Treatment of refractoriness to platelet transfusion by protein A column therapy

Christie, Douglas J.; Howe, Robert B.; Lennon, Shari; Sauro, Shari C.

doi:10.1046/j.1537-2995.1993.33393174450.x

Cited by 53 publications

(18 citation statements)

References 47 publications

(3 reference statements)

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“…The results of these studies are not uniform. Lopez–Plaza et al [90]found no beneficial effect of PAIA while Christie et al [91]found improvement in responsiveness to platelet transfusions. Patients with aplastic anaemia with haemorrhagic diathesis and infection risks, however, are not ideal candidates for this approach.…”

Section: Therapeutic Approaches In Platelet Transfusion Refractorinessmentioning

confidence: 99%

Prevention and Management of Platelet Transfusion Refractoriness

Novotný¹

1999

Vox Sanguinis

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Platelet transfusion refractoriness is a major complication of long–term platelet supportive care. Refractoriness may lead to fatal bleeding complications in thrombocytopenic patients. Major factors involved are factors related to the clinical condition of the patient as well as HLA alloimmunisation. Non–alloimmune factors may occur in up to 80% of the patients. However, platelet transfusion outcome is impaired in only 50% of the patients having these conditions. HLA alloimmunisation has been convincingly reduced by the use of leucocyte–depleted transfusions. UV–B irradiation of platelet transfusions may be alternatively used to reduce HLA alloimmunisation. Despite these measures, patients with a history of pregnancy or non–leucocyte–depleted transfusions form HLA antibodies in a high proportion (up to 50%). HPA antibodies play a minor but relatively important role in patients with HLA antibodies. ABO antibodies may play a role in refractoriness, which can be abolished by transfusion of ABO–identical platelets. Screening for the presence of HLA and/or HPA antibodies is indicated in case of transfusion failure after ABO–identical or HLA–matched platelets. If no alloantibodies are detected, further analysis to define a role of drug– related or autoantibodies is required. In case of HLA and/or HPA alloimmunisation associated with refractoriness, matched platelet transfusions are indicated. In case of non–alloimmune factors associated with increased platelet consumption, increasing the transfusion frequency can be considered. Additional investigations are still necessary to define risk factors for secondary HLA alloimmunisation and refractoriness due to non–immune factors to further decrease the incidence of refractoriness.

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Section: Therapeutic Approaches In Platelet Transfusion Refractorinessmentioning

confidence: 99%

Prevention and Management of Platelet Transfusion Refractoriness

Novotný¹

1999

Vox Sanguinis

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“…1,2 Protein A immunoadsorption column composes of an activated carrier and protein A, which is bonding to the surface of the carrier. Agarose gel is the carrier of protein A immunoadsorption column and its activation reaction process in the stirred reactor is the key to achieve larger scale industrial production of blood purification materials.…”

Section: Introductionmentioning

confidence: 99%

Simulation of Solid–liquid Suspension and Scale-Up of Agarose Gel Activation Reactor

Zhou

Liu²,

Yu³

et al. 2016

J. Mech. Med. Biol.

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Agarose gel activation reaction, which is of great importance in preparing the carrier of the column packing material for blood purification, would be significantly influenced by the configuration and parameter of reactor. In order to optimize the structure design of the reactor and operating parameters of the process, the characteristics of suspension system composed of agarose gel, NaOH, water, 3-allyl bromide, and activated alumina were simulated numerically utilizing an Eulerian multiphase flow model and multi-reference frame (MRF) approach. The effect of impeller configuration was studied with three typical impellers, including Rushton disk turbine (DT), pitched blade downflow turbine (PBTD45), and pitched blade upflow turbine (PBTU45). The results showed that the optimum solid suspension was obtained using PBTD45 impeller with a diameter of 100 mm and critical suspension speed of 570 rpm in a 20 L stirred reactor. In addition, the critical suspension speeds using the three impellers were calculated § Corresponding author. and the errors were all within the engineering allowance. Finally, the feasibility of scaleup design for agarose gel activation reactor was preliminarily discussed. The results would be useful to the optimization and scale-up of relevant reactor design. NomenclatureB : Impeller width, mm C : Impeller off-bottom clearance, mm C D0 : Drag coefficient in still liquid C D : Drag coefficient in turbulent liquid d P : Particle diameter, m D : Impeller diameter, mm H : Liquid height, mm k : Turbulent kinetic energy, m 2 /s 2

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“…Nilsson et al have used protein A-linked agarose beads for removal of IgG from patients with chronic lymphocytic leukemia and autoimmune hemolytic anemia [11,12]. Recently, Chriestie et al have reported the treatment of refractoriness to platelet transfusion by protein A column therapy [13].…”

Section: Introductionmentioning

confidence: 99%

Protein A immobilization and HIgG adsorption onto porous/nonporous and swellable HEMA-incorporated polyEGDMA microspheres

Ayhan¹,

Kesenci̇²,

Pi̇şki̇n³

2000

Journal of Biomaterials Science, Polymer Edition

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Both non swellable and swellable poly(EGDMA/HEMA) microbeads were produced by suspension copolymerization. These microbeads were modified by immobilization of a spacer-arm (hexamethylene diamine (HMDA)) and protein A. The optimal values for modifications were as follows: sodium periodate concentration, 1.0 mgml(-1); HMDA concentration, 4 mgml(-1); and glutaraldehyde concentration, 0.070 microgml(-1). Adsorption of protein A onto the plain and periodate oxidized poly(EGDMA/HEMA) microbeads were very close to each other, and were 0.01-0.02 mg protein A on the 1-g Microbeads I and II, respectively. Protein A immobilization on poly(EGDMA/HEMA) microbeads were studied at different temperatures, times, and pHs using single protein solution containing different amounts of proteins. The optimal values for immobilization were as follows: the initial protein A concentration, 0.1 mgml(-1); temperature, 25 degrees C; pH, 9.5; and immobilization time, 120 min. Incorporation of protein A resulted in 1.420 and 1.825 mg protein A on the 1-g Microbeads I and II, respectively. HIgG adsorption capacity on the protein A-incorporated poly(EGDMA/HEMA) microbeads is 27 and 35 mg HIgGg(-1) polymer for Microbeads I and II, respectively.

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Treatment of refractoriness to platelet transfusion by protein A column therapy

Cited by 53 publications

References 47 publications

Prevention and Management of Platelet Transfusion Refractoriness

Prevention and Management of Platelet Transfusion Refractoriness

Simulation of Solid–liquid Suspension and Scale-Up of Agarose Gel Activation Reactor

Protein A immobilization and HIgG adsorption onto porous/nonporous and swellable HEMA-incorporated polyEGDMA microspheres

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