Schubert Peter, Culibrk Brankica, Karwal Simrath, Serrano Katherine, Levin Elena, Bu Daniel, Bhakta Varsha, Sheffield William P, Goodrich Raymond P, Devine Dana V
Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia, Canada.
Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.
Transfusion. 2015 Apr;55(4):815-23. doi: 10.1111/trf.12895. Epub 2014 Oct 29.
Pathogen inactivation (PI) technologies are currently licensed for use with platelet (PLT) and plasma components. Treatment of whole blood (WB) would be of benefit to the blood banking community by saving time and costs compared to individual component treatment. However, no paired, pool-and-split study directly assessing the impact of WB PI on the subsequently produced components has yet been reported.
In a "pool-and-split" study, WB either was treated with riboflavin and ultraviolet (UV) light or was kept untreated as control. The buffy coat (BC) method produced plasma, PLT, and red blood cell (RBC) components. PLT units arising from the untreated WB study arm were treated with riboflavin and UV light on day of production and compared to PLT concentrates (PCs) produced from the treated WB units. A panel of common in vitro variables for the three types of components was used to monitor quality throughout their respective storage periods.
PCs derived from the WB PI treatment were of significantly better quality than treated PLT components for most variables. RBCs produced from the WB treatment deteriorated earlier during storage than untreated units. Plasma components showed a 3% to 44% loss in activity for several clotting factors.
Treatment of WB with riboflavin and UV before production of components by the BC method shows a negative impact on all three blood components. PLT units produced from PI-treated WB exhibited less damage compared to PLT component treatment.
病原体灭活(PI)技术目前已获许可用于血小板(PLT)和血浆成分。与单个成分处理相比,全血(WB)处理将通过节省时间和成本而使血库受益。然而,尚未有直接评估WB PI对随后产生的成分影响的配对、混合与分离研究报告。
在一项“混合与分离”研究中,WB要么用核黄素和紫外线(UV)光处理,要么不处理作为对照。采用白膜层(BC)法制备血浆、PLT和红细胞(RBC)成分。将未处理的WB研究组产生的PLT单位在生产当天用核黄素和UV光处理,并与处理后的WB单位产生的PLT浓缩物(PC)进行比较。使用一组针对三种类型成分的常见体外变量,在其各自储存期内监测质量。
对于大多数变量,WB PI处理产生的PC质量明显优于处理后的PLT成分。WB处理产生的RBC在储存期间比未处理的单位更早恶化。血浆成分的几种凝血因子活性损失了3%至44%。
在通过BC法生产成分之前,用核黄素和UV处理WB对所有三种血液成分均显示出负面影响。与PLT成分处理相比,PI处理的WB产生的PLT单位受损较小。