Picker Susanne M, Radojska Stela M, Gathof Birgit S
Transfusion Medicine, University of Cologne, Cologne, Germany.
Transfusion. 2007 Apr;47(4):687-96. doi: 10.1111/j.1537-2995.2007.01172.x.
New technologic developments enable automated collection and preparation of red blood cells (RBCs). This study's aim was to evaluate quality of apheresis-derived RBCs (ARBCs) collected as single units along with platelets (RBC-Ps) or double units (2-RBCs) with four different apheresis systems.
Sixty-six donors with similar baseline variables underwent RBC apheresis collection with various machines (Amicus [15 RBC-Ps] and Alyx [15 2-RBCs], Baxter; the Trima Accel [9 RBC-Ps, 8 2-RBCs], Gambro, and the MCS+[9 RBC-Ps, 10 2-RBCs], Haemonetics Corp.). In vitro properties were analyzed during 49 days of storage and compared to manual RBCs (MRBCs, n = 14).
All units but one, Alyx, demonstrated white blood cell counts of less than 1 x 10(6). ARBCs showed lower variability in volume compared to MRBCs. All units met international requirements (European, AABB) for hematocrit (50%-70%), hemoglobin (>40 g/unit), and RBC mass (>or=153 mL). pH values remained similar between study groups without reaching critical limits in any unit. MRBCs had slight advantages for hemolysis at the end of storage and were significantly superior in energy maintenance as indicated by less ATP degradation and potassium leak most likely due to more pronounced anoxidative glycolysis particularly during the first half of storage. Owing to more declining oxidative glucose metabolism, ARBCs demonstrated higher methemoglobin formation and subsequent oxygen release until the end of storage.
ARBCs exhibited better predictability in volume and absolute RBC mass than MRBCs and demonstrated sufficient in vitro quality throughout storage, even though lower ATP preservation and higher methemoglobin formation were observed compared to MRBCs probably due to differences in glucose metabolism.
新技术的发展使得红细胞(RBC)能够自动采集和制备。本研究的目的是评估使用四种不同的血液成分单采系统采集的单单位红细胞(ARBC)与血小板组合(RBC-Ps)或双单位红细胞(2-RBCs)的质量。
66名具有相似基线变量的献血者使用不同机器(Baxter公司的Amicus[15个RBC-Ps]和Alyx[15个2-RBCs];Gambro公司的Trima Accel[9个RBC-Ps,8个2-RBCs];Haemonetics公司的MCS+[9个RBC-Ps,10个2-RBCs])进行红细胞单采。在储存49天期间分析体外特性,并与手工采集的红细胞(MRBCs,n = 14)进行比较。
除Alyx外的所有单位白细胞计数均低于1×10⁶。与MRBCs相比,ARBCs的体积变异性更低。所有单位的血细胞比容(50%-70%)、血红蛋白(>40 g/单位)和红细胞量(≥153 mL)均符合国际要求(欧洲、AABB)。各研究组之间的pH值保持相似,任何单位均未达到临界极限。MRBCs在储存末期的溶血方面略有优势,并且在能量维持方面明显更优,表现为ATP降解和钾泄漏较少,这很可能是由于在储存的前半段尤其更明显的无氧糖酵解。由于氧化葡萄糖代谢下降更多,ARBCs在储存末期表现出更高的高铁血红蛋白形成及随后的氧释放。
与MRBCs相比,ARBCs在体积和绝对红细胞量方面表现出更好的可预测性,并且在整个储存过程中表现出足够的体外质量,尽管与MRBCs相比观察到较低的ATP保存和较高的高铁血红蛋白形成,这可能是由于葡萄糖代谢的差异。