Goodrich Raymond P, Segatchian Jerard
Infectious Disease Research Center, Colorado State University, Fort Collins, CO, USA.
International Consultancy in Blood Components Quality/Safety improvement, Audit/Inspection, and DDR Strategies, London, UK.
Transfus Apher Sci. 2018 Jun;57(3):374-377. doi: 10.1016/j.transci.2018.05.022. Epub 2018 May 16.
Pediatric patients requiring transfusion constitute one of the most challenging areas of transfusion practice. Due to the limitations posed by their particular physiological conditions they routinely require specialized component support and more personalised transfusion care than what is routinely utilized in the care of adult patients. Pediatric patients, unlike many adult patients requiring transfusion support, also generally have significant lifespans post-transfusion. This combined with the possibility of long term consequences to adverse events related to transfusion such as infection or change in immunological status drives the need to continue to use improved blood components in the transfusion support of pediatric patients. While considerable progress has been made on methods to improve the safety and efficacy of blood components, the use of these products in pediatric patients continues to be a subject of debate and additional considerations. These additional considerations arise due to the changes in blood product quality and function that is observed following treatment with pathogen reduction methods. Additional considerations regarding toxicological and immunological aspects related to these products are heightened in the case of pediatric patients. This manuscript provides an overview of current practice regarding the use of pathogen reduced products in pediatric patients with discussion of issues for consideration in their implementation in routine, including cost/benefit and risk/benefit aspects associated with their use.
需要输血的儿科患者是输血实践中最具挑战性的领域之一。由于其特殊生理状况带来的限制，他们通常需要特殊的血液成分支持以及比成年患者常规护理中更个性化的输血护理。与许多需要输血支持的成年患者不同，儿科患者输血后的生存期通常也很长。这一点，再加上输血相关不良事件（如感染或免疫状态改变）可能产生长期后果，使得在儿科患者的输血支持中继续使用改良血液成分成为必要。虽然在提高血液成分安全性和有效性的方法方面已经取得了相当大的进展，但这些产品在儿科患者中的使用仍然是一个有争议的话题，并且需要更多的考量。这些额外的考量源于采用病原体灭活方法处理后血液制品质量和功能的变化。在儿科患者中，与这些产品相关的毒理学和免疫学方面的额外考量更为突出。本文概述了目前在儿科患者中使用病原体灭活产品的实践情况，并讨论了在常规应用中需要考虑的问题，包括使用这些产品的成本效益和风险效益方面。
