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一项主动血液监测计划对采用氨甲喋呤和 UVA 光化学处理制备的 7483 份血浆成分输血的安全性特征进行了描述。

An active hemovigilance program characterizing the safety profile of 7483 transfusions with plasma components prepared with amotosalen and UVA photochemical treatment.

机构信息

EFS-Alsace, Strasbourg, France.

出版信息

Transfusion. 2010 Jun;50(6):1210-9. doi: 10.1111/j.1537-2995.2009.02579.x. Epub 2010 Jan 22.

Abstract

BACKGROUND

Photochemical pathogen inactivation treatment (PCT) of plasma components with amotosalen and UVA has been implemented in Europe. To establish a postapproval safety database, an active hemovigilance (HV) program utilizing an electronic data capture system (EDCS) was initiated.

STUDY DESIGN AND METHODS

The response to transfusion was documented after each PCT-plasma transfusion. The primary outcome was the incidence of acute transfusion reactions (ATRs) within 24 hours of transfusion. An ATR was defined as an adverse event (AE) possibly related, probably related, or related to the PCT-plasma transfusion. For AEs, the following were collected: time of event after transfusion, clinical description, vital signs, clinical and laboratory test results, severity (Grade 0-4), seriousness, and causal relationship to transfusion of PCT-plasma.

RESULTS

To date, 3232 patients (59.1% male) with a primary indication for plasma transfusion due to a hematology disorder (23.1%), surgery (32.4%), or a general medical condition (44.4%) received 7483 PCT-plasma transfusions (composed of 19,069 apheresis plasma components). The mean age of the patient population was 57.3 years (2884 adults, 160 children, and 188 infants). ATRs were reported for 8/7483 transfusions (0.11%; 95% confidence interval [CI], 0.03-0.19) and 8/3232 patients (0.25%; 95% CI, 0.08-0.42%). Five ATRs were of Grade 1 severity. The remaining three ATRs were classified as serious. No deaths or episodes of transfusion-related acute lung injury attributed to a PCT-plasma transfusion were reported.

CONCLUSION

PCT-plasma transfusions were well tolerated in routine clinical use. The EDCS HV program facilitated collection and reporting of safety information on a real-time basis from multiple sites.

摘要

背景

用氨甲喋呤和长波紫外线对血浆成分进行光化学病原体灭活处理(PCT)已在欧洲实施。为建立上市后安全性数据库,利用电子数据采集系统(EDCS)启动了主动血液监测(HV)计划。

研究设计和方法

每次 PCT 血浆输注后,都记录对输血的反应。主要结局是输注后 24 小时内急性输血反应(ATR)的发生率。ATR 定义为可能与、可能相关或与 PCT 血浆输注相关的不良事件(AE)。对于 AE,采集以下信息:输注后事件发生时间、临床描述、生命体征、临床和实验室检查结果、严重程度(0-4 级)、严重性以及与 PCT 血浆输注的因果关系。

结果

迄今为止,由于血液系统疾病(23.1%)、手术(32.4%)或一般医疗状况(44.4%)而接受血浆输注的 3232 名患者(59.1%为男性)接受了 7483 次 PCT 血浆输注(由 19069 份单采血浆成分组成)。患者人群的平均年龄为 57.3 岁(2884 名成人、160 名儿童和 188 名婴儿)。报告了 8/7483 次输注(0.11%;95%置信区间 [CI],0.03-0.19)和 8/3232 名患者(0.25%;95% CI,0.08-0.42)发生 ATR。5 例 ATR 为 1 级严重程度。其余 3 例 ATR 被归类为严重。未报告与 PCT 血浆输注相关的死亡或急性肺损伤病例。

结论

PCT 血浆输注在常规临床应用中耐受良好。EDCS HV 计划便于从多个站点实时收集和报告安全性信息。

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