A case of extravascular hemolysis with Tk‐activation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108281/1/ccr380.pd

ABO‐associated antibody‐mediated rejection following A2B‐to‐B renal transplantation and successful treatment with therapeutic plasma exchange

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149287/1/trf15201_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149287/2/trf15201.pd

A case of cryocrystalglobulinemia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133638/1/trf13528_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133638/2/trf13528.pd

Performance and safety of femoral central venous catheters in pediatric autologous peripheral blood stem cell collection

IntroductionAutologous peripheral blood hematopoietic progenitor cell collection (A‐HPCC) in children typically requires placement of a central venous catheter (CVC) for venous access. There is scant published data regarding the performance and safety of femoral CVCs in pediatric A‐HPCC.MethodsSeven‐year, retrospective study of A‐HPCC in pediatric patients collected between 2009 and January 2017. Inclusion criteria were an age ≤ 21 years and A‐HPCC using a femoral CVC for venous access. Femoral CVC performance was examined by CD34 collection rate, inlet rate, collection efficiency (MNC‐FE, CD34‐FE), bleeding, flow‐related adverse events (AE), CVC removal, and product sterility testing. Statistical analysis and graphing were performed with commercial software.ResultsA total of 75/119 (63%) pediatric patients (median age 3 years) met study criteria. Only 16% of children required a CVC for ≥ 3 days. The CD34 collect rate and CD34‐FE was stable over time whereas MNC‐FE decreased after day 4 in 80% of patients. CD34‐FE and MNC‐FE showed inter‐ and intra‐patient variability over time and appeared sensitive to plerixafor administration. Femoral CVC showed fewer flow‐related AE compared to thoracic CVC, especially in pediatric patients (6.7% vs. 37%, P = 0.0005; OR = 0.12 (95%CI: 0.03‐0.45). CVC removal was uneventful in 73/75 (97%) patients with hemostasis achieved after 20–30 min of pressure. In a 10‐year period, there were no instances of product contamination associated with femoral CVC colonization.ConclusionFemoral CVC are safe and effective for A‐HPCC in young pediatric patients. Femoral CVC performance was maintained over several days with few flow‐related alarms when compared to thoracic CVCs.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139987/1/jca21548.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139987/2/jca21548_am.pd

Procedure‐related complications and adverse events associated with pediatric autologous peripheral blood stem cell collection

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135698/1/jca21465.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135698/2/jca21465_am.pd

Efficacy of therapeutic plasma exchange on angiotensin II type‐1 receptor antibodies on two kidney transplant recipients

BackgroundAngiotensin II type‐1 receptor antibody (AT1RAb) has been reported to cause antibody mediated rejection (AMR) in kidney transplant recipients possibly by contraction of renal arteries. We here report 2 kidney transplant recipients with elevated AT1RAbs and negative HLA donor specific antibodies (DSA) and anti‐major histocompatibility complex class I chain‐related gene A (MICA) Abs who received therapeutic plasma exchange (TPE) treatment followed by IVIG.Case 1Thirty‐eight‐year‐old patient received second kidney transplant for end stage renal disease (ESRD) with chronic rejection. Three years post‐transplant, she developed AMR with AT1RAb level >40 U/mL. She received 5 TPE and AT1RAb decreased by 20%, and biopsy showed improvement of AMR. She received another 3 TPE and AT1RAb decreased by 60%. Her creatinine (Cr) was stabilized at around 1.4 mg/dL.Case 2Twenty‐four‐year‐old patient received kidney transplant for ESRD with unclear etiology. Two weeks post‐transplant, her Cr rose with AT1RAb level at 18 U/mL and biopsy showed possible AMR. She received 6 TPE treatments and AT1RAb decreased by 55% and biopsy showed improvement of AMR. She received weekly TPE for subsequently rising AT1RAb but TPE was discontinued because of unsuccessful decrease of AT1RAb. Her Cr was stabilized at around 1.7 mL/dL.ConclusionWe reported 2 patients who received TPE treatments to decrease AT1RAbs. A course of TPE treatment successfully decreased AT1RAb. Histological improvement was observed quickly and Cr was also stabilized following the TPE treatment. Further study is necessary to determine the optimal use of TPE in renal transplant recipients with AT1RAbs.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146572/1/jca21657.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146572/2/jca21657_am.pd

Efficacy of plasmapheresis on donor‐specific antibody reduction by HLA specificity in post–kidney transplant recipients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111098/1/trf12923.pd

Effects of the search technique on the measurement of the change in quality of randomized controlled trials over time in the field of brain injury

BACKGROUND: To determine if the search technique that is used to sample randomized controlled trial (RCT) manuscripts from a field of medical science can influence the measurement of the change in quality over time in that field. METHODS: RCT manuscripts in the field of brain injury were identified using two readily-available search techniques: (1) a PubMed MEDLINE search, and (2) the Cochrane Injuries Group (CIG) trials registry. Seven criteria of quality were assessed in each manuscript and related to the year-of-publication of the RCT manuscripts by regression analysis. RESULTS: No change in the frequency of reporting of any individual quality criterion was found in the sample of RCT manuscripts identified by the PubMed MEDLINE search. In the RCT manuscripts of the CIG trials registry, three of the seven criteria showed significant or near-significant increases over time. CONCLUSIONS: We demonstrated that measuring the change in quality over time of a sample of RCT manuscripts from the field of brain injury can be greatly affected by the search technique. This poorly recognized factor may make measurements of the change in RCT quality over time within a given field of medical science unreliable

Significant methemoglobinemia with bovine hemoglobin infusion in a case with severe autoimmune hemolytic anemia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117556/1/trf13441.pd