Tissot J-D, Bardyn M, Sonego G, Abonnenc M, Prudent M
Transfusion interrégionale CRS, Laboratoire de Recherche sur les Produits Sanguins, 2, route de la Corniche, CH-1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland.
Transfusion interrégionale CRS, Laboratoire de Recherche sur les Produits Sanguins, 2, route de la Corniche, CH-1066 Epalinges, Switzerland.
Transfus Clin Biol. 2017 Sep;24(3):277-284. doi: 10.1016/j.tracli.2017.05.012. Epub 2017 Jun 30.
Red blood cell (RBC) concentrates are stored in additive solutions at 4C for up to 42 days, whereas platelets concentrates (PCs) are stored at 22C with continuous agitation for up to 5 to 7 days, according national regulations, and the use or not of pathogen inactivation procedures. Storage induces cellular lesion and alters either RBC or platelet metabolism, and is associated with protein alterations. Some age-related alterations prove reversible, while other changes are irreversible, notably following protein oxidation. It is likely that any irreversible damage affects the blood component quality and thus the transfusion efficiency. Nevertheless, there still exists a debate surrounding the impact of storage lesions, for both RBCs and PCs. Uncertainty is not completely resolved. Several studies show a tendency for poorer outcomes to occur in patients receiving older blood products; however, no clear significant association has yet been demonstrated. The present short review aims to promote a better understanding of the occurrence of storage lesions, with particular emphasis on biochemical modifications opening discussions of the future advancement of blood transfusion processes. The paper is also an advocacy for the implementation of an independent international organization in charge of planning and controlling clinical studies in transfusion medicine, in order to base transfusion medicine practices both on security principles, but also on clinical evidences.
红细胞浓缩液在添加溶液中于4℃储存长达42天，而血小板浓缩液则在22℃连续搅拌下储存长达5至7天，这取决于国家法规以及是否使用病原体灭活程序。储存会引发细胞损伤，改变红细胞或血小板的代谢，并与蛋白质改变有关。一些与年龄相关的改变被证明是可逆的，而其他变化则是不可逆的，尤其是在蛋白质氧化之后。任何不可逆的损伤都可能影响血液成分的质量，进而影响输血效率。然而，关于储存损伤对红细胞和血小板的影响仍存在争议。不确定性尚未完全解决。多项研究表明，接受较陈旧血液制品的患者出现较差预后的趋势；然而，尚未证明有明确的显著关联。本简短综述旨在促进对储存损伤发生情况的更好理解，特别强调生化修饰，开启对输血过程未来进展的讨论。本文还主张设立一个独立的国际组织，负责规划和控制输血医学的临床研究，以便使输血医学实践既基于安全原则，又基于临床证据。
