Romphruk Amornrat V, Cheunta Siriluk, Pakoate Lamoon, Kumpeera Pravee, Sripara Poonsup, Paupairoj Chintana, Romphruk Arunrat
Blood Transfusion Center, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Transfus Apher Sci. 2012 Apr;46(2):125-8. doi: 10.1016/j.transci.2012.01.006. Epub 2012 Feb 23.
Platelet concentrates from ABO-identical donors are the components of choice for patients. However, since inventories are generally insufficient and because there is usually a relative abundance of group O donors, perfect matches are not always possible. It is therefore the accepted practice for platelets to be transfused out of the ABO group when ABO-identical platelets are unavailable. Notwithstanding, the transfusion of platelets containing high titers of antibodies to the antigens on the red blood cells of the patient can cause clinically significant hemolysis. The way to improve the safety of group O platelets has focused on defining a safe level of antibodies or reducing the volume of incompatible plasma. In the current study, 107 group O single donor platelets (SDP) were modified after collecting the platelet pellet in a bag. The AB plasma was added instead of the donor's own plasma. The direct agglutination titers of anti-A/anti-B in the original group O SDPs' plasma were performed by doing a gel test, resulting in from 1:4 to 1:1024. The prevalence of high titers (i.e., at least 1:64 in our study) was relatively high, ∼63% for anti-A and 78% for anti-B. The titer of residual anti-A/anti-B in the modified SDPs ranged from negative to 1:8. In most of the modified SDPs anti-A/anti-B could not be detected in the plasma (58.9% and 52.3%, respectively). The results indicate that our modified SDPs have very low titers; that is, acting as a universal SDP which is safe for all ABO patients. This modified SDP form is a more convenient way to overcome the risk from incompatible plasma or loss of platelets during the process of volume reduction and can help effectively manage our inventory.
来自 ABO 血型相同供者的血小板浓缩物是患者的首选成分。然而，由于库存通常不足，且 O 型供者通常相对较多，所以并非总能实现完美匹配。因此，当无法获得 ABO 血型相同的血小板时，跨 ABO 血型输注血小板已成为公认的做法。尽管如此，输注含有高滴度针对患者红细胞抗原抗体的血小板可能会导致具有临床意义的溶血。提高 O 型血小板安全性的方法主要集中在确定抗体的安全水平或减少不相容血浆的体积。在本研究中，107 份 O 型单采血小板（SDP）在袋中收集血小板沉淀后进行了改良。加入的是 AB 型血浆而非供者自身的血浆。通过凝胶试验检测原始 O 型 SDP 血浆中抗 A/抗 B 的直接凝集效价，结果为 1:4 至 1:1024。高滴度（即本研究中至少为 1:64）的发生率相对较高，抗 A 约为 63%，抗 B 约为 78%。改良后 SDP 中残留抗 A/抗 B 的效价范围为阴性至 1:8。在大多数改良后的 SDP 中，血浆中无法检测到抗 A/抗 B（分别为 58.9%和 52.3%）。结果表明，我们改良后的 SDP 滴度非常低；也就是说，可作为对所有 ABO 血型患者都安全的通用 SDP。这种改良的 SDP 形式是一种更便捷的方式，可克服在体积减少过程中不相容血浆带来的风险或血小板损失，并有助于有效管理我们的库存。
