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当前冷冻保存脐带血的解冻和输注实践:对移植物质量、受者安全性及移植结果的影响。

Current thawing and infusion practice of cryopreserved cord blood: the impact on graft quality, recipient safety, and transplantation outcomes.

作者信息

Akel Salem, Regan Donna, Wall Donna, Petz Laurence, McCullough Jeffrey

机构信息

St Louis Cord Blood Bank/Cellular Therapy Laboratory, SSM Cardinal Glennon Children Medical Center, St Louis, Missouri, Canada.

出版信息

Transfusion. 2014 Nov;54(11):2997-3009. doi: 10.1111/trf.12719. Epub 2014 Jun 4.

Abstract

Methods of handling, thawing, and infusion of cord blood (CB) products vary substantially among thaw/transplant centers (TCs). This review 1) compares currently available CB product types and thaw methods recommended by CB banks (CBBs), 2) discusses causes of inconsistency in thaw method application at TCs, 3) advises elements to consider in thaw method approval or selection at the TC, 4) provides a procedural template for the traditional thaw methods, and 5) suggests acceptable time from product thaw to infusion and other considerations for safe infusion. It also compares postinfusion adverse reaction and engraftment data as functions of thaw methods. Remarks and suggestions made throughout this review are: 1) not intended to supersede manufacturer's instructions but meant to support the standardization of preparative procedures recommended by CBBs and 2) intended to help TCs to investigate relevant quality issues and handle challenges, especially when the TC is unable to follow recommendations due to foreseeable technical, quality, and/or clinical factors.

摘要

脐带血(CB)产品的处理、解冻和输注方法在不同的解冻/移植中心(TC)之间存在很大差异。本综述:1)比较了脐带血库(CBB)推荐的当前可用的CB产品类型和解冻方法;2)讨论了TC应用解冻方法不一致的原因;3)给出了TC在批准或选择解冻方法时应考虑的因素;4)提供了传统解冻方法的程序模板;5)给出了从产品解冻到输注的可接受时间以及安全输注的其他注意事项。它还比较了作为解冻方法函数的输注后不良反应和植入数据。本综述中的评论和建议是:1)无意取代制造商的说明,而是旨在支持CBB推荐的制备程序的标准化;2)旨在帮助TC调查相关质量问题并应对挑战,特别是当TC由于可预见的技术、质量和/或临床因素而无法遵循建议时。

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