Markers for transfusion-transmitted disease in different groups of blood donors

Article Abstract:

An increasing number of people are arranging for autologous blood transfusions, in which individuals donate their own blood to be stored in case a transfusion is necessary. Another trend is that of directed donations, in which a patient chooses a friend or relative to donate blood. Both practices are intended to reduce the risk of contracting AIDS (acquired immunodeficiency syndrome) from donated blood. While autologous blood clearly exposes the patient to no new diseases, directed donations may not be as safe as expected. Friends and relatives may feel pressured to donate despite risk factors in their past; a survey showed that 22 percent of directed donors admitted they might change their responses to health questions in order to be allowed to donate. Blood stored for autologous or directed donation may not be needed for the intended patient, and health officials are concerned about how safe it is to use this blood for other recipients, a practice called crossing over. Twenty blood centers participated in a study to evaluate donated blood for hepatitis B and HIV-1 (human immunodeficiency virus type 1). While blood centers screen all blood for these diseases, the screening tests are less than 100 percent accurate. Results showed that both autologous and directed donations had a greater chance of transmitting hepatitis B than blood from general volunteer donors. Crossover use of this blood may detract from the overall safety of the blood supply. None of the 10,090 units from directed donors or the 3,094 units from autologous donations were positive for antibodies to HIV-1, but this number of samples is relatively small. Researchers could not fairly evaluate the relative risk for HIV antibodies in blood from different donor groups.

Evaluation, Medical examination, Disease transmission, Hepatitis B, Blood, AIDS (Disease), Blood donors, Blood donation, Blood tests

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As more surgeons opt for autologous transfusion route, what's ahead?

Article Abstract:

The trend is growing to use autologous blood (blood from the same person) as opposed to homologous blood (blood from another person) when transfusions are required. This was the topic of discussion during the annual meeting of the American College of Surgeons in Atlanta. Steven A. Gould, an associate professor of surgery at Michael Reese Hospital and Medical Center in Chicago, presented the results of a continuing program for autologous transfusions at his institution. The program utilized two basic methods; perioperative cell salvage (CS) and preoperative autologous donations (PAD). Cell salvage is a method employed during surgery in cases without infection or cancer, where blood is accumulated using a device called a "cell saver." The PAD method involves more planning and the availability of facilities for blood collection. Patients make their donations prior to surgery. Collection was performed as frequently as every three days, although once a week was more common. These individuals were monitored carefully for anemia and other problems. The results of the program were quite successful and the combination of these two techniques yielded optimal results in reducing the need for surgical-related homologous transfusions. Approximately 62 percent of the patients who participated in the CS program required homologous transfusions. However, only 18 percent of the patients who were involved in both programs of blood collection needed homologous blood transfusions. Other hospitals reported similar success in the use of autologous blood. It was concluded that continued improvement in this area will require careful planning. Methods to reduce the need for transfusions during surgery should also be pursued.

Research, Blood collection and preservation, Gould, Steven A.

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For better hip replacement results, surgeon's best friend may be a robot

Article Abstract:

Scientist at the University of California-Davis in collaboration with IBM have developed a robot that can assist surgeons in preparing the femur (thigh bone) during hip replacement surgery. Robodoc, produced by Integrated Surgical Systems in Sacramento, can drill a hole into the femur much more precisely than a surgeon, allowing a better fit between the bone and the implant. This could extend the life of the artificial hip joint. In experiments on cadaver bones, surgeons working without the robot created an opening 30% larger than needed; when the artificial hip was implanted, only 20% of the implant was in contact with bone and there were gaps up to 4 millimeters (mm) around the implant. When the surgeons used Robodoc, 96% of the implant was in contact with bone, and gaps were reduced to 0.05 mm. The procedure has been tested in dogs, and the first trial in humans is expected in 1992.

Methods, Usage, Artificial hip joints, Hip prostheses, Robotics

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