Davey R J, McCoy N C, Yu M, Sullivan J A, Spiegel D M, Leitman S F
Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland.
Transfusion. 1992 Jul-Aug;32(6):525-8. doi: 10.1046/j.1537-2995.1992.32692367195.x.
Transfusion-associated graft-versus-host disease (TA-GVHD) may occur whenever immunologically competent allogeneic lymphocytes are transfused to an immunocompromised recipient. Irradiation of blood components eliminates the risk of TA-GVHD but may damage the cellular elements in the transfused component, particularly if the cells are stored for prolonged periods in the irradiated state. To study the effect of irradiation on long-term storage of red cells, AS-1 red cells from eight normal subjects were prepared on two occasions. On one occasion, the units were stored as standard AS-1 red cells for 42 days at 4 degrees C; on the other, they were exposed to 3000 cGy radiation within 4 hours of collection and then were stored as AS-1 red cells for 42 days at 4 degrees C. The donations were at least 12 weeks apart. Irradiated units demonstrated significant elevations in poststorage plasma hemoglobin (Hb) (623 +/- 206 vs. 429 +/- 194 g/dL [6230 +/- 2060 vs. 4290 +/- 1940 g/L], p less than 0.02) and plasma potassium (78 +/- 4 vs. 43 +/- 9 mEq/L [78 +/- 4 vs. 43 +/- 9 mmol/L], p less than 0.01) and significant decreases in red cell ATP (1.9 +/- 0.2 vs. 2.1 +/- 0.3 microM/g Hb, p less than 0.04) and 24-hour posttransfusion red cell recovery (68.5 vs. 78.4%, p less than 0.02), as compared to nonirradiated units. It can be concluded that irradiation with 3000 cGy damages red cells and that long-term storage in the irradiated state may enhance this damage. Red cells should not be stored for 42 days after irradiation with 3000 cGy.
只要将具有免疫活性的异基因淋巴细胞输注给免疫功能低下的受者，就可能发生输血相关移植物抗宿主病（TA-GVHD）。对血液成分进行辐照可消除TA-GVHD的风险，但可能会损害输注成分中的细胞成分，特别是当细胞在辐照状态下长时间储存时。为了研究辐照对红细胞长期储存的影响，两次从8名正常受试者采集制备AS-1红细胞。一次，这些单位作为标准AS-1红细胞在4℃下储存42天；另一次，它们在采集后4小时内接受3000 cGy辐射，然后作为AS-1红细胞在4℃下储存42天。两次献血间隔至少12周。与未辐照的单位相比，辐照后的单位在储存后血浆血红蛋白（Hb）（623±206 vs. 429±194 g/dL [6230±2060 vs. 4290±1940 g/L]，p<0.02）和血浆钾（78±4 vs. 43±9 mEq/L [78±4 vs. 43±9 mmol/L]，p<0.01）显著升高，红细胞ATP（1.9±0.2 vs. 2.1±0.3 μmol/g Hb，p<0.04）和输血后24小时红细胞回收率（68.5 vs. 78.4%，p<0.02）显著降低。可以得出结论，3000 cGy的辐照会损害红细胞且在辐照状态下长期储存可能会加剧这种损害。红细胞在接受3000 cGy辐照后不应储存42天。
