Human Stem Cells- Introduction
Types of HSC transplants
Indications
Sources of stem cells
Collection and mobilization
Types of Mobilizing agents
Processing
Cryopreservation and storage
PBSC Transplant
Quality control
Complications
Hematopoietic stem cell transplantation involves replacing a patient's abnormal or diseased hematopoietic system with healthy stem cells from a donor. It is used to treat both malignant and non-malignant hematological disorders. There are various sources of stem cells including bone marrow, peripheral blood, and umbilical cord blood. Complications after transplantation can include graft-versus-host disease, infections, and transplant-related toxicities. Close monitoring and management is required after transplantation to monitor engraftment and address any complications that may arise.
Role of transfusion medicine in hematopoietic stem cellFigo Khan
The role of transfusion medicine in hematopoietic stem cell transplantation involves donor evaluation and stem cell collection, processing, cryopreservation, thawing, and infusion. Transfusion medicine specialists ensure proper HLA typing and immunohematologic compatibility between donors and recipients. They collect stem cells via bone marrow aspiration, peripheral blood apheresis, or umbilical cord blood collection. Collected stem cells are processed, cryopreserved, thawed as needed, and infused into recipients. Transfusion medicine specialists also provide transfusion support and monitor for engraftment and complications related to ABO blood group compatibility.
This document provides an overview of hematopoietic stem cell transplantation (HSCT). It defines hematopoietic stem cells and HSCT, and describes the types of transplants including autologous and allogenic. The key indications for each type are outlined. The process of HSCT is summarized, including donor selection, stem cell collection, cryopreservation, conditioning chemotherapy, stem cell infusion, and engraftment recovery. Post-transplant complications and supportive care measures are briefly discussed.
This document discusses hematopoietic growth factors and their role in regulating blood cell production. It notes that hematopoietic stem cells originate in the fetal liver and later migrate to the bone marrow. Growth factors such as G-CSF, GM-CSF and thrombopoietin stimulate the differentiation of committed blood cell progenitors. Recombinant forms of these growth factors are used to treat chemotherapy-induced neutropenia and mobilize stem cells for transplantation. While growth factors generally increase white blood cell counts, they require careful dosing due to potential toxicities including bone pain, fever and splenic rupture.
Bone marrow and peripheral Hematopoietic stem cell collection and processing.KISHORE KUMAR
This document provides an overview of bone marrow and peripheral blood stem cell collection and processing for hematopoietic stem cell transplantation. It discusses the indications for transplant, sources of stem cells, mobilization techniques using growth factors and chemotherapy, collection methods for bone marrow and peripheral blood, processing steps including volume reduction, cryopreservation and storage, and thawing for infusion. The key steps in bone marrow collection, peripheral blood mobilization, apheresis, and processing the collected stem cells are outlined.
The document discusses stem cell transplantation therapy and immunosuppressant therapy for hematological malignancies. It provides an overview of hematopoietic stem cells, the history and types of hematopoietic stem cell transplantation, the transplantation process including stem cell collection, cryopreservation, conditioning, and complications. The presentation also covers hematopoietic stem cell transplantation for different hematological malignancies and non-malignant conditions.
This document discusses hematopoietic stem cell transplantation (HSCT), including indications for autologous and allogeneic HSCT, pre-transplant evaluation procedures, sources of stem cells, HLA matching, peripheral blood stem cell mobilization and collection, and cryopreservation of stem cells. Key points include that HSCT involves transferring stem cells to repopulate the bone marrow, common indications include various forms of cancer and blood disorders, extensive pre-transplant testing is required, and stem cells can be obtained from bone marrow, peripheral blood, or cord blood and must be cryopreserved at specific temperatures and rates to maintain viability long-term.
Haematopoietic Stem Cell Mobilisation and ApheresisEBMT
The document provides an overview of autologous stem cell transplantation, including scientific background on blood cell formation and the bone marrow microenvironment. It describes the stem cell transplant process, including stem cell mobilization using agents like filgrastim and plerixafor, stem cell collection via apheresis, and patient evaluation and preparation for the collection procedure. The goal of the process is to collect enough CD34+ stem cells from the patient's peripheral blood to later be reinfused after high-dose chemotherapy or radiation to rescue the patient's bone marrow.
Hematopoietic stem cell transplantation involves replacing a patient's abnormal or diseased hematopoietic system with healthy stem cells from a donor. It is used to treat both malignant and non-malignant hematological disorders. There are various sources of stem cells including bone marrow, peripheral blood, and umbilical cord blood. Complications after transplantation can include graft-versus-host disease, infections, and transplant-related toxicities. Close monitoring and management is required after transplantation to monitor engraftment and address any complications that may arise.
Role of transfusion medicine in hematopoietic stem cellFigo Khan
The role of transfusion medicine in hematopoietic stem cell transplantation involves donor evaluation and stem cell collection, processing, cryopreservation, thawing, and infusion. Transfusion medicine specialists ensure proper HLA typing and immunohematologic compatibility between donors and recipients. They collect stem cells via bone marrow aspiration, peripheral blood apheresis, or umbilical cord blood collection. Collected stem cells are processed, cryopreserved, thawed as needed, and infused into recipients. Transfusion medicine specialists also provide transfusion support and monitor for engraftment and complications related to ABO blood group compatibility.
This document provides an overview of hematopoietic stem cell transplantation (HSCT). It defines hematopoietic stem cells and HSCT, and describes the types of transplants including autologous and allogenic. The key indications for each type are outlined. The process of HSCT is summarized, including donor selection, stem cell collection, cryopreservation, conditioning chemotherapy, stem cell infusion, and engraftment recovery. Post-transplant complications and supportive care measures are briefly discussed.
This document discusses hematopoietic growth factors and their role in regulating blood cell production. It notes that hematopoietic stem cells originate in the fetal liver and later migrate to the bone marrow. Growth factors such as G-CSF, GM-CSF and thrombopoietin stimulate the differentiation of committed blood cell progenitors. Recombinant forms of these growth factors are used to treat chemotherapy-induced neutropenia and mobilize stem cells for transplantation. While growth factors generally increase white blood cell counts, they require careful dosing due to potential toxicities including bone pain, fever and splenic rupture.
Bone marrow and peripheral Hematopoietic stem cell collection and processing.KISHORE KUMAR
This document provides an overview of bone marrow and peripheral blood stem cell collection and processing for hematopoietic stem cell transplantation. It discusses the indications for transplant, sources of stem cells, mobilization techniques using growth factors and chemotherapy, collection methods for bone marrow and peripheral blood, processing steps including volume reduction, cryopreservation and storage, and thawing for infusion. The key steps in bone marrow collection, peripheral blood mobilization, apheresis, and processing the collected stem cells are outlined.
The document discusses stem cell transplantation therapy and immunosuppressant therapy for hematological malignancies. It provides an overview of hematopoietic stem cells, the history and types of hematopoietic stem cell transplantation, the transplantation process including stem cell collection, cryopreservation, conditioning, and complications. The presentation also covers hematopoietic stem cell transplantation for different hematological malignancies and non-malignant conditions.
This document discusses hematopoietic stem cell transplantation (HSCT), including indications for autologous and allogeneic HSCT, pre-transplant evaluation procedures, sources of stem cells, HLA matching, peripheral blood stem cell mobilization and collection, and cryopreservation of stem cells. Key points include that HSCT involves transferring stem cells to repopulate the bone marrow, common indications include various forms of cancer and blood disorders, extensive pre-transplant testing is required, and stem cells can be obtained from bone marrow, peripheral blood, or cord blood and must be cryopreserved at specific temperatures and rates to maintain viability long-term.
Haematopoietic Stem Cell Mobilisation and ApheresisEBMT
The document provides an overview of autologous stem cell transplantation, including scientific background on blood cell formation and the bone marrow microenvironment. It describes the stem cell transplant process, including stem cell mobilization using agents like filgrastim and plerixafor, stem cell collection via apheresis, and patient evaluation and preparation for the collection procedure. The goal of the process is to collect enough CD34+ stem cells from the patient's peripheral blood to later be reinfused after high-dose chemotherapy or radiation to rescue the patient's bone marrow.
Hematopoietic stem cell transplantation (HSCT) involves replacing a patient's bone marrow with healthy stem cells from a donor. The document provides an overview of HSCT, including its history, types of transplants, the transplant process, and potential complications. It discusses how stem cells are collected from bone marrow, peripheral blood, or umbilical cord blood and cryopreserved. The transplant process includes conditioning chemotherapy/radiation, stem cell infusion, and recovery. Complications can include graft-versus-host disease and infection. Careful donor matching and screening is important for transplant success.
Bone marrow transplantation involves replacing damaged or destroyed bone marrow with healthy bone marrow stem cells. There are three types of bone marrow transplants: autologous using the patient's own stem cells collected before treatment, allogeneic using a donor's stem cells, and syngeneic using an identical twin's stem cells. Preparations for transplant include testing and treatments to suppress the immune system to prevent rejection of the donor cells. Risks include infection, graft failure or rejection, and complications from the immune suppression. Nurses monitor patients closely during transplant for issues like pain, fatigue, infection risk, and fluid imbalances.
APHERESIS METHODS AND TYPES APERESIS.pptItsMe468321
Apheresis is a technique where whole blood is collected from a donor or patient and separated into its components. The desired component is retained while the remaining constituents are returned. It is used to collect blood components for transfusion or remove pathological components. There are two main types of apheresis machines - intermittent flow centrifugation and continuous flow centrifugation. The process involves drawing blood, separating components via centrifugation, and collecting the desired component while returning the rest. Complications can include citrate toxicity, allergic reactions, and hypotension. Apheresis provides benefits over regular blood donation such as less HLA sensitization and lower risk of transfusion-transmitted infections.
Stem cell transplantation involves replacing a patient's bone marrow and immune system through chemotherapy and/or radiation, followed by infusion of stem cells from either another donor or the patient's own previously harvested cells. There are three main sources of stem cells: bone marrow, peripheral blood, and umbilical cord blood. After collection, stem cells are processed and the patient undergoes conditioning chemotherapy and/or radiation to prepare for transplantation. Post-transplant, patients experience pancytopenia followed by engraftment of the donor cells and gradual immune reconstitution over months. Complications can include graft-versus-host disease, infection, and relapse of the original disease.
Hematopoietic Stem Cell Harvesting and Mobilization.pptxroysudip900
procedure of bone marrow stem cell harvesting for bone marrow transplant by apheresis. mobilization of stem cell from bone marrow to peripheral blood. GCSF mobilization. Apheresis principle and procedure. stem cell from bone marrow collection. effect of stem cell collection form different sources. newer drugs for stem cell harvesting. adequate dose of stem cell to be collected. minimal invasive procedure.
Autologous bone marrow transplant involves harvesting a patient's own bone marrow stem cells, storing them, and later re-infusing them after high-dose chemotherapy or radiation treatment to destroy cancerous cells. The stem cells help repopulate the bone marrow and restore the immune system. Complications can include infections during the neutropenic phase, graft-versus-host disease, and mucositis. Long term effects may include secondary cancers or sterility. Autologous transplants are commonly used to treat blood cancers like lymphoma or multiple myeloma.
Peripheral blood stem cell transplantation (PBSCT) involves collecting stem cells from a patient's bloodstream and later infusing them back into the patient after chemotherapy or radiation therapy. PBSCT has replaced bone marrow as the most common stem cell transplantation procedure. Stem cells are collected from the bloodstream using growth factors alone or with chemotherapy, and the minimum number needed for a safe transplant is 2 million CD34+ cells per kilogram of body weight. PBSCT results in faster recovery time compared to bone marrow transplants due to higher numbers of stem cells and T cells collected.
Hematopoietic stem cell transplantation (HSCT) involves transplanting healthy stem cells to replace a patient's stem cells that have been destroyed by disease, radiation, or chemotherapy. There are two main types - autologous transplants which use the patient's own stem cells, and allogeneic transplants which use a donor's stem cells. The transplantation process includes conditioning the patient with chemotherapy and/or radiation, harvesting stem cells from the bone marrow or peripheral blood, transplanting the stem cells, and supporting the patient through engraftment and recovery. Complications can include graft versus host disease in allogeneic transplants or delayed engraftment if stem cell doses are too low.
The document discusses stem cell and bone marrow transplantation. It defines stem cells, embryonic stem cells, and adult stem cells. It also defines bone marrow transplantation and describes the different sources of bone marrow stem cells including peripheral blood, bone marrow harvest, and umbilical cord blood. The document outlines the indications for bone marrow stem cell transplantation and the types including autologous and allogeneic transplants. It provides details on the procedures for bone marrow transplantation and post-transplantation care and discusses common side effects.
Whole blood can be separated into various blood components through centrifugation due to differences in specific gravity. This includes packed red cells, which are red cells with most plasma removed; platelet concentrates, which contain platelets obtained from centrifuging whole blood; and fresh frozen plasma, which contains all coagulation factors obtained by freezing plasma within 6 hours. These components are used to treat different deficiencies and conditions like anemia, thrombocytopenia, and coagulation factor deficiencies. Blood derivatives manufactured from fractionating large plasma pools include immunoglobulins, coagulation factor concentrates, and albumin, which are used to treat immunodeficiencies, bleeding disorders, and hypoproteinemia.
INTRODUCTION
HISTORY
NEED OF SYNCHRONIZATION
SYNCHRONOUS CULTURES CAN BE OBTAINED IN SEVERAL WAYS:
Physical fractionation .
Chemical appro ach
CENTRIFUGAL ELUTRIATION
Inhibition of DNA synthesis
Nutritional deprivation
SYNCHRONIZATION AT LOW TEMPERATURE
CELLULAR TOTIPOTENCY
SOME HIGHLIGHTS OF CELL SYNCHRONIZATION
REFERENCES
Resealed erythrocytes as a novel delivery carrierMariamZewail
Resealed erythrocytes are effective and safe drug carriers for targeted and sustained drug delivery. Drugs can be easily entrapped into erythrocytes by several techniques. Resealed erythrocytes can be used a carrier for drugs, enzyme replacement therapy etc. However, the concept needs further optimization to be converted into a regular drug delivery system.
Resealed erythrocytes as a novel delivery carrierMariamZewail
Resealed erythrocytes can be obtained due to the different responses of red blood cells in response to different pHs. Resealed erythrocytes have several applications as a drug or enzyme carrier.
This document provides an overview of bone marrow transplantation (BMT). It discusses the definition, sources, types, indications, preparations, complications, and outcomes of BMT. Key points include: BMT involves transferring stem cells to replace abnormal stem cells or reconstitute treated marrow. Sources include bone marrow, peripheral blood stem cells, and cord blood. Complications can include graft-versus-host disease and rejection. Outcomes have improved with advances like HLA matching and use of unrelated donors, though conditioning mortality remains up to 15%.
Aplastic anemia comprises disorders of hematopoietic stem cells resulting in suppression of red blood cells, white blood cells, and platelets. It can be inherited or acquired from viruses, toxins, chemicals, or immune-mediated causes. Clinically, it presents as pancytopenia and bone marrow hypocellularity. Definitive treatment is hematopoietic stem cell transplant, which has better outcomes when using cells from an HLA-identical sibling donor. Without treatment, prognosis depends on severity of cytopenias and presence of risk factors.
This document provides an overview of hematopoietic stem cell transplantation (HSCT). It discusses the history and development of HSCT, the types of transplants including autologous and allogeneic, stem cell sources, the transplant process from collection and storage to conditioning and infusion, complications, and management considerations. Key events in the history of HSCT are highlighted, such as the first successful transplant between identical twins in 1956 and advances that enabled unrelated donor transplants.
Apheresis is a medical technology where blood is passed through an apparatus that separates out one constituent and returns the remainder to circulation. It works by centrifugation separating components by specific gravity. It can be used to collect blood components from donors or perform therapeutic procedures. Therapeutic apheresis includes plasma exchange and cytapheresis to treat conditions like thrombotic thrombocytopenic purpura or remove toxins. Guidelines categorize conditions based on evidence for apheresis with category I being primary therapy and category IV not responding. Potential adverse effects include citrate toxicity, infections, or depletion of components, so careful monitoring is important.
This document discusses the requirements and procedures for virus isolation through cell culture. The four main requirements are a cell culture facility, sterile technique, quality reagents, and knowledge of cell culture techniques. Primary and continuous cell lines differ in their lifespan and ability to produce growth factors. Cell cultures provide a convenient way to isolate viruses compared to eggs or animals. Successful virus isolation relies on appropriate sample collection, processing, and detection of cytopathic effects in cell monolayers through microscopic examination. Quality control measures like reagent screening and aseptic technique help prevent microbial contamination of cell cultures.
An Octogenarian Patient Of Intracapsular Neck Of Femur Fracture With Pre-oper...DrShinyKajal
Pre-operative Thrombocytopenia
collection and preparation of sdp single donor platelets
Hb, pt inr, platelet counts
apheresis
principle
donation criteria
sdp vs rdp
guidelines for platelet transfusion
etiologies of thrombocytopenia
isolated thrombocytopenia management
first line second line management
A case presentation of Exchange Transfusion in new born infant with Neonatal ...DrShinyKajal
A case of Exchange Transfusion in new born infant with Neonatal Jaundice and Rh incompatibility
transfusion management
double volume exchange transfusion
follow up at blood centre
antibody screening
direct antiglobulin test
technique
AABB standards
reconstituted whole blood
hyperbilirubinemia
kernicterus
encephalopathy
hematocrit and volume
Hemolytic disease of the fetus and newborn
Antigens which can cross placenta
RH immunoglobulin administration
RhIg
Hematopoietic stem cell transplantation (HSCT) involves replacing a patient's bone marrow with healthy stem cells from a donor. The document provides an overview of HSCT, including its history, types of transplants, the transplant process, and potential complications. It discusses how stem cells are collected from bone marrow, peripheral blood, or umbilical cord blood and cryopreserved. The transplant process includes conditioning chemotherapy/radiation, stem cell infusion, and recovery. Complications can include graft-versus-host disease and infection. Careful donor matching and screening is important for transplant success.
Bone marrow transplantation involves replacing damaged or destroyed bone marrow with healthy bone marrow stem cells. There are three types of bone marrow transplants: autologous using the patient's own stem cells collected before treatment, allogeneic using a donor's stem cells, and syngeneic using an identical twin's stem cells. Preparations for transplant include testing and treatments to suppress the immune system to prevent rejection of the donor cells. Risks include infection, graft failure or rejection, and complications from the immune suppression. Nurses monitor patients closely during transplant for issues like pain, fatigue, infection risk, and fluid imbalances.
APHERESIS METHODS AND TYPES APERESIS.pptItsMe468321
Apheresis is a technique where whole blood is collected from a donor or patient and separated into its components. The desired component is retained while the remaining constituents are returned. It is used to collect blood components for transfusion or remove pathological components. There are two main types of apheresis machines - intermittent flow centrifugation and continuous flow centrifugation. The process involves drawing blood, separating components via centrifugation, and collecting the desired component while returning the rest. Complications can include citrate toxicity, allergic reactions, and hypotension. Apheresis provides benefits over regular blood donation such as less HLA sensitization and lower risk of transfusion-transmitted infections.
Stem cell transplantation involves replacing a patient's bone marrow and immune system through chemotherapy and/or radiation, followed by infusion of stem cells from either another donor or the patient's own previously harvested cells. There are three main sources of stem cells: bone marrow, peripheral blood, and umbilical cord blood. After collection, stem cells are processed and the patient undergoes conditioning chemotherapy and/or radiation to prepare for transplantation. Post-transplant, patients experience pancytopenia followed by engraftment of the donor cells and gradual immune reconstitution over months. Complications can include graft-versus-host disease, infection, and relapse of the original disease.
Hematopoietic Stem Cell Harvesting and Mobilization.pptxroysudip900
procedure of bone marrow stem cell harvesting for bone marrow transplant by apheresis. mobilization of stem cell from bone marrow to peripheral blood. GCSF mobilization. Apheresis principle and procedure. stem cell from bone marrow collection. effect of stem cell collection form different sources. newer drugs for stem cell harvesting. adequate dose of stem cell to be collected. minimal invasive procedure.
Autologous bone marrow transplant involves harvesting a patient's own bone marrow stem cells, storing them, and later re-infusing them after high-dose chemotherapy or radiation treatment to destroy cancerous cells. The stem cells help repopulate the bone marrow and restore the immune system. Complications can include infections during the neutropenic phase, graft-versus-host disease, and mucositis. Long term effects may include secondary cancers or sterility. Autologous transplants are commonly used to treat blood cancers like lymphoma or multiple myeloma.
Peripheral blood stem cell transplantation (PBSCT) involves collecting stem cells from a patient's bloodstream and later infusing them back into the patient after chemotherapy or radiation therapy. PBSCT has replaced bone marrow as the most common stem cell transplantation procedure. Stem cells are collected from the bloodstream using growth factors alone or with chemotherapy, and the minimum number needed for a safe transplant is 2 million CD34+ cells per kilogram of body weight. PBSCT results in faster recovery time compared to bone marrow transplants due to higher numbers of stem cells and T cells collected.
Hematopoietic stem cell transplantation (HSCT) involves transplanting healthy stem cells to replace a patient's stem cells that have been destroyed by disease, radiation, or chemotherapy. There are two main types - autologous transplants which use the patient's own stem cells, and allogeneic transplants which use a donor's stem cells. The transplantation process includes conditioning the patient with chemotherapy and/or radiation, harvesting stem cells from the bone marrow or peripheral blood, transplanting the stem cells, and supporting the patient through engraftment and recovery. Complications can include graft versus host disease in allogeneic transplants or delayed engraftment if stem cell doses are too low.
The document discusses stem cell and bone marrow transplantation. It defines stem cells, embryonic stem cells, and adult stem cells. It also defines bone marrow transplantation and describes the different sources of bone marrow stem cells including peripheral blood, bone marrow harvest, and umbilical cord blood. The document outlines the indications for bone marrow stem cell transplantation and the types including autologous and allogeneic transplants. It provides details on the procedures for bone marrow transplantation and post-transplantation care and discusses common side effects.
Whole blood can be separated into various blood components through centrifugation due to differences in specific gravity. This includes packed red cells, which are red cells with most plasma removed; platelet concentrates, which contain platelets obtained from centrifuging whole blood; and fresh frozen plasma, which contains all coagulation factors obtained by freezing plasma within 6 hours. These components are used to treat different deficiencies and conditions like anemia, thrombocytopenia, and coagulation factor deficiencies. Blood derivatives manufactured from fractionating large plasma pools include immunoglobulins, coagulation factor concentrates, and albumin, which are used to treat immunodeficiencies, bleeding disorders, and hypoproteinemia.
INTRODUCTION
HISTORY
NEED OF SYNCHRONIZATION
SYNCHRONOUS CULTURES CAN BE OBTAINED IN SEVERAL WAYS:
Physical fractionation .
Chemical appro ach
CENTRIFUGAL ELUTRIATION
Inhibition of DNA synthesis
Nutritional deprivation
SYNCHRONIZATION AT LOW TEMPERATURE
CELLULAR TOTIPOTENCY
SOME HIGHLIGHTS OF CELL SYNCHRONIZATION
REFERENCES
Resealed erythrocytes as a novel delivery carrierMariamZewail
Resealed erythrocytes are effective and safe drug carriers for targeted and sustained drug delivery. Drugs can be easily entrapped into erythrocytes by several techniques. Resealed erythrocytes can be used a carrier for drugs, enzyme replacement therapy etc. However, the concept needs further optimization to be converted into a regular drug delivery system.
Resealed erythrocytes as a novel delivery carrierMariamZewail
Resealed erythrocytes can be obtained due to the different responses of red blood cells in response to different pHs. Resealed erythrocytes have several applications as a drug or enzyme carrier.
This document provides an overview of bone marrow transplantation (BMT). It discusses the definition, sources, types, indications, preparations, complications, and outcomes of BMT. Key points include: BMT involves transferring stem cells to replace abnormal stem cells or reconstitute treated marrow. Sources include bone marrow, peripheral blood stem cells, and cord blood. Complications can include graft-versus-host disease and rejection. Outcomes have improved with advances like HLA matching and use of unrelated donors, though conditioning mortality remains up to 15%.
Aplastic anemia comprises disorders of hematopoietic stem cells resulting in suppression of red blood cells, white blood cells, and platelets. It can be inherited or acquired from viruses, toxins, chemicals, or immune-mediated causes. Clinically, it presents as pancytopenia and bone marrow hypocellularity. Definitive treatment is hematopoietic stem cell transplant, which has better outcomes when using cells from an HLA-identical sibling donor. Without treatment, prognosis depends on severity of cytopenias and presence of risk factors.
This document provides an overview of hematopoietic stem cell transplantation (HSCT). It discusses the history and development of HSCT, the types of transplants including autologous and allogeneic, stem cell sources, the transplant process from collection and storage to conditioning and infusion, complications, and management considerations. Key events in the history of HSCT are highlighted, such as the first successful transplant between identical twins in 1956 and advances that enabled unrelated donor transplants.
Apheresis is a medical technology where blood is passed through an apparatus that separates out one constituent and returns the remainder to circulation. It works by centrifugation separating components by specific gravity. It can be used to collect blood components from donors or perform therapeutic procedures. Therapeutic apheresis includes plasma exchange and cytapheresis to treat conditions like thrombotic thrombocytopenic purpura or remove toxins. Guidelines categorize conditions based on evidence for apheresis with category I being primary therapy and category IV not responding. Potential adverse effects include citrate toxicity, infections, or depletion of components, so careful monitoring is important.
This document discusses the requirements and procedures for virus isolation through cell culture. The four main requirements are a cell culture facility, sterile technique, quality reagents, and knowledge of cell culture techniques. Primary and continuous cell lines differ in their lifespan and ability to produce growth factors. Cell cultures provide a convenient way to isolate viruses compared to eggs or animals. Successful virus isolation relies on appropriate sample collection, processing, and detection of cytopathic effects in cell monolayers through microscopic examination. Quality control measures like reagent screening and aseptic technique help prevent microbial contamination of cell cultures.
An Octogenarian Patient Of Intracapsular Neck Of Femur Fracture With Pre-oper...DrShinyKajal
Pre-operative Thrombocytopenia
collection and preparation of sdp single donor platelets
Hb, pt inr, platelet counts
apheresis
principle
donation criteria
sdp vs rdp
guidelines for platelet transfusion
etiologies of thrombocytopenia
isolated thrombocytopenia management
first line second line management
A case presentation of Exchange Transfusion in new born infant with Neonatal ...DrShinyKajal
A case of Exchange Transfusion in new born infant with Neonatal Jaundice and Rh incompatibility
transfusion management
double volume exchange transfusion
follow up at blood centre
antibody screening
direct antiglobulin test
technique
AABB standards
reconstituted whole blood
hyperbilirubinemia
kernicterus
encephalopathy
hematocrit and volume
Hemolytic disease of the fetus and newborn
Antigens which can cross placenta
RH immunoglobulin administration
RhIg
A Case presentation of Massive Transfusion in post LSCS PPH patientDrShinyKajal
workup at blood centre
components issued
transfusion summary
criteria for massive transfusion
goal of massive transfusion
Indication protocol for massive transfusion for whole blood, prbc, ffp, cryo, platelets
Targets of resuscitation in massive blood loss
Complications of Massive Transfusion
citrate toxicity
lethal triad
case presentation on diagnosis of beta thalassemia majorDrShinyKajal
case history of 9 month old infant
Paediatric Clinical Approach to this case
examination
workup at blood centre
HPLC screening
laboratory findings
screening of father mother
prominent facial features
PBF and bone marrow findings
usg abdomen
xray skull
prbc transfusion therapy in thalassemia major
classification of thalassemia
national burden in india
pathogenesis- anemia skull bone iron overload
world thalassemia day
Troubleshooting in Transfusion transmissible infection TTI laboratoryDrShinyKajal
Checklist of categories for troubleshooting in TTI
Factors affecting Troubleshooting in TTI Lab
controls used in assay testing
Principles and Practices of ELISA and Rapid for TTI Screening
Equipment Management in TTI Laboratory
calibration of equipments used
Documentation and Records in TTI Laboratory
Root Cause Analysis and Process Improvement in TTI Laboratory
External Quality Assessment Scheme and Proficiency Testing
Waste management in transfusion centre
Principle of Troubleshooting in TTI Lab
Case presentation onHeterozygous variant of Hemoglobin EDrShinyKajal
case presentation on heterozygous hemoglobin E
investigations
HPLC high performance liquid chromatography test
HbA2
fetal hemoglobin values in different variants of hempglobin
hemoglobinopathies
HbS, HbE, HbD
Case presentation on Antibody screening- how to solve 3 cell and 11 cell panel?DrShinyKajal
Blood group antibodies
different reaction grades
test material required for antibody identification
procedure
antibody screening using 2-3 cell panel
antibpdy identification using 11 cell panel
immediate spin phase
37 degree c
ahg phase
check cells
interpretation antibody workups
enzyme technique
Tissue Banking and Umbilical Cord Blood BankingDrShinyKajal
Umbilical cord blood vs bone marrow vs peripheral stem cells
indications of stem cell transplant
Regulatory requirements for cord blood banking
Requirements for processing, testing and storage areas for UCB
Air-handling system
Personnel for Cord Blood Bank
Collection of processed UCB component
procedure- in utero ex utero
transportation
processing
freezing
storage
screening tests
quality control
advantages and disadvantages
labelling
tissue collection
live and deceased donors
Transfusion support in Surgery- elective surgery, cardiac surgery, MSBOS, Tra...DrShinyKajal
AABB indications
Elective surgeries- Maximum surgical blood ordering schedule
Anemia and surgery- including Transfusion Trigger
Surgery and coagulation disorders- including factor replacement
Transfusion in cardiac surgeries- including autologous transfusion
Patient Blood management in surgery
Allogenic Transfusion
Autologous Transfusion- Intra And Postoperative Red Cell Salvage, Haemodilution
Blood Substitutes
Haematopoietic Factors
Antifibrinolytics
Fibrin Sealants
Conjugated Oestrogens.
AABB pretransfusion testing schemes
Type and screen
Maximum surgical blood ordering schedule
transfusion trigger for surgery
factor replacement in surgery
autologous transfusion
cell salvage
perioperative
massive transfusion protocol
pathogen inactivation of cellular components.pptxDrShinyKajal
Chemical inactivation
Photo-inactivation
Solvent-detergent Plasma
Photosensitizers
Methylene Blue light treatment
Psoralen Ultraviolet Light Treatment
Riboflavin Light Treatment
INTERCEPT System
Mirasol system
Platelet and plasma Pathogen Inactivation
FRALE and azridine compounds
1. Bio preservation of Red Cell Components 2. CULTURED RBCs 3. solvent plasmaDrShinyKajal
1. Bio preservation of Red Cell Components
2. CULTURED RBCs
3. Solvent plasma
Hypothermic storage
Cryopreservation
Lyophilization
Desiccated RBCs
Three major sources of cells are under consideration:
circulating stem and progenitor cells from adults or from cord blood
immortalized progenitors
pluripotent stem cells.
Immortalized Progenitors
LIQUID CULTURE METHODS- by the SED (stem cell factor (SCF), erythropoietin, and dexamethasone) and STIF cocktails (stem cell factor, thombopoietin, insulin-like growth factor-2, fibroblast growth factor-2)
ENUCLEATION- separation of extruded nuclei from cRBCs
SCALING UP- using cord blood CD34+ cells in bioreactors
and treated for 4 h with TNBP (tri-nitrobutylphosphate)solvent and with Triton X-100 detergent
Storage of Blood Components- equipments, effects of improper storage, transpo...DrShinyKajal
Introduction
Equipments required
Harmful effects of improper storage
Storage of various blood components- AABB guidelines
NACO guidelines for storage
Storage during transport
Storage in frozen state
Physical and chemical changes in stored blood
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
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The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
At Apollo Hospital, Lucknow, U.P., we provide specialized care for children experiencing dehydration and other symptoms. We also offer NICU & PICU Ambulance Facility Services. Consult our expert today for the best pediatric emergency care.
For More Details:
Map: https://cutt.ly/BwCeflYo
Name: Apollo Hospital
Address: Singar Nagar, LDA Colony, Lucknow, Uttar Pradesh 226012
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End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
1. A seminar on-
Peripheral Blood Stem
Cell Transplantation
Presented By- Dr. Shiny
Moderator- Dr. Yadwinder Kaur Virk
2. TOPICS
Human Stem Cells- Introduction
Types of HSC transplants
Indications
Sources of stem cells
Collection and mobilization
Types of Mobilizing agents
Processing
Cryopreservation and storage
PBSC Transplant
Quality control
Complications
3. INTRODUCTION
Hematopoietic stem cells (HSC)
Primitive pluripotent cells, multipotent in adult stem cells (restricted
differentiation capacity depending upon location)
Capable of self-renewal
Differentiation into any cells of haematopoietic lineage
(lymphocytes, monocytes, granulocytes, erythrocytes, and platelets).
4. Clinically, HSCs can fully reconstitute the functions of
marrow when transplanted into susceptible recipients.
Stem cells are forming the core of a new field called
“Regenerative Medicine”.
HSC transplantation has been increasingly utilized to treat
different hematologic and non-hematologic conditions.
5. PROPERTIES OF STEM CELLS
SELF MAINTENANCE- Ability to maintain their own population at constant level
ASYMMETRIC REPLICATION- With each stem cell replication, some daughter
cells differentiate into other mature cells while remaining cells form stem cells
STEM CELL IDENTITY- At present, CD34 is widely used to identify HSCs
6. HAEMOTOPOIETIC GROWTH FACTORS
SCFs (Stem Cell Factors)- responsible for proliferation and self renewal of these cells.
Glycoprotein Growth Factors- for proliferation and maturation of cells that enter blood from
marrow.
Colony Stimulating Factors (CSFs)
Others- Erythropoietin, Thrombopoietin
Granulocyte-macrophage CSF (GM-CSF)
Macrophage- CSF (M-CSF)
Granulocyte- CSF (G-CSF)
7. Haematopoietic Stem Cell (HSC) Transplantation
Defined as ability to achieve long term reconstitution of both myeloid and lymphoid
lineages.
TYPES
ALLOGENIC
• HSCs from donor having
different genetic constitution
• For defective marrow function or
when tumour cells are extensively
infiltrating bone marrow.
• Also requires graft vs host disease
prophylaxis.
SYNGENEIC
HSCs from
identical twin
AUTOLOGOUS
HSCs from patient’s own BM or
peripheral blood, later infused
back after intensive chemo or
radiotherapy.
• Performed when bone marrow
function is normal.
• Eg.- Multiple Myeloma
9. SOURCES OF STEM CELLS
MOST COMMON OTHER UNCOMMON
Bone Marrow Wharton’s Jelly
Peripheral Blood Liposuction Waste
Umbilical Cord Blood Mesenchymal Cell Structures
etc.
10.
11. STANDARD PROTOCOL FOR HSC
TRANSPLANTATION
DONOR EVALUATION BLOOD GROUPAND
INFECTION TESTING
STEM CELL
HARVESTING
1. Marrow assay- to see
sufficient mobilization
of stem cells
2. Detailed history,
thorough physical
examination
3. HLA compatibility
between donor and
recipient
ABO-Rh, Hep B, Hep C,
Syphilis, TORCH etc. within
30 days of scheduled
collection of stem cell
product.
Collection
Processing
Storage
13. Collection of peripheral blood stem cells
(PBSC)
PBSCs- used in most autologous and allogeneic stem cell transplantation.
Mobilization of stem cells into the peripheral blood- defined as the increased
release of immature and mature haematopoietic cells from the marrow into the blood
circulation.
Initially, stem cell mobilization was achieved by- chemotherapy alone.
Presently-
Recombinant growth factors such as granulocyte-colony stimulating factors (G-
CSF)- considered the standard mobilizing agent.
14. First, Hematopoietic progenitor cells are measured using the CD34+ cell
surface marker
A dose of G-CSF, 5-15 µg/kg for a period of 5 days, is usually sufficient
to increase HSCs in peripheral circulation.
A Dose of G-CSF alone- From a baseline concentration of <5x106/L, blood
CD34+ cell counts increase 10 to 30 folds at 96-144 hours after first daily
dose of G-CSF or single injection of pegfilgrastim; peak comes at 120
hours.
COLLECTION- Mobilization
15. COLLECTION- Mobilization
PREFERRED MOBILIZATION STRATEGY for autologous
transplant in oncology patients-
Most reliable Chemomobilization drug- Cyclophosphamide
Advantage- enhances more progenitors to be collected with fewer
apheresis procedures
Growth Factor Administration + Chemotherapy
(Chemomobilization)
16. Mobilization is followed by collection using the apheresis method
Poor mobilization of PBSCs might occur due to old age, female
gender, prior radiation to active marrow sites, prior treatment with
purine analogues (especially fludarabine), or due to increasing cycles
and regimens of chemotherapy.
Mobilizing agents can be divided into- chemotherapy, cytokines,
or chemokines
17. A. CHEMOTHERAPY
used as a mobilization agent only in autologous transplant settings
Typical chemotherapy agents used for mobilization include:
• Single-agent cyclophosphamide, especially in patients with Multiple myeloma
• Combination chemotherapy regimens like ifosfamide,carboplatin,etoposide (ICE)
Advantage: It can be coordinated as a part of a salvage chemotherapy regimen
Disadvantage: The timing of apheresis is not as predictable as it is with G-CSF alone
Side effects:
• Side effects of individual chemotherapies
• Risk of myelosuppression, risk of infections
18. B. CYTOKINES
The standard agent for cytokine mobilization -> G-CSF
Has been shown to mobilize more CD34+cells with less toxicity than other GFs.
A standard dose of G-CSF is 10-15μg/kg/day given subcutaneously
Advantage: Predictability of apheresis scheduling is easier as CD34+ cells peak by
day 4 or 5 of G-CSF mobilization
Disadvantage: Sometimes, G-CSF mobilization fails to provide an adequate
collection and is termed as poor mobilization
Side effects: Injection site erythema, Bone pain, Headache, Fever, Splenic rupture
19. C. CHEMOKINES
Chemokines: Plerixafor- reversible bicyclam inhibitor of haematopoietic stem cell
binding to stromal cell-derived factor-1 alfa (SDF-1) on marrow stromal cells
Used alone or in combination with G-CSF
On the evening of day 4 of G-CSF dose, plerixafor (240 μg/kg given subcutaneously) is
administered approximately 10-11 hrs before apheresis, followed by apheresis on day 5.
Non-responders to G-CSF often respond to a dose of plerixafor administered on the
previous night of collection.
Side effects: Injection site erythema, Vomiting, Flatulence, Diarrhoea
20. Collection of PBSCs by apheresis
Commonly used machines- Optia Spectra, Cobe Spectra, CS 3000 Plus, etc.
PBSC collection can be either started when peripheral leukocyte counts rise to ≥ 1.0 x
109/μl or when peripheral blood CD34 level is above the centre’s cut-off (typically 5-
20 CD34+ cells/ μL).
Because PBSCs segregate in the mononuclear cell fraction of blood, apheresis
devices capable of mononuclear cell concentration and harvest may be used to collect
these cells.
Processing 2-3 blood volume (10-15 L) per procedure requires approximately 3-5
hours.
21.
22.
23. Adverse effects of PBSC Collection
Procedures for mobilization and collection of PBSCs from patients and
normal donors are well-tolerated by most of them.
Common adverse effects of mobilization with growth factors include bone
pain, myalgia, headache, and fatigue.
Subside on their own or on mild medication and subside completely when
growth factors are stopped.
Citrate toxicity in apheresis procedure
Sometimes complications can result from peripheral/central line placement
(including hematoma, thrombosis, infection, etc.).
24. Appropriate Time and Target of collection
1. When Leukocyte count exceeds 5x109/L. (However Leukocyte
concentration does not always correlate with no. of HSCs in peripheral
blood)
2. Analysis of CD34+ cells by Flow cytometry (Standard- when CD34+
cells > 10 cells/µL)
3. Collection Targets- Minimum threshold of CD34+ cells necessary
for engraftment is 2-5x106 cells/kg body weight of patient.
4. In terms of MNC count- 4-6 x 108 MNCs/kg
26. VARIOUS METHODS FOR PROCESSING
ROUTINE METHODS SPECIALIZED METHODS
1. Volume Reduction- to prevent fluid overload in
patients
2. Red Cell Reduction- to prevent haemolytic
transfusion reactions
3. Buffy Coat preparation
4. Thawing- in a 37°C water bath
5. Washing- removes lysed red cells, haemoglobin,
and cryoprotectant (DMSO)
6. Filtration- to remove bone spicules, aggregates,
and debris
1. Elutriation- separates cell populations based on
two physical characteristics— size and density
(sedimentation coefficient)
2. Cell Selection Systems- the isolation of the cell
type of interest by either positive
selection(target cells retained) or negative
selection (target cells depleted) using target
antibodies as magnet
3. Cell expansion- includes stem cell factor, FMS-
like tyrosine kinase 3 (FLT-3) ligand, and
thrombopoietin,
27. CELL PROCESSING METHODS for PBSCs
Fluorescent- Activated
Cell Sorting
Immunoadsorption Systems Physical Parameter
separation
-Combines flow
cytometry with physical
separation to segregate
individual cells based on
the expression of
molecules.
-Not used on large scale
1. Positive Selection- CD34+ cells
magnetically retained, unwanted
cells removed. (passive
depletion)
2. Negative selection- Tumor cells
magnetically retained, desired
cells released and collected.
(active depletion)
Magnetic bead- Anti CD34 antibody
Machines- Isolex 300i system
(magnetic cell separator),
CliniMACS
1. By centrifugation on the
basis of density of
progenitor cells.
2. By increasing density of
unwanted cells and
removing them.
28. PERIPHERAL BLOOD PROCESSING
2 protocols to process PBSC Products-
PBSC Volume Reduction Peripheral Blood Stem Cell
washing
Reducing volume of PBSCs after
leucopheresis to optimize cell
concentration and reduce DMSO
toxicity
Automated safe removal of DMSO
and haemolyzed plasma from thawed
leucopheresis products.
30. CRYOPRESERVATION AND STORAGE
The product is collected in Liquid state.
Can be stored as liquid for 3 days at 4 degrees C without any significant loss of
viability; then cryopreserved until infusion
No expiry date defined till now.
Cryoprotectant used- DMSO (Allows controlled freezing and thawing of
mononuclear cells without development of membrane lysis).
Preparation of cryoprotectant solution-
hydroxyethyl starch (HES)- 60 ml
DMSO(Dimethyl sulfoxide)- 15 ml
Albumin- 25 ml
For every 100 mL of
cryoprotectant solution
31.
32. METHODS OF FREEZING
CONTROLLED-RATE
FREEZING
NON- CONTROLLED RATE
FREEZING
A controlled rate freezer used,
whose temperature is slowly
decreased by 1 degree/minute
till product reached a specific
temperature.
Products are stored at -80 degrees
C mechanical freezer after
mixing with cryoprotectant.
These products have been
engrafted for as long as 2 years of
storage
LIQUID NITROGEN
STORAGE
In liquid nitrogen freezer.
• Liquid state maintains
at -180 degrees C or
lower
• Vapor state maintains
at -140 degrees or lower
34. Thawing and Infusion
Flow through Central Venous catheter; cells are infused by gravity drip,
calibrated pump or manual push with/without in-line filter.
Thaw one bag at a time to minimize thawed cells exposure to DMSO ex vivo
Or, immerse entire bag except access ports, into sterile water or saline at 37-
40 degrees C.
Infusion- at the rate of 10-15 ml/minute.
Infusion volume- not more than 10 mL/kg body weight of patient per
infusion
35. Transfusion support in PBSC transplant
ABO incompatible transplants require more transfusions because of delayed
cellular engraftment and red cell aplasia.
Plasma reduction may be performed in cases of minor ABO incompatibility
White red cell depletion may be performed in cases of Major ABO
incompatibility
For 2-way incompatibility- Group O RBC units and Group AB plasma
should be used
Leucoreduction and irradiation- widely done to avoid HLA
alloimmunization or transfusion associated GVHD.
36.
37. QUALITY CONTROL AND EVALUATION
1. CELL COUNTS- Total MNC concentration
2. BACTERIAL AND FUNGAL CULTURES- usually just before
freezing in autologous transplants and before infusion in allogenic
transplants.
3. CD34 ANALYSIS- Yield analysis using flow cytometry
4. CELL VIABILITY ASSAY- Acceptable standard of >70%
viability of cells
5. COLONY FORMING CELLASSAY- to demonstrate in-vitro
proliferative capacity of haematopoietic cell sample.
39. ACUTE GVHD CHRONIC GVHD
• Usually diagnosed before day 100
• Typically occurs near time of engraftment
• Almost always involves skin
• Also can involve intestine, liver, or lung
• Substantial cause of morbidity and
mortality
• SIGNS/SYMPTOMS- Palmar Erythema,
Puritic Maculopapular Rash, etc.
Diagnosed after day 100
Includes-
• Immunodeficiency
• Skin- lichen planus, poikiloderma
• Vitiligo, hyperpigmentation
• Scleroderma
• Limited joint mobility
• Sicca syndrome
• Mouth ulceration/food sensitivity
• Hepatic- vanishing bile ducts
• Pulmonary- bronchiolitis obliterans
• GI- esophageal strictures, fat
malabsorption
40.
41. Quick Summary
Transplantation- Allogenic, Autologous
Sources- Bone marrow, Peripheral Blood, Umbilical cord blood
Mobilization- Chemotherapy, Cytokines(G-CSF-5-10ug/kg), Chemokines
Processing- Routine(volume reduction,red cell
reduction,thawing,washing,filtration)
- Special methods(Positive & Negative depletion, Elutriation)
Cryostorage- controlled, uncontrolled, liquid nitrogen
Infusion- 10-15 mL/min, not more than 10 mL/kg body weight per infusion
42. REFERENCES
Principles and Practice of Transfusion Medicine, Dr. R. N. Makroo, 2nd edition.
DGHS, Transfusion medicine, technical manual 3rd edition 2022.
Denise. Harmening, Modern Blood Banking and transfusion practices, 7th
edition.