Schuetz Audrey N, Hillyer Krista L, Roback John D, Hillyer Christopher D
Transfusion Medicine Program, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Transfus Med Rev. 2004 Jul;18(3):168-76. doi: 10.1016/j.tmrv.2004.03.002.
Leukoreduction of cellular blood products by filtration has been shown to decrease the incidence of febrile nonhemolytic transfusion reactions, transmission of leukocyte-associated viruses, and HLA alloimmunization. However, the increasing popularity of leukofiltering blood products over the past few years has highlighted specific filtration failures associated with sickle trait (hemoglobin AS) blood. Sickle trait blood does not filter adequately, which leads to prolonged or incomplete filtration, often with a higher number of postfiltration leukocytes in the unit than the mandated minimal residual volume of <1 to 5 x 10(6). This review of the literature highlights various parameters that affect the adequacy of filtration of blood products, including effects of temperature, pH, osmolarity, type of anticoagulant, time of storage, and oxygen saturation of the blood unit. A combination of these factors likely contributes to the frequent filtration failure of sickle trait products. Although blood units are not routinely screened for sickle cell hemoglobin, administration of units with sickle trait red blood cells can be disadvantageous to certain patient populations. This review concludes with a discussion of different approaches to screening blood units for sickle cell trait.
通过过滤对细胞血液制品进行白细胞去除已被证明可降低发热性非溶血性输血反应的发生率、白细胞相关病毒的传播以及HLA同种免疫。然而，在过去几年中，白细胞过滤血液制品越来越受欢迎，这凸显了与镰状细胞性状（血红蛋白AS）血液相关的特定过滤失败情况。镰状细胞性状血液过滤不充分，导致过滤时间延长或不完全，单位制品中过滤后的白细胞数量通常高于规定的最小残留量<1至5×10(6)。本文献综述强调了影响血液制品过滤充分性的各种参数，包括温度、pH值、渗透压、抗凝剂类型、储存时间以及血液单位的氧饱和度的影响。这些因素的综合作用可能导致镰状细胞性状制品频繁出现过滤失败。尽管血液单位通常不常规筛查镰状细胞血红蛋白，但输注含有镰状细胞性状红细胞的单位制品对某些患者群体可能不利。本文献综述最后讨论了筛查血液单位镰状细胞性状的不同方法。
