Rentas F J, Macdonald V W, Rothwell S W, McFaul S J, Asher L V, Kennedy A M, Hmel P J, Meledandri C J, Salata J M, Harman R W, Reid T J
Department of Blood Research, Department of Pathology, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
Transfusion. 2004 Jul;44(7):959-66. doi: 10.1111/j.1537-2995.2004.03398.x.
In late January 2003, some blood centers and hospitals throughout the US voluntarily sus-pended the use of some RBC and plasma units for trans-fusion due to the presence of unknown white particulate matter (WPM) in these units. To better understand the WPM phenomena, a number of technologies were used to establish the nature of the particulates observed in Terumo Collection sets.
All AS-5 nonleuko-reduced RBCs and plasma units were visually inspected for WPM by placing the bags on a flat counter, undisturbed, for approximately 10 minutes and then perform-ing a visual examination for particles. Particles were isolated and placed on microscope slides or in plastic tubes for further analysis. Electron microscopy, bright field microscopy, differential interference contrast microscopy, infrared spectroscopy, and flow cytometry procedures were performed to establish the nature of the particulate matter. In addition, leukoreduction filters and blood transfusion sets were used on RBCs units with WPM.
The particles were mostly composed of PLTs and WBCs, and fragments of these cells. All macroscopic WPM was removed from RBCs with leukoeduction and transfusion filters.
WPM originated from PLTs and WBCs. Foreign matter (e.g., plastic) was not observed in any of the units. Leukoreduction and transfusion filters can be used to remove macroscopic WPM.
2003年1月下旬,美国各地的一些血液中心和医院因部分红细胞(RBC)和血浆制品中存在不明白色颗粒物(WPM)而自愿暂停使用这些制品用于输血。为了更好地了解WPM现象,使用了多种技术来确定在泰尔茂采集装置中观察到的颗粒物的性质。
通过将所有未进行白细胞滤除的AS-5红细胞和血浆制品袋放置在平坦的台面上,静置约10分钟,然后对颗粒物进行目视检查,以肉眼检查WPM。将颗粒物分离出来,放置在显微镜载玻片上或塑料管中进行进一步分析。进行电子显微镜、明场显微镜、微分干涉对比显微镜、红外光谱和流式细胞术程序,以确定颗粒物的性质。此外,对含有WPM的红细胞制品使用白细胞滤除器和输血装置。
这些颗粒物主要由血小板(PLT)和白细胞(WBC)以及这些细胞的碎片组成。通过白细胞滤除和输血过滤器,所有宏观WPM均从红细胞中去除。
WPM源自血小板和白细胞。在任何制品中均未观察到异物(如塑料)。白细胞滤除和输血过滤器可用于去除宏观WPM。