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关于英国/欧洲输血移植病毒安全性现状以及在先进细胞疗法/再生医学蓬勃发展时代加强供体/受体医疗保健的新策略的思考。

Reflections on current status of blood transfusion transplant viral safety in UK/Europe and on novel strategies for enhancing donors/recipients healthcare in promising era of advanced cell therapy/regenerative medicine.

作者信息

Seghatchian Jerard

机构信息

International Consultancy in Blood Components, Quality/Safety Improvement, Audit/Inspection and DDR Strategies, London, England, UK.

出版信息

Transfus Apher Sci. 2019 Aug;58(4):532-537. doi: 10.1016/j.transci.2019.06.007. Epub 2019 Jun 22.

Abstract

In this report, a personal view is provided on the current achievements and challenges with unresolved issues regarding the viral and transfusion safety of blood in the UK and Europe. Advances in plasma fractionation processes and the use of alternative strategies to reshape treatment of bleeding disorders are also explored. The relationships between the cellular storage lesion and transfusion outcomes using newer tools such as -omics are explored. The use of some newer developments in the promising areas of diagnosis, development, and research [DDR] strategies for improving healthcare of both donors and recipients are discussed using the current transfusion transplant practices in the UK as an example. Other key sections include: a concise presentation of the "Big Six Parameters" for enhancing the safety of transfusion / transplant practice; surmounting the unresolved issues of blood viral safety and food borne diseases, the circulatory role of the donor-gut microbiome in transfusion-induced immunomodulation, and the use of extracellular vesicles [EV] in routine aspects of the cell lesion and in the clinical performance of red cells. These topics are discussed together with the concept of using cell microparticles in drug delivery and the promising role of novel blood products such as serum eye drops and platelet lysates in regenerative medicine. It is hoped that the information conveyed in this overview would be of educational value and serve the transfusion/ transplant services and those involved in related clinical-DDR strategies worldwide and cultivate future talents capable of serving patients.

摘要

在本报告中,针对英国和欧洲血液的病毒安全性及输血安全性方面的当前成就、挑战与未解决问题,提供了个人观点。还探讨了血浆分离过程的进展以及采用替代策略重塑出血性疾病的治疗方法。利用诸如 -组学等更新工具,探索了细胞储存损伤与输血结果之间的关系。以英国当前的输血移植实践为例,讨论了在诊断、开发和研究[DDR]策略等有前景领域的一些新进展在改善献血者和受血者医疗保健方面的应用。其他关键部分包括:简要介绍用于提高输血/移植实践安全性的“六大参数”;克服血液病毒安全性和食源性疾病的未解决问题、供体肠道微生物群在输血诱导的免疫调节中的循环作用,以及细胞外囊泡[EV]在细胞损伤常规方面和红细胞临床性能中的应用。这些主题与细胞微粒在药物递送中的应用概念以及血清眼药水和血小板裂解物等新型血液制品在再生医学中的潜在作用一同进行了讨论。希望本综述所传达的信息具有教育价值,能为全球的输血/移植服务以及参与相关临床-DDR策略的人员提供帮助,并培养能够为患者服务的未来人才。

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