Department of Surgery, The University of South Alabama, Mobile, AL.
Department of Surgery, University of Mississippi, Jackson, MS.
J Am Coll Surg. 2020 Apr;230(4):596-602. doi: 10.1016/j.jamcollsurg.2019.12.042.
Recent reports suggest that component plasma products contain significant quantities of cellular contamination. We hypothesized that leukoreduction of whole blood before preparation of derived plasma is an effective method to prevent cellular contamination of stored plasma.
Samples of never-frozen liquid plasma prepared by standard methods (n = 25) were obtained from 3 regional blood centers that supply 3 major trauma centers. Samples were analyzed for leukocyte and platelet contamination by flow cytometry. To determine if leukoreduction of whole blood before centrifugation and expression of plasma prevents cellular contamination of liquid plasma, 1 site generated 6 additional units of liquid plasma from leukoreduced whole blood, which were then compared with units of liquid plasma derived by standard processing.
Across all centers, each unit of never-frozen liquid plasma contained a mean of 12.8 ± 3.0 million leukocytes and a mean of 4.6 ± 2 billion platelets. Introduction of whole blood leukoreduction (LR) before centrifugation and plasma extraction essentially eliminated all contaminating leukocytes (Non-LR: 12.3 ± 2.9 million vs LR: 0.05 ± 0.05 million leukocytes) and platelets (Non-LR: 4.2 ± 0.3 billion platelets vs LR: 0.00 ± 0.00 billion platelets).
Despite widespread belief that stored plasma is functionally acellular, testing of liquid plasma from 3 regional blood banks revealed a significant amount of previously unrecognized cellular contamination. Introduction of a leukoreduction step before whole blood centrifugation essentially eliminated detectable leukocyte and platelet contaminants from plasma. Therefore, our study highlights a straightforward and cost-effective method to eliminate cellular contamination of stored plasma.
最近的报告表明，成分血浆制品含有大量的细胞污染。我们假设在制备衍生血浆之前对全血进行白细胞减少处理是防止储存血浆发生细胞污染的有效方法。
从未冷冻的液体血浆样本（通过标准方法制备，n=25）由 3 个为 3 个主要创伤中心提供服务的区域血液中心获得。通过流式细胞术分析白细胞和血小板污染。为了确定在离心前对全血进行白细胞减少处理并表达血浆是否可以防止液体血浆的细胞污染，1 个地点从白细胞减少的全血中产生了 6 个额外的液体血浆单位，然后将这些单位与通过标准处理获得的液体血浆单位进行比较。
在所有中心，每个单位的未冷冻液体血浆平均含有 1280 万±300 万个白细胞和 46 亿±20 亿个血小板。在离心和血浆提取之前引入全血白细胞减少处理（LR）基本上消除了所有污染的白细胞（非 LR：1230 万±290 万个白细胞 vs LR：0.05±0.05 万个白细胞）和血小板（非 LR：42 亿±0.3 亿个血小板 vs LR：0.00±0.00 亿个血小板）。
尽管普遍认为储存的血浆在功能上是无细胞的，但对来自 3 个地区血库的液体血浆进行测试显示，存在大量以前未被识别的细胞污染。在全血离心前引入白细胞减少处理步骤，基本上从血浆中消除了可检测到的白细胞和血小板污染物。因此，我们的研究强调了一种简单且具有成本效益的方法，可以消除储存血浆的细胞污染。
