Hemodilution – An Overview of Current Canadian Practices

Cell and Tissue Banking - Tập 2 - Trang 41-44 - 2001
Chris Rose1, Jim Mohr2, Michael Gross3, Spencer Lee4
1Regional Tissue Bank, QEII Health Sciences Centre, Halifax, Canada
2Transplantation Services, QEII Health Sciences Centre, Halifax, Canada
3Department of Surgery, QEII Health Sciences Centre, Halifax, Canada
4Department of Immunology, QEII Health Sciences Centre, Halifax, Canada

Tóm tắt

Background. Transplant teams evaluate potential organ and tissue donors to exclude donation of tissues at risk for disease transmission. Standards dictate that serological tests be performed on every donor to assess the presence of transmissible diseases including: Human Immunodeficiency Virus 1 & 2, Human T Lymphotropic Virus 1 & 2, Hepatitis C, Hepatitis B surface Antigen, Hepatitis B core Antibody and Syphilis. A limitation of serological testing is the risk of false negative results due to the dilution of the serum. Hemodilution results from the transfusion of fluids (blood products, colloids and/or crystalloid). Confidence in the accuracy and sensitivity of donor serology testing is of utmost importance to ensure the provision of safe organs and tissues for transplantation. Methods. In order to determine the preferred and validated methodology for determining hemodilution, if any; and to determine the level of hemodilution that jeopardizes serologic test results, we reviewed the literature and current testing practices. Tissue banks throughout Canada as well as accrediting bodies were contacted regarding the hemodilution algorithm they utilize. Results. In the absence of a pretransfusion sample, hemodilution calculations are the prevalent methodology for assessing sensitivity of serology testing. A literature search and personal communications provided no documentation on the validation of any hemodilution algorithm or evidence that 50% hemodilution is an acceptable level for accurate serology testing. Conclusion. A validation of hemodilution algorithms and the acceptable or unacceptable rate of hemodilution is required. The utilization of a validated algorithm should be mandated in standards to ensure continuity of practice by all transplantation centres. If validation cannot be obtained, alternative methodologies for serology testing should be investigated.

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Tài liệu tham khảo

Abbott Diagnostics (1994a) Antibody to HepatitisBSurface Antigen (Goat): Conjugate (Mouse Monoclonal Coated Microparticles). Abbott Laboratories. 66-2197/R2. Ontario, Canada. Test Kit Insert

Abbott Diagnostics (1995) Hepatitis C Virus Encoded Antigen. Abbott Laboratories. 82-8810/R2. Ontario, Canada. Test Kit Insert

Abbott Diagnostics (1994b) Human T-Lymphotropic Virus Types I and II. Abbott Laboratories. 66-0450/R7. Ontario, Canada. Test Kit Insert

American Association of Tissue Banks (1998) Standards for Tissue Banking. McLean, Virginia

American Association of Tissue Banks (1997) Information Alert. McLean, Virginia Vol VII(4)

Becton Dickinson (1995) Passive latex agglutination test for detection of antibodies to CMV. Becton Dickinson Microbiology Systems. MD USA. Test Kit Insert

Bureau of Biologics and Radiopharmaceuticals Drugs Directorate (1996) Draft Canadian Standards on Safety of Tissue for Transplantation. Ottawa, Ontario, Canada

Canadian Organ Replacement Register (1999 Report), Canadian Institute for Health Information, Ottawa, Ontario

Center for Disease Contol (1994) Guidelines for preventing transmission of Human Immunodeficiency Virus through transplantation of human tissue and organs. Morbidity and Mortality Weekly Report 43(RR-8): 1-18

Eastlund, Ted (2000) Hemodilution due to blood loss and transfusion and reliability of cadaver tissue donor infectious disease testing. Cell and Tissue Banking 1(2): 121-127

Eye Bank Association of America (1999) Procedures Manual. Washington, D.C.

Harmening D (1991) Clinical Hematology and Fundamentals of Homeostasis. pp. 54-63. FA Davis Company. Philadelphia, PA

Koopman-van Gemert AWMM 1996) Hemodilution: what is right? Transplant Proceedings 28(5): 2934-2936

Lefrere JJ,Cantaloube JF,Defer C et al. (1999) Screening for HBV, HCVandHIVgenomes in blood conations: shortcomings of pooling revealed by multicenter study simulating real-time testing. J Virological Methods 80: 33-44

LeFor W,Shines D,McGonigle A et al. (1995) Hemoconcentration prior to serology testing in hemodiluted cadaver bone and tissue donors. Clinical Transplantation No 9: 297-300

Pulse Scientific Inc. (1995) RPR Screening Test for Syphilis. Pulse Scientific Inc. Ontario Canada. Test Kit Insert

Roche (1996) Amplicor HIV-1 Monitor Test. Roche Diagnostic Systems Inc. Ontario, Canada. Test Kit Insert

Stiene-Martin A,Lotspeich-Steininger CA andKoepke JA (1998) Clinical Hematology, 2nd edition. pp 107-112. Lippincott-Raven Publishers, Philadelphia, PA

Williams W,Beutler E,Erslev A,Lichtman M (1983) Hematology, 3rd edition. McGraw-Hill, New York, NY

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Cell and Tissue Banking

Tập 2

41-44

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