A saline-adenine-glucose-phosphate-maltose (SAGP-maltose) quadruple-pack system was devised to improve the conventional method of preparing blood components. One of the features of this method is that high-speed centrifugation was used as the initial spin in the two-step centrifugation of whole blood. This feature permitted the removal of the buffy coat from red cells at the same time the platelets were isolated. Since the platelets were concentrated without forming a button, the damage to the platelets due to mechanical stress in preparation was minimized. Another major feature was the use of the SAGP-maltose solution. Maltose effectively prevented hemolysis during storage in a protein-poor medium for preserving red cells. Judging from the red cell adenosine triphosphate level and morphology score, it should be possible to store red cells for 35 to 42 days in SAGP-maltose preservative. In addition, approximately 25 percent more plasma was collected in the present system than in conventional multiple-pack systems.

Abstract-The influences of restraint stress on the functions of T cells, B cells and adherent cells in antibody responses were investigated. Antibody response against sheep red blood cells (SRBC), a T cell-dependent antigen, in cultured splenocytes from restrained mice was reduced to about 40-50% of that from the control mice. Addition of normal T cells to these cultures, however, restored the suppressed response.Moreover, helper T cell activities were lowered in restrained mice. On the other hand, suppressor T cell activities induced by both concanavalin A (Con A) and SRBC were significantly decreased in restrained mice. However, the antibody responses to T cell-independent antigens in stressed mice were approximately 40% higher than the control response. These enhancemant were also observed in T cell-depleted splenocytes. Polyclonal antibody response induced by lipopolysaccharide (LPS) was increased in stressed mice. Antigen presenting cell activities were little influenced by restraint stress. Proliferative response to Con A, but not that to LPS, was suppressed in splenocytes from restrained mice. These results suggest that both helper and suppressor activities of T cells are suppressed, but B cell activity is rather enhanced in splenocytes from restrained mice.

BACKGROUND Cross‐matched platelet (cross‐matched PLT) transfusion is effective for immune‐mediated platelet transfusion refractoriness (PTR), but is more costly and time‐consuming for physical cross‐match than using standard PLT units. Recent studies have reported the utility of human leucocyte antigens (HLA) virtual cross‐matched PLT (HLA‐matched PLT) that is defined as HLA‐A/B matched or no antibody against donor‐specific antigen. Here, we evaluated the effect of HLA‐matched PLTs for PTR in post hematopoietic stem cell transplant (HSCT) recipients. STUDY DESIGN AND METHODS Our study included a total of 241 PLTs in 16 patients who underwent HSCT at Okayama University Hospital between 2010 and 2017, receiving either HLA‐matched or cross‐matched PLTs. We calculated the 24‐hour corrected count increments (CCI‐24) to evaluate the effect of PLTs. A CCI‐24 ≥ 4500 was considered to be a successful transfusion. RESULTS We analyzed 139 cross‐matched PLTs and 102 HLA‐matched PLTs. In the immune‐mediated PTR, the rate of successful transfusion was 60.5% for cross‐matched PLT and 63.4% for HLA‐matched PLT (p = 0.825). On the other hand, the median CCI‐24 for cross‐matched PLT transfusions and HLA‐matched PLT transfusions were 1856 and 5824 (p < 0.001), with a success rate of 28.1 and 54.1% in cases with non‐immune‐mediated PTR, respectively (p = 0.001). CONCLUSION The effectiveness of HLA‐matched PLT is not inferior to cross‐matched PLT. This result indicates that physical cross‐match can be omitted in post HSCT PTR.

Prolonged storage of red blood cells in a liquid state was achieved by replacing the preservative using a sextuple-bag system. The bag system consists of one primary bag containing citrate-phosphate-dextrose (CPD) solution, three satellite bags containing saline-adenine-glucose-phosphate-maltose (SAGP-maltose) solution, and two empty satellite bags to remove plasma and buffy coat. Preservative can be exchanged three times in this closed system. The system is able to supply nutrients, such as glucose, and to remove harmful metabolites, such as lactic acid, by exchanging the preservative during storage. As a result, red cells stored by this method showed much higher levels of total adenylate and morphological score after the second preservative exchange, when compared with red cells stored by the conventional method (P < 0.01). Judging from these two in-vitro parameters, red cells may tolerate storage for at least 10 weeks in a liquid state. This method might be useful for 'predeposit autologous transfusion', as it is more convenient and more cost effective than the freeze-preservation method.

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