{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:04:28Z","timestamp":1753869868168,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000454","KL2TR000455"],"award-info":[{"award-number":["UL1TR000454","KL2TR000455"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>During major ABO\u2010mismatched bone marrow transplant (BMT), the infusion of incompatible red blood cells (RBCs) that are present in the bone marrow graft can cause adverse events from hemolysis. RBC depletion of the bone marrow graft can decrease this risk, but the optimal method to prevent hemolysis is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We conducted a retrospective cohort study of patients who underwent major ABO\u2010mismatched BMT at a pediatric center and had RBC depletion with either hydroxyethyl starch (HES) sedimentation or Ficoll density gradient separation. Postinfusion hemoglobinuria and creatinine values were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2002 and 2016, 37 patients received HES\u2010treated and 16 patients received Ficoll\u2010treated major ABO\u2010mismatched bone marrow grafts. The median residual volume of RBCs was significantly greater with HES\u2010treated grafts (HES 21.0\u00a0ml vs. Ficoll 1.4\u00a0ml, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). Patients who received HES\u2010treated grafts had a higher prevalence of postinfusion hemoglobinuria (HES 57%\u00a0vs. Ficoll 6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0009), but renal impairment was rare. Considering only HES\u2010treated grafts, the volume of RBCs was not associated with either postinfusion hemoglobinuria or a creatinine increase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ficoll density gradient separation achieves smaller RBC volumes and less postinfusion hemoglobinuria than HES sedimentation, but both can prevent significant hemolysis. Further studies are needed to determine the residual incompatible RBC volume threshold in major ABO\u2010mismatched BMT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26883","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T11:08:51Z","timestamp":1510139331000},"source":"Crossref","is-referenced-by-count":2,"title":["Infusion hemolysis after pediatric major ABO\u2010mismatched bone marrow transplant: Comparison of two red blood cell depletion techniques"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4277-7523","authenticated-orcid":false,"given":"Robert Sheppard","family":"Nickel","sequence":"first","affiliation":[{"name":"Division of Hematology Children's National Health System  Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muna","family":"Qayed","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta Department of Pediatrics, Emory University  Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Worthington\u2010White","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta Department of Pediatrics, Emory University  Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean R.","family":"Stowell","sequence":"additional","affiliation":[{"name":"Department of Pathology Center for Transfusion and Cellular Therapy Emory University  Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuang\u2010Yueh","family":"Chiang","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology The Hospital for Sick Children  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21025"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12466"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.04106.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12552"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.03.021"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.02.020"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24771"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704816"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1999.39299154733.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.036"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02734.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13353"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.11.011"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12933"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.160804"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.230"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1309\/VXY1ULAFUY6E6JT3"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.264"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03069.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1985.tb00152.x"},{"key":"e_1_2_8_22_1","article-title":"Isolation of mononuclear cells from human cord blood by Ficoll\u2010Paque density gradient","author":"Jaatinen T","year":"2007","journal-title":"Curr Protoc Stem Cell Biology"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00735.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13001"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704579"},{"volume-title":"Hematopoietic Cellular Therapy Accreditation Manual","key":"e_1_2_8_26_1","first-page":"123"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.309"}],"container-title":["Pediatric Blood &amp; 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