Wiltshire Michael, Cardigan Rebecca, Thomas Stephen
Components Development Laboratory, NHS Blood and Transplant, Brentwood, UK.
Transfus Med. 2010 Dec;20(6):383-91. doi: 10.1111/j.1365-3148.2010.01024.x.
To investigate methods for the production of red cell concentrates (RCC) in saline, adenine, glucose and mannitol (SAG-M), from whole blood or red cells stored in plasma for 5 or 6 days and to provide evidence that exchange transfusion RCC in citrate phosphate dextrose (CPD) plasma or citrate, phosphate, dextrose, adenine (CPDA-1) plasma are of comparable quality.
Ten RCC in SAG-M were produced following the remanufacture of red cells in CPD plasma on day 5/6 or after 5 days hold as leucodepleted CPD whole blood. In addition, 10 RCC in CPD plasma and 9 in CPDA-1 plasma were stored without further processing. Units were assessed for red cell parameters including haemolysis, adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG) and extracellular potassium.
Units in SAG-M produced by remanufacture of RCC in plasma or by delayed manufacture of whole blood had comparable levels of haemolysis, ATP and 2,3-DPG. Furthermore, these units underwent biochemical changes similar to reference SAG-M units, with the exception of haemolysis which was greater at the end of shelf life and supernatant potassium which was lower following remanufacture. As expected, the decline in ATP was greater in red cells stored in CPD plasma compared with CPDA-1 plasma. In general, units in CPD plasma were of similar quality at day 28 compared to those in CPDA-1 plasma at day 35.
RCC produced following the remanufacture of RCC in plasma or the delayed manufacture of whole blood are of acceptable in vitro quality and should be assigned the same shelf life as standard RCC in SAG-M.
研究从储存5天或6天的全血或血浆中的红细胞制备生理盐水、腺嘌呤、葡萄糖和甘露醇(SAG-M)红细胞浓缩液(RCC)的方法,并提供证据证明在枸橼酸盐磷酸盐葡萄糖(CPD)血浆或枸橼酸盐、磷酸盐、葡萄糖、腺嘌呤(CPDA-1)血浆中进行换血输血的RCC质量相当。
在第5/6天对CPD血浆中的红细胞进行再加工后,或在作为白细胞滤除的CPD全血保存5天后,制备10份SAG-M中的RCC。此外,10份CPD血浆中的RCC和9份CPDA-1血浆中的RCC未经进一步处理进行储存。对各单位进行红细胞参数评估,包括溶血、三磷酸腺苷(ATP)、2,3-二磷酸甘油酸(2,3-DPG)和细胞外钾。
通过血浆中RCC的再加工或全血的延迟制备而产生的SAG-M中的单位,其溶血、ATP和2,3-DPG水平相当。此外,这些单位经历了与参考SAG-M单位相似的生化变化,但在保质期结束时溶血更大,再加工后上清钾更低除外。正如预期的那样,与CPDA-1血浆相比,CPD血浆中储存的红细胞中ATP的下降更大。一般来说,与第35天CPDA-1血浆中的单位相比,第28天CPD血浆中的单位质量相似。
血浆中RCC的再加工或全血的延迟制备后产生的RCC体外质量可接受,应给予与SAG-M中标准RCC相同的保质期。