van Marwijk Kooy M, van Prooijen H C, Borghuis L, Moes M, Akkerman J W
Department of Hematology, University Hospital Utrecht, The Netherlands.
Transfusion. 1990 Jan;30(1):34-8. doi: 10.1046/j.1537-2995.1990.30190117626.x.
HLA alloimmunization is a major problem for thrombocytopenic patients receiving long-term platelet support. It is caused by white cells (WBCs) that are present as contaminants in platelet concentrates (PCs). Recent data have shown that filtration is an effective means to reduce WBC contamination, but it has little effect on the recovery of platelets. The present report evaluates two filters, a cellulose acetate (CA) filter requiring the inactivation of platelets with prostacyclin and a cotton wool (CW) filter requiring no platelet inactivation. The results show that, using fresh pooled PCs from six random donors, both filters reduce WBC contamination below 10(7) per PC, the likely threshold below which alloimmunization does not develop. With platelets stored for 2 to 3 days the efficacy of the CW filter decreases. Neither filter inflicts important damage to the platelets, as there is no considerable platelet activation or cell disruption. Moreover, PCs prepared by both filters show normal survival and effectively reduce the bleeding times. Thus, filtration of PCs results in platelets with optimal responsiveness both in vitro and in vivo.
对于接受长期血小板支持的血小板减少症患者而言，人类白细胞抗原（HLA）同种免疫是一个主要问题。它是由作为污染物存在于血小板浓缩物（PCs）中的白细胞（WBCs）引起的。近期数据表明，过滤是减少白细胞污染的有效手段，但对血小板的回收率影响不大。本报告评估了两种过滤器，一种是需要用前列环素使血小板失活的醋酸纤维素（CA）过滤器，另一种是不需要血小板失活的棉绒（CW）过滤器。结果显示，使用来自六名随机供体的新鲜混合PCs时，两种过滤器都能将白细胞污染降低至每单位PC低于10⁷，这可能是不会发生同种免疫的阈值。对于储存2至3天的血小板，CW过滤器的功效会降低。两种过滤器均未对血小板造成重大损害，因为没有明显的血小板活化或细胞破坏。此外，通过两种过滤器制备的PCs显示出正常的存活率，并有效缩短了出血时间。因此，对PCs进行过滤可产生在体外和体内均具有最佳反应性的血小板。
