在血小板浓缩物储存前在线过滤过程中，流速对白细胞去除率有显著影响。

Janetzko K, Schlenke P, Klüter H

Institute of Immunology and Transfusion Medicine, University of Lübeck School of Medicine, Germany.

Transfus Sci. 1999 Oct;21(2):123-8. doi: 10.1016/s0955-3886(99)00083-1.

BACKGROUND

White cell reduction of blood products minimizes the risks of alloimmunization against HLA-antigens, the transmission of viral diseases and the incidence of platelet transfusion reactions. One modern strategy is leukocyte depletion with an integrated filter system immediately after preparation and prior to storage.

STUDY DESIGN AND METHODS

We evaluated the efficiency of a novel in-line filter system Sepacell PLX-5 BPS for leukocyte reduction of platelet concentrates (PC) from pooled buffy-coats. A total of 44 PCs were investigated with regard to different filtration flow rates (25-110 ml/min) and leukocyte depletion and thrombocyte recovery rates were analysed. Furthermore, we studied the influence of filtration on PCs over a storage period of 6 days (n = 12) by investigation of pH, lactate and glucose. Platelet function was determined by means of hypotonic shock response, external shape change and expression of CD62p.

RESULTS

The mean leukocyte depletion rate was > log 5. After filtration the mean leukocyte count was 0.12 +/- 0.21 x 10(6). In 60% of the PCs the leukocyte count lay below the detection level of the Nageotte chamber, which is < 0.3 x 10(5). The flow rate correlates significantly with the leukocyte count in the PCs (r = 0.325; p = 0.033) and therefore with the leukocyte depletion rate (r = -0.422; p = 0.01). Flow rates under 40 ml lead to a significantly lower leukocyte contamination. Only in one PC, at a flow rate of 84 ml/min, was the leukocyte threshold of 1 x 10(6) exceeded. We did not find a significant correlation between filtration flow rate and thrombocyte recovery (r = 0.315; p = 0.069). The mean platelet count in the PC was 2.88 +/- 0.47 x 10(11). Compared with the thrombocyte count in the pooled buffy coat, the recovery was 68.6%. We observed a decrease of pH, glucose, external shape change and hypotonic shock response over the storage period while lactate and the expression of CD62p increased.

CONCLUSION

The filter system Sepacell PLX-5 BPS proved to be suitable for in-line filtration of platelet concentrates prior to storage. Filtration flow rates of up to 40 ml/min allowed efficient leukocyte depletion without significant loss in the quality of the platelet concentrates and the platelet function in vitro.

背景

血液制品的白细胞去除可将针对人类白细胞抗原的同种免疫、病毒性疾病传播及血小板输血反应发生率的风险降至最低。一种现代策略是在制备后及储存前立即使用集成过滤系统进行白细胞去除。

研究设计与方法

我们评估了一种新型在线过滤系统Sepacell PLX-5 BPS对从混合 Buffy 层中制备的血小板浓缩物（PC）进行白细胞去除的效率。共研究了44份PC，涉及不同的过滤流速（25 - 110 ml/min），并分析了白细胞去除率和血小板回收率。此外，我们通过检测pH、乳酸和葡萄糖，研究了过滤对PC在6天储存期内的影响（n = 12）。通过低渗休克反应、外形变化和CD62p表达来测定血小板功能。

结果

平均白细胞去除率>log 5。过滤后平均白细胞计数为0.12 +/- 0.21 x 10(6)。60%的PC中白细胞计数低于Nageotte计数板的检测水平，即<0.3 x 10(5)。流速与PC中的白细胞计数显著相关（r = 0.325；p = 0.033），因此与白细胞去除率相关（r = -0.422；p = 0.01）。流速低于40 ml会导致白细胞污染显著降低。仅在一份流速为84 ml/min的PC中，白细胞阈值超过了1 x 10(6)。我们未发现过滤流速与血小板回收率之间存在显著相关性（r = 0.315；p = 0.069）。PC中的平均血小板计数为2.88 +/- 0.47 x 10(11)。与混合Buffy层中的血小板计数相比，回收率为68.6%。我们观察到在储存期内pH、葡萄糖、外形变化和低渗休克反应降低，而乳酸和CD62p表达增加。