An adventure in biotechnology: the development of haemophilia A therapeutics ‒ from whole-blood transfusion to recombinant DNA to gene therapy

2002 ◽  
Vol 35 (2) ◽  
pp. 141 ◽  
Author(s):  
Henry S. Kingdon ◽  
Roger L. Lundblad
Keyword(s):  
Gene Therapy ◽  
Blood Transfusion ◽  
Whole Blood ◽  
Recombinant Dna ◽  
Haemophilia A

scholarly journals Preemptive intravenous iron therapy versus autologous whole blood therapy for early postoperative hemoglobin level in patients undergoing bimaxillary orthognathic surgery: a prospective randomized noninferiority trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Whole Blood ◽  
Orthognathic Surgery ◽  
Hemoglobin Level ◽  
Iron Therapy ◽  
Iron Group ◽  
Autologous Whole Blood ◽  
Bimaxillary Orthognathic Surgery ◽  
Iv Iron

Abstract Background Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery. Methods This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was − 1 g/dL. Results Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group—whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = − 0.83 to 1.0). As the lower limit of the 95% CI (− 0.83) was higher than the prespecified noninferiority margin (δ = − 1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery. Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019. https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my.

THE EFFECT OF EARLY BLOOD TRANSFUSION ON THE OUTCOME OF GASTROINTESTINAL HAEMORRHAGE

1987 ◽  
Author(s):  
S D Blair ◽  
S B Javanvrin ◽  
C N McCollum ◽  
R M Greenhalgh
Keyword(s):  
Blood Transfusion ◽  
Blood Coagulation ◽  
Whole Blood ◽  
Randomised Trial ◽  
Gastrointestinal Haemorrhage ◽  
Clotting Time ◽  
Prospective Randomised Trial ◽  
Coagulation Tests ◽  
To Receive ◽  
Upper Gastrointestinal

It has been suggested that mortality due to upper gastrointestinal haemorrhage may be reduced by restricting blood transfusion [1], We have assessed whether this is due to an anticoagulant effect in a prospective randomised trial.One hundred patients with severe, acute gastrointestinal haemorrhage were randomised to receive either at least 2 units of blood during the first 24 hours of admission, or no blood unless their haemaglobin was lessthan 8g/dl or they were shocked. Minor bleeds and varices were excluded As hypercoagulation cannot be measured using conventional coagulation tests, fresh whole blood coagulation was measured by the Biobridge Impedance Clotting Time (ICT). Coagulation was assessed at 24 hour intervals and compared to age matched controls with the results expressed as mean ± sem.The ICT on admission for the transfusion group (n=50) was 3.2±0.2 mins compared to 10±0.2 mins in controls. This hyper-coagulable state was partially reversed to 6.4±0.3 mins at 24 hours (p<0.001). The 50 allocated to receive no blood had a similar ICT on admission of 4.4±0.4 mins but the hypercoagulable state was maintained with ICT at 24 hours of 4.320.4 mins. Only 2 patients not transfused rebled compared to 15 in the early transfusion group (p<0.001). Five patients died, and they were all in the early transfusion group.These findings show there is a hypercoagulable response to haemorrhage which is partially reversed by blood transfusion leading to rebleeding

scholarly journals Analysis of blood transfusion request and utilization pattern at teaching hospital in Eastern Nepal

2018 ◽  
Vol 8 (2) ◽  
pp. 1374-1377 ◽  
Author(s):  
Santosh Upadhyaya Kafle ◽  
Krishna Kumar Jha ◽  
Mrinalini Singh ◽  
Shilpi Shaukin
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Teaching Hospital ◽  
Whole Blood ◽  
Age Group ◽  
Utilization Pattern ◽  
Total Blood ◽  
Cross Sectional ◽  
Male And Female ◽  
Gynecology And Obstetrics

Background: Blood transfusion unit collection, storage and dispatching on Birat Medical College and Teaching Hospital began from 19 June 2016 via blood bank. After which, many blood distribution were made accessible via this service. This study analyzes the blood transfusion request and utilization pattern and also to monitor for managing the bloodstocks meeting present and future demand in hospital. Materials and Methods: This is descriptive cross-sectional study conducted for all the requests of whole blood dispatched from 19th June, 2016 to 04th July, 2018. Whole blood requisitions from various departments were reviewed regarding the number of requisition, total blood unit replaced, blood group and socio-demographic profile of patients.Results: Of 648 transfusion units dispatched, 131 and 324 patients were male and female respectively, B positive blood group were most common, followed by A positive, O positive, AB positive, A negative, O negative and AB negative respectively. The largest numbers of requisitions were from Gynecology and Obstetric department in the hospital of 258 requisitions followed by internal medicine, surgery department, postoperative ward and orthopaedic department. Majority of the requisitions were for 20-29 years age group from the local district Morang. The total blood units replaced were 75, of which 29 and 46 of male and female respectively. Conclusions: B Positive was the predominant requested blood group with Gynecology and Obstetrics department making the most requests, among 20-29 years age group from Morang district. The total replaced blood units were less in number with some requisition forms even lacked essential details.

scholarly journals Preemptive intravenous iron therapy versus autologous whole blood therapy for early postoperative hemoglobin level in patients undergoing bimaxillary orthognathic surgery: A prospective randomized noninferiority trial

2020 ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Whole Blood ◽  
Orthognathic Surgery ◽  
Hemoglobin Level ◽  
Iron Therapy ◽  
Iron Group ◽  
Autologous Whole Blood ◽  
Bimaxillary Orthognathic Surgery ◽  
Iv Iron

Abstract Background: Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery.Methods: This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was –1 g/dL. Results: Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group – whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = –0.83 to 1.0). As the lower limit of the 95% CI (–0.83) was higher than the prespecified noninferiority margin (δ = –1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion: As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery.Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my

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