Maitta Robert W
Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Andrews 647A PTH 5077, 11100 Euclid Avenue, Cleveland, OH 44106, United States.
Transfus Apher Sci. 2018 Oct;57(5):606-613. doi: 10.1016/j.transci.2018.09.009. Epub 2018 Sep 11.
Apheresis is at the forefront of therapeutic approaches for an increasing number of indications caused by formation of pathologic antibodies treated by therapeutic plasma exchange, or through the use of red cell exchanges to overcome complications secondary to sickle cell crises. Likewise, the number of hematopoietic stem cell transplants has continued to grow annually and this is the direct result of the expansion of apheresis collections. Over the years a number of apheresis platforms have been utilized, but as one of the oldest and most widely used systems, the COBE Spectra, has ceased to be used therapeutically and at blood centers for donations there is an active search to find suitable systems that will replace it and have the versatility to perform as many procedures as possible. Computer innovations have made it possible with current apheresis technology to obtain more real-time information of the procedure which permits the operator to adjust parameters not only to optimize the specific procedure but also to safeguard against potential adverse events. The focus of this review is to go over available clinical data describing the operation, outcomes and applications of apheresis platforms, and discuss those systems that are likely to meet clinical demands and those of blood donation centers.
对于越来越多由病理性抗体形成所导致的病症，治疗性血浆置换是治疗方法的前沿手段，或者通过红细胞置换来克服镰状细胞危象继发的并发症。同样，造血干细胞移植的数量每年都在持续增长，这是单采血液成分采集量增加的直接结果。多年来，人们使用了多种单采血液成分技术平台，但作为最古老且使用最广泛的系统之一，COBE Spectra已不再用于治疗，在血液中心也不再用于献血采集，目前正在积极寻找合适的系统来取代它，并使其具有执行尽可能多程序的通用性。计算机创新使得当前的单采血液成分技术能够获取更多程序的实时信息，这使得操作人员不仅可以调整参数以优化特定程序，还能预防潜在的不良事件。本综述的重点是回顾描述单采血液成分技术平台操作、结果和应用的现有临床数据，并讨论那些可能满足临床需求和献血中心需求的系统。
