Haddad Salim A, Lichtiger Benjamin, Klein Harvey G
Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Transfusion. 2006 Aug;46(8):1306-10. doi: 10.1111/j.1537-2995.2006.00896.x.
Platelet (PLT) concentrates are currently stored in an incubator at 20 to 24 degrees C with continuous gentle agitation. PLTs are routinely shipped for transfusion to thrombocytopenic patients, however. There is a concern that PLT concentrates may be adversely affected during the shipping process.
A 40-year-old woman with severe aplastic anemia and immune refractory to unselected PLT transfusions was transferred to a distant medical center for a hematopoietic peripheral blood progenitor cell transplant where she continued to receive HLA-matched PLTs from her dedicated donors. Sixteen such components were collected and air-shipped in insulated boxes to the transplant center. Thirty-seven plateletpheresis components from the same dedicated donors had been transfused to the patient before transfer. Corrected count increments (CCIs) at the two sites were compared, with assessment of the role of HLA-match grades. The mean interruption time of controlled agitation during shipment was approximately 10.5 hours. The mean CCI of all distant transfusions was 14,450 +/- 9700 PLTs per microL x m2 per 10(11) and that of local transfusions was 10730 +/- 4870. The mean donor-paired difference between CCIs at the two sites was 1140 +/- 9940. At the remote location no clinically significant bleeding occurred and one posttransfusion febrile reaction was noted.
Despite the study limitations, the effectiveness, in a single patient, of leukoreduced, irradiated apheresis PLTs shipped by lengthy combined surface and airline transport is reported, as measured by posttransfusion CCIs.
目前血小板浓缩物储存在20至24摄氏度的培养箱中，并持续轻柔搅拌。然而，血小板浓缩物通常会被运送至血小板减少的患者处进行输血。人们担心血小板浓缩物在运输过程中可能会受到不利影响。
一名40岁的重度再生障碍性贫血女性，对未经筛选的血小板输血产生免疫抵抗，被转至一家遥远的医疗中心接受造血外周血祖细胞移植，在那里她继续接受来自其专属供体的人类白细胞抗原（HLA）匹配的血小板。采集了16份这样的成分，并通过航空运输装在保温箱中运往移植中心。在转院之前，已将来自相同专属供体的37份单采血小板成分输注给了该患者。比较了两个地点的校正计数增加值（CCI），并评估了HLA匹配等级的作用。运输过程中控制搅拌的平均中断时间约为10.5小时。所有远程输血的平均CCI为每微升×平方米每10¹¹中有14450±9700个血小板，而本地输血的平均CCI为10730±4870。两个地点CCI的平均供体配对差异为1140±9940。在远程地点未发生具有临床意义的出血，且记录到1例输血后发热反应。
尽管本研究存在局限性，但报告了在一名患者中，通过输血后CCI测量，经长时间地面和航空联合运输的白细胞滤除、辐照的单采血小板的有效性。
