Stroncek David F, England Lee
Cell Processing Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland USA.
ISBT Sci Ser. 2015 Apr 1;10(Suppl 1):108-114. doi: 10.1111/voxs.12150.
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.
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。