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一项对5106次使用经光化学病原体灭活处理制备的成分进行血小板输注的前瞻性观察队列安全性研究。

A prospective observational cohort safety study of 5106 platelet transfusions with components prepared with photochemical pathogen inactivation treatment.

作者信息

Osselaer Jean C, Messe Nathalie, Hervig Tor, Bueno Jose, Castro Emma, Espinosa Aurora, Accorsi Patrizia, Junge Klaus, Jacquet Michele, Flament Jocelyne, Corash Laurence

机构信息

Blood Transfusion Center, Cliniques Universitaires de Mont Godinne, Université Catholique de Louvain, Yvoir, Belgium.

出版信息

Transfusion. 2008 Jun;48(6):1061-71. doi: 10.1111/j.1537-2995.2008.01643.x. Epub 2008 Mar 13.

Abstract

BACKGROUND

Inactivation of pathogens and white blood cells in platelet (PLT) components with amotosalen and UVA light (INTERCEPT, Cerus Europe BV) has entered clinical practice in European blood centers. A prospective cohort study was implemented to characterize the safety profile of this new PLT component in a broad patient population.

STUDY DESIGN AND METHODS

Apheresis or buffy-coat PLT components were leukoreduced, suspended in approximately 35 percent plasma and 65 percent PLT additive solution, and treated with the INTERCEPT process. Blood centers were requested to complete a safety data form after each transfusion.

RESULTS

Data for 5106 INTERCEPT components administered to 651 patients were monitored. A total of 5051 (98.9%) transfusions and 609 (93.5%) patients had no reported reactions. Fifty-five (1.1%) transfusions were associated with adverse events, and 42 (0.8%) were possibly, probably, or related to the PLT transfusion. Adverse events occurred in 42 (6.4%) patients, but in only 32 (4.9%) patients was a causal relationship to PLT transfusion established. One reaction was serious, and no deaths were related to PLT transfusion. Among the transfusions reactions, the most frequent clinical events in descending frequency were chills, fever, dermatologic reactions, dyspnea, nausea or vomiting, and hypotension. No episodes of transfusion-related acute lung injury were reported.

CONCLUSIONS

In this cohort study, 99.2 percent of transfusions were without reactions attributed to PLTs. INTERCEPT PLTs exhibited a safety profile similar to that previously reported for conventional PLT components.

摘要

背景

使用氨甲环酸和紫外线A光(INTERCEPT,Cerus Europe BV)对血小板(PLT)成分中的病原体和白细胞进行灭活,已在欧洲血液中心进入临床实践。开展了一项前瞻性队列研究,以描述这种新型PLT成分在广泛患者群体中的安全性特征。

研究设计与方法

对单采或白膜层PLT成分进行白细胞去除,悬浮于约35%的血浆和65%的PLT添加剂溶液中,并采用INTERCEPT工艺进行处理。要求血液中心在每次输血后填写一份安全数据表。

结果

监测了给651例患者输注的5106份INTERCEPT成分的数据。共有5051次(98.9%)输血和609例(93.5%)患者未报告有反应。55次(1.1%)输血与不良事件相关,42次(0.8%)可能、很可能或与PLT输血有关。42例(6.4%)患者发生了不良事件,但只有32例(4.9%)患者确定与PLT输血存在因果关系。有1例反应严重,且无死亡与PLT输血相关。在输血反应中,按发生频率从高到低排列,最常见的临床事件为寒战、发热、皮肤反应、呼吸困难、恶心或呕吐以及低血压。未报告输血相关急性肺损伤事件。

结论

在这项队列研究中,99.2%的输血未出现归因于PLT的反应。INTERCEPT PLT的安全性特征与先前报道的传统PLT成分相似。

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