Ringwald Jürgen, Althoff Frauke, Zimmermann Robert, Strasser Erwin, Weisbach Volker, Zingsem Jürgen, Eckstein Reinhold
Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany.
Transfusion. 2006 Feb;46(2):236-43. doi: 10.1111/j.1537-2995.2006.00716.x.
Rare clinical conditions cause the need for washed platelet (PLT) concentrates (PCs). Saline-washed PCs can only be stored shortly, however, owing to lack of substrates for PLT metabolism. New PLT additive solutions (PASs) contain such substrates and might be used alternatively. The in vitro quality of apheresis PCs washed with Composol-PS or modified PAS-III (PAS-IIIM) stored up to 48 hours after wash was compared.
Twelve blood donors underwent two apheresis procedures (A and B) collecting 6.0 x 10(11) PLTs in 500 mL of plasma with a least 2 weeks in between. The PCs collected by Apheresis A were stored for 3 days and then split in two equal units before washing with Composol-PS or PAS-IIIM. The PCs collected by Apheresis B were split after collection. One unit was released for transfusion and 1 unit was stored unwashed up to Day 6 and used as reference unit. In vitro testing was performed before and after washing as well as 24 and 48 hours after wash.
After 48 hours of postwash storage, the units washed with either PAS showed acceptable results for hypotonic shock response (HSR), P-selectin expression, and pH, whereas PLT aggregability was significantly impaired. Throughout the storage, unwashed units showed better in vitro quality. HSR and P-selectin expression were similar before and immediately after the washing procedure.
Based on these in vitro results, 48-hour postwash storage of washed PCs with the two PASs seems to be feasible. In vivo recovery studies, however, must confirm this finding in the future.
罕见的临床情况导致需要洗涤血小板(PLT)浓缩物(PCs)。然而,由于缺乏PLT代谢的底物,生理盐水洗涤的PCs只能短期储存。新的PLT添加剂溶液(PASs)含有此类底物,可作为替代使用。比较了用Composol-PS或改良的PAS-III(PAS-IIIM)洗涤后储存长达48小时的单采PCs的体外质量。
12名献血者接受了两次单采程序(A和B),每次采集500 mL血浆中的6.0×10¹¹个PLT,两次采集间隔至少2周。单采A采集的PCs储存3天,然后分成两个相等的单位,再用Composol-PS或PAS-IIIM洗涤。单采B采集的PCs采集后进行分割。一个单位放行用于输血,另一个单位未洗涤储存至第6天,用作参考单位。在洗涤前后以及洗涤后24小时和48小时进行体外检测。
洗涤后储存48小时后,用任何一种PAS洗涤的单位在低渗休克反应(HSR)、P-选择素表达和pH方面显示出可接受的结果,而PLT聚集性明显受损。在整个储存过程中,未洗涤的单位显示出更好的体外质量。洗涤程序前后HSR和P-选择素表达相似。
基于这些体外结果,用两种PAS洗涤的PCs洗涤后储存48小时似乎是可行的。然而,体内恢复研究必须在未来证实这一发现。