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[通过分离器采集母体血小板用于抗 PLA1 同种免疫病例中的胎儿输血的制备]

[Preparation of maternal platelets collected by separator for use in fetal transfusion in a case of alloimmunization by anti-PLA1].

作者信息

Woimant G, Gautreau C, Bardin J M, Brossard Y, Poissonnier M H, Pinon F

机构信息

Poste de Transfusion Sanguine, Hôpital Cochin, Paris.

出版信息

Rev Fr Transfus Hemobiol. 1989 Jun;32(3):227-34. doi: 10.1016/s1140-4639(89)80043-7.

Abstract

In one case of fetal thrombocytopenia due to maternal immunization against PLA1 fetal platelet antigen, maternal platelets were collected by automated plasmapheresis. The platelets were collected 24 hours before fetal transfusion at 28, 29, 31 and 36 weeks of gestation. The maternal platelets were irradiated and concentrated in a small volume (7.10(10) to 1,4.10(11) plts in less than 20 ml maternal plasma) a few hours before transfusion. When prepared as described, maximal and irreversible platelet aggregation is obtained with 20 microM of ADP and the pH is over 6, 5-6 hours after concentration. The amounts of transfused platelets were determined to increase theoretically fetal platelet counts over 200,000 plts/mm3. The fetal platelet counts, determined immediately after transfusion, showed an increase of 100,000 plts/mm3. Prenatal fetal transfusion of maternal platelets is available to avoid fetal bleeding during delivery, and during the early neonatal period.

摘要

在一例因母亲针对PLA1胎儿血小板抗原免疫而导致胎儿血小板减少的病例中,通过自动血浆置换术采集母亲的血小板。在妊娠28、29、31和36周进行胎儿输血前24小时采集血小板。在输血前数小时,将母亲的血小板进行辐照并浓缩至小体积(在少于20毫升母亲血浆中含有7×10¹⁰至1.4×10¹¹个血小板)。按照所述方法制备后,在浓缩后5至6小时,用20微摩尔ADP可获得最大且不可逆的血小板聚集,且pH值超过6.5。所输注血小板的量经测定理论上可使胎儿血小板计数增加至超过200,000个/立方毫米。输血后立即测定的胎儿血小板计数显示增加了100,000个/立方毫米。产前输注母亲的血小板可避免分娩期间及新生儿早期胎儿出血。

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