Seghatchian J, Beard M J, Krailadsiri P
National Blood Service-North London, Colindale Avenue, Colindale, London NW9 5BG, UK.
Platelets. 2001 Aug;12(5):298-301. doi: 10.1080/09537100120068189.
With the implementation of universal leucodepletion, an in-line, negatively charged LRF6H leucodepleting filter became an essential part of the Haemonetics MCS+ plateletpheresis system. A larger-scale (968) study using the standard protocol revealed a 2.79% leucodepletion failure rate (standard < 5 x 10(6) leucocytes per adult therapeutic dose). Factors influencing the efficacy of the filter were investigated. The pH of the filtrate was 7.0, the temperature 28 degrees C and filtration rate 80 ml/min. Reduction of the filtration rate to 30 ml/min (784 doses) reduced leucodepletion failure to 0.38%. Measurement of the leucocyte count, pre- and post-filtration of the platelet products, revealed that donations from 1% of donors contained substantially larger numbers of leucocytes in pre-filter samples (300-1500/microl) than in control samples (35-70/microl). This number tends to increase progressively with subsequent donations in these individuals, leading to leucodepletion failure, whilst peripheral leucocyte counts remain normal. The new continuous filtration protocol (version C) using a less impact filter LRF-XL and a lower (7 ml/min) head pressure was also effective but failure still occurred twice on one of the donors who persistently showed high pre-filter count. We conclude that leucodepletion failures in the Haemonetics system are related to both donor leucocyte (i.e., being light and non-adherent) and operational/filter performance.
随着普遍白细胞去除术的实施,一种在线的、带负电荷的LRF6H白细胞去除滤器成为了Haemonetics MCS+血小板单采系统的重要组成部分。一项使用标准方案的更大规模(968例)研究显示白细胞去除失败率为2.79%(标准为每成人治疗剂量<5×10⁶个白细胞)。对影响滤器效能的因素进行了研究。滤液的pH值为7.0,温度为28℃,过滤速率为80 ml/min。将过滤速率降至30 ml/min(784剂)可将白细胞去除失败率降至0.38%。对血小板制品过滤前后的白细胞计数进行测量发现,1%的献血者的预过滤样本中的白细胞数量(300 - 至1500/微升)比对照样本(35 - 70/微升)多得多。在这些个体中,这个数量往往会随着后续献血而逐渐增加,导致白细胞去除失败,而外周白细胞计数仍保持正常。使用影响较小的滤器LRF-XL和较低(7 ml/min)的头部压力的新连续过滤方案(版本C)也有效,但在一名持续显示预过滤计数高的献血者身上仍出现了两次失败情况。我们得出结论,Haemonetics系统中的白细胞去除失败与献血者白细胞(即质地轻且不黏附)以及操作/滤器性能都有关。