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Background: Mechanical devices have been used here as a bridging technology to support 26 patients prior to cardiac transplantation since 1992. Twenty-three patients utilized the Novacor left ventricular assist system (NLVAS) (Novacor Corporation, Oakland, CA). These patients are prone to several complications, notably bleeding, yet little information has been published regarding their transfusion requirements. We report amounts and types of blood/components required by these patients in refractory heart failure awaiting transplantation. Methods: The transfusion records of 23 men supported by NLVAS awaiting cardiac transplant were reviewed. Results: Those patients had a mean age of 41.8 years (21-62). The most frequent diagnoses were advanced coronary artery disease and dilated cardiomyopathy. Four patients expired prior to transplant. The 19 men who underwent cardiac transplantation had a mean time on the device of 92.2 days (11-116) compared with a mean time on device of 79.2 days (9-166) for all 23 men. All transplanted patients are alive with follow-up of less than 2 months to >9 years. RBCs were the component most frequently required. Conclusion: Total requirements of blood/components associated with NLVAS support was nearly double the amounts transfused during transplantation. Transfusion requirements during implantation of the device were less than during transplantation. [ABSTRACT FROM AUTHOR]

Examines the effectiveness of automated red cell exchanges in relieving priapism in patients with sickle cell anemia. Characterization of priapism; Association between priapism development and sickle cell anemia; Complications of priapism; Concept of red cell exchange process.

Background: Febrile reactions, a rise ³1 °C above normal/baseline temperature, in patients receiving transfusions are well known yet little studied. Some believe that removing white blood cells from all cellular components prevent these events and that febrile reactions are so deleterious to patients' health that they should be prevented regardless of the tremendous costs involved. Methods: The Indiana University Medical Center hospitals (1999) transfused about 50K RBCs and 50K platelets providing hemotherapy support for two level I trauma centers, 51 liver and 157 renal allografts, 228 marrow transplants, as well as a large full service pediatric hospital. Records of 2000, 1999, 1995, 1990, 1984 febrile reactions were reviewed to determine their occurrence in patients receiving nonleukoreduced and leukoreduced blood components. Results: 191 febrile reactions in 186 patients were reported and reviewed. 162 (∼85%) reactions were caused by RBCs, 25 (∼13%) by platelets, 2 (∼1%) by FFP. The vast major of these patients were on the Medicine service (Hematology/Oncology). Forty-eight patients (∼30%) experienced febrile reactions after receiving leukoreduced products, 33 from RBCs, 15 from platelets. Three patients experienced recurrent reactions, two receiving leukoreduced RBCs while another had 3 recurrent reactions, one to leukoreduced platelets, one to non leukoreduced platelets and one to non leukoreduced RBCs. Two patients experienced reactions after receiving FFP. All reactions were self limited and without serious morbidity. Two patients developed mild shaking chills. Conclusion: Leukoreduction did not prevent all febrile reactions. Most were caused by RBCs. Febrile reactions can rarely be caused by FFP. In our experience, febrile reactions do not pose a serious threat to patients' health. [ABSTRACT FROM AUTHOR]

Background: Sparse data are published regarding the amounts and types of intraoperative blood/components required during lung transplantation. Methods: The medical records of 165 patients undergoing lung transplantation from 1986 to 2000 were reviewed. Two patients required re-transplantation. Heart-lung transplant patients were excluded. Results: RBCs were the most frequent component transfused average 3 units(u), median 1 (range 0-44) followed by platelets: average 2 u, median 0 (range 0-60), cryoprecipitate: average 1, median 0 (range 0-30) and FFP: average 1 u, median 0 (range 0-27). Aprotinin was not given to most patients. No patients died during surgery. Conclusion: Intraoperative blood requirements for single-lung (s) transplantation are minimal. Double-lung (D) recipients require much moro (7,300%) intraoperative transfusion support than single-lung recipients perhaps because it is a more extensive and lengthy procedure. Some of these patients require cardiopulmonary bypass, which is well known to increase blood requirements. [ABSTRACT FROM AUTHOR]