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  • 1
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    Reliable Determination of Fetal RhD Status by 〈b〉〈i〉RHD 〈/i〉〈/b〉Genotyping from Maternal Plasma
    S. Karger AG ; 2013
    In:  Transfusion Medicine and Hemotherapy Vol. 40, No. 1 ( 2013), p. 37-43
    Details
    In: Transfusion Medicine and Hemotherapy, S. Karger AG, Vol. 40, No. 1 ( 2013), p. 37-43
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Immunoprophylaxis with IgG anti-D is a standard prevention of hemolytic disease of the fetus and newborn. Fetal Rhesus D (RhD) blood group genotyping from maternal plasma of RhD-negative pregnant women allows targeted prophylaxis with IgG anti-D in RhD-positive pregnancies only. We set up a reliable protocol for prenatal 〈 i 〉 RHD 〈 /i 〉 genotyping. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 153 pregnant Caucasian RhD-negative women were tested in the 27th week (range 7–38th week) of pregnancy. 18 of them were alloimmunized to the RhD antigen. The fetal 〈 i 〉 RHD 〈 /i 〉 genotype was determined based on an automated DNA extraction and real-time polymerase chain reaction method. Intron 4 and exons 5, 7 and 10 of the 〈 i 〉 RHD 〈 /i 〉 gene and the 〈 i 〉 SRY 〈 /i 〉 gene were targeted. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The fetal RhD status and gender was 100% correctly predicted in all 153 pregnancies (55 RhD-positive males, 45 RhD-positive females; 23 RhD-negative males, 30 RhD-negative females). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The accuracy and applicability of our protocol for non-invasive fetal RhD determination allows the correct management of RhD-incompatible pregnancies. Our protocol could prevent unnecessary immunoprophylaxis in 53 of 153 cases. We therefore recommend that non-invasive fetal 〈 i 〉 RHD 〈 /i 〉 genotyping is introduced as an obligatory part of prenatal screening.
    Type of Medium: Online Resource
    ISSN: 1660-3796 , 1660-3818
    URL: Article
    DOI: 10.1159/000345682
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 2100533-3
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  • 2
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    Ciljana zaščita RhD-negativnih nosečnic z imunoglobulinom anti-D v 28. tednu nosečnosti v severovzhodni Sloveniji
    Slovenian Medical Association ; 2022
    In:  Slovenian Medical Journal ( 2022-09-30), p. 1-9
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, ( 2022-09-30), p. 1-9
    Abstract: Ciljana zaščita z imunoglobulinom anti-D je program, ki na podlagi presejalnega testa omogoča neinvazivno določitev plodovega genotipa RHD iz periferne krvi RhD-negativne nosečnice. Pred uvedbo določanja predvidenega fenotipa RhD so vse RhD-negativne nosečnice prejele zaščito z imunoglobulinom anti-D v 28.–30. tednu nosečnosti. V Evropi 40 % RhD-negativnih nosečnic nosi RhD-negativen plod in zaščite ne potrebuje, saj med materjo in plodom ni RhD-neskladnosti in zato ni nevarnosti senzibilizacije na antigen RhD. Z uvedbo tega testa pa nosečnice zaščito z imunoglobulinom anti-D prejmejo ciljano glede na predvideni plodov fenotip RhD. Z uvedbo nacionalnega programa je Slovenija postala ena redkih držav v svetovnem merilu, ki izvaja ciljano zaščito z imunoglobulinom anti-D.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.3336
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2022
    detail.hit.zdb_id: 2502309-3
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  • 3
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    Napačna kri v epruveti: spodrsljaj ali nevarnost za bolnika
    Slovenian Medical Association ; 2019
    In:  Slovenian Medical Journal Vol. 88, No. 9-10 ( 2019-10-28), p. 468-78
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 88, No. 9-10 ( 2019-10-28), p. 468-78
    Abstract: Izhodišče: Napake ob odvzemu in označevanju vzorca krvi so pomemben skorajšnji razlog za napačno transfuzijo krvi. Vodijo lahko v smrten dogodek zaradi napačne (neskladne) transfuzije in na splošno kažejo kakovost slovenskega zdravstva. Ker jih lahko preprečimo, je treba ugotoviti vzrok nastanka in preučiti možne rešitve, da se morebitni smrtni zaplet sploh ne bi zgodil.Metode: Kot eden od kazalnikov kakovosti spremljamo število napačnih vzorcev krvi v epruveti glede na število analiziranih vzorcev. Pregledali in analizirali smo vse primere, ugotovljene na Zavodu RS za transfuzijsko medicino (ZTM).Rezultati: V zadnjih petih letih se na ZTM ta številka giblje med 0,04 in 0,2 promila, kar je zelo ugodno razmerje. Konkretno to pomeni, da je bilo v letu 2012 odkritih 9 primerov, v 013. letu 2, v 2014. letu 6, v 2015. letu 5, v 2016. letu 8 ter 7 primerov napačne krvi v epruveti v 2017. letu.Zaključek: V članku so zbrani vzroki in učinkoviti načini, ki ob dosledni uporabi stremijo k skupnemu cilju – nič primerov napačne krvi v epruveti. Glede na rezultate lahko sklepamo, da imamo na ZTM dobro in varno prakso ter nizko tveganje za neskladno transfuzijo zaradi napačnega vzorca v epruveti.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2870
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2019
    detail.hit.zdb_id: 2502309-3
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  • 4
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    Perinatalna zaščita z imunoglobulinom anti-D in vpliv senzibilizacije na antigen RhD med nosečnicami v Sloveniji
    Slovenian Medical Association ; 2022
    In:  Slovenian Medical Journal ( 2022-04-28), p. 1-9
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, ( 2022-04-28), p. 1-9
    Abstract: Izhodišča: Senzibilizacije na eritrocitne antigene so lahko pomemben vzrok perinatalne obolevnosti plodov in novorojenčkov. Od vseh eritrocitnih antigenov lahko med nosečnostjo preprečujemo nastanek aloprotiteles le proti antigenu RhD (D), in sicer s perinatalnim preventivnim vbrizganjem imunoglobulina anti-D (Ig anti-D). Kljub temu odkrivamo med nosečnicami nove senzibilizacije na antigen D. Namen članka je določiti incidenco senzibilizacij na antigen D med nosečnicami v Sloveniji v obdobju od 1. 1. 2010 do 31. 12. 2020 ter prepoznati najverjetnejše vzroke za njihov nastanek. Metode: Retrospektivno smo pregledali medicinsko dokumentacijo z anamnestičnimi podatki in izvide laboratorijskih preiskav v transfuzijskem informacijskem sistemu za nosečnice, pri katerih smo v izbranem obdobju prvič odkrili protitelesa anti-D. Iz dokumentacije smo razbrali najverjetnejše vzroke za nastanek anti-D. Raziskava je potekala na Zavodu RS za transfuzijsko medicino v Ljubljani (ZTM) ter na Centru za transfuzijsko medicino v Univerzitetnem kliničnem centru Maribor (CTM). Rezultati: V obravnavanem obdobju smo odkrili 69 novih senzibilizacij na antigen D, kar pomeni, da se je senzibiliziralo 0,16 % D-negativnih (D-neg) nosečnic oz. 0,26 % D-neg nosečnic s tveganjem. Med nosečnostjo je nastalo 45 % senzibilizacij, 29 % po rojstvu D-pozitivnega (D-poz) otroka, 9 % po predhodni prekinitvi nosečnosti. Od 45 % senzibilizacij med nosečnostjo bi lahko preprečili 8 primerov (26 %), 1 primera (3 %) nismo mogli preprečiti, ostali primeri (71 %) pa so najverjetneje posledica tihih fetomaternalnih krvavitev (FMK). Od 38 % senzibilizacij, ki so nastale po predhodnem porodu ali prekinitvi nosečnosti, bi lahko preprečili 4 primere (15 %): 2 primera po prekinitvi nosečnosti, 1 primer po rojstvu D-poz otroka v tujini, 1 primer zavrnitve zaščite. Skupno bi lahko preprečili 12 senzibilizacij (17,5 %), ki so najverjetneje posledica nepopolnega upoštevanja smernic za preventivno vbrizganje Ig anti-D (med njimi sta 2 nosečnici (3 %) zaščito zavrnili), enega primera (1,5 %) nismo mogli preprečiti (nosečnica kljub krvavitvi ni prišla h ginekologu). Zaključek: Več kot 80 % senzibilizacij je nastalo kljub upoštevanju smernic za njihovo preprečevanje, 12 primerov (17,5 %) bi lahko preprečili (7 primerov nepopolne perinatalne zaščite z Ig anti-D, 1 primer neizvedene zaščite po rojstvu D-poz otroka in 2 po prekinitvi nosečnosti, 2 primera zavrnjene zaščite), enega primera (1,5 %) pa kljub upoštevanju smernic nismo mogli preprečiti, ker nosečnica kljub krvavitvi ni obiskala ginekologa. Novi ukrep za preprečevanje senzibilizacij bi lahko bila rutinska zaščita z Ig anti-D še v drugem trimesečju nosečnosti in dodatni izobraževalni programi pred načrtovanjem nosečnosti. Posebno pozornost bi bilo potrebno nameniti prepoznavanju in ukrepanju ob možnih dogodkih, ko lahko pride do senzibiliziranja v nosečnosti, krvni skupini D ter ob posledicah zavrnitve zaščite z Ig anti-D. Ciljana zaščita že predstavlja enega od ukrepov na tem področju.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.3276
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2022
    detail.hit.zdb_id: 2502309-3
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  • 5
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    Induction/Engineering, Detection, Selection, and Expansion of Clinical-Grade Human Antigen-Specific CD 8 + Cytotoxic T Cell Clones for Adoptive Immunotherapy
    Hindawi Limited ; 2010
    In:  Journal of Biomedicine and Biotechnology Vol. 2010 ( 2010), p. 1-15
    Details
    In: Journal of Biomedicine and Biotechnology, Hindawi Limited, Vol. 2010 ( 2010), p. 1-15
    Abstract: Adoptive transfer of effector antigen-specific immune cells is becoming a promising treatment option in allogeneic transplantation, infectious diseases, cancer, and autoimmune disorders. Within this context, the important role of CD 8 + cytotoxic T cells (CTLs) is objective of intensive studies directed to their in vivo and ex vivo induction, detection, selection, expansion, and therapeutic effectiveness. Additional questions that are being addressed by the scientific community are related to the establishment and maintenance of their longevity and memory state as well as to defining critical conditions underlying their transitions between discrete, but functionally different subtypes. In this article we review and comment latest approaches and techniques used for preparing large amounts of antigen-specific CTLs, suitable for clinical use.
    Type of Medium: Online Resource
    ISSN: 1110-7243 , 1110-7251
    URL: Article
    DOI: 10.1155/2010/705215
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2010
    detail.hit.zdb_id: 2698540-8
    detail.hit.zdb_id: 2512507-2
    SSG: 12
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  • 6
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    Telemedicine in the blood transfusion laboratory – remote interpretation of pre-transfusion tests
    SAGE Publications ; 2007
    In:  Journal of Telemedicine and Telecare Vol. 13, No. 7 ( 2007-10-01), p. 357-362
    Details
    In: Journal of Telemedicine and Telecare, SAGE Publications, Vol. 13, No. 7 ( 2007-10-01), p. 357-362
    Abstract: We have developed a telemedicine system for blood transfusion work, to supply the local hospital laboratory with an expert opinion from the central reference laboratory. The telemedicine system allows remote inspection and interpretation of pre-transfusion tests, which are performed by ID-cards (micro-tube gel technology). The system was installed at three blood transfusion laboratories in Slovenia, approximately 70 km apart. Validation of the telemedicine system was performed using 99 clinical cases selected randomly from routine work. Two groups of immunohaematology specialists participated. Group A ( n = 8) performed the read-out of the pre-transfusion tests on ID-cards by using the telemedicine system. Group B ( n = 2) then read the ID-cards independently using the standard visual method. All 98 final interpretations which were recorded using the telemedicine system were correct. We recorded 591 micro-tube read-outs of agglutination strength using the telemedicine system, of which 582 were correct. For comparison, we recorded 591 micro-tube read-outs using the standard visual method, of which 582 were correct. The validation proved that the telemedicine system was suitable for operational use.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    URL: Article
    DOI: 10.1258/135763307782215370
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2007700-2
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  • 7
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    Online Resource
    Rhd and C/cE/e genotyping in Slovenian population
    Springer Science and Business Media LLC ; 2000
    In:  Pflügers Archiv - European Journal of Physiology Vol. 439, No. S1 ( 2000-1), p. r058-r059
    Details
    In: Pflügers Archiv - European Journal of Physiology, Springer Science and Business Media LLC, Vol. 439, No. S1 ( 2000-1), p. r058-r059
    Type of Medium: Online Resource
    ISSN: 0031-6768 , 1432-2013
    URL: Article
    DOI: 10.1007/s004240000091
    RVK:
    WA 15000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2000
    detail.hit.zdb_id: 1463014-X
    SSG: 12
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  • 8
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    Respiracijske transfuzijske reakcije
    Slovenian Medical Association ; 2017
    In:  Slovenian Medical Journal Vol. 86, No. 9-10 ( 2017-11-06)
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 86, No. 9-10 ( 2017-11-06)
    Abstract: Respiratory transfusion-related reactions are not very frequent, partly also because recognition and reporting transfusion reactions is still underemphasized. Tis article describes the most important respiratory transfusion reactions, their pathophysiology, clinical picture and treatment strategies. Respiratory transfusion related reactions can be primary or secondary. The most important primary transfusion-related reactions are TRALI - transfusion-related acute lung injury, TACO – transfusion-associated circulatory overload, and TAD - transfusion-associated dyspnea. TRALI is immuneassociated injury of alveolar basal membrane, which becomes highly permeable and causes noncardiogenic pulmonary edema. Treatment of TRALI is mainly supportive with oxygen, fluids (in case of hypotension) and in cases of severe acute respiratory failure also mechanic ventilation. TACO is caused by volume overload in predisposed individuals, such as patients with heart failure, the elderly, infants, patients with anemia and patients with positive fluid balance. Clinical picture is that of a typical pulmonary cardiogenic edema, and the therapy is classical: oxygen and diuretics, and in severe cases also non-invasive or invasive mechanical ventilation. TAD is usually a mild reaction of unknown cause and cannot be classified as TACO or TRALI, nor can it be ascribed to patient’s preexisting diseases. Although the transfusion-related reactions are not very common, knowledge about them can prevent serious consequences. On the one hand preventive measures should be sought, and on the other early recognition is beneficial, so that proper treatment can take place.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2493
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2017
    detail.hit.zdb_id: 2502309-3
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  • 9
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    Online Resource
    Izdaja Kell skladnih krvnih komponent z namenom preprečevanja anti-K senzibilizacij pri ženskah v rodni dobi.
    Slovenian Medical Association ; 2016
    In:  Slovenian Medical Journal Vol. 85, No. 4 ( 2016-07-03)
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 85, No. 4 ( 2016-07-03)
    Abstract:  With selecting K compatible blood for transfusion, we prevent K immunization and many unnecessary prenatal testing and gynecological examinations for at least 78% of pregnant women with K negative partners, whose fetus is not at risk of hemolytic disease of fetus and newborn. Abstract  Background Kell antibodies are beside RhD and c antibodies one of most clinically important antibodies that can cause severe hemolytic disease of the fetus and newborn (HDFN) in pregnancy,which is still remaining one of the major causes of perinatal morbidity and mortality. Therefore, pregnant women with eryhrocyte alloantibodies anti-K need many prenatal testing and gynecological examinations. The major cause for anti-K immunisation is transfusion of incompatible blood in the past.    Methods We analysed retrospectively the data of 71 pregnant woman with alloantibodies anti-K, which were followed in Blood Transfusion Centre of Slovenia from 2004 -2014. We collected data of partner´s phenotype and woman´s transfusion history. Data were statistically analyzed with basic statistical methods.   Results 61 out of 71 partners were tested (86%) and 48 were K negative (78%).The transfusion history was available for only 23 women (32%). The transfusion history was available for 23 out of 48 women with K negative partner (48%). All of them were transfused. 78% received incompatible-K positive blood, for the rest 22% women donations they received were not K typed.    Conclusions From the obtained data, we found that in 78% of cases cause for K alloimunnization is transfusion of K incompatible blood in past. With selecting K compatible blood for transfusion, we can prevent K immunization and many unnecessary prenatal testing and gynecological examinations for 78% pregnant women with K negative partners . 
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.1393
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2016
    detail.hit.zdb_id: 2502309-3
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  • 10
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    Obravnava nosečnic glede na tip RhD
    Slovenian Medical Association ; 2020
    In:  Slovenian Medical Journal Vol. 88, No. 11-12 ( 2020-01-09), p. 582-592
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 88, No. 11-12 ( 2020-01-09), p. 582-592
    Abstract: Natančna opredelitev antigena (Ag) RhD (D) je pomembna pri nosečnicah, prejemnikih transfuzij in krvodajalcih. Glede na tip D se pri nosečnicah odločamo o pred- in poporodni zaščiti z imunoglobulinom anti-D (Ig anti-D). Glede na določitev Ag D lahko posameznike razvrstimo med D-pozitivne (D-poz) ali D-negativne (D-neg), obstajajo pa tudi številne druge različice Ag D (variante D, D-var). Variantni aleli gena RHD (D) lahko nosijo zapis za različne oblike proteina D, razdelimo jih lahko na šibke, parcialne in Del. Ag D določamo s serološkimi metodami, v primeru nejasnosti si pomagamo z molekularnobiološkimi metodami za določitev gena D. Dokončno opredelitev D-var podamo na podlagi molekularnobioloških metod.Nosečnicam smo iz vzorcev periferne venske krvi določili Ag D na ploščici (reagent Seraclone anti-D) in na gelu (testni sistem z gelskimi karticami DiaClon ABO/D + Reverse Grouping, monoclonal antibodies, Bio-Rad, Nemčija, s katerimi ne zaznamo krvne skupine D kategorija VI). 49 nosečnicam smo opravili razširjeno serološko testiranje KS D (komercialni set ID-Partial RhD Typing Set, Bio-Rad, Nemčija). Nadaljevali smo z molekularnobiološkimi metodami: osamitev DNA (uporaba aparata BioRobot EZ1 in komercialnega set EZ1 DNA Blood 350 μl Kit, Qiagen, Nemčija), določitev genotipa D z metodo PCR-SSP (komercialni seti RBC-Ready Gene CDE, RBC-Ready Gene D weak in RBC-Ready Gene D AddOn, Inno-Train; Nemčija), pomnoževanje (aparat Veriti, Apllied BioSystems, ZDA), ločevanje produktov (elektroforezni system, BioRad, ZDA) na agaroznem gelu (Sigma, Nemčija).Ugotovili smo, da so šibke oblike D predstavljale 41 primerov (83,7 %), parcialne oblike D pa 8 primerov (16,3 %) vseh D-var. Najpogostejša oblika D-var med nosečnicami je bila šibki D tip 1 s 17 primeri (34,7 %), sledil je šibki D tip 3 s 13 primeri (26,5 %) in šibki D tip 2 z 10 primeri (20,4 %). Najpogostejša parcialna oblika D je bila D kategorija VII s 5 primeri (10,2 %).Nosečnice in prejemnike transfuzij, ki so nosilci šibkih D tipa 1, 2 ali 3, lahko varno obravnavamo kot D-poz, nosilce vseh ostalih D-var pa kot D-neg. Krvodajalce z D-var obravnavamo kot D-poz. S tem algoritmom lahko preprečimo približno 172 nepotrebnih aplikacij Ig anti-D letno in ohranjamo tudi primerne zaloge D-neg eritrocitnih komponent krvi.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2687
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2020
    detail.hit.zdb_id: 2502309-3
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