Bone marrow response to large volume blood collection in the horse

Abstract Background and study aims Endoscopic ultrasound (EUS) has been used for portal vein sampling in patients with pancreaticobiliary cancers for enumerating circulating tumor cells but is not yet a standard procedure. Further evaluation is needed to refine the methodology. Therefore, we evaluated the feasibility and safety of 19-gauge (19G) versus a 22-gauge (22 G) EUS fine-needle aspiration needles for portal vein sampling in a swine model. Methods Celiotomy was performed on two farm pigs. Portal vein sampling occurred transhepatically. We compared 19 G and 22 G needles coated interiorly with saline, heparin or ethylenediaminetetraacetic acid (EDTA). Small- (10 mL) and large- (25 mL) volume blood collections were evaluated. Two different collection methods were tested: direct-to-vial and suction syringe. A bleeding risk trial for saline-coated 19 G and 22 G needles was performed by puncturing the portal vein 20 times. Persistent bleeding after 3 minutes was considered significant. Results All small-volume collection trials were successful except for 22 G saline-coated needles with direct-to-vial method. All large-volume collection trials were successful when using suction syringe; direct-to-vial method for both 19 G and 22 G needles were unsuccessful. Collection times were shorter for 19 G vs. 22 G needles for both small and large-volume collections (P < 0.05). Collection times for saline-coated 22 G needles were longer compared to heparin/EDTA-coated (P < 0.05). Bleeding occurred in 10 % punctures with 19 G needles compared to 0 % with 22 G needles. Conclusion The results of this animal study demonstrate the feasibility and the safety of using 22 G needles for portal vein sampling and can form the basis for a pilot study in patients.

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Risk scores to facilitate preoperative prediction of transfusion and large volume blood transfusion associated with adult cardiac surgery †

British Journal of Anaesthesia ◽

10.1093/bja/aeu483 ◽

2015 ◽

Vol 114 (5) ◽

pp. 757-766 ◽

Cited By ~ 39

Author(s):

R. Goudie ◽

J.A.C. Sterne ◽

V. Verheyden ◽

M. Bhabra ◽

M. Ranucci ◽

...

Keyword(s):

Cardiac Surgery ◽

Blood Transfusion ◽

Large Volume ◽

Risk Scores ◽

Preoperative Prediction ◽

Volume Blood ◽

Adult Cardiac Surgery

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Predictive factors for peripheral-blood progenitor-cell collections using a single large-volume leukapheresis after cyclophosphamide and granulocyte-macrophage colony-stimulating factor mobilization.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.3.705 ◽

1995 ◽

Vol 13 (3) ◽

pp. 705-714 ◽

Cited By ~ 63

Author(s):

J L Passos-Coelho ◽

H G Braine ◽

J M Davis ◽

A M Huelskamp ◽

K G Schepers ◽

...

Keyword(s):

Bone Marrow ◽

Large Volume ◽

Peripheral Blood ◽

High Dose ◽

Colony Stimulating Factor ◽

Cell Content ◽

Cd34 Cells ◽

Macrophage Colony Stimulating Factor ◽

Macrophage Colony ◽

Stimulating Factor

PURPOSE (1) To study the ability of mobilized peripheral-blood progenitor cells (PBPC) collected in a single large-volume leukapheresis performed on a predetermined date to accelerate engraftment after high-dose cyclophosphamide and thiotepa; (2) to establish the minimum dose of PBPC associated with early engraftment; and (3) to identify parameters predictive of collection of large numbers of PBPC. PATIENTS AND METHODS Twenty-three patients with breast cancer received cyclophosphamide (4 g/m2) and granulocyte-macrophage colony-stimulating factor ([GM-CSF] 5 micrograms/kg/d x 15 days) for PBPC mobilization. A single leukapheresis was performed 15 days after cyclophosphamide administration. Then, patients received high-dose cyclophosphamide and thiotepa followed by reinfusion of PBPC and 4-hydroperoxycyclophosphamide (4HC)-purged bone marrow. PBPC concentration was measured in serial peripheral-blood samples and in the leukapheresis product. Correlation analysis between PBPC dose and engraftment and between leukapheresis yield and patient characteristics was attempted. RESULTS A single leukapheresis processed a median 36 L (range, 24 to 46) blood and collected 5 x 10(6) CD34+ cells/kg (< 0.3 to 24) and 6.2 x 10(5) colony-forming units granulocyte-macrophage (CFU-GM)/kg (< 0.001 to 29). All sixteen patients (70%) reinfused with > or = 2.9 x 10(6) CD34+ cells/kg reached a level of greater than 1,000 leukocytes/microL by day 13 and greater than 50,000 platelets/microL by day 15. All of these patients had a percentage of peripheral-blood CD34+ cells > or = 0.5%, and all but one, a level of greater than 100,000 platelets/microL, on the day of leukapheresis. The bone marrow CD34+ cell percentage at study entry predicted the number of CD34+ cells collected after PBPC mobilization (R2 = .42, P = .002). All patients with > or = 2.5% bone marrow CD34+ cells experienced early engraftment. CONCLUSION Reinfusion of PBPC collected in a single leukapheresis accelerates engraftment in the majority of patients. Pretreatment bone marrow CD34+ cell content determines PBPC mobilization capacity and may help select hematopoietic rescue strategies.

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Risk Scores to Facilitate Preoperative Prediction of Transfusion and Large Volume Blood Transfusion Associated With Adult Cardiac Surgery

Survey of Anesthesiology ◽

10.1097/01.sa.0000480664.54971.53 ◽

2016 ◽

Vol 60 (2) ◽

pp. 45-46

Author(s):

R. Goudie ◽

J. A. C. Sterne ◽

V. Verheyden ◽

M. Bhabra ◽

M. Ranucci ◽

...

Keyword(s):

Cardiac Surgery ◽

Blood Transfusion ◽

Large Volume ◽

Risk Scores ◽

Preoperative Prediction ◽

Volume Blood ◽

Adult Cardiac Surgery

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Outcomes of autologous blood collection prior to bone marrow harvest for matched unrelated donors.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18535 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18535-e18535

Author(s):

Brian Hemendra Ramnaraign ◽

Brittany Kayla Rogers ◽

Susan P. McGorray ◽

Michele Sugrue ◽

Hemant S. Murthy ◽

...

Keyword(s):

Bone Marrow ◽

Blood Transfusion ◽

Autologous Blood ◽

Blood Collection ◽

Common Procedure ◽

Post Harvest ◽

Patient Request ◽

Unrelated Donors ◽

And Gender ◽

Bone Marrow Harvesting

e18535 Background: Autologous (auto) blood collection prior to bone marrow (BM) harvest is a common procedure however there is little data to say whether this is beneficial. Methods: This is a retrospective study evaluating the efficacy of pre-op auto blood collection in healthy unrelated donors who underwent BM harvesting at our institution between 9/2009 and 8/2017. Unrelated donors aged 18 or older who underwent their first BM harvest were included. Comparisons were made using two sample t-tests. Results: Among the 73 BM donors, 54 (74%) underwent auto blood collection resulting in 78 units collected. The cohorts with and without auto blood collected were similar in age and gender (mean age 31.0 vs 30.2; female 59% vs 41%). Those with auto blood collected donated larger volumes of marrow (mean 1395 mL vs 799 mL, p = 0.0002). Baseline hemoglobin (Hb) was similar between the cohorts (mean 14.1 g/dL vs 14.0 g/dL, p = 0.87). However, those with auto blood collected had lower pre-harvest (mean 13.1 g/dL vs 13.8 g/dL, p = 0.0430) and post-harvest Hb (mean 10.0 g/dL vs 11.3 g/dL, p = 0.0120). Of the 78 auto blood units collected, 45 units (58%) were used with 92% of women and 56% of men receiving their auto blood post-op. 33 (42%) auto blood units were discarded. Donors who were given back their auto blood were more likely to be female and have lower pre- and post-harvest Hb. Reasons for auto blood transfusion were blood availability (31%), donor post-op symptoms (i.e. hypotension, dizziness, syncope, and bleeding; 23%), intra-operative transient hypotension (26%), post-op anemia (11%) and patient request (9%). None of the patients who were transfused auto blood, or donors without auto blood collection, required allogeneic blood. Conclusions: Based on our results, collection of auto blood prior to bone marrow harvest leads to lower pre-op Hb and increases the likelihood of post-op blood transfusion. In addition, availability of auto blood can lead to over transfusion which may be detrimental to donor health. Although there may be a subset of donors who might benefit, routine auto blood collection prior to bone marrow harvesting is unnecessary and can be potentially hazardous to donors.

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A method for large volume blood sampling and transfusion in rats

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1986.250.3.e331 ◽

1986 ◽

Vol 250 (3) ◽

pp. E331-E337

Author(s):

H. R. Berthoud ◽

W. B. Laughton ◽

T. L. Powley

Keyword(s):

Large Volume ◽

Whole Blood ◽

Superior Vena ◽

Vena Cava ◽

Blood Sampling ◽

Indwelling Catheters ◽

Multiple Channel ◽

Glucose Levels ◽

Include Blood Pressure ◽

Volume Blood

A new protocol that makes it feasible to withdraw large volumes of whole blood from an individual rat within 1 h or less is described. This method involves the use of indwelling catheters for withdrawal of blood from the inferior vena cava with concurrent isovolemic replacement of whole blood into the superior vena cava. Simultaneity of the transfusion and withdrawal, strict equality of volumes, and a smooth exchange of blood are assured by the use of separate channels of the same multiple-channel peristaltic pump for withdrawal and replacement. Validation experiments using both anesthetized and unanesthetized rats indicate that several responses remain essentially undisturbed during large volume blood sampling; these parameters include blood pressure, heart rate, hematocrit, plasma hormones including insulin and glucagon, plasma glucose levels, and feeding behavior. Considerations of technical and physiological limitations of the protocol, including choice of catheters and catheter placement, pump, sampling parameters, and obtaining donor blood, are discussed.

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