Hussein E
Clinical Pathology Department, Transfusion Medicine Division, Cairo University, Cairo, Egypt.
Transfus Med. 2015 Feb;25(1):20-6. doi: 10.1111/tme.12187. Epub 2015 Mar 24.
The clinical efficacy of different types of platelets remains under debate. We conducted a pilot study to prospectively evaluate the impact of subsequent storage on the in vitro quality and post-transfusion outcome of apheresis prepared platelets (APCs) vs random donor platelets (RDPs).
We studied 30 units of APCs, and 30 units of RDPs. We performed assays on days 1, 3, 5 and 7, evaluating ADP aggregation, platelet count and pH. Fifteen thrombocytopenic patients with haematologic conditions were evaluated. Each patient received prophylactic transfusions of both components, and their post-transfusion platelet increments were compared. Twenty-five transfusions were apheresis prepared, and 35 transfusions were received as RDPs. None of the RDPs were leukoreduced.
The median platelet counts for APCs on days 1, 3, 5 and 7 were; 2070, 1990, 1680 and 1240 × 10(3) µL(-1) , respectively, and were; 1290, 850, 499 and 284 × 10(3) µL(-1) , respectively for RDPs. The pH of all units was more than 6·2. Both groups demonstrated a significant decrease of ADP aggregation after 3 days of storage (P < 0·05). However, APCs provided satisfactory increments for 90·9% of transfusions. On the sixth and seventh days of storage, APCs provided significantly higher platelet increments (18·7 × 10(3) µL(-1) ) compared with RDPs (3·20 × 10(3) µL(-1) ) (P < 0·05). Significantly longer transfusion intervals were also achieved with APCs (P < 0·05).
Although other variables may have confounded the results, subsequent storage of APCs appeared to provide higher increments with longer intervals of transfusion compared with RDPs. Future prospective studies are needed, adjusting for other possible confounding variables.
不同类型血小板的临床疗效仍存在争议。我们开展了一项前瞻性初步研究，以评估后续储存对单采血小板（APCs）与随机供者血小板（RDPs）体外质量及输血后结果的影响。
我们研究了30单位的APCs和30单位的RDPs。在第1、3、5和7天进行检测，评估二磷酸腺苷（ADP）聚集、血小板计数和pH值。对15例患有血液系统疾病的血小板减少患者进行了评估。每位患者均接受了这两种成分的预防性输血，并比较了输血后血小板的增加值。25次输血采用单采制备的血小板，35次输血采用随机供者血小板。所有随机供者血小板均未进行白细胞去除处理。
APCs在第1、3、5和7天的血小板计数中位数分别为2070、1990、1680和1240×10³μL⁻¹，而RDPs的中位数分别为1290、850、499和284×10³μL⁻¹。所有单位的pH值均大于6.2。两组在储存3天后ADP聚集均显著下降（P<0.05）。然而，APCs在90.9%的输血中提供了令人满意的增加值。在储存的第6天和第7天，与RDPs（3.20×10³μL⁻¹）相比，APCs提供的血小板增加值显著更高（18.7×10³μL⁻¹）（P<0.05）。使用APCs还显著延长了输血间隔时间（P<0.05）。
尽管其他变量可能混淆了结果，但与RDPs相比，APCs的后续储存似乎能提供更高的增加值且输血间隔更长。未来需要进行前瞻性研究，对其他可能的混杂变量进行校正。
