Der von Laurell und Eriksson 1963 (8) beschriebene a1-Antitrypsin-Defekt hat wie alle bisher bekannten Defektpathoproteinämien eine besondere klinische Bedeutung. Er wird wahrscheinlich rezessiv-autosomal vererbt (3, 6,9). 5070°/o der Defekt-

In a 5-year-study of HLA-phenotypes in 411 HIV-1-infected individuals, a progressive decrease of the formerly elevated frequency of HLA-DR5 has been observed. HLA-DR3 seems to have a protective effect. These results are discussed with respect to the mimicry-hypothesis of HLA and disease associations. Further preliminary results indicate that HIV-associated Kaposi's sarcoma could be associated with HLA-A28, and therefore might be a different etiologic entity than HIV-infection alone.

By means of automation of the serological working steps and automated reading of typing trays by a PC-based microscope photometer System, 34000 voluntary unrelated bone marrow donors were been HLA-class l (A, B)-typed from March 199 to November 1992 in the laboratory of the Düsseldorf Center of the Bone Marrow Donor Registry of ' lab.med. 17: 95 (1993) 95 Brought to you by | University of Manchester Authenticated Download Date | 5/26/15 6:06 PM Originalle North Rhine Westfalia. This high frequency of HLA-class l typing (2000-2500/month) correlates with the increase in the number of requests for HLA-class II (DP, DQ) typing. In order to ensure rapid and accurate DB, DQ typing, either isolated B-cell preparations or unseparated mononuclear cells were employed in the dual color fluorescent cytotoxicity test. The advantage of B/T cell Separation with immunomagnetic beads lies in the extreme purity ofthe isolated B lymphocyte subset (95-100%) and in a noticeable saving of time in comparison to nylon wool-enriched B-lymphocyte preparations. In particular, automated reading of the HLA class II typing trays using a PC-based microscope photometer System results in superior precision äs well a$ further considerable saving of time. Thus the effective reading time has been reduced from 5-75 min per tray (visual) to 20 sec. This, furthermore, provides the prerequisite for the high frequency oftypings per day. The direct comparison of HLA-DR, DQ typing between automated and visual reading shows a very high degree of reliability (99%, basis 1600 DR, DQ typings). The concordance ofboth readouts (visual and by automatic microscope) is 93.9%. This calculation is based on the comparison of the serological scores of 100 defined DR72 well trays equaling 72000 wells, which were examined for consistency on a score-by-score basis, and by cross-tabulation ofthese data. The fact that unseparated B and T cells, i.e. mononuclear cell can also be employed directly for the automated reading of class II typing trays, is of particular importance in regard to infectious cell material, e.g. from HIV positive individuals. The automatic microscope sets an electronic tray specific sensitivity Standard with respect to HLA-DR and -DQ typing. This methodological Variation is particularly effective when separate trays are used for the DR and DQ reading. Reading by the automatic microscope, however, becomes complicated because of the different sera reactions for DR and DQ, if DR and DQ specific sera are on the same tray, Sharing their positive and negative control reactions.

No abstract

In spite of intensive efforts to reduce the risk of hepatitis B after heart operations, this complication is observed in 40 % or more of the cases. Over a period of three years (1974-1976) we examined 588 patients who had undergone open heart surgery. The following results were found: In 1974 the hepatitis frequency was 2.0 %, while in 1975 and 1976 it was 0.6 % hepatitis B and 0.6 % non-B hepatitis. We believe the reason for this improvement is a more careful selection of blood donors and their continuous control according to the following parameters: regular clinical observation; regular chest x-ray; determination of BSR, hemoglobin and aminotransferases; TPHA test; and search for antibodies. In 1974 hepatitis-B-surface-antigen (HBsAg) was detected by means of reverse hemagglutination tests. Since 1975 a modified radioimmunoassay has been used for this purpose. No donor blood with abnormal results was transfused, except for a very small number of extreme emergencies. The good results demonstrated can only be obtained by following the described program and by strictly avoiding pool preparations.