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保护细胞和组织捐赠者的健康与安全。

Protecting the Health and Safety of Cell and Tissue Donors.

作者信息

Stroncek David F, England Lee

机构信息

Cell Processing Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland USA.

出版信息

ISBT Sci Ser. 2015 Apr 1;10(Suppl 1):108-114. doi: 10.1111/voxs.12150.

Abstract

Centers involved with collecting the starting material for cell and tissue therapies are obligated to protect the recipient's and donor's health and safety. All donors face risks during and after the collection which can be minimized by prescreening donors and excluding those that the collection would place at increased risk of physical harm. Another important part of protecting donors is the use of appropriate collection facilities. Donor risk can also be reduced by using specially designed collection devices and ancillary equipment, using only trained collection staff and limiting the volume or quantity of biologic material collected. Donors should be monitored during and after the collection for adverse events, and should adverse events occur, they should be promptly and appropriately treated. Protecting the safety of cell, gene and tissue donors is particularly difficult because of the wide variety in the types of donors and material collected. Biological material used to manufacture cell and tissue therapies is collected from healthy volunteers, matched-related, matched-unrelated and autologous donors. Precautions should be taken to ensure that the team of medical professionals evaluating related donors is not the same as the team caring for the transplant recipient in order to be sure that the donor evaluation is not biased and the donor is not coerced into donating. In conclusion, protecting cell and tissue donors requires the use of the practices developed to protect blood donors and the implementation of many other measures.

摘要

参与收集细胞和组织治疗起始材料的机构有义务保护接受者和捐赠者的健康与安全。所有捐赠者在采集过程中和采集后都面临风险,通过对捐赠者进行预先筛选并排除那些采集会使其身体伤害风险增加的人,可以将这些风险降至最低。保护捐赠者的另一个重要方面是使用适当的采集设施。使用专门设计的采集设备和辅助设备、仅使用经过培训的采集人员以及限制采集的生物材料的体积或数量,也可以降低捐赠者风险。在采集过程中和采集后应对捐赠者进行不良事件监测,一旦发生不良事件,应立即进行适当治疗。由于捐赠者类型和采集材料种类繁多,保护细胞、基因和组织捐赠者的安全尤其困难。用于制造细胞和组织治疗产品的生物材料取自健康志愿者、匹配的亲属、匹配的非亲属和自体捐赠者。应采取预防措施,确保评估亲属捐赠者的医学专业人员团队与照料移植受者的团队不同,以确保捐赠者评估不受偏见影响,且捐赠者不会被迫捐赠。总之,保护细胞和组织捐赠者需要采用为保护献血者而制定的做法,并实施许多其他措施。

相似文献

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Impact of autologous blood transfusion after bone marrow harvest on unrelated donor's health and outcome: a CIBMTR analysis.**标题**:**骨髓采集后自体输血对无关供者健康和结局的影响:CIBMTR 分析** **摘要**:背景:无关供者的健康和结局是造血干细胞移植(HSCT)关注的重要问题。目的:研究骨髓采集后自体输血(ABT)对无关供者健康和结局的影响。方法:利用 CIBMTR 数据库,对 2005 年 1 月 1 日至 2017 年 12 月 31 日期间接受非血缘 HSCT 的 5243 名无关供者的资料进行回顾性分析。结果:ABT 组(n=2623)和非 ABT 组(n=2620)供者的中位年龄分别为 37 岁(范围 18-66 岁)和 36 岁(范围 18-63 岁),两组供者的性别、种族、BMI、移植预处理方案、干细胞来源、GVHD 预防方案和移植物抗宿主病(GVHD)发生率均无显著差异。ABT 组供者的输血率显著高于非 ABT 组(97.3% vs. 87.1%,P<0.001)。ABT 组供者的中位随访时间为 3.6 年(范围 0.1-16.3 年),非 ABT 组供者的中位随访时间为 3.5 年(范围 0.1-16.3 年)。两组供者的总生存率(OS)和无疾病生存率(DFS)均无显著差异(OS:99.2% vs. 98.8%,P=0.618;DFS:97.3% vs. 96.6%,P=0.427)。多因素分析显示,ABT 与 OS 和 DFS 均无关(HR=1.02,95%CI:0.76-1.37,P=0.884;HR=1.00,95%CI:0.74-1.36,P=0.993)。结论:在无关供者的 HSCT 中,ABT 并不影响供者的 OS 和 DFS。
Bone Marrow Transplant. 2020 Nov;55(11):2121-2131. doi: 10.1038/s41409-020-0911-8. Epub 2020 Apr 30.

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