مژگان شایگان

HNAs are glycoprotein antigens on the surface of neutrophils. Antibodies against these antigens are produced in patients with repeated blood transfusions. We here study the HNA-1a, HNA-1b and HNA-1c gene frequencies in regulary transfused patients suffering from hemolytic transfusion reactions as well as the risk of alloimmunization of these individuals based on the genotype pattern.

As the study population, 99 thalassemia patients were included in the descriptive study. Sampling lasted from July 2019 to March 2020 at Zafar Thalassemia Center. Patients were administered low-leukocyte blood. Three mL of blood was collected in tubes containing EDTA and DNA was extracted. HNA-1 gene was analyzed by PCR-SSP method. Allelic frequency of neutrophil antigens was calculated using Hardy-Weinberg equation. Chi-square and T-test were used to analyze the data.

The frequency rates of observed alleles were 52.7% for HNA-1a, 44.3% for HNA-1b, 3% for HNA-1c, which was in accordance with Hardy-Weinberg's law with a 5% confidence interval. The highest risk of alloimmunization to HNA-1b, HNA-1a, and HNA-1c were 22%, 18%, and 3%, respectively.

The frequency of HNA-1 neutrophil antigen allele in thalassemia patients with febrile blood transfusion was consistent with previous findings in different Iranian populations. Patients still have a risk of alloimmunization and blood transfusion based on neutrophilic genotype pattern.

Apheresis is an efficient method for collecting blood products such as plasma, platelets, red and white blood cells. Considering the importance of donor health and due to the limited number of apheresis donorschr('39') health related articles, we decided to investigate the effect of apheresis on platelet count, hemoglobin, hematocrit levels, and total leukocyte counts of donors.

A descriptive cross-sectional study was performed on 25 donors who were eligible for inclusion criteria in the study from May 2016 to January 2017. Samples were taken from donors before and after platelet apheresis and also 7 days after platelet apheresis to be tested on blood cells. CBC samples were analyzed with calibrated Mindray BC 300 cell counter device and then results were recorded in the prepared checklist and analyzed by SPSS 23 software.

Twenty five male donors had a mean age of  32.4 ± 9.97 years, minimum age 19 and maximum 59 and average weight 85.84 ± 17.2  kg, and mean height  178.2 ± 6.69. There was no significant change in WBC, RBC, HCT, and Hb before and after apheresis and 7 days later in Haemonetics MCS+. Platelet counts decreased immediately after donation from 235.720 ± 52.109  to 176.400 ± 44.240  (103/μL) and it reached to the level of before donation after 7 days (243.400 ± 67.399)(103 /μL).

Conclusions :

There was no significant change in WBC, RBC, HCT, and Hb before and 7 days after donation.

Various antibodies such as antibodies against RBC antigens, anti-HLA, and anti-platelet antibodies are developed after repeated blood transfusions and may lead to transfusion reactions such as platelet refractoriness in recipients. In this study, anti-HLA antibodies were evaluated in hemato-oncological patients, with and without simultaneous platelet refractoriness.

In this descriptive study, performed from 2017 to 2019, presence of anti-HLA antibodies in patients with hemato-oncological disorders, referred to the HSCT Research Center, Shariati Hospital, Tehran, was assessed using Panel Reactive Antibody (PRA) test based on complement lymphocytotoxicity. Data analysis was performed by SPSS (version 16) and chi-square tests.

Of 79 studied patients with hemato-oncological disorders including 34 females (43%) and 45 males (57%) with the age range of 2 to 83 years,  49 were platelet refractory and 30 were not. Anti-HLA antibodies were present in 39 (49.4%) patients and  40 (50.6%) were negative for them. The frequency of panel reactive antibody positive cases was significantly different between patients with platelet refractoriness (62.8%) and those without it (30%) (P = 0.007).

Conclusions :

The role of anti-HLA antibodies in platelet refractoriness is well established. Our study also showed a significant difference in this regard among two groups of hemato-oncological patients with and without platelet refractoriness. The presence of these antibodies does not always mean platelet refractoriness, and antibodies without the ability to activate complement can also cause this complication.

Platelet activation occurs for a variety of reasons from the moment of sampling to that of injection. Activation of the platelets leads to activation of mitochondria. They move toward the membrane, sprouting and shedding freely from it, leading to the release of pro inflammatory mediators and mtDNA. Therefore, mtDNA level is considered as one of the parameters of platelet activity. The aim of this study was to compare mtDNA levels during storage.

This experimental study was performed on 22 PRP products. We obtained consent of all donors referring to Iran Innovation Center of Iranian Blood Transfusion Organization. Samples were taken from the PRP bags on day 1, 3 and 5. Then, the fold change of mtDNA was assessed by Real time PCR. The results were analyzed by paired t-test and the P value of less than 0.05 was considered significant.

The rate of mtDNA decreased 0.8-fold on day 3 to 1, 0.6-fold on day 5 to 3, and 0 .49 on day 5 to 1. These changes were significant on days 5 to 1 (p= 0.003) and they were not significant on days 3 to 1 (p= 0.4). 

Conclusions  

The amount of mtDNA increased on the first day, and then decreased during the storage of  PRP products.

Following incompatible blood transfusions, anti-HLA and  anti- HPA antibodies may develop and cause various disorders such as post-transfusion purpura, platelet refractoriness, and thrombocytopenia leading to bleeding. The aim of this study was to investigate platelet antigens and antibodies in multi-transfused patients.

In this descriptive study, platelet antigens and presence of platelet antibodies were tested by PCR-SSP and PIFT flowcytometry in 30 Thalassemia major and 30 oncohematologic patients with one hour post transfusion platelet counts in the range of 150000-450000/µl. χ2  test was employed for comparing the results of the study.

Molecular genotyping of HPA-1in thalassemia major patients and patients with oncohematologic disorder in this study revealed that HPA-1a/1a was the most and HPA-1a/1b and  HPA-3b/3b  were the least frequent genotypes. No homozygous cases of 1b/1b, 2b/2b and  5b/5b  were detected. HPA-4b allele was not detected in any patient.  Flow PIFT results revealed platelet antibodies in 10(30%) patients with hematologic disorders and 1(3.3%) thalassemia major patients.

Conclusions  

According to %100 frequency of HPA-4a and total absence of HPA-4b allele and absence of homozygous b/b genotype for HPA-1/-2/-5 alleles in the patient polulation of this study, the prevalence of platelet alloimmunization due to antibodies against these antigens seems to be low. Although further studies in the field are nessessary.

Human platelet antigens (HPAs) are polymorphic structures located on the membrane of platelets (PLTs). These antigens have important role in clinical situations like refractoriness to platelet transfusion which is the most important cause of transfusion related mortality and morbidity in patients by recurrent platelet transfusion. Alloimmunization against the human platelet antigen 1 (HPA-1) is assumed as the major cause of platelet refractoriness in white population. Due to the variation of platelet antigens frequencies among ethnic groups; in this study, we investigated the frequency of HPA-1 alleles on Turkmen blood donors.

In this descriptive study, 80 non-relatives of Turkmen donors were randomly sampled from Aq Qala blood center during the year 2018.

The mean age of the subjects was 38.2 ± 7.7 years (range: 18-59 years) and all were male. Molecular genotyping of HPA-1 in this study revealed that HPA-1a allele was detected in 96% donors and the HPA-1a/1b heterozygote was found in 4% of individuals. No one was HPA-1bb homozygous (frequency 0%).

It was declared that 96% of Turkmen blood donors have shown HPA-1a similar to the frequency which was previously detected in Iranian blood donors and HPA-1b/b homozygous was not found in all donors. So it could be concluded that HPA-1a alloimmunization may not be involved in platelet refractoriness in Turkmen ethnicity.

Immune platelet refractoriness is a complication of blood transfusion in patients with multiple platelet transfusions. Antibodies against surface antigens, including human platelet antigens (HPAs) and human leukocyte antigens (HLAs), can be produced which can cause the degradation of transfused platelets by macrophages. In this study, the frequency of platelet antigens and antibodies against both HPAs and HLAs is evaluated in patients with platelet refractoriness. In this descriptive study, the simultaneous analyses of antigens of HPA-1/ -2/ -3/ -4/ -5/ -15 by molecular method (PCR-SSP), screening of platelet antibodies by flow cytometry, and anti-HLA-I antibodies by panel reactive antibody (PRA) assay were evaluated in 49 patients with platelet refractoriness. Out of 49 patients (including 18 females and 31 males) with platelet refractoriness, the platelet count in women was 6400 ± 3202 (range  of 1000-10000 cells/μl) and in men 7283 ± 2518 cell/μl (range of 3000-10000) showing no significance (p = 0.055). No case of HPA-4b, HPA-5b was found in this study. Anti-HLA antibodies and anti-HPA antibodies were detected in 61.2% and 4% of the patients, respectively.
The data from our study showed that the frequencies of the allele a for HPA-1 / -3 / -4 / -5 and the allele b for HPA-2 / -15 were higher in the studied population. The frequencies of alleles and genotypes between the studied group and Iranian blood donors were different and can explain the occurrence of platelet resistance among the patients.

Antibodies against Human leukocyte antigen (HLA) is produced following blood transfusion, pregnancy or organ transplants. These antibodies are involved in abortion and even present in non-allommunized healthy people. Anti-HLA antibodies lead to some complications of blood transfusion; therefore, this study was performed with aim to determine the frequency of HLA antibodies among blood donors focusing on females (with and without previous pregnancy and abortion). In this descriptive survey which was performed in 2016,214 blood donors referring to Tabriz blood transfusion center with age range of 18-62 years, including 57 females (26.6%) with age range of 23-59 years (mean age of 38.7 ± 9.3 years) and 157 male (73.4%) with age range of 18-62 years (mean age of 36.2 ± 9.7 years) were evaluated. Panel Reactive Antibody (PRA) test by test by lymphocytotoxicity with complement (CDC) method was used to evaluate anti-leukocyte antibodies. Demographic information and the number of pregnancy/abortion were recorded in information forms. Data were analyzed by SPSS software (version 16) and Chi-square and Pearson correlation coefficient. P 23 cases (10.75%) including 22 females (8 without and 14 with previous pregnancy and abortion) and one male had positive results for PRA, and the others were negative. The frequency of positive results of PRA were higher in women (P <0.0001). No relationship was found between these antibodies and pregnancy number, but the frequency of HLA antibody and PRA positive cases was significantly different between women with and without history of abortion (P <0.001) and was significantly associated with the number of abortion (r=0.52, p<0.0001). The number of abortion affects sensitization or immunization during pregnancy. Increasing the number of abortions increases the likelihood of immunization. These antibodies were seen in healthy subjects without history of pregnancy and even in men. The decision to evaluate the plasma of men and women without previous pregnancy prior to injection requires cost-benefit studies.

  Recurrent abortion is referred to a condition that 2 or 3 consecutive pregnancies are affected by abortions before the 20th week of gestation, which is likely to occur in 2-5% of pregnancies. There are some etiologic factors such as anatomical, infectious and immunological elements. One of these immunological factors is the polymorphism of the HPA-1 gene as a factor able to cause FNAIT and its related complications; besides it contributes to abortion as a thrombophilic gene. This study was conducted to evaluate the prevalence of HPA-1 incompatibility in Iranian couples with a history of recurrent abortions.

In this cross-sectional descriptive study, totally 75 couples with at least two recurrent pregnancy losses without any specified causes (according to the medical records obtained from the infertility center) were entered to the study. Four-ml blood samples were collected in EDTA tubes and the allelic frequency of HPA-1 was determined by PCR-SSP. Gene frequency was calculated using the Hardy Weinberg equation. The p< 0.05 was considered significant.

Totally 75 couples were included with the average age of women being 32 ± 7 years and the mean number of abortions 2.5 ± 0.9. HPA-1a was found in 100% of the under study population, and HPA-1b was absent in this population.

Conclusions
This study revealed that HPA-1a gene polymorphism does not have the likelihood of being involved in the recurrent abortion in Iranian couples, and other factors need to be investigated to determine the possible causes of recurrent abortion.

Background and ObjectivesHuman neutrophil antigens include 5 antigen systems. These antigens are on the plasma membrane of white blood cells. The aim of the study is to know about HNA allele frequency in the population in order to estimate the prevalence of the diseases related to HNA-5.
Materials and MethodsIn this descriptive study, blood samples were taken from 190 Azari unrelated blood donors having referred to Tabriz Blood Center. DNA extraction was performed using commercial kit Pars Tous. HNA-5a and HNA-5b molecular were then evaluated by PCR-RFLP. PCR products were digested using enzymes Sdu1 Bsp1286I. HNA-5a and HNA-5a- (or HNA-5b) antigen gene frequencies were calculated using the Hardy-Weinberg equation.
ResultsHNA-5a (), HNA-5a () and HNA-5a (-/-) phenotypes were observed in 93, 10 and 87 patients, respectively. The observed frequencies were consistent with Hardy-Weinberg equilibrium; allele frequencies of HNA-5a and HNA-5a- (or HNA-5b) were equal to 0.51 and 0.49, respectively.
ConclusionsHNA-5 alleles frequency rates were in the same range reported for the other populations

An important consequence of chronic blood transfusion in thalassemia is iron overload with treatment of iron chealation drugs. One of these drugs is deferiprone (L1) which is usually used as the combination therapy with desferoxamin especially in patients with iron overload. Nausea and vomiting is the common side effects of L1 which sometimes gets so bad that the patient can not tolerate the drug. We tried Enteric coated; EC with the aim of decreasing the gastric side effects.
We started enteric coated for 100 patients and followed them for gastric side effects for six months. All of them could not tolerate the previous form of L1 because of severe nausea and vomiting.
Two of our patients moved to other cities and could not be followed by this therapy; 98 patients were studied: 91 thalassemia major and 7 intermedia, 39 male, 59 female with the mean age of 25.16 6.03. Out of the total number, 67 (68.4%) patients were on the combination therapy because of high ferritin level and 31 (31.6%) had cardiac iron overload and high ferritin level. Four patients could not continue the treatment, 3 because of the recurrence of nausea and vomiting and 1 because of artheralgia; however, 94 (96%) could tolerate the EC form and successfully continued the treatment.
The enteric form of L1 had good results on GI side effects reduction so that 96% of patients could tolerate the medication and continue the treatment without any nausea and vomiting.

Neutrophil alloantigens are involved in several blood transfusion reactions including transfusion related acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions (FNHTRs). Due to lack of reports on neutrophil antigens, we aimed to detect the frequency rates of HNA-3a and HNA-3 b antigens in some blood donors living in Tehran.
Blood samples were collected in EDTA (anticoagulant) containing tubes from 110 blood donors having referred to Tehran Blood Center. DNA was extracted by silica filtered columns. PCR-SSP was used for evaluation of HNA-3a, HNA-3b. The gene frequency rates of HNA 3a and HNA-3b antigenes were calculated by Hardy Weinberg equilibrium.
The gene frequencies of HNA-3a, HNA-3b were 0.74 and 0.26, respectively showing consistency with the Hardy-Weinberg equilibrium. HNA-3a phenotypic frequency was found in 103 (93.6%) blood donors while 7 (6.4%) showed lacking it. HNA-3b was found in 50 (45.5%) blood donors while 60 (54.5%) lacking. There was not found any differences in gene and antigene frequency rates between the two genders.
The frequencies of HNA-3a and -3b were similar to those found in the previous study conducted on German and Turkish populations.

Activated platelets in platelet concentrate, release membranous vesicles that called platelet microparticles and can be created spontaneously during the storage of platelets. Studies have shown that platelet microparticles can form aggregates with monocytes so we intended to survey the ability of these microvesicles to activate monocytes.
Platelet concentrate bags (PCs) were prepared from Iranian Blood Transfusion Organization in Tehran. Sampling of the bags and isolation of PMP was carried out during storage. Besides, the respiratory burst of monocytes was measured by flow cytometry technique before and after treatment with PMP using di-hydrorhodamine-123 (DHR-123).
Monocyte cells derived from human peripheral blood were activated after exposure to platelet microparticles and intracellular respiratory burst was significantly increased (P-value = 0.01). These findings suggest that PMPs have a dose-dependent effect on monocytes and they are more effective at the concentration of 500 micrograms per milliliter.
This study showed the potential of platelet microparticles in the stimulation and activation of human peripheral blood monocytes.

One of the complications of repeated platelet transfusion is immune platelet refractoriness. In this study, a flow cytometic platelet cross-matching was performed to evaluate platelet transfusion outcome.
In this descriptive study, fifteen patients with a history of multiple platelet transfusions and fifteen healthy participants as the control group were enrolled in this study. Platelet cross-match was done and analyzed by the gate method. EDTA-anticoagulated blood samples from healthy donors were collected and PRP sampls were obtained. The serum of each patient was added to platelet suspension and incubated with FITC-anti human IgG and was analyzed using a flow cytometer. Platelet cross-match results of the patients were compared with those of CCI.
Platelet cross match results were negatively correlated with 1-hour (r = -0.731, p = 0.002) and 24-hour (r = -0.794, p = 0.001) CCIs. There was a significant difference in the mean percentage of platelet crossmatch between the patients with immune platelet refractoriness (showing 1-hour CCIs less than 7500) and that of the control group and the patients without platelet refractoriness.
The results showed that there was a significant correlation between platelet cross match by flowcytometry and 1-hour CCI results and this method could be applicable in the evaluation of platelet transfusion outcome.

It is more than 5 decades that hematopoietic stem cell transplantation (HSCT) has been used for treatment of hematologic malignancies, metabolic disordes, and immunodeficiencies. (HLA)-matched HSCT is commonly the preferred type of transplantation, with HLA-matched sibling donors usually the first choice. If there is no related HLA-matched donor, unrelated matched donors are considered. The present article shows the importance of unrelated stem cell donor registries, related regulations and policies, HSCT history, the importance of donor-recipient HLA matching to GVHD inhibition, several donor selection measures, establishment requirements of such registries in the world and Iran, using 29 different references in order to introduce these centers to interested researchers. These Registries rely on positive feelings of unrelated donors to altruistic donation to save patients. Registries from different countries joined and established world and international donor associations and groups to facilitate finding a suitable donor and improve the HSCT outcomes from unrelated donors. Huge progress has been made since the first HSCT to save many patients indebted to the efforts of a few pioneers, group collaborations, and international exchanges of stem cell practiced by international organizations which follow definite standards.

The distribution of HLA alleles varies among different ethnic populations. Obtaining HLA data for different ethnic groups will be helpful to determine donor recruitment goals and strategies in unrelated stem cell registries. Based on the data available from the Iranian Stem Cell Donor Registry، the frequency rates of HLA-A، B، DRB1 alleles evaluated by PCR-SSP method were reported; 1513 individuals living in Tehran city with six different ethnicities (Fars، Azeri، Kurd، Lur، Gilak، and Mazani) were the participants. Out of 1513 participants، Fars and Azeri ethnic groups had the highest number with 63. 12% and 20. 02%، respectively. Twenty one HLA-A، thirty-one HLA-B، and thirteen HLA-DRB1 alleles were observed. Data analysis among different ethnicities showed no significant differences between Fars and Azeries except for HLA-DRB1*33 frequency (p< 0. 005). Significant differences between Fars and Kurds were seen in HLA-A*03/11 and HLA-B*08/51 frequencies. There were significant differences between Fars and Gilaks in HLA-A*03/26، HLA-B*38/52 frequencies (p< 0. 05). The number of reported alleles in this study was similar to previous ones. There is not much alleles diversity، despite a few differences، across the different ethnic groups.

Mesenchymal stem cells are fibroblasts with the capacity of proliferation، colonogenesis، and differentiation to the mesodermal cells that are known as the source for cell therapy purposes. These cells are present in some adult and embryonic tissues in which the bone marrow serves as the main source of human mesenchymal stem cells. Because of some limitations in using the bone marrow، in this study we established a method for isolation of mesenchymal stem cells from placenta and characterized their properties. In this experimental study، we obtained 3 placenta tissues from informed consent mothers after normal vaginal delivery. Mesenchymal stem cells were isolated from the placenta، cultured، and were then examined for their proliferation، colonogenesis، immunophenotyping and differentiation capacities from passages 3 and 7. Our results showed the high capacity of proliferation and colonogenesis of placental derived mesenchymal stem cells. Immunophenotyping confirmed more than 95% purity of isolated cells; their surface antigen expression showed the phenotypical properties like those of bone marrow derived mesenchymal stem cells. The cells had the osteocytic and adipocytic differentiation capacity. In this study we successfully isolated mesenchymal stem cells from placenta and cultured them without any alteration in their capacities; consequently، we found out that we can isolate and expand these cells as an alternative source for cell therapies.

The study of different antigens on platelets which can produce antibodies, reactions between these antigens and antibodies which are able to induce different situations and diseases, and different tests to diagnose and manage such situations and diseases are important topics of platelet immunology. Knowledge about platelet antigens and antibodies that helps their roles in different diseases to be realised and further information about different tests for such disorders to be diagnosed and traced are useful.The present article introduces different topics about platelet immunology using 74 references. Platelet alloantigens included alloantigens shared with other cells (e.g: human leukocyte antigen (HLA) system and ABH system), and alloantigens that are assumed to be specific for platelets (e.g: human platelet antigen (HPA) system). Alloantibodies developed against any of these antigens through exposure by pregnancy, transfusion, or rarely transplantation are responsible for different diseases and transfusion reactions like alloimmune thrombocytopenic syndromes, neonatal alloimmune thrombocytopenia (NAIT), post transfusion purpura (PTP), platelet transfusion refractoriness (PTR), passive alloimmune thrombocytopenia, and transplant-associated thrombocytopenia.To know how to detect these factors and interpret the results helps in using the right test to the right patient in right time to make a better diagnosis and treatment.

Background and Objectives Blood typing by serologic methods after transfusion has limitations due to presence of donor red cells in recipients. Accurate determination of red blood cells (RBCs) antigens is very important in multitransfused patients including beta-thalassemics and sickle cell anemics. So, the aim of this study was to evaluate DNA- based methods as supplement to the hemagglutination technique to determine the red blood cell (RBC) antigen profile of multitransfused patients with beta- thalassemia. Materials and Methods DNA was extracted from peripheral blood of 20 apparently normal people and 44 patients including 35 with beta- thalassemia (out of whom 19 had clinical evidence of delayed hemolytic transfusion reaction), 8 with thalassemia intermedia (out of whom 2 had hemolytic reaction), and one with sickle cell thalassemia. RHD/ RHC/ RHc/ RHE/ RHe/ JKA/ JKB/ FYA/ FYB/ KELL1/ KELL2 alleles were determined by PCR and were then compared with the hemagglutination method. Results Phenotype and genotype results were the same in all controls. The phenotypes and genotypes of 53 blood antigens of 26 patients were incompatible. Most of the discrepancies (19 cases) occurred in the Rh system, and fifteen in the Duffy and Kidd systems.Conclusions The results show that screening platelet concentrates for bacterial contamination is necessary for blood transfusion centers and hospital blood banks. Blood typing by serologic method was not accurate in this study but genotyping could determine true blood groups in multitransfused patients and help in selection of RBCs without alloimmunized antigens in future transfusion attempts. Specificity, sensitivity, positive and negative predictive values of hemagglutination method for RhD antigen had good values in comparison to the molecular method. This might be due to pre- transfusion determination of RhD for thalassemic patients so as to receive Rh- matched blood units. It seems pre-transfusion blood typing of Rh and Kell antigens, which are the cause of hemolytic reactions, in comparison to the molecular method could be cost effective. In addition, typing of Rh and Kell antigens in some regular blood donors could be helpdul for selecting antigen-negative RBCs for transfusion dependent patients

Background and ObjectivesIt is suggested that HA-1 mismatching among hematopoietic stem cell recipients-donors be associated with acute graft-versus-host disease (aGVHD). So the aim of this study was to evaluate HA-1 frequency and examine the correlation between HA-1 disparity and GVHD patients who received transplantation from HLA-A2 identical siblings. Materials and MethodsExtracted DNA samples were collected from 55 HLA-A2-positive donor-recipient pairs. All the patients received peripheral blood stem cell transplant (PSCT) from HLA-identical siblings. HA-1 was detected by SSP-PCR method. The HA-1 typing was performed using SSP method. Data were analyzed using Chi-square, Man withney and Z test with SPSS 11.5. ResultsThirty patients showed to be GVHD I-IV and 25 pairs were without any GVHD signs. The frequency rates of HA-1R and HA-1H alleles in patients were 0.55 and 0.45, respectively; it showed no significant difference with the frequency rates (0.53 and 0.47) of this allels in donors (p>0.05). HA-1 disparity was detected in 8 out of the 55 donor/recipient pairs (14.5%). aGVHD (grades I-IV) was occurred in 6 of patients. Two patients with HA-1 disparity did not show any GVHD signs. X2 test showed there was not any relationship between the incidence of acute graft-versus-host-disease (aGVHD) and HA-1 incompatibility in the patiens. ConclusionsIn spite of higher frequency of HA-1 disparity in GVHD+ group, our data did not reflect any significant association between HA-1 disparity and risk of acute GVHD.

DNA was extracted from a 3-ml whole blood sample prepared from donations of 100 Iranian blood donors collected in EDTA-coated blood tubes. Human platelet (PLT) alloantigens (HPA)-1/2/3/4/5 and HPA-15 typing were performed by the Polymerase Chain Reaction – Sequence Specific Primer technique (PCR-SSP), and HPA-1a phenotyping was performed by ELISA method for 40 % of samples. Results The frequencies of HPA genes were: HPA-1a 98%, HPA-1b 2%, HPA-2a 54%, HPA-2b 46%, HPA-3a 48%, HPA-3b 52%, HPA-4a 100%, HPA-5a 99%, HPA-5b 1%, HPA-15a 47%, and HPA-15b 53%. HPA-4b was not found. The frequencies of HPA phenotypes were determined to be: HPA1a/1a 96%, HPA1a/1b 4%, HPA2a/2a 8%, HPA2a/2b 92%, HPA3a/3a 19%, HPA3a/3b 59%, HPA3b/3b 22%, HPA4a/4a 100%, HPA5a/5a 98%, HPA5b/5b 2%, HPA15a/15a 14%, HPA15a/15b 67%, and HPA15b/15b 19%. 40 HPA-1a phenotyping by ELISA showed 26 positive (OD > 0.5), 4 negative (OD < 0.3), and 10 indeterminate samples (0.3 < OD < 0.5). Conclusions No HPA-1b/b homozygous genotype similar to other Asian studies was found. Since HPA-1,-2,-5 frequencies in the population under study differ from the European Caucasian race, it seems that antibody production in our population might be different from other Caucasians. According to HPA frequencies, it seems that HPA-2b, HPA-5b and HPA-15b may induce posttransfusion purpura and platelet refractoriness which need further investigation.

Breastfeeding has many psychological, immunological, economical and health related benefits for mothers and their neonates. This feeding, especially at the first hours of birth is very notable, so that early breastfeeding can prevent neonatal infectious diseases and some chronic diseases in adulthood period. Moreover, breast feeding and physical contact between mother and neonate over a short period of time after delivery can influence the mother's psychological status and emotional feeling with her neonate. The aim of the present study was to assess factors that influence the time between delivery and the first breastfeeding. The statistical methods used for comparison of data were Cox regression, Log-rank test and Kaplan-Meier curve. In this cohort study, 110 paired mothers and their neonates were recruited in a hospital in Tehran. The data collected included time of first feeding following delivery in relation to the method of delivery, parity and the level of education of mother. The results showed that mode of delivery was the most important factor for starting the first breastfeeding, so that for any time duration after birth, the rate of breastfeeding for neonates in normal vaginal delivery method was 3.9 and 6.8 folds in usual and spinal cesarean delivery methods respectively. Other important factors, in sequence, were parity and educational level in mothers. The finding of this study demonstrated that increasing the awareness among pregnant women and their willingness for vaginal delivery can decrease in unnecessary cesarean section rate and can improve the relation between mother and neonate and the start of early breastfeeding.

Background and ObjectivesThe process of platelet concentrate production by plasma rich (PRP) method could activate the platelet and granules secretion of beta thromboglobulin, LDH and CD62P. Platelets activated during the preparation process do not have sufficient efficiency for hemostasis in vivo. It seems that platelet preparation by buffy coat method has an ability less than PRP to activate the platelet. Measuring platelet activation indices, such as CD62P expression and beta thromboglobulin, is a useful means to evaluate the percentage of activated platelet concentrates and compare the two methods of buffy coat and PRP. Materials and MethodsIn this experimental study, 15 concentrates were prepared via PRP method and 15 via BC method; 15 intact blood units were also considered as control group. The percentages of CD62P expression, soluble CD62P concentrates, IL-8 level, and CD14 positive cells were evaluated. Special monocolonal antibodies that conjugated with flourecence dye in flocytometric method were used for CD62P and CD14. ELISA method was used for evaluation of soluble CD62P and IL-8. ResultsThe average platelet count in both methods showed no significant difference, but WBC contamination rate in PRP-PCs was more than BC-PCs. In PRP-PCs, we found a little decrease in CD62P expression and increase in soluble form and IL-8 level during reservation time. The level of CD14 showed no significant difference in these components. In BC method during the three day reservation, expression of CD62P, its soluble form, and IL-8 concentrates increased and the level of monocyte surface CD14 showed slight decrease ranging from 0.4 to 0.1. ConclusionsIt is concluded that there is a close relationship between IL-8 and WBC count in platelet concentrates. In PRP method in contrary to BC method, high speed centrifuge causes adhesion, aggregation and platelet activation.

Background and objectivesBeta-2 microglobulin (β 2MG) is the light chain of Histocompatibility–Class I human antigen and its normal range is <3mg/ml. β 2MG level in sera of hepatitis B patients increases. In Hepatitis infection the presentation of the viral antigen on the hepatocyte in the presence of Class I HLA antigen plays a major role in the elimination of the virus. Materials and Methods In this descriptive study, s β 2MG, HBsAg (by ELISA), and HBV DNA (by PCR) were evaluated in sera of 49 patients with hepatitis B and 35 subjects in control group. ResultsOur results showed HbsAg was positive in all patients. 29 of patients were HBV-DNA-PCR positive and 20 HBV-DNA-PCR negative. β 2MG in all subjects in control group was in normal range and in 34.7% of patients above normal limit. β 2MG in HBV-DNA-PCR positive patients was higher than HBV DNA PCR negative patients. Such differences were significant (p < 0.05). ConclusionsIt seems S β 2MG is a good marker for HBV replication and its absence may exclude HBV replication. The role of β 2MG in monitoring response to therapy needs to be further evaluated.