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Research paper thumbnail of The use of malaria antibody tests in the prevention of transfusion-transmitted malaria

Vox Sanguinis, 2010

The International Forum of Vox Sanguinis is meant to obtain information concerning important and ... more The International Forum of Vox Sanguinis is meant to obtain information concerning important and ⁄ or controversial subjects of transfusion medicine. Transfusiontransmitted malaria is severe and often fatal. The measures taken to prevent it in non-endemic areas have been successful, although cases still occur occasionally. However, the number of immigrants from and travellers to endemic areas has increased considerably and is still increasing. Furthermore, new tests have been developed to detect plasmodium antibodies and are used for selected group of donors in various blood centres. Also, tests to detect plasmodium antigens and nucleic acid amplification testing (NAT) for parasite DNA have been developed. It seemed therefore of interest to evaluate the preventive measures taken at present in non-endemic areas. To obtain the relevant information, the following questions were sent to transfusion services.

Research paper thumbnail of Thrombin-inducible platelet adhesion and regulation of the platelet seven-transmembrane thrombin receptor-1 (PAR-1): Effects of unfractionated heparin and lepirudin

Platelets, 2009

Heparin may induce platelet activation and even heparin-induced thrombocytopenia. Lepirudin has b... more Heparin may induce platelet activation and even heparin-induced thrombocytopenia. Lepirudin has been approved for HIT treatment. We speculated that lepirudin inhibits platelet function under high shear and the platelet thrombin receptor PAR-1 better than heparin. Thrombin-inducible platelet adherence under high shear conditions and the expression of PAR-1 were studied after samples from healthy donors were exposed in vitro to increasing concentrations of unfractionated heparin or lepirudin. Compared to baseline and to lepirudin, heparin induced platelet P-selectin expression (p = 0.04). Platelet adherence increased slightly in the presence of lepirudin, but not heparin (p = 0.04). Thrombin-inducible platelet aggregate formation and consecutive adherence under high shear conditions was inhibited by both anticoagulants (p = 0.004). Further, heparin and lepirudin inhibited thrombin-inducible cleavage and internalization of PAR-1 at a dosage of 1.0 U/ml and 1.6 microg/ml, respectively (p = 0.004). Thus, heparin and lepirudin inhibit thrombin-inducible platelet activation in vitro to a similar extent.

Research paper thumbnail of Calcium-channel blockers decrease clopidogrel-mediated platelet inhibition

Heart, 2010

http://heart.bmj.com/content/96/3/186.full.html Updated information and services can be found at:

Research paper thumbnail of Neonatal allo-immune thrombocytopenia due to fetomaternal HPA-1 incompatibility of a homozygous HPA-1a mother and a homozygous HPA-1b father

European Journal of Pediatrics, 1994

We report a case of neonatal allo-immune thrombocytopenia due to fetomaternal human platelet anti... more We report a case of neonatal allo-immune thrombocytopenia due to fetomaternal human platelet antigen (HPA)-1 incompatibility. Anit-HPA-1b antibodies were detectable in maternal serum. Repeated treatment of the infant with high-dose IgG effectively raised platelet counts transiently, but the patient remained thrombocytopenic for more than 6 weeks. Serological and DNA analysis revealed that the mother was homozygous HPA-1a and the father homozygous HPA-1b.

Research paper thumbnail of High Concentrations of Soluble P-Selectin Are Associated with Risk of Venous Thromboembolism and the P-Selectin Thr715 Variant

Clinical Chemistry, 2007

Methods: This study was a case-control study of 116 patients with confirmed recurrent VTE and at ... more Methods: This study was a case-control study of 116 patients with confirmed recurrent VTE and at least 1 event of unprovoked deep venous thrombosis or pulmonary embolism, and 129 age-and sex-matched healthy individuals. We measured sP-selectin by ELISA and P-selectin gene (SELP) variation by genotyping and sampled blood after a mean interval of 2.55 years after the most recent VTE event. Results: The mean (SD) sP-selectin concentration was higher in patients than in controls: 47.3 (15.0) g/L vs 36.8 (11.0) g/L, P <0.001. The unadjusted odds ratio (OR) for sP-selectin >55.1 g/L, representing the 95th percentile for controls, was 8.5 (95% CI, 3.7-23.3; P <0.001) and increased after adjustment for factor V Leiden, the prothrombin G20210A variant, increased factor VIII, and hyperhomocysteinemia (OR, 10.6; 95% CI, 4.1-31.2; P <0.001). Pro715 carriers were more prevalent among controls than patients (21.7% vs 14.7%). sP-selectin concentrations were lower in this subgroup than in noncarriers: 31.3 (7.9) g/L vs 44.1 (14.1) g/L; P <0.001). Conclusions: Increased sP-selectin concentrations are associated with VTE and genotype status. sP-selectin concentrations are lower in individuals carrying the P-selectin Pro715 variant than in those without this variant.

Research paper thumbnail of High-dose intravenous immunoglobulin for post-transfusion purpura

British Journal of Haematology, 1985

Five patients with post-transfusion purpura (four due to Zw(a), one presumably due to HLA antibod... more Five patients with post-transfusion purpura (four due to Zw(a), one presumably due to HLA antibodies) were treated with intravenous immunoglobulin (IgG) at doses of 0.4 g per kg body weight. IgG therapy was immediately effective as indicated by cessation of bleeding and rise of platelet counts in four out of five cases.

Research paper thumbnail of Research and development

Research paper thumbnail of Prophylactic platelet transfusions

Research paper thumbnail of The use of malaria antibody tests in the prevention of transfusion-transmitted malaria

Vox Sanguinis, 2010

The International Forum of Vox Sanguinis is meant to obtain information concerning important and ... more The International Forum of Vox Sanguinis is meant to obtain information concerning important and ⁄ or controversial subjects of transfusion medicine. Transfusiontransmitted malaria is severe and often fatal. The measures taken to prevent it in non-endemic areas have been successful, although cases still occur occasionally. However, the number of immigrants from and travellers to endemic areas has increased considerably and is still increasing. Furthermore, new tests have been developed to detect plasmodium antibodies and are used for selected group of donors in various blood centres. Also, tests to detect plasmodium antigens and nucleic acid amplification testing (NAT) for parasite DNA have been developed. It seemed therefore of interest to evaluate the preventive measures taken at present in non-endemic areas. To obtain the relevant information, the following questions were sent to transfusion services.

Research paper thumbnail of Thrombin-inducible platelet adhesion and regulation of the platelet seven-transmembrane thrombin receptor-1 (PAR-1): Effects of unfractionated heparin and lepirudin

Platelets, 2009

Heparin may induce platelet activation and even heparin-induced thrombocytopenia. Lepirudin has b... more Heparin may induce platelet activation and even heparin-induced thrombocytopenia. Lepirudin has been approved for HIT treatment. We speculated that lepirudin inhibits platelet function under high shear and the platelet thrombin receptor PAR-1 better than heparin. Thrombin-inducible platelet adherence under high shear conditions and the expression of PAR-1 were studied after samples from healthy donors were exposed in vitro to increasing concentrations of unfractionated heparin or lepirudin. Compared to baseline and to lepirudin, heparin induced platelet P-selectin expression (p = 0.04). Platelet adherence increased slightly in the presence of lepirudin, but not heparin (p = 0.04). Thrombin-inducible platelet aggregate formation and consecutive adherence under high shear conditions was inhibited by both anticoagulants (p = 0.004). Further, heparin and lepirudin inhibited thrombin-inducible cleavage and internalization of PAR-1 at a dosage of 1.0 U/ml and 1.6 microg/ml, respectively (p = 0.004). Thus, heparin and lepirudin inhibit thrombin-inducible platelet activation in vitro to a similar extent.

Research paper thumbnail of Calcium-channel blockers decrease clopidogrel-mediated platelet inhibition

Heart, 2010

http://heart.bmj.com/content/96/3/186.full.html Updated information and services can be found at:

Research paper thumbnail of Neonatal allo-immune thrombocytopenia due to fetomaternal HPA-1 incompatibility of a homozygous HPA-1a mother and a homozygous HPA-1b father

European Journal of Pediatrics, 1994

We report a case of neonatal allo-immune thrombocytopenia due to fetomaternal human platelet anti... more We report a case of neonatal allo-immune thrombocytopenia due to fetomaternal human platelet antigen (HPA)-1 incompatibility. Anit-HPA-1b antibodies were detectable in maternal serum. Repeated treatment of the infant with high-dose IgG effectively raised platelet counts transiently, but the patient remained thrombocytopenic for more than 6 weeks. Serological and DNA analysis revealed that the mother was homozygous HPA-1a and the father homozygous HPA-1b.

Research paper thumbnail of High Concentrations of Soluble P-Selectin Are Associated with Risk of Venous Thromboembolism and the P-Selectin Thr715 Variant

Clinical Chemistry, 2007

Methods: This study was a case-control study of 116 patients with confirmed recurrent VTE and at ... more Methods: This study was a case-control study of 116 patients with confirmed recurrent VTE and at least 1 event of unprovoked deep venous thrombosis or pulmonary embolism, and 129 age-and sex-matched healthy individuals. We measured sP-selectin by ELISA and P-selectin gene (SELP) variation by genotyping and sampled blood after a mean interval of 2.55 years after the most recent VTE event. Results: The mean (SD) sP-selectin concentration was higher in patients than in controls: 47.3 (15.0) g/L vs 36.8 (11.0) g/L, P <0.001. The unadjusted odds ratio (OR) for sP-selectin >55.1 g/L, representing the 95th percentile for controls, was 8.5 (95% CI, 3.7-23.3; P <0.001) and increased after adjustment for factor V Leiden, the prothrombin G20210A variant, increased factor VIII, and hyperhomocysteinemia (OR, 10.6; 95% CI, 4.1-31.2; P <0.001). Pro715 carriers were more prevalent among controls than patients (21.7% vs 14.7%). sP-selectin concentrations were lower in this subgroup than in noncarriers: 31.3 (7.9) g/L vs 44.1 (14.1) g/L; P <0.001). Conclusions: Increased sP-selectin concentrations are associated with VTE and genotype status. sP-selectin concentrations are lower in individuals carrying the P-selectin Pro715 variant than in those without this variant.

Research paper thumbnail of High-dose intravenous immunoglobulin for post-transfusion purpura

British Journal of Haematology, 1985

Five patients with post-transfusion purpura (four due to Zw(a), one presumably due to HLA antibod... more Five patients with post-transfusion purpura (four due to Zw(a), one presumably due to HLA antibodies) were treated with intravenous immunoglobulin (IgG) at doses of 0.4 g per kg body weight. IgG therapy was immediately effective as indicated by cessation of bleeding and rise of platelet counts in four out of five cases.

Research paper thumbnail of Research and development

Research paper thumbnail of Prophylactic platelet transfusions

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