Ferrer F, Rivera J, Corral J, González-Conejero R, Vicente V
Unit of Hematology-Hemotherapy and Clinical Oncology, School of Medicine, General University Hospital, Regional Centre of Blood Donation, Murcia, Spain.
Vox Sang. 2000;78(4):235-41. doi: 10.1159/000031187.
The use of leukocyte-depleted platelet concentrates (PCs) is justified, yet questions remain regarding their properties. We have assessed the in vitro quality of WBC-reduced PCs obtained by using a new in-line filter.
Twenty blood units were randomized for standard component preparation, or for processing including in-line leukodepletion of platelet-rich plasma using an ATS(TM) PL Pall filter. The resultant PCs were compared during storage for several in vitro platelet quality parameters, content of cytokines and anaphylatoxins, and coagulation markers.
In-line filtration of platelet-rich plasma through ATS PL was highly efficient rendering PCs with 99.93% less white blood cells (WBCs) than standard PCs. During storage for up to 9 days, leukocyte-depleted units displayed platelet content, biochemical parameters, and platelet surface expression of glycoproteins Ibalpha, IIb/IIa, CD62 and CD63, similar to those of standard units. However, in-line leukocyte-reduced PCs displayed no significant accumulation of IL-6 and IL-8 during storage in contrast to standard units. Moreover, while storage promoted complement activation with C3a and C4a liberation in both WBC-reduced PCs and standard units, the concentration of these anaphylatoxins after the 9-day storage period was higher in the former group. Finally, all units, standard and leukocyte-reduced, displayed a similar storage-promoted rise in TGF-beta(1), and a mild prolongation of activated partial thromboplastin and prothrombin times.
In-line filtration during component preparation appears as an easy and effective procedure for obtaining prestorage leukocyte-depleted PCs. During subsequent blood bank storage, these WBC-reduced PCs display, in comparison with standard PCs, normal in vitro platelet properties, decreased accumulation of cytokines IL-6 and IL-8, and increased complement activation.
使用白细胞去除血小板浓缩液(PCs)是合理的,但关于其特性仍存在疑问。我们评估了使用新型在线过滤器获得的白细胞减少PCs的体外质量。
将20个血液单位随机分为标准成分制备组,或采用ATS(TM) PL Pall过滤器对富含血小板血浆进行在线白细胞去除的处理组。在储存期间,对所得的PCs进行比较,检测其体外血小板质量参数、细胞因子和过敏毒素含量以及凝血标志物。
通过ATS PL对富含血小板血浆进行在线过滤效率很高,所得PCs的白细胞(WBCs)比标准PCs少99.93%。在长达9天的储存期间,白细胞去除单位的血小板含量、生化参数以及糖蛋白Ibalpha、IIb/IIa、CD62和CD63的血小板表面表达与标准单位相似。然而,与标准单位相比,在线白细胞减少的PCs在储存期间IL-6和IL-8没有显著积累。此外,虽然储存会促进白细胞减少的PCs和标准单位中补体激活并释放C3a和C4a,但在9天储存期后,前一组中这些过敏毒素的浓度更高。最后,所有单位,无论是标准的还是白细胞减少的,在储存过程中TGF-β(1)均有类似的升高,活化部分凝血活酶时间和凝血酶原时间也有轻度延长。
成分制备过程中的在线过滤似乎是获得储存前白细胞减少PCs简便有效的方法。在随后的血库储存期间,与标准PCs相比,这些白细胞减少的PCs显示出正常的体外血小板特性、细胞因子IL-6和IL-8积累减少以及补体激活增加。