Through the aid of a questionnaire, a group of prospective donors, donors and ex-donors was studied. The most important incentive to become a donor was the direct approach by another donor. The most important motives were altruistic in nature and the medical check-up which is a part of donation. The complaints and objections of donors related to the medical check-up, the distance traveled to the site of the medical examination and blood collection and the rather impersonal way donors were treated. The most important reasons why ex-donors had stopped giving blood referred to medical complaints, practical inconveniences, physical reactions to the giving of blood, the impersonal approach and the fear of detrimental side-effects of the giving of blood. The Dutch system, whereby no financial remuneration is offered for the donation of blood, appears to function satisfactorily. The survey justifies future research aimed to a greater degree on the connection between the motives of the donor and the way the blood bank functions.
HTLV-I and -II infection is rare among Dutch blood donors. HTLV screening will prevent few cases of HTLV-related disease, but it will prevent a further spread of the virus by transfusion. In a low-risk population, conservative guidelines for WB interpretation unnecessarily generate an excess of false-positive results.
Summary: A controlled clinical trial was carried out to test the effectiveness of a comparatively low dose of anti-D immunoglobulin (250 pg) in preventing rhesus immunization.In the control group 17 out of 329 women (5%) formed rhesus antibodies, whereas in the treated group only 3 out of 333 women (0.9%) showed active immunization, all three of whom had an exceptionally large transplacental bleeding.
The possibility of protecting women against rhesus immunization by the administration of anti-D immunoglobulin shortly after delivery has lately received considerable attention. The combined results of several recent clinical trials with this form of treatment have been summarized by Clarke (1967): of 628 women who received prophylactic treatment only one developed rhesus antibodies, whereas 75 cases of immunization were found among 599 women in the control group.It has been shown that rhesus immunization is generally caused by small amounts (less than 1 ml.) of foetal blood that enter the maternal circulation during labour. Rarely, however, very large foeto-maternal haemorrhages occur, and it is important to know if anti-D immunoglobulin prophylaxis is also effective in these cases. Only one case has been described in which a woman with a large transplacental haemorrhage was treated, and in that instance no immunization occurred.While conducting a clinical trial on the effect of anti-D immunoglobulin prophylaxis in Holland we found two cases of massive foeto-maternal hacmorrhage, while two other cases were referred to us for investigation because the child was anaemic at birth. All four women were treated with anti-D immunoglobulin shortly after delivery. Despite this treatment, all four mothers developed rhesus antibodies. The purpose of this report is to discuss the possible reasons for the therapeutic failures and to consider the future management of similar cases.
Material and Methods
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