinman, S
    University British Columbia.
    The use of malaria antibody tests in the prevention of transfusion-transmitted malaria2010Inngår i: VOX SANGUINIS, ISSN 0042-9007, Vol. 98, nr 3, s. 468-478Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    n/a

  • 10.
    Roth, W K
    et al.
    Germany.
    Busch, M P
    USA.
    Schuller, A
    Germany.
    Ismay, S
    Australia.
    Cheng, A
    Australia.
    Seed, C R
    Australia.
    Jungbauer, C
    Austria.
    Minsk, P M
    Belarus.
    Sondag-Thull, D
    Belgium.
    Wendel, S
    Brazil.
    Levi, J E
    Brazil.
    Fearon, M
    Canada.
    Delage, G
    Canada.
    Xie, Y
    China.
    Jukic, I
    Croatia.
    Turek, P
    Czech Republic.
    Ullum, H
    Denmark.
    Tefanova, V
    Estonia.
    Tilk, M
    Estonia.
    Reimal, R
    Estonia.
    Castren, J
    Finland.
    Naukkarinen, M
    Finland.
    Assal, A
    France.
    Jork, C
    Germany.
    Hourfar, M K
    Germany.
    Michel, P
    Germany.
    Offergeld, R
    Germany.
    Pichl, L
    Germany.
    Schmidt, M
    Germany.
    Schottstedt, V
    Germany.
    Seifried, E
    Germany.
    Wagner, F
    Germany.
    Weber-Schehl, M
    Germany.
    Politis, C
    Greece.
    Lin, C K
    Hong Kong.
    Tsoi, W C
    Hong Kong.
    O'Riordan, J
    Ireland.
    Gottreich, A
    Israel.
    Shinar, E
    Israel.
    Yahalom, V
    Israel.
    Velati, C
    Italy.
    Satake, M
    Japan.
    Sanad, N
    Kuwait.
    Sisene, I
    Latvia.
    Bon, A H
    Malaysia.
    Koppelmann, M
    the Netherlands.
    Flanagan, P
    New Zealand.
    Flesland, O
    Norway.
    Brojer, E
    Poland.
    Lętowska, M
    Poland.
    Nascimento, F
    Portugal.
    Zhiburt, E
    Russia.
    Chua, S S
    Singapore.
    Teo, D
    Singapore.
    Levicnik Stezinar, S
    Slovenia.
    Vermeulen, M
    South Africa.
    Reddy, R
    South Africa.
    Park, Q
    South Korea.
    Castro, E
    Spain.
    Eiras, A
    Spain.
    Gonzales Fraile, I
    Spain.
    Torres, P
    Spain.
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Niederhauser, C
    Switzerland.
    Chen, H
    Taiwan.
    Oota, S
    Tailand.
    Brant, L J
    United Kingdom.
    Eglin, R
    United Kingdom.
    Jarvis, L
    United Kingdom.
    Mohabir, L
    United Kingdom.
    Brodsky, J
    USA.
    Foster, G
    USA.
    Jennings, C
    USA.
    Notari, E
    USA.
    Stramer, S
    USA.
    Kessler, D
    USA.
    Hillyer, C
    USA.
    Kamel, H
    USA.
    Katz, L
    USA.
    Taylor, C
    USA.
    Panzer, S
    Austria.
    Reesink, H W
    the Netherlands.
    International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009.2012Inngår i: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 102, nr 1, s. 82-90Artikkel i tidsskrift (Fagfellevurdert)
  • 11. Bestill onlineKjøp publikasjonen >>
    Tynngård, Nahreen
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Free oscillation rheometry in the assessment of platelet quality2008Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Platelets play an important role in the haemostatic process in order to seal damaged blood vessels. The platelets form a platelet plug at the damaged area and prevent blood loss. Once the damage to the vessel wall has been covered, the platelets retract the coagulum, to allow the blood to flow freely in the vessel. Free oscillation rheometry (FOR) can be used for analysis of coagulation as measured by clotting time and changes in clot elasticity (G'). Clot G' provides information about the fibrin network in the coagulum and the platelets’ ability to retract the coagulum. FOR analysis is performed using the ReoRox® 4 instrument. The blood sample is added to a cylindrical sample cup, which is set into free oscillation. The frequency and damping of the oscillation is recorded over time as the blood coagulates. The change in G' is calculated from the frequency and damping measured. Patients with malignant haematological diseases are often thrombocytopaenic and require platelet transfusions to prevent or stop bleeding. To ensure good haemostatic function in the recipient it is important that the quality of the platelets used for transfusion is well preserved. The aim of this thesis was to determine the quality of platelet concentrates (PCs), during storage, using various in vitro methods, including FOR, and to investigate how various preparation processes affect the quality. We also investigated whether FOR can be used to evaluate the haemostatic status in subjects at risk for thrombosis or bleeding as well as how the haemostatic status was affected by a platelet transfusion.

    We show that FOR can provide information about the coagulation properties in subjects at risk of thrombosis (pregnant women) or bleeding (thrombocytopaenic patients). We also show that the coagulation as measured by FOR is influenced by red blood cells and the fibrinogen concentration. However, the presence of functional platelets accounted for 90% of the G'. Furthermore we present data that FOR can provide information on the haemostatic effect of platelet transfusions and on the function of the transfused platelets.

    PCs produced by two different cell separators showed similar quality during storage for 7 days as assessed by FOR analysis. Leukocytes in the PCs can cause transfusion-associated graft-versus-host disease which can be prevented by gamma irradiation of the PCs. Gamma irradiation did not affect the quality of PCs during 7 days of storage as analysed by FOR. The clotting time was unchanged during the storage period. The capacity of platelets to retract the coagulum was reduced from days 1 to 5 of storage as seen by a prolonged time to reach maximum G' and the reduced mean change in G' per minute. However, if sufficient time is allowed for the platelets to regain their function, the clot will be fully retracted (as seen by a well maintained maximum G'). The FOR parameters were similar for 5- and 7-day old PCs, which, combined with other in vitro tests (e.g. hypotonic shock response, changes in pH, swirling, lactate and glucose), support the prolongation of the platelet storage period to 7 days. Intercept treatment of PCs can be performed to inhibit replication of contaminating bacteria in PCs. Intercept treatment of PCs did not diminish the clot-promoting capacity of the platelets as assessed by FOR clotting time.

    In conclusion, FOR is a promising method for assessing hyper- and hypocoagulability. It can provide information on the haemostatic effect of platelet transfusions and the function of the transfused platelets. FOR was also shown to be useful for analysing PC quality during different preparation and storage conditions.

    Delarbeid
    1. Effects of different blood components on clot retraction analysed by measuring elasticity with a free oscillating rheometer
    Åpne denne publikasjonen i ny fane eller vindu >>Effects of different blood components on clot retraction analysed by measuring elasticity with a free oscillating rheometer
    2006 (engelsk)Inngår i: Platelets, ISSN 0953-7104, Vol. 17, nr 8, s. 545-554Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Free oscillation rheometry (FOR) using the ReoRox® 4 instrument makes it possible, at bedside, to study the coagulation process in blood over time and gives information on clotting time and coagulum elastic properties. In order to find out how various factors influence the FOR analysis we studied the coagulation process and change of elasticity over time in non-anticoagulated and citrated blood samples, plasma samples with various platelet concentrations (0-200 109/l) and blood samples with various haematocrit (0-40%). Blood samples supplemented with fibrinogen were analysed to elucidate the importance of fibrinogen on elasticity. The importance of the GPIIb/IIIa receptor on platelets was investigated by comparing the elasticity development in blood samples in presence and absence of a GPIIb/IIIa receptor inhibitor, abciximab. Anticoagulation with citrate did not have major influence on the viscoelastic properties of the coagulum. Increasing number of platelets and increasing fibrinogen concentration resulted in higher elasticity while increasing haematocrit gave lower elasticity. Blood samples with GPIIb/IIIa receptor inhibitor had very low elasticity indicating the importance of functional GPIIb/IIIa receptors. In conclusion we consider FOR to be a useful method to study the elastic properties of the coagulum. Various factors such as the number of red blood cells and platelets as well as the fibrinogen concentration should be taken into consideration when evaluating the results. The ReoRox® 4 instrument had excellent measuring range and unusually small artefactual effects on clot elasticity induced by the instrument in comparison with published results on other instruments.

    Emneord
    Coagulation; clot retraction; elasticity; platelets; rheology
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-13164 (URN)10.1080/09537100600759238 (DOI)
    Tilgjengelig fra: 2008-04-14 Laget: 2008-04-14 Sist oppdatert: 2020-01-23
    2. Free oscillation rheometry detects changes in clot properties in pregnancy and thrombocytopaenia
    Åpne denne publikasjonen i ny fane eller vindu >>Free oscillation rheometry detects changes in clot properties in pregnancy and thrombocytopaenia
    Vise andre…
    2008 (engelsk)Inngår i: Platelets, ISSN 0953-7104, Vol. 19, nr 5, s. 373-378Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Improved methods are needed to identify patients at risk for thrombotic or bleeding events. Free oscillation rheometry (FOR) is a technique that offers information on coagulation, based on contributions of all blood components, by measurement of clotting time and changes in clot elasticity. This is the first study that evaluates FOR parameters in subjects likely to represent hypercoagulability (pregnant women) and hypocoagulability (thrombocytopenic patients). Clotting time and blood clot elasticity were measured by FOR in blood samples obtained from women in different pregnancy trimesters (n = 58), in thrombocytopenic patients before and after a platelet transfusion (n = 20) and in healthy blood donors (n = 60). The clotting time was shorter and the clot elasticity higher in pregnant women compared to the non-pregnant female blood donors. The elasticity was higher in late pregnancy compared to early pregnancy. Compared to the blood donors, the thrombocytopenic patients had lower elasticity, which was increased by a platelet transfusion, but there was no difference in clotting time. The results suggest that FOR can provide new information on the haemostatic status of patients at risk of thrombotic or bleeding events as well as information on the haemostatic effect of a platelet transfusion.

    Emneord
    Clot elasticity, clot retraction, coagulation, platelets
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-13165 (URN)10.1080/09537100802082264 (DOI)
    Tilgjengelig fra: 2008-04-14 Laget: 2008-04-14 Sist oppdatert: 2020-01-23
    3. The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods
    Åpne denne publikasjonen i ny fane eller vindu >>The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods
    Vise andre…
    2008 (engelsk)Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 48, nr 4, s. 715-722Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: The quality of PLT concentrates (PCs) can be evaluated using various in vitro methods. A new technique, free oscillation rheometry (FOR), can be used to monitor coagulation properties of PCs and gives information on clotting time and coagulum elasticity. This study compared the quality of apheresis PCs produced by COBE Spectra and Trima Accel during storage for 7 days using in vitro tests including FOR.

    Study design and methods: Apheresis PCs were collected with the COBE Spectra (n=10) and Trima Accel (n=10) cell separators. Swirling, blood gases and metabolic parameters were analyzed on day 0. Samples taken on day 1, 5 and 7 were also analyzed for hypotonic shock response (HSR), P-selectin and GPIb expression and evaluation of coagulation by FOR.

    Results: Swirling, HSR and percent GPIb expressing PLTs were well maintained for 7 days whereas glucose decreased and lactate increased significantly during storage for both Spectra and Trima PCs. Percent P-selectin expressing cells increased to the same extent in both types of PCs during storage. pH increased between day 0 and 1 but then decreased. The clotting time remained constant throughout the storage period whereas the development of elasticity was reduced on day 5 and 7 compared to day 1 (p<0.05) for both types of PCs.

    Conclusion: The results indicate that the PLT quality after storage for 7 days is well preserved although activation of PLTs occurs during storage as assessed by in vitro tests. No difference in platelet quality was observed between Spectra and Trima produced PCs.

    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-12533 (URN)10.1111/j.1537-2995.2007.01610.x (DOI)
    Merknad
    The definitive version is available at www.blackwell-synergy.com: Nahreen Tynngård, Tomas L. Lindahl, Marie Trinks, Monika Studer and Gösta Berlin, The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods, 2008, Transfusion, (48), 4, 715-722. Copyright: Blackwell Publishing www.blackwell-synergy.comTilgjengelig fra: 2008-09-08 Laget: 2008-09-12 Sist oppdatert: 2017-12-08bibliografisk kontrollert
    4. The effect of gamma irradiation on the quality of apheresis platelets during storage for 7 days
    Åpne denne publikasjonen i ny fane eller vindu >>The effect of gamma irradiation on the quality of apheresis platelets during storage for 7 days
    Vise andre…
    2008 (engelsk)Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Transfusion, Vol. 48, nr 8, s. 1669-1675Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background:This study compares the quality of gamma-irradiated versus nonirradiated platelet (PLT) concentrates (PCs) during storage for 7 days as assessed by various in vitro methods. A new technique, free oscillation rheometry (FOR), which measures clotting time and coagulum elasticity, was also used to evaluate the PLT function.

    Study design and methods: Single-donor PLTs were collected by apheresis technique (n = 20). The PLTs from each donor were divided into two PCs, one gamma-irradiated with 25 Gy and the other used as a nonirradiated control. Blood gases, metabolic variables, and swirling were analyzed from Day 0. Samples taken on Days 1, 5, and 7 were also analyzed for hypotonic shock response (HSR), P-selectin, and glycoprotein (GP)Ib expression by flow cytometry and coagulation by FOR.

    Results: Swirling, HSR, and the percentage of GPIb-expressing cells were well maintained for 7 days of storage. pH was always within accepted range (6.4-7.4). Glucose decreased and lactate increased during the storage period (p < 0.05). P-selectin expression increased during storage (p < 0.05). The FOR clotting time remained constant, whereas the build-up of elasticity was slower after storage (p < 0.05). No difference was found between irradiated and nonirradiated PCs.

    Conclusion: The results indicate a well-preserved quality of gamma-irradiated apheresis PLTs during storage for 7 days as assessed by in vitro methods, with no difference compared to nonirradiated PLTs.

    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-13167 (URN)10.1111/j.1537-2995.2008.01746.x (DOI)
    Tilgjengelig fra: 2008-04-14 Laget: 2008-04-14 Sist oppdatert: 2017-12-13
    5. Effects of intercept pathogen inactivation on platelet function as analysed by free oscillation rheometry
    Åpne denne publikasjonen i ny fane eller vindu >>Effects of intercept pathogen inactivation on platelet function as analysed by free oscillation rheometry
    Vise andre…
    2008 (engelsk)Inngår i: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 38, nr 1, s. 85-88Artikkel i tidsskrift (Fagfellevurdert) Published
    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.

    Emneord
    Apheresis, Pathogen inactivation, Platelet concentrates, Platelet function
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-13168 (URN)10.1016/j.transci.2007.12.012 (DOI)
    Tilgjengelig fra: 2008-04-14 Laget: 2008-04-14 Sist oppdatert: 2017-12-13
    Fulltekst (pdf)
    FULLTEXT01
    Download (pdf)
    COVER01
    Download (pdf)
    POPULARSUMMARY01
  • 12.
    Tynngård, Nahreen
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Preparation, storage and quality control of platelet concentrates.2009Inngår i: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 41, nr 2, s. 97-104Artikkel, forskningsoversikt (Fagfellevurdert)
    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.

  • 13.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfussionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Johansson, Britt-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Lindahl, Tomas L
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Hansson, Mona
    Karolinska University Hospital and Karolinska Institute.
    Effects of intercept pathogen inactivation on platelet function as analysed by free oscillation rheometry2008Inngår i: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 38, nr 1, s. 85-88Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 14.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfussionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lindahl, Tomas L
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Ramström, Sofia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfussionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Effects of different blood components on clot retraction analysed by measuring elasticity with a free oscillating rheometer2006Inngår i: Platelets, ISSN 0953-7104, Vol. 17, nr 8, s. 545-554Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Free oscillation rheometry (FOR) using the ReoRox® 4 instrument makes it possible, at bedside, to study the coagulation process in blood over time and gives information on clotting time and coagulum elastic properties. In order to find out how various factors influence the FOR analysis we studied the coagulation process and change of elasticity over time in non-anticoagulated and citrated blood samples, plasma samples with various platelet concentrations (0-200 109/l) and blood samples with various haematocrit (0-40%). Blood samples supplemented with fibrinogen were analysed to elucidate the importance of fibrinogen on elasticity. The importance of the GPIIb/IIIa receptor on platelets was investigated by comparing the elasticity development in blood samples in presence and absence of a GPIIb/IIIa receptor inhibitor, abciximab. Anticoagulation with citrate did not have major influence on the viscoelastic properties of the coagulum. Increasing number of platelets and increasing fibrinogen concentration resulted in higher elasticity while increasing haematocrit gave lower elasticity. Blood samples with GPIIb/IIIa receptor inhibitor had very low elasticity indicating the importance of functional GPIIb/IIIa receptors. In conclusion we consider FOR to be a useful method to study the elastic properties of the coagulum. Various factors such as the number of red blood cells and platelets as well as the fibrinogen concentration should be taken into consideration when evaluating the results. The ReoRox® 4 instrument had excellent measuring range and unusually small artefactual effects on clot elasticity induced by the instrument in comparison with published results on other instruments.

  • 15.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lindahl, Tomas L
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Ramström, Sofia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Räf, Tuulia
    Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk kemi.
    Rugarn, Olof
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Free oscillation rheometry detects changes in clot properties in pregnancy and thrombocytopaenia2008Inngår i: Platelets, ISSN 0953-7104, Vol. 19, nr 5, s. 373-378Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Improved methods are needed to identify patients at risk for thrombotic or bleeding events. Free oscillation rheometry (FOR) is a technique that offers information on coagulation, based on contributions of all blood components, by measurement of clotting time and changes in clot elasticity. This is the first study that evaluates FOR parameters in subjects likely to represent hypercoagulability (pregnant women) and hypocoagulability (thrombocytopenic patients). Clotting time and blood clot elasticity were measured by FOR in blood samples obtained from women in different pregnancy trimesters (n = 58), in thrombocytopenic patients before and after a platelet transfusion (n = 20) and in healthy blood donors (n = 60). The clotting time was shorter and the clot elasticity higher in pregnant women compared to the non-pregnant female blood donors. The elasticity was higher in late pregnancy compared to early pregnancy. Compared to the blood donors, the thrombocytopenic patients had lower elasticity, which was increased by a platelet transfusion, but there was no difference in clotting time. The results suggest that FOR can provide new information on the haemostatic status of patients at risk of thrombotic or bleeding events as well as information on the haemostatic effect of a platelet transfusion.

  • 16.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfussionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Lindahl, Tomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Trinks, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Studer, Monika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    The quality of platelet concentrates produced by COBE Spectra and Trima Accel during storage for 7 days as assessed by in vitro methods2008Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 48, nr 4, s. 715-722Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The quality of PLT concentrates (PCs) can be evaluated using various in vitro methods. A new technique, free oscillation rheometry (FOR), can be used to monitor coagulation properties of PCs and gives information on clotting time and coagulum elasticity. This study compared the quality of apheresis PCs produced by COBE Spectra and Trima Accel during storage for 7 days using in vitro tests including FOR.

    Study design and methods: Apheresis PCs were collected with the COBE Spectra (n=10) and Trima Accel (n=10) cell separators. Swirling, blood gases and metabolic parameters were analyzed on day 0. Samples taken on day 1, 5 and 7 were also analyzed for hypotonic shock response (HSR), P-selectin and GPIb expression and evaluation of coagulation by FOR.

    Results: Swirling, HSR and percent GPIb expressing PLTs were well maintained for 7 days whereas glucose decreased and lactate increased significantly during storage for both Spectra and Trima PCs. Percent P-selectin expressing cells increased to the same extent in both types of PCs during storage. pH increased between day 0 and 1 but then decreased. The clotting time remained constant throughout the storage period whereas the development of elasticity was reduced on day 5 and 7 compared to day 1 (p<0.05) for both types of PCs.

    Conclusion: The results indicate that the PLT quality after storage for 7 days is well preserved although activation of PLTs occurs during storage as assessed by in vitro tests. No difference in platelet quality was observed between Spectra and Trima produced PCs.

    Fulltekst (pdf)
    FULLTEXT01
  • 17.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfussionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Studer, Monika
    Lindahl, Tomas L
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Trinks, Marie
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    The effect of gamma irradiation on the quality of apheresis platelets during storage for 7 days2008Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Transfusion, Vol. 48, nr 8, s. 1669-1675Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:This study compares the quality of gamma-irradiated versus nonirradiated platelet (PLT) concentrates (PCs) during storage for 7 days as assessed by various in vitro methods. A new technique, free oscillation rheometry (FOR), which measures clotting time and coagulum elasticity, was also used to evaluate the PLT function.

    Study design and methods: Single-donor PLTs were collected by apheresis technique (n = 20). The PLTs from each donor were divided into two PCs, one gamma-irradiated with 25 Gy and the other used as a nonirradiated control. Blood gases, metabolic variables, and swirling were analyzed from Day 0. Samples taken on Days 1, 5, and 7 were also analyzed for hypotonic shock response (HSR), P-selectin, and glycoprotein (GP)Ib expression by flow cytometry and coagulation by FOR.

    Results: Swirling, HSR, and the percentage of GPIb-expressing cells were well maintained for 7 days of storage. pH was always within accepted range (6.4-7.4). Glucose decreased and lactate increased during the storage period (p < 0.05). P-selectin expression increased during storage (p < 0.05). The FOR clotting time remained constant, whereas the build-up of elasticity was slower after storage (p < 0.05). No difference was found between irradiated and nonirradiated PCs.

    Conclusion: The results indicate a well-preserved quality of gamma-irradiated apheresis PLTs during storage for 7 days as assessed by in vitro methods, with no difference compared to nonirradiated PLTs.

  • 18.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Trinks, M.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    In vitro quality of platelets during prolonged storage after washing with three platelet additive solutions2012Inngår i: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 102, nr 1, s. 32-39Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Objectives Patients with anaphylactic transfusion reactions require washed platelet concentrates (PCs) for subsequent platelet (PLT) transfusions. New PLT additive solutions (PASs) contain substances that might be beneficial for the preservation of PLT function during storage. This study compares the quality of PLTs washed and stored with T-Sol, Composol or SSP+. Study Design and Methods Fifteen buffy coats were pooled and divided into three parts. PCs with 30% plasma and 70% PAS (T-Sol, Composol or SSP+) were prepared. Washing was performed on day 5 of storage. Ten PCs were prepared and washed with each PAS. In vitro variables including haemostatic function (clotting time and clot retraction) were analysed on day 5 before, directly after and up to 2days after washing. Results Swirling was well preserved, and pH was within acceptable limits (6·4-7·4) during storage for all PASs. The PLT number was reduced by washing for all PASs, and T-Sol PCs had a further decrease during storage. PLTs in T-Sol were spontaneously more activated and had lower capacity to respond to an agonist than Composol or SSP+ PLTs. The haemostatic function was only slightly changed by washing and during postwashing storage. Conclusion PLTs washed with T-Sol, Composol or SSP+ had good in vitro quality for two days after washing despite absence of glucose. PLTs in T-Sol were more affected by the washing procedure and subsequent storage than Composol or SSP+ PLTs as judged by higher spontaneous activation. © 2011 The Author(s). Vox Sanguinis © 2011 International Society of Blood Transfusion.

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    fulltext
  • 19.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Trinks, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gosta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Platelet quality after washing: the effect of storage time before washing2010Inngår i: TRANSFUSION, ISSN 0041-1132, Vol. 50, nr 12, s. 2745-2752Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Patients who have experienced anaphylactic transfusion reactions receive washed platelet (PLT) concentrates (PCs) where the plasma has been substituted with a PLT additive solution. This study compares the in vitro quality of PCs washed at the beginning of the storage period (Day 1) to PCs washed at the end of storage (Day 7). STUDY DESIGN AND METHODS: PLTs were prepared by the buffy coat procedure. Two concentrates were pooled and then split to obtain an identical pair of PCs. One of the PCs was washed with T-Sol on Day 1 and the other on Day 7 of storage. Swirling, blood gases, and metabolic variables were analyzed before washing. Analyses of surface expression of CD62P and coagulation by free oscillation rheometry (FOR) were performed before and after washing. RESULTS: pH was acceptable in all PCs. Washing on Days 1 and 7 increased the CD62P surface expression. The FOR variables clotting time and clot retraction were not influenced by washing on either day. Washing resulted in a decrease in the number of PLTs and the decrease was larger on Day 7 compared to Day 1. CONCLUSIONS: PLTs washed on Days 1 and 7 of storage are effected by washing in a similar manner. However, a larger loss of PLTs occurred during washing on Day 7.

  • 20.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Trinks, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gosta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    QUALITY OF PLATELETS IN CONCENTRATES DURING STORAGE IN THREE ADDITIVE SOLUTIONS: T-SOL, COMPOSOL AND SSP in VOX SANGUINIS, vol 99, issue , pp 214-2142010Inngår i: VOX SANGUINIS, Blackwell Publishing Ltd , 2010, Vol. 99, s. 214-214Konferansepaper (Fagfellevurdert)
    Abstract [en]

    n/a

  • 21.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Trinks, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gosta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    THE INFLUENCE OF DIFFERENT PLATELET ADDITIVE SOLUTIONS ON THE QUALITY OF PLATELETS AFTER WASHING in VOX SANGUINIS, vol 99, issue , pp 214-2142010Inngår i: VOX SANGUINIS, Blackwell Publishing Ltd , 2010, Vol. 99, s. 214-214Konferansepaper (Fagfellevurdert)
    Abstract [en]

    n/a

  • 22.
    Tynngård, Nahreen
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Trinks, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Berlin, Gösta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    In vitro properties of platelets stored in three different additive solutions2012Inngår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 52, nr 5, s. 1003-1009Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: New platelet (PLT) additive solutions (PASs) contain compounds that might improve the storage conditions for PLTs. This study compares the in vitro function, including hemostatic properties (clot formation and elasticity), of PLTs in T-Sol, Composol, or SSP+ during storage for 5 days. STUDY DESIGN AND METHODS: Fifteen buffy coats were pooled and divided into three parts. PLT concentrates (PCs) with 30% plasma and 70% PAS (T-Sol, Composol, or SSP+) were prepared (n = 10). Swirling, PLT count, blood gases, metabolic variables, PLT activation markers, and coagulation by free oscillation rheometry (FOR) were analyzed on Days 1 and 5. RESULTS: Swirling was well preserved and pH acceptable (6.4-7.4) during storage for all PASs. Storage of PLTs in T-Sol led to a decrease in PLT count whereas the number of PLTs was unchanged in Composol or SSP+ PCs. PLTs in T-Sol showed higher glucose metabolism than PLTs in Composol or in SSP+. At the end of storage PLTs in T-Sol had higher spontaneous activation and lower ability to respond to an agonist than PLTs in Composol or SSP+. PLTs in all the PASs had a similar ability to promote clot formation and clot elasticity. CONCLUSION: Storage of PLTs in Composol or in SSP+ improved the quality of PCs in terms of better maintained PLT count, lower glucose metabolism, lower spontaneous activation, and improved response to a PLT agonist compared to PLTs in T-Sol. PLTs stored in the various PASs had similar hemostatic properties. These findings make Composol and SSP+ interesting alternatives as PASs.

  • 23.
    Waldenstrom, Jesper
    et al.
    University of Gothenburg, Sweden .
    Konar, Jan
    Sahlgrens University Hospital, Sweden .
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Norder, Helene
    University of Gothenburg, Sweden .
    Lagging, Martin
    University of Gothenburg, Sweden .
    Neonatal transfusion-transmitted hepatitis C virus infection following a pre-seroconversion window-phase donation in Sweden2013Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 10, s. 796-799Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A 9-day-old child developed a transfusion-transmitted hepatitis C virus (HCV) infection following a pre-seroconversion window-phase donation. Retrospective analysis of donor plasma revealed detectable HCV core antigen (154 fmol/l), as well as HCV RNA (87,000 IU/ml). Of 5.24 million Swedish plasma samples from December 1998 to September 2012, 5 additional window-phase donations were identified.

  • 24.
    Winstedt, Dag
    et al.
    Lund University, Sweden.
    Tynngård, Nahreen
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Olanders, Knut
    Lund University, Sweden.
    Schott, Ulf
    Lund University, Sweden.
    Free oscillation rheometry monitoring of haemodilution and hypothermia and correction with fibrinogen and factor XIII concentrates2013Inngår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, E-ISSN 1757-7241, Vol. 21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Haemodilution and hypothermia induce coagulopathy separately, but their combined effect on coagulation has not been widely studied. Fibrinogen concentrate can correct dilutional coagulopathy and has an additional effect when combined with factor XIII concentrate. However, their effect on dilutional coagulopathy concomitant with hypothermia has not been studied previously. Free oscillation rheometry – FOR (Reorox®) – is a novel viscoelastic haemostatic assay that has not been studied in this context before.

    Methods

    Blood from 10 healthy volunteers was diluted by 33% with hydroxyethyl starch or Ringer’s acetate solutions. Effects of fibrinogen added in vitro with and without factor XIII were studied at 33°C and 37°C. Coagulation velocity (coagulation time) and clot strength (elasticity) were assessed with FOR. Coagulation was initiated in vitro with thromboplastin alone, or thromboplastin plus a platelet inhibitor.

    Results

    Hydroxyethyl starch increased the coagulation time and decreased clot strength significantly more than Ringer’s acetate solution, both in the presence and absence of a platelet inhibitor. There was a significant interaction between haemodilution with hydroxyethyl starch and hypothermia, resulting in increased coagulation time. After addition of fibrinogen, coagulation time shortened and elasticity increased, with the exception of fibrinogen-dependent clot strength (i.e., elasticity in the presence of a platelet inhibitor) after hydroxyethyl starch haemodilution. Factor XIII had an additional effect with fibrinogen on fibrinogen-dependent clot strength in blood diluted with Ringer’s acetate solution. Hypothermia did not influence any of the coagulation factor effects.

    Conclusions

    Both haemodilution and mild hypothermia impaired coagulation. Coagulopathy was more pronounced after haemodilution with hydroxyethyl starch than with Ringer’s acetate. Addition of fibrinogen with factor XIII was unable to reverse hydroxyethyl starch induced clot instability, but improved coagulation in blood diluted with Ringer’s acetate solution. Fibrinogen improved coagulation irrespective of hypothermia.

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