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一种无需离心即可将捐献的全血处理成高质量成分的便携式系统。

A portable system for processing donated whole blood into high quality components without centrifugation.

作者信息

Gifford Sean C, Strachan Briony C, Xia Hui, Vörös Eszter, Torabian Kian, Tomasino Taylor A, Griffin Gary D, Lichtiger Benjamin, Aung Fleur M, Shevkoplyas Sergey S

机构信息

Halcyon Biomedical Incorporated, Friendswood, Texas, United States of America.

Department of Biomedical Engineering, University of Houston, Houston, Texas, United States of America.

出版信息

PLoS One. 2018 Jan 18;13(1):e0190827. doi: 10.1371/journal.pone.0190827. eCollection 2018.

Abstract

BACKGROUND

The use of centrifugation-based approaches for processing donated blood into components is routine in the industrialized world, as disparate storage conditions require the rapid separation of 'whole blood' into distinct red blood cell (RBC), platelet, and plasma products. However, the logistical complications and potential cellular damage associated with centrifugation/apheresis manufacturing of blood products are well documented. The objective of this study was to evaluate a proof-of-concept system for whole blood processing, which does not employ electromechanical parts, is easily portable, and can be operated immediately after donation with minimal human labor.

METHODS AND FINDINGS

In a split-unit study (n = 6), full (~500mL) units of freshly-donated whole blood were divided, with one half processed by conventional centrifugation techniques and the other with the new blood separation system. Each of these processes took 2-3 hours to complete and were performed in parallel. Blood products generated by the two approaches were compared using an extensive panel of cellular and plasma quality metrics. Comparison of nearly all RBC parameters showed no significant differences between the two approaches, although the portable system generated RBC units with a slight but statistically significant improvement in 2,3-diphosphoglyceric acid concentration (p < 0.05). More notably, several markers of platelet damage were significantly and meaningfully higher in products generated with conventional centrifugation: the increase in platelet activation (assessed via P-selectin expression in platelets before and after blood processing) was nearly 4-fold higher for platelet units produced via centrifugation, and the release of pro-inflammatory mediators (soluble CD40-ligand, thromboxane B2) was significantly higher for centrifuged platelets as well (p < 0.01).

CONCLUSION

This study demonstrated that a simple, passive system for separating donated blood into components may be a viable alternative to centrifugation-particularly for applications in remote or resource-limited settings, or for patients requiring highly functional platelet product.

摘要

背景

在工业化国家,采用基于离心的方法将捐献的血液加工成成分血是常规操作,因为不同的储存条件要求将“全血”快速分离成不同的红细胞(RBC)、血小板和血浆制品。然而,与血液制品的离心/单采制造相关的后勤并发症和潜在的细胞损伤已有充分记录。本研究的目的是评估一种用于全血加工的概念验证系统,该系统不使用机电部件,便于携带,并且在捐献后可立即操作,人力需求极少。

方法与结果

在一项分组研究(n = 6)中,将新鲜捐献的全血完整单位(约500mL)分开,一半采用传统离心技术处理,另一半采用新的血液分离系统处理。这两个过程各自需要2 - 3小时完成,并且并行进行。使用大量细胞和血浆质量指标对两种方法产生的血液制品进行比较。几乎所有红细胞参数的比较显示两种方法之间无显著差异,尽管便携式系统产生的红细胞单位中2,3 - 二磷酸甘油酸浓度略有但在统计学上有显著提高(p < 0.05)。更值得注意的是,传统离心产生的制品中几种血小板损伤标志物显著且有意义地更高:通过离心产生的血小板单位,血小板活化增加(通过血液处理前后血小板中P - 选择素表达评估)几乎高出4倍,并且离心血小板中促炎介质(可溶性CD40 - 配体、血栓素B2)的释放也显著更高(p < 0.01)。

结论

本研究表明,一种将捐献血液分离成成分血的简单、被动系统可能是离心的可行替代方案——特别是对于在偏远或资源有限环境中的应用,或对于需要高功能血小板制品的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a96/5773086/788e0bd03173/pone.0190827.g001.jpg

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