Departments of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
Vox Sang. 2009 Oct;97(3):254-9. doi: 10.1111/j.1423-0410.2009.01197.x. Epub 2009 May 7.
Storage of platelets > 5 days provides improved availability, logistical management and decreased outdating. Promising results on in vitro parameters and on in vivo post-transfusion recovery and survival of autologous platelets in healthy volunteers have earlier been shown. To provide additional verification, randomized patient transfusion studies are needed.
Sixty allogeneic haematopoietic progenitor cell transplant recipients were randomized to receive buffy-coat (BC) platelets stored in platelet additive solution (PAS) for 1-5 days the first time a prophylactic transfusion was needed after transplantation, followed the second time by platelets stored for 6-7 days or vice versa. The corrected count increment (CCI) for 1 and 24 h were calculated.
CCI 1 h and CCI 24 h were higher for platelets stored 1-5 days as compared to 6-7 days, 10.4 +/- 5.1 vs. 7.4 +/- 3.8 (P < 0.001) and 5.4 +/- 4.1 vs. 2.6 +/- 2.6 (P < 0.001), respectively. Time to next platelet transfusion was significantly longer after a transfusion of platelets stored for 1-5 days as compared to platelets stored for 6-7 days: 2.2 +/- 1.1 vs. 1.6 +/- 0.8 days, respectively (P < 0.005). No differences in bleeding events and no transfusion reaction were recorded.
The advantage of an extension of platelet storage time beyond day 5 should be balanced against the increased need for platelet transfusions that may occur and the conceivable risk of transfusion failure.
储存血小板超过 5 天可提高可用性、物流管理水平,并减少过期。此前已经证明,在体外参数以及健康志愿者中自体血小板输注后的恢复和存活方面,都有很好的效果。为了提供更多的验证,需要进行随机患者输血研究。
60 例异基因造血祖细胞移植受者在移植后第一次需要预防性输血时,随机分为接受储存于血小板添加剂溶液(PAS)中的浓缩血小板(BC),储存 1-5 天,第二次则储存 6-7 天或反之。计算 1 小时和 24 小时校正计数增加(CCI)。
与储存 6-7 天的血小板相比,储存 1-5 天的血小板的 1 小时 CCI 和 24 小时 CCI 更高,分别为 10.4 ± 5.1 比 7.4 ± 3.8(P < 0.001)和 5.4 ± 4.1 比 2.6 ± 2.6(P < 0.001)。与储存 6-7 天的血小板相比,储存 1-5 天的血小板的下一次输血时间显著延长:分别为 2.2 ± 1.1 比 1.6 ± 0.8 天(P < 0.005)。未记录到出血事件和输血反应的差异。
血小板储存时间延长至 5 天以上的优势,应与可能发生的血小板输注需求增加以及输注失败的可想象风险相平衡。