Fontana Stefano, Keller Peter, Taleghani Behrouz Mansouri
Blood Transfusion Service of the Swiss Red Cross, Division of Transfusion Medicine, Inselspital, University Hospital, Bern, Switzerland.
Transfus Med Hemother. 2011;38(3):195-198. doi: 10.1159/000328634. Epub 2011 May 11.
BACKGROUND: Recruitment of platelets (PLT) during donor PLT apheresis may facilitate the harvest of multiple units within a single donation. METHODS: We compared two PLT apheresis procedures (Amicus and Trima Accel) in a prospective, randomized, paired cross-over study in 60 donors. The 120 donations were compared for depletion of circulating PLT in the donors, PLT yields and PLT recruitment. A recruitment was defined as ratio of total PLT yield and donor PLT depletion > 1. RESULTS: Despite comparable differences of pre- and post-apheresis PLT counts (87 × 10(9)/l in Trima Accel vs. 92 × 10(9)/l in Amicus, p = 0.383), PLT yields were higher with Trima Accel (7.48 × 10(11) vs. 6.06 × 10(11), p < 0.001), corresponding to a higher PLT recruitment (1.90 vs. 1.42, p < 0.001). We observed a different increase of WBC counts after aphereses, which was more pronounced with Trima Accel than with Amicus (1.30 × 10(9)/l vs. 0.46 × 10(9)/l, p < 0.001). CONCLUSION: Both procedures induced PLT recruitment. This was higher in Trima Accel, contributing to a higher yield in spite of a comparable depletion of circulating PLT in the donors. This recruitment facilitates the harvest of multiple units within a single donation and seems to be influenced by the procedure utilized. The different increases of circulating donor white blood cells after donation need further investigation.
背景:在捐献者血小板单采过程中募集血小板(PLT)可能有助于在单次捐献中采集多个单位的血小板。方法:我们在一项针对60名捐献者的前瞻性、随机、配对交叉研究中比较了两种血小板单采程序(Amicus和Trima Accel)。对120次捐献进行比较,观察捐献者循环血小板的消耗情况、血小板产量和血小板募集情况。血小板募集定义为总血小板产量与捐献者血小板消耗的比值>1。结果:尽管单采前后血小板计数的差异具有可比性(Trima Accel组为87×10⁹/L,Amicus组为92×10⁹/L,p = 0.383),但Trima Accel的血小板产量更高(7.48×10¹¹ vs. 6.06×10¹¹,p < 0.001),对应的血小板募集率也更高(1.90 vs. 1.42,p < 0.001)。我们观察到单采后白细胞计数有不同程度的升高,Trima Accel比Amicus更明显(1.30×10⁹/L vs. 0.46×10⁹/L,p < 0.001)。结论:两种程序均能诱导血小板募集。Trima Accel的血小板募集率更高,尽管捐献者循环血小板的消耗程度相当,但仍有助于提高产量。这种募集有助于在单次捐献中采集多个单位的血小板,并且似乎受所采用程序的影响。单采后捐献者循环白细胞的不同升高情况需要进一步研究。