Red cell deformability and filterability : proceedings of the second workshop held in London, 23 and 24 September 1982, under the auspices of the Royal Society of Medicine and the Groupe de travail sur la filtration erythrocytaire

This book is an edited verbatim account of the proceedings of the Second London Workshop on Red Cell Filtration and Deformability, organised jointly by the Royal Society of Medicine and the Groupe de Travail sur la Filtration Erythrocytaire. The first such London Workshop was held on the occasion of the Second European Conference on Clinical Haemorheology in 1981 and its con­ clusions were published in an abbreviated form. The interest in blood filtration as a technique for assessing red cell deformability has continued to increase and there are now several hundred centres around the world using some form of filtration. It was, therefore, felt that the informal detailed discussions held by a small invited group of experts from many countries would be of more general interest and therefore worth publishing. This has been made possible by the continued interest and generous support of Hoechst. Spontaneous open discussion rather than formal presentations has been the hallmark of these workshops, with precirculation of all scientific data to the participants. We have attempted to preserve this flavour in editing the transcript of the proceedings. This, together with our anxiety for rapid publication, may have resulted in a less than finely polished text which may contain some in­ accuracies. The topics discussed were loosely structured into eight sessions, outlined in the accompanying programme. This book contains the proceedings of a symposium on the use of synthetic substrates in clinical blood coagulation assays, which was held at the University of Leuven, Belgium, on March 1st, 1980. This meeting was organized in order to exchange and discuss recent develop­ ments and applications in this field. Advantages and disadvantages of synthetic substrates are discussed, while expert workers report on their practical experience with the use of chromogenic substrates in routine assays for blood coagulation and fibrinolysis. The indications when to perform antithrombin III, a2-antiplasmin, factor X and factor II determinations are discussed. For each of the determinations a critical evaluation of the chromogenic assay as compared to the classical assay is presented. The clinical relevance of these assays for anticoagulated and cirrhotic patients, detection of vitamin K deficiency, monitoring heparin therapy and the fibrinolytic system are discussed. Recent developments in the use of fluorogenic substrates for the assay of low concentrations of fibrin­ olytic activators are presented. Taking into account all practical, medical and economical con­ siderations an answer is prepared to the question'Are synthetic sub­ strates to be recommended for routine use?'. To make this symposium useful, rapid publication of the proceedings has been undertaken. We are grateful to the participants in this meeting for their co­ operation and for their willingness to provide manuscripts of their presentations. The manuscripts provided by C. Kluft and H.H.D.M. The practice of transfusing blood started at the bedside but over the last few decades blood transfusion has become more and more a laboratory directed discipline. The emphasis on serology and laboratory controlled measures has made blood transfusion safer and more effective, but laboratory and clinical aspects of the discipline have tended to become increasingly separated. As a result of this separation clinical developments in blood transfusion may not have derived full benefit from the knowledge accrued in blood transfusion services. Over the last five years the Red Cross Blood Bank Groningen-Drenthe has organised yearly symposia with a clinical theme in order to bring blood banks and clinicians closer together. Many of the recent major advances in clinical medicine have been based on developments in blood transfusion practice. This is certainly true for paediatric medicine. For instance, in paediatric oncology, including leukemia, cell separator programmes have made available new forms of support. Further, blood component therapy has provided an effective means of control in some of the bleeding disorders of children. Some of these topics are discussed in this symposium dealing with intensive care. Haemolytic disease of the newborn and exchange transfusion are other aspec.ts of intensive care. Our purpose in dealing with them was twofold. J.J. Van Loghem Previously to this symposium, five others have taken place in Groningen. The first one in 1976. This yearly scientific happening has continued. It has greatly stimulated the in­ terest in blood transfusion and all allied disciplines in our country. It is clear that these meetings are organized not only by a good scientist, but at the same time by a gifted or­ ganizer who, as director of the Red Cross Blood Bank Gro­ ningen-Drenthe, has shown that the heavy load of daily routine work can very well be combined with a large amount of experimental and clinical research in blood component therapy, coagulation disorders, blood group genetics and serology, the latter in cooperation with the Blood Group laboratory of the University Hospital Groningen under the directorship of Dr. Van Dijk. All these activities show how much a well-organized blood bank can contribute to a national blood transfusion orga­ nization. Front Matter....Pages I-X Welcome....Pages 1-1 Welcome....Pages 3-4 Introduction....Pages 5-6 Consideration of the ideal sampling technique, anticoagulant, storage conditions and temperature of measurement....Pages 7-35 Shear stresses and haemolysis in filtration tests....Pages 36-63 Effects of haematocrit, leukocytes and platelets....Pages 64-103 Plasma and suspending medium....Pages 104-116 Types of filters....Pages 117-146 Filtration equipment....Pages 147-168 Report from the Groupe de Travail sur la Filtration Erythrocytaire (French Filtration Group)....Pages 169-175 Clinical relevance of filtration tests....Pages 176-215 Specific recommendations for filtration tests....Pages 216-221 Overall conclusions....Pages 222-223 Sponsored By The Commission Of The European Communities, As Advised By The Committee On Medical And Public Health Research ; Edited By N. Fabris. Includes Bibliographies. Edited By H. R. Lijnen, D. Collen, M. Verstraete. Proceedings Of A Symposium Held At The University Of Leuven, Belgium, Mar. 1, 1980. Includes Bibliographical References. Organized By The Red Cross Bloodbank Groningen-drenthe ; Edited By C. Th. Smit Sibinga, P.c. Das, And J.o. Forfar. Includes Bibliographies.