Manish Gandhi - Academia.edu (original) (raw)

Papers by Manish Gandhi

Research paper thumbnail of WITHDRAWN: Prestorage leukoreduction does not increase hemolysis of stored red cell concentrates

Transfusion and Apheresis Science, 2006

The Publisher regrets that this article was an accidental duplication of an article that has alre... more The Publisher regrets that this article was an accidental duplication of an article that has already been published in Transfus Apher Sci, 36 (1) 17 - 22, doi:10.1016/j.transci.2006.09.007. The duplicate article has therefore been withdrawn.

Research paper thumbnail of Prestorage leukoreduction does not increase hemolysis of stored red cell concentrates

Transfusion and Apheresis Science, 2007

In December 2004, Pall Corporation initiated voluntary recall of certain filters used for leukocy... more In December 2004, Pall Corporation initiated voluntary recall of certain filters used for leukocyte-reduction of blood products. Although our center had not used the implicated lots, certain customers reported observing increased hemolysis in the red-cell units (RC) provided by us. The purpose of this study was to determine the level of hemolysis seen in RC produced by our center. In the first-phase, we evaluated 20 leukocyte-reduced (LR)-RC, those judged by one of our hospitals to have the highest degree of hemolysis (age: 10-30 days; average=16 days). Results were compared to ten randomly selected non-LR-RC (age: 10-19 days; average: 15 days). Samples obtained directly from the RC were tested for hemoglobin (Hb), hematocrit (Hct) and supernatant-Hb. Percent-hemolysis (% hemolysis) was calculated. In the second-phase, the above measurements were made on 70RCs. Ten RCs were studied before and after leukofilteration on day-2 after collection. Ten units each (LR & non-LR) were selected randomly from inventory at days: 15, 30 and 40 after collection (LR-units filtered within 48 h). In the first-phase LR-RCs exhibited an average 0.06% hemolysis vs. 0.02% for non-LR units. In the second-phase the average % hemolysis before and after filteration on day-2 (LR: 0.04% & non-LR: 0.04%) was similar. While on days: 15 (LR: 0.09%, non-LR: 0.05%) and 30 (LR: 0.16%, non-LR: 0.13%) % hemolysis was slightly more in LR as compared to non-LR. It was the opposite for day 40 (LR: 0.19%, non-LR: 0.31%). However, none of these differences were statistically significant. The % hemolysis increased as the age of the unit increased. There was no significant statistical difference between LR-RC and non-LR-RCs. This data did not confirm our hospitals' concerns regarding increased hemolysis following LR.

Research paper thumbnail of Donor derived malignancy following transplantation: a review

Cell and Tissue Banking, 2007

Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the re... more Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donor-related malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies.

Research paper thumbnail of 14-P: Association Between Donor Specific Antibody (DSA) Detected by Solid Phase Assay (SpA) and Flow Cytometric Crossmatch (FXM

Research paper thumbnail of 6OR A case of rejection in 10/10 allele matched transplant with “high titer low avidity” HLA-DP donor specific antibodies

Human Immunology, 2011

Aim: We present a case of graft rejection in 10/10 allele matched unrelated peripheral blood stem... more Aim: We present a case of graft rejection in 10/10 allele matched unrelated peripheral blood stem cell transplant(SCT) with donor specific antibody(DSA)to HLA-DP detected by solid phase assay(SpA).

Research paper thumbnail of The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis: A REVIEW OF PLASMA TRANSFUSION OUTCOMES

Transfusion, 2010

BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. ... more BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. We systematically reviewed the literature to summarize the available evidence regarding the benefits and harms of plasma transfusion in common clinical settings.STUDY DESIGN AND METHODS: We searched electronic databases from inception through August 2009. Eligible studies enrolled adult patients transfused with plasma and compared to a control group. Paired reviewers independently assessed studies for eligibility and extracted quality and outcome data.RESULTS: Thirty-seven studies met eligibility criteria, most of which were observational. In patients undergoing massive transfusion, plasma infusion at high plasma : red blood cell ratios was associated with a significant reduction in the risk of death (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.24-0.60) and multiorgan failure (OR, 0.40; 95% CI, 0.26-0.60). However, the quality of this evidence was very low due to significant unexplained heterogeneity and several other biases. In a single retrospective study, plasma transfusion was associated with reduced mortality in anticoagulated patients with intracranial hemorrhage (OR, 0.29; 95% CI, 0.09-0.98). In patients undergoing surgery without massive transfusion, plasma infusion was associated with a trend toward increased mortality (OR, 1.22; 95% CI, 0.73-2.03). Plasma transfusion was associated with increased risk of developing acute lung injury (OR, 2.92; 95% CI, 1.99-4.29).CONCLUSIONS: Very-low-quality evidence suggests that plasma infusion in the setting of massive transfusion for trauma patients may be associated with a reduction in the risk of death and multiorgan failure. A survival benefit was not demonstrated in most other transfusion populations.

Research paper thumbnail of 26-P Inter and intra laboratory concordance of HLA antibody results obtained by solid phase assay

Human Immunology, 2011

Aim: Even though the solid phase assay(SpA) to identify antibodies to HLA(HLA-Abs) is marketed as... more Aim: Even though the solid phase assay(SpA) to identify antibodies to HLA(HLA-Abs) is marketed as a qualitative test, it is increasingly used as a quantitative test. This is possible because the test results provide mean fluorescence intensity(MFI) which is found to correlate well with the strength of the antibody. The aim of this exercise was to study the laboratory to laboratory variability in performing the SpA using LABScreen Single Antigen Beads (One Lambda) on a Luminex platform.

Research paper thumbnail of 24-P Flow cytometric crossmatching comparing an automated cell washer and a tube method for washing and incubation

Human Immunology, 2011

Aim: Flow Cytometric Crossmatch Testing (FXM) in our laboratory is performed by cell washing and ... more Aim: Flow Cytometric Crossmatch Testing (FXM) in our laboratory is performed by cell washing and incubations in micro-centrifuge(MC) tubes. We investigated the possibility of transitioning to an automated cell(AC) washing system and hypothesised that automation would enhance efficiency and reproducibility of this test.

Research paper thumbnail of WITHDRAWN: Prestorage leukoreduction does not increase hemolysis of stored red cell concentrates

Transfusion and Apheresis Science, 2006

The Publisher regrets that this article was an accidental duplication of an article that has alre... more The Publisher regrets that this article was an accidental duplication of an article that has already been published in Transfus Apher Sci, 36 (1) 17 - 22, doi:10.1016/j.transci.2006.09.007. The duplicate article has therefore been withdrawn.

Research paper thumbnail of Prestorage leukoreduction does not increase hemolysis of stored red cell concentrates

Transfusion and Apheresis Science, 2007

In December 2004, Pall Corporation initiated voluntary recall of certain filters used for leukocy... more In December 2004, Pall Corporation initiated voluntary recall of certain filters used for leukocyte-reduction of blood products. Although our center had not used the implicated lots, certain customers reported observing increased hemolysis in the red-cell units (RC) provided by us. The purpose of this study was to determine the level of hemolysis seen in RC produced by our center. In the first-phase, we evaluated 20 leukocyte-reduced (LR)-RC, those judged by one of our hospitals to have the highest degree of hemolysis (age: 10-30 days; average=16 days). Results were compared to ten randomly selected non-LR-RC (age: 10-19 days; average: 15 days). Samples obtained directly from the RC were tested for hemoglobin (Hb), hematocrit (Hct) and supernatant-Hb. Percent-hemolysis (% hemolysis) was calculated. In the second-phase, the above measurements were made on 70RCs. Ten RCs were studied before and after leukofilteration on day-2 after collection. Ten units each (LR & non-LR) were selected randomly from inventory at days: 15, 30 and 40 after collection (LR-units filtered within 48 h). In the first-phase LR-RCs exhibited an average 0.06% hemolysis vs. 0.02% for non-LR units. In the second-phase the average % hemolysis before and after filteration on day-2 (LR: 0.04% & non-LR: 0.04%) was similar. While on days: 15 (LR: 0.09%, non-LR: 0.05%) and 30 (LR: 0.16%, non-LR: 0.13%) % hemolysis was slightly more in LR as compared to non-LR. It was the opposite for day 40 (LR: 0.19%, non-LR: 0.31%). However, none of these differences were statistically significant. The % hemolysis increased as the age of the unit increased. There was no significant statistical difference between LR-RC and non-LR-RCs. This data did not confirm our hospitals' concerns regarding increased hemolysis following LR.

Research paper thumbnail of Donor derived malignancy following transplantation: a review

Cell and Tissue Banking, 2007

Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the re... more Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donor-related malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies.

Research paper thumbnail of 14-P: Association Between Donor Specific Antibody (DSA) Detected by Solid Phase Assay (SpA) and Flow Cytometric Crossmatch (FXM

Research paper thumbnail of 6OR A case of rejection in 10/10 allele matched transplant with “high titer low avidity” HLA-DP donor specific antibodies

Human Immunology, 2011

Aim: We present a case of graft rejection in 10/10 allele matched unrelated peripheral blood stem... more Aim: We present a case of graft rejection in 10/10 allele matched unrelated peripheral blood stem cell transplant(SCT) with donor specific antibody(DSA)to HLA-DP detected by solid phase assay(SpA).

Research paper thumbnail of The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis: A REVIEW OF PLASMA TRANSFUSION OUTCOMES

Transfusion, 2010

BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. ... more BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. We systematically reviewed the literature to summarize the available evidence regarding the benefits and harms of plasma transfusion in common clinical settings.STUDY DESIGN AND METHODS: We searched electronic databases from inception through August 2009. Eligible studies enrolled adult patients transfused with plasma and compared to a control group. Paired reviewers independently assessed studies for eligibility and extracted quality and outcome data.RESULTS: Thirty-seven studies met eligibility criteria, most of which were observational. In patients undergoing massive transfusion, plasma infusion at high plasma : red blood cell ratios was associated with a significant reduction in the risk of death (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.24-0.60) and multiorgan failure (OR, 0.40; 95% CI, 0.26-0.60). However, the quality of this evidence was very low due to significant unexplained heterogeneity and several other biases. In a single retrospective study, plasma transfusion was associated with reduced mortality in anticoagulated patients with intracranial hemorrhage (OR, 0.29; 95% CI, 0.09-0.98). In patients undergoing surgery without massive transfusion, plasma infusion was associated with a trend toward increased mortality (OR, 1.22; 95% CI, 0.73-2.03). Plasma transfusion was associated with increased risk of developing acute lung injury (OR, 2.92; 95% CI, 1.99-4.29).CONCLUSIONS: Very-low-quality evidence suggests that plasma infusion in the setting of massive transfusion for trauma patients may be associated with a reduction in the risk of death and multiorgan failure. A survival benefit was not demonstrated in most other transfusion populations.

Research paper thumbnail of 26-P Inter and intra laboratory concordance of HLA antibody results obtained by solid phase assay

Human Immunology, 2011

Aim: Even though the solid phase assay(SpA) to identify antibodies to HLA(HLA-Abs) is marketed as... more Aim: Even though the solid phase assay(SpA) to identify antibodies to HLA(HLA-Abs) is marketed as a qualitative test, it is increasingly used as a quantitative test. This is possible because the test results provide mean fluorescence intensity(MFI) which is found to correlate well with the strength of the antibody. The aim of this exercise was to study the laboratory to laboratory variability in performing the SpA using LABScreen Single Antigen Beads (One Lambda) on a Luminex platform.

Research paper thumbnail of 24-P Flow cytometric crossmatching comparing an automated cell washer and a tube method for washing and incubation

Human Immunology, 2011

Aim: Flow Cytometric Crossmatch Testing (FXM) in our laboratory is performed by cell washing and ... more Aim: Flow Cytometric Crossmatch Testing (FXM) in our laboratory is performed by cell washing and incubations in micro-centrifuge(MC) tubes. We investigated the possibility of transitioning to an automated cell(AC) washing system and hypothesised that automation would enhance efficiency and reproducibility of this test.