Neonatal Hepatitis and Excessive Hepatic Iron Deposition Following Intrauterine Blood Transfusion

1995 ◽  
Vol 12 (01) ◽  
pp. 14-17 ◽  
Author(s):  
Michelle Lasker ◽  
Keith Eddleman ◽  
Ashfaq Toor
Keyword(s):  
Blood Transfusion ◽  
Iron Deposition ◽  
Neonatal Hepatitis ◽  
Hepatic Iron ◽  
Intrauterine Blood Transfusion

Management of Twin Anemia-Polycythemia Sequence Using Intrauterine Blood Transfusion for the Donor and Partial Exchange Transfusion for the Recipient

2013 ◽  
Vol 34 (2) ◽  
pp. 121-126 ◽  
Author(s):  
L. Genova ◽  
F. Slaghekke ◽  
F.J. Klumper ◽  
J.M. Middeldorp ◽  
S.J. Steggerda ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Exchange Transfusion ◽  
Intrauterine Blood Transfusion

Segmental Hepatic Iron Deposition due to Peripheral Portal Vein Tumor Thrombus

1991 ◽  
Vol 15 (6) ◽  
pp. 1042-1044 ◽  
Author(s):  
Yasuhiro Kawamori ◽  
Osamu Matsui ◽  
Kiyohide Kitagawa ◽  
Masumi Kadoya ◽  
Teruo Yamahana ◽  
...  
Keyword(s):  
Portal Vein ◽  
Tumor Thrombus ◽  
Iron Deposition ◽  
Portal Vein Tumor Thrombus ◽  
Hepatic Iron

scholarly journals Optimal blood transfusion therapy in haemoglobinopathies

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
John Porter
Keyword(s):  
Blood Transfusion ◽  
Exchange Transfusion ◽  
Standard Of Care ◽  
Venous Access ◽  
Iron Deposition ◽  
Iron Loading ◽  
Blood Products ◽  
Transfusion Therapy ◽  
Increased Risk ◽  
Thalassaemia Intermedia

For reasons of time, this short talk will be confined to the optimal frequency, timing, indications and dosing of blood transfusion. Blood transfusion protocols in thalassaemia syndromes are more widely agreed (1) than for sickle disorders but questions still remain about optimal Hb levels, timing and frequency. In transfusion thalassaemia thalassaemias (TDT) , the purpose of blood transfusion is to maximise quality of life by correcting anaemia and suppressing ineffective erythropoiesis, whilst minimising the complications of the transfusion itself. Under-transfusion will limit growth and physical activity while increasing intramedullary and extra-medullary erythroid expansion. Over transfusion may cause unnecessary iron loading and increased risk of extra-hepatic iron deposition however. Although guidelines imply a ‘one size fits all’ approach to transfusion, in reality this is not be the case. Indeed a flexible approach crafted to the patient’s individual requirements and to the local availability of safe blood products is needed for optimal outcomes. For example in HbEβ thalassaemias, the right shifted oxygen dissociation curve tends to lead to better oxygen delivery per gram of Hb than in β thalassaemia intermedia with high Hb F. Patients with Eβthal therefore tend to tolerate lower Hb values than β thalassaemia intermedia. Guidelines aim to balance the benefits of oxygenation and suppression of extra-medullary expansion with those of excessive iron accumulation from overtransfusion. In an Italian TDT population, this balance was optimised with pre-transfusion values of 9.5-10.5g/dl (2). However this may not be universally optimal because of different levels of endogenous erythropoiesis with different genotypes in different populations. Recent work by our group (3) suggests that patients with higher levels of endogenous erythropoiesis, marked by higher levels of soluble transferrin receptors, at significantly lower risk of cardiac iron deposition than in those where endogenous erythropoiesis is less active, as would be the case in transfusion regimes achieving higher levels of pre-transfusion Hb. In sickle cell disorders, the variability in the phenotype between patients and also within a single patient at any given time means that the need for transfusion also varies. A consideration in sickle disorders, not usually applicable to thalassaemia syndromes, is that of exchange transfusion versus simple top up transfusion. Exchanges have the advantages of lower iron loading rates and more rapid lowering of HbS%. Disadvantages of exchange transfusion are of increased exposure to blood products with inherent increased risk of allo-immunisation or infection, requirement for better venous access for adequate blood flow, and requirements for team of operators capable of performing either manual or automated apheresis, often at short notice. Some indications for transfusion in sickle disorders are backed up by randomised controlled data, such as for primary and secondary stroke prevention, or prophylaxis of sickle related complications for high-risk operations (4). Others are widely practiced as standard of care without randomised data, such as treatment of acute sickle chest syndrome. Other indications for transfusion, not backed up by randomised studies, but still widely practiced in selected cases, include the management of pregnancy, leg ulceration or priapism and repeaed vaso-occlusive crises. Allo-immunisation is more common in sickle patients than in thalassaemia disorders and hyper-haemolysis is a rare but growing serious problem in sickle disorders. It is arguable that increased use of transfusion early in life, is indicated to decrease silent stroke rates and that early exposure to blood will decease red cell allo-immunisation rates.

scholarly journals Hepatic Iron Deposition in Humans

Blood ◽  
1967 ◽  
Vol 30 (4) ◽  
pp. 417-424 ◽  
Author(s):  
R. A. FAWWAZ ◽  
H. S. WINCHELL ◽  
M. POLLYCOVE ◽  
T. SARGENT
Keyword(s):  
Intestinal Tract ◽  
Binding Capacity ◽  
Large Fraction ◽  
Iron Deposition ◽  
Hepatic Iron ◽  
Iron Binding ◽  
Iron Binding Capacity

Abstract In patients with spontaneous chronic low plasma latent iron-binding capacity, a large fraction of the intestinally absorbed iron is deposited in the liver without prior appearance in the systemic plasma. Such hepatic iron is not released to any large extent during the subsequent 2 weeks. Our results are consistent with the hypothesis that iron absorbed from the intestinal tract is not initially bound to transferrin. When the plasma latent iron-binding capacity is normal, iron binds to transferrin prior to reaching the liver; when the plasma latent iron-binding capacity is low, a portion of the iron reaches the liver either unbound or abnormally bound to transferrin, resulting in its immediate hepatic deposition.

scholarly journals Comparison of Computerized Image Analysis with Traditional Semiquantitative Scoring of Perls’ Prussian Blue Stained Hepatic Iron Deposition

2013 ◽  
Vol 41 (7) ◽  
pp. 992-1000 ◽  
Author(s):  
A. Peter Hall ◽  
Wendy Davies ◽  
Katie Stamp ◽  
Isabel Clamp ◽  
Alison Bigley
Keyword(s):  
Image Analysis ◽  
Prussian Blue ◽  
Iron Deposition ◽  
Hepatic Iron ◽  
Computerized Image Analysis

scholarly journals Value of Abdominal Susceptibility-Weighted Magnetic Resonance Imaging for Quantitative Assessment of Hepatic Iron Deposition in Patients with Chronic Hepatitis B: Comparison with Serum Iron Markers

2012 ◽  
Vol 40 (3) ◽  
pp. 1005-1015 ◽  
Author(s):  
W Lv ◽  
F Yan ◽  
M Zeng ◽  
J Zhang ◽  
Y Yuan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Chronic Hepatitis ◽  
Magnetic Resonance ◽  
Serum Iron ◽  
Hbv Infection ◽  
Iron Deposition ◽  
Hepatic Iron ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging

OBJECTIVE: To assess hepatic iron deposition quantitatively in patients with chronic hepatitis B (HBV) infection, using abdominal susceptibility-weighted magnetic resonance imaging (SWI). METHODS: Patients with HBV infection and healthy controls underwent abdominal SWI and were assessed for serum iron markers. Phase values were measured and five grades of hepatic iron deposition were described by SWI. RESULTS: Patients with HBV infection ( n = 327) and healthy controls ( n = 50) were prospectively enrolled. In total, 77 (25.4%) patients with HBV infection had hepatic iron deposition as determined by SWI. Phase values were significantly different between patients with hepatic iron deposition compared with patients without hepatic iron deposition or controls, and were significantly different across different grades of hepatic iron deposition. Serum iron, ferritin, transferrin and transferrin saturation were significantly higher in patients with, versus those without, hepatic iron deposition. Only serum ferritin was significantly different across different grades of hepatic iron deposition, and there was a low inverse correlation between serum ferritin and phase values. CONCLUSIONS: Compared with serum iron markers, abdominal SWI may represent a powerful tool to assess hepatic iron deposition quantitatively in patients with chronic HBV infection.

Hepatic Iron Deposition in Patients With Liver Disease: Preliminary Experience With Breath-Hold Multiecho T2*-Weighted Sequence

2009 ◽  
Vol 193 (5) ◽  
pp. 1261-1267 ◽  
Author(s):  
Hersh Chandarana ◽  
Ruth P. Lim ◽  
Jens H. Jensen ◽  
Cristina H. Hajdu ◽  
Mariela Losada ◽  
...  
Keyword(s):  
Liver Disease ◽  
Iron Deposition ◽  
Breath Hold ◽  
Hepatic Iron ◽  
Weighted Sequence
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