从Haemonetics和Trima Accel自动血液采集系统获得的血小板的质量验证。

Hsuan-Hui Wang, Li-Na Liao, Chi-Ling Lin, L. Yen, Y. Hsiao, J. Ko
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引用次数: 0

摘要

背景:治疗血液肿瘤或创伤患者需要输注血小板。近年来,利用血小板分离设备进行的血小板分离(PPH)迅速增加。白细胞减少血小板分离(LRPH)可以降低输血时血小板难治性和发热性非溶血性输血反应(FNHTRs)的风险。因此,本研究旨在研究和比较使用Haemonetics进行的PPH和使用Trima Accel细胞分离器进行的LRPH在血小板代谢和功能方面的反应。方法通过PPH和LRPH采集的血小板在5 d的保存期间,从视觉外观、形态、血小板聚集变化、代谢活性和细菌筛选试验等方面评价血小板的质量。统计分析采用双样本t检验和广义估计方程(GEE)法。结果在LRPH中保存5 d,剩余白细胞均<1.0×106,血小板功能参数如下:血小板聚集为5′-二磷酸腺苷(ADP)和胶原等激动剂,形状改变程度和pO2在PPH和LRPH之间无统计学差异。LRPH组第0、1、3天的低渗休克反应(HSR)明显高于PPH组(71.78±6.92∶64.10±7.42;p = 0.002;71.53±8.98 vs. 62.96±9.84;p = 0.007;68.05±7.28 vs. 57.76±6.80;分别为p < 0.0001)。在第0、1、3天,PPH组的平均血小板体积(MPV)值均大于LRPH组。第5天,LRPH组的漩涡评分高于PPH组。平均乳酸水平在PPH和LRPH之间无统计学差异。另外,对40个样品进行了细菌筛选试验,未观察到生长。结论通过比较Trima Accel和Haemonetics自动血液采集系统收集的LRPH和PPH产品,发现尽管需要额外的过程来减少白细胞,但这两种产品都具有良好的血小板质量。此外,有必要调查其他采血工具的结果,重点关注供体、产品和受体的安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quality validation of platelets obtained from the Haemonetics and Trima Accel automated blood-collection systems.
BACKGROUND Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PPH) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPH) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PPH performed with Haemonetics and LRPH performed with Trima Accel cell separator. METHODS The qualities of platelets collected through PPH and LRPH were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method. RESULTS During 5-day storage in LRPH, residual leucocytes were all <1.0×106, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO2 showed no statistically significant difference between PPH and LRPH. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPH than in PPH (71.78±6.92 vs. 64.10±7.42; p=0.002; 71.53±8.98 vs. 62.96±9.84; p=0.007; 68.05±7.28 vs. 57.76±6.80; p<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PPH than in LRPH on days 0, 1, and 3. On day 5, the swirling score was higher in LRPH than in PPH. The mean lactate levels had no statistically significant difference between PPH and LRPH. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples. CONCLUSION Comparison of LRPH and PPH products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.
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