Shanwell Agneta, Diedrich Beatrice, Falker Cecilia, Jansson Berit, Sandgren Per, Sundkvist Lars, Svensson Leif, Vesterinen Mervi, Gulliksson Hans
Department of Transfusion Medicine, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
Transfusion. 2006 Jun;46(6):973-9. doi: 10.1111/j.1537-2995.2006.00830.x.
To improve clinical access to platelet concentrates (PCs), prolonging the storage period is one alternative, provided that they are free from bacteria. The quality of platelets (PLTs) stored for 1 versus 7 days was compared by in vitro analyses and in vivo recovery and survival in blood donors.
Apheresis PCs from 10 donors were divided and stored in PLT additive solution in 2 equal units for a paired comparison. PLTs in one unit were (111)In-labeled at 1 day of storage, and PLTs in the other unit were labeled after 7 days of storage. PLTs were injected into the donor after labeling and samples were drawn after 30, 60, and 150 minutes and thereafter once a day for 14 days for recovery and survival measurements.
PLT recovery on Day 7 was 80 percent of the recovery on Day 1 (p<0.05), and the survival on Day 7 was 65 percent of survival on Day 1 (p<0.005). No significant differences were seen regarding mean PLT volume (MPV), pH, pCO2, pO2, bicarbonate, or hypotonic shock response. Lactate increased and lactic dehydrogenase increased slightly, whereas glucose and ATP decreased, but not to a critical level. A significant increase in RANTES (110.7+/-76.6 vs. 277.6+/-50.8 pg/10(6) PLTs [p<0.005]) and PLT factor 4 (19.9+/-9.6 vs. 59.8+/-7.5 IU/10(6) PLTs [p<0.0001]) was noticed during storage.
Recovery and survival of PCs stored for 7 days decreased, but met suggested criteria. Analyzed in vitro parameters showed acceptable results. Randomized patient transfusion studies will provide additional verification of the suitability of 7-day storage of PLTs.
为改善临床对血小板浓缩物(PCs)的获取,延长储存期是一种选择,前提是它们不含细菌。通过体外分析以及在献血者体内的回收率和存活率,对储存1天和7天的血小板(PLTs)质量进行了比较。
将来自10名献血者的单采血小板浓缩物分成两份等量的单位,储存在血小板添加剂溶液中进行配对比较。一个单位的血小板在储存1天时用铟-111标记,另一个单位的血小板在储存7天后标记。标记后将血小板注入献血者体内,并在30、60和150分钟后以及此后每天采集一次样本,持续14天,以测量回收率和存活率。
第7天的血小板回收率为第1天回收率的80%(p<0.05),第7天的存活率为第1天存活率的65%(p<0.005)。在平均血小板体积(MPV)、pH值、二氧化碳分压(pCO2)、氧分压(pO2)、碳酸氢盐或低渗休克反应方面未观察到显著差异。乳酸增加,乳酸脱氢酶略有增加,而葡萄糖和三磷酸腺苷(ATP)减少,但未降至临界水平。在储存期间观察到调节激活正常T细胞表达和分泌因子(RANTES)显著增加(110.7±76.6对277.6±50.8 pg/10⁶血小板 [p<0.005])以及血小板第4因子显著增加(19.9±9.6对59.8±7.5 IU/10⁶血小板 [p<0.0001])。
储存7天的血小板浓缩物的回收率和存活率降低,但符合建议标准。体外分析参数显示结果可接受。随机患者输血研究将为血小板7天储存的适用性提供额外验证。