Moroff G, Holme S
American Red Cross, Biomedical Research and Development Laboratories, Rockville, MD 20855.
Transfus Med Rev. 1991 Jan;5(1):48-59. doi: 10.1016/s0887-7963(91)70192-2.
Substantial experimentation over the last 20 years has led to the conditions that are currently used to prepare and store platelets. Although platelet rich plasma is used in most instances to prepare platelet concentrates, there may be some benefit associated with the use of buffy coats as the source component. Extension of the maximum allowable storage time for platelets to 5 days has been possible as a result of defining the conditions which allow for the better retention of platelet properties. Storage temperature, permeability of the storage container, volume of platelet suspension, and the need to agitate platelets have been identified as key parameters that maintain platelet viability and functional properties. Storage in the 20 to 24 degrees C range prevents a reduction in posttransfusion viability that occurs when platelets are maintained at lower temperatures. Adequate influx of oxygen through container walls to support platelet metabolism and, to a lesser degree, adequate efflux of produced carbon dioxide are essential for maintaining pH levels, a key parameter that also influences posttransfusion viability. Permeability is influenced by container size and material, by use of a satisfactory volume of plasma and by agitating the container. Although platelet concentrates prepared from whole blood have been primarily used to delineate appropriate storage conditions, they also apply to platelets harvested by aphersis technology. Storage under currently used conditions, although providing products with acceptable clinical efficacy, is associated with a reduction in viability and functional characteristics. The development of storage media, specific for platelets, may minimize the occurrence of deleterious changes.
过去20年里大量的实验得出了目前用于制备和储存血小板的条件。尽管大多数情况下使用富含血小板血浆来制备血小板浓缩物,但使用白膜层作为来源成分可能有一些益处。由于确定了能更好地保持血小板特性的条件,血小板的最长允许储存时间已延长至5天。储存温度、储存容器的通透性、血小板悬液的体积以及血小板搅拌需求已被确定为维持血小板活力和功能特性的关键参数。在20至24摄氏度范围内储存可防止血小板在较低温度下保存时出现输血后活力下降的情况。通过容器壁有足够的氧气流入以支持血小板代谢,以及在较小程度上有足够的二氧化碳排出,对于维持pH值水平至关重要,pH值是一个也会影响输血后活力的关键参数。通透性受容器大小和材料、血浆体积是否合适以及容器搅拌的影响。尽管从全血制备的血小板浓缩物主要用于确定合适的储存条件,但这些条件也适用于通过单采技术采集的血小板。在目前使用的条件下储存,虽然能为产品提供可接受的临床疗效,但会导致活力和功能特性降低。开发专门针对血小板的储存介质可能会减少有害变化的发生。