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Background: IgA deficient individuals are at risk to suffer anaphylactic transfusion reactions due to IgA antibodies. IgA deficiency itself has been reported to occur 1 in 340 blood donors (0.29%), the frequency of IgA antibodies amounts to 0.08%. The respective antibodies may occur spontaneously or arise after application of blood components containing plasma. Due to the fact that the application of heterologous blood components is considered as a relative contraindication in this setting we performed a tailored autologous blood donation program with an IgA deficient individual undergoing hemihepatectomy. Case Report: In a 43 year old male who underwent hemihepatectomy IgA deficiency was diagnosed: IgA was not detectable (limit of detection 50 mg/l) as were anti-PgA antibodies (latex agglutination test). The patient was subjected to 4 whole blood donations (including 1 leap frog procedure due to change of the operation schedule) and 3 apheresis procedures starting 62 days before surgery. The patient's autologous blood deposit comprised of 3 red blood cell concentrates (RBC), 15 units of fresh frozen plasma (FFP) and 1 apheresis platelet concentrate. On request, only one blood donation service had 12 FFPs from an IgA-deficient donor (IgA 70 mg/l with no IgA antibodies detectable) available. For the day of surgical intervention and 5 days thereafter, we daily prepared washed heterologous leukocyte-reduced RBCs in case of unexpected bleeding events. The autologous blood donation, the hemihepatectomy itself and the postoperative course were uneventful. In total, 2 FFPs and 1 RBC from the patient's autologous deposit were transfused postoperatively on day 2 and 3, respectively. The patient was discharged 12 days after surgery. Conclusions: In IgA deficient individuals IgA antibodies are associated with anaphylactic transfusion reactions. Thus, transfusion of heterologous blood components in IgA deficient individuals should be avoided whenever possible. From our experience, the supply with adequate amounts of IgA deficient components in Germany needs to be improved as IgA deficiency is not infrequent. [ABSTRACT FROM AUTHOR]

Background: The effect of gamma irradiation on leukocyte-reduced single-donor apheresis platelet concentrates (LRSDPs) was studied to assess product quality during shelf life. Applying novel separation devices with two different continuous-flow cell separators we performed a unique comparative study. Methods: In 13 donations 26 LRSDPs were prepared with the AMICUS (Baxter) and COMTEC (Fresenius) cell separator. One LRSDP of each donation was irradiated with 30 Gy. On the day of preparation (d 0) and during storage spontaneous and TRAP6 (thrombin receptor activating peptide 6) induced CD62p expression were measured by flow cytometry. Residual red cells were counted microscopically, leukocytes by flow cytometry. Statistical analysis was performed by Student's t-test. Two-tailed p < 0.05 was considered significant. Results: The expression of CD62p increased significantly during storage, while the response to TRAP6 did not change consistently. As expected irradiation did not affect platelet function. But the LRSDPs produced with the AMICUS (n= 14) exhibited a significantly higher spontaneous activation on day 0 and day 3 as compared to the concentrates prepared with the COMTEC (n= 12). Likewise platelets prepared with the AMICUS showed a weaker response to TRAP stimulation as compared to the COMTEC products. Residual erythrocytes were similar in both kinds of LRSDPs (<0.4x 10E9/unit). All units contained < 0.3x 10E6 leukocytes/unit while the AMICUS products had significantly lower counts than the COMTEC ones. Conclusions: We found a higher degree of platelet activation as assessed by a higher CD62p expression and a lower response to the thrombin analogue TRAP-6 in the LRSDPs prepared with the AMICUS cell separator as compared to those from the COMTEC machine. These findings did not correlate to residual leukocyte content, but is probably due to the fact that in the AMICUS the platelets harvested are stored within the centrifuge during the entire donation procedure in contrast to the COMTEC where the platelets are disposed into a storage bag outside the centrifuge. [ABSTRACT FROM AUTHOR]