Müller-Steinhardt Michael, Hennig Holger, Kirchner Holger, Schlenke Peter
Institute of Immunology and Transfusion Medicine, University of Lübeck School of Medicine, Lübeck, Germany.
Transfusion. 2002 Feb;42(2):153-8. doi: 10.1046/j.1537-2995.2002.00035.x.
The introduction of universal WBC filtration of RBCs prior to storage is currently under consideration in many countries, as it is thought to minimize the incidence of transfusion-associated adverse effects. Centrifugation of blood containers with newly developed soft-shell WBC filters is more convenient, and so of great interest.
Two different quadruple blood pack systems with integrated soft-shell WBC filters were compared (Sepacell OptiPure RC, Baxter Biotech, vs. LCR 5, Maco Pharma). Buffy coat-depleted RBC units were investigated from whole-blood donations that were held for 2 to 3 hours before centrifugation and subsequent filtration at 22 degrees C (Group 1, OptiPure RC, 450 mL; Group 2, LCR 5, 450 mL; Group 3, OptiPure RC, 500 mL; Group 4, LCR 5, 500, mL, n = 12 per group). Filtration performance was analyzed, and the impact of WBC filtration on hemolysis rate, Hb content, pH, supernatant potassium, ATP, and 2,3 DPG was investigated weekly during storage for 42 days.
Filtration reduced the WBC count by 4.4 to 5.1 log. Mean +/- SD Hb content was 44.7 +/- 3.0, 41.2 +/- 3.3, 53.1 +/- 5.0, and 51.5 +/- 6.3 g per unit, respectively, with a corresponding mean RBC recovery after filtration of 71.0 +/- 3.0, 68.3 +/- 3.3, 76.6 +/- 1.7, and 68.9 +/- 4.5 percent. WBC filtration resulted in a significant reduction of Hct (0.10-0.14) in all four groups. Investigation of all RBC storage variables revealed acceptable values throughout the storage for 42 days.
WBC filtration with two newly developed soft-shell filters showed acceptable WBC-reduction efficacy without any difference between filter types in buffy coat-depleted RBCs from 450- and 500-mL whole-blood donations. However, the application of both filters resulted in an unacceptably low RBC recovery after filtration, which was particularly evident with the LCR5 filter. Our findings raise concern that WBC reduction with these filters may result in the production of RBCs with an inappropriately low Hb concentration.
目前许多国家正在考虑在储存前对红细胞进行普遍的白细胞过滤，因为人们认为这可以将输血相关不良反应的发生率降至最低。使用新开发的软壳白细胞过滤器对血袋进行离心更为方便，因此备受关注。
比较了两种不同的带有集成软壳白细胞过滤器的四联血袋系统（Sepacell OptiPure RC，百特生物技术公司，与LCR 5，Maco制药公司）。对全血捐献的去除白膜层的红细胞单位进行了研究，这些全血在离心和随后于22℃过滤前保存2至3小时（第1组，OptiPure RC，450 mL；第2组，LCR 5，450 mL；第3组，OptiPure RC，500 mL；第4组，LCR 5，500 mL，每组n = 12）。分析了过滤性能，并在42天的储存期内每周研究白细胞过滤对溶血率、血红蛋白含量、pH值、上清钾、三磷酸腺苷和2,3 -二磷酸甘油酸的影响。
过滤使白细胞计数降低了4.4至5.1个对数级。平均±标准差血红蛋白含量分别为每单位44.7±3.0、41.2±3.3、53.1±5.0和51.5±6.3 g，过滤后相应的红细胞回收率平均为71.0±3.0%、68.3±3.3%、76.6±1.7%和68.9±4.5%。白细胞过滤导致所有四组的血细胞比容显著降低（0.10 - 0.14）。对所有红细胞储存变量的研究表明，在42天的储存期内各项值均在可接受范围内。
使用两种新开发的软壳过滤器进行白细胞过滤显示出可接受的白细胞减少效果，对于450毫升和500毫升全血捐献的去除白膜层的红细胞，不同过滤器类型之间没有差异。然而，两种过滤器的应用均导致过滤后红细胞回收率低至不可接受的程度，这在LCR5过滤器中尤为明显。我们的研究结果引发了人们的担忧，即使用这些过滤器进行白细胞减少可能会导致产生血红蛋白浓度过低的红细胞。
