Hillyer Christopher D, Roback John D, Hillyer Krista L, Josephson Cassandra D, Page Peter L
Transfusion Medicine Program, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Transfusion. 2004 Jul;44(7):977-83. doi: 10.1111/j.1537-2995.2004.04036.x.
In January 2003, "white particulate matter" (WPM) was transiently observed in red blood cell (RBC) units collected predominately in the southeastern US. In this report, these events, their chronology, pertinent observations and investigations, and summaries and conclusions associated with WPM during the 2-week observation period are described.
On January 27, 2003, WPM was first identified in RBCs; by January 31, 2003, 110 RBC units containing WPM had been identified. Elective surgeries were postponed. Approximately 400 RBC units containing WPM were inspected in the blood center and characterized into four types: I, II, III, and IV. A variety of preparations of aspirated WPM were made, including light and electron microscopic sections.
The rate of WPM-containing units was 1.67 percent (1 in 60 units), whereas the background incidence was less than 0.25 percent. Investigations revealed that WPM was composed of activated and nonactivated platelets (PLTs); no toxins, infectious agents, or agents of bioterrorism were identified. WPM correlated with certain variables studied, including PLT-rich components that had been centrifuged with a "hard spin" before leukoreduction and manufactured in one vendor's collection sets. Because the increased rate of appearance of WPM was a transient phenomenon, it is not clear whether this is a newly noticed or a new and different phenomenon from "aggregates" observed in the past.
2003年1月，在美国东南部主要采集的红细胞（RBC）单位中短暂观察到“白色颗粒物”（WPM）。在本报告中，描述了这些事件、其时间顺序、相关观察和调查，以及在为期2周的观察期内与WPM相关的总结和结论。
2003年1月27日，首次在红细胞中发现WPM；到2003年1月31日，已识别出110个含有WPM的红细胞单位。择期手术被推迟。血液中心检查了大约400个含有WPM的红细胞单位，并将其分为四种类型：I型、II型、III型和IV型。制备了各种吸出的WPM制剂，包括光学和电子显微镜切片。
含WPM单位的发生率为1.67%（60个单位中有1个），而背景发生率低于0.25%。调查显示，WPM由活化和未活化的血小板（PLT）组成；未发现毒素、感染因子或生物恐怖主义制剂。WPM与所研究的某些变量相关，包括在白细胞去除前用“强力离心”法离心且在一个供应商的采集装置中生产的富含血小板的成分。由于WPM出现率的增加是一种短暂现象，尚不清楚这是一种新发现的现象，还是与过去观察到的“聚集体”不同的新现象。
