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采用 PRP 方法对病原体减少的全血进行血液成分分离可产生可接受的红细胞,但血小板的产量和功能会降低。

Blood component separation of pathogen-reduced whole blood by the PRP method produces acceptable red cells but platelet yields and function are diminished.

机构信息

Coagulation & Blood Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA.

Institute of Biomedical Studies, Baylor University, Waco, Texas, USA.

出版信息

Transfusion. 2020 Jun;60 Suppl 3:S124-S133. doi: 10.1111/trf.15766. Epub 2020 Jun 1.

Abstract

BACKGROUND

This study evaluated blood components processed by the platelet rich plasma (PRP) method from fresh whole blood (FWB) treated with a pathogen reduction technology (PRT). The effects of storage temperature on PRT treated platelet concentrates (PCs) were also examined.

STUDY DESIGN AND METHODS

PRT was performed using riboflavin and ultraviolet light on FWB in citrate phosphate dextrose anticoagulant. Following PRT, red blood cells (RBCs), PCs, and plasma for fresh frozen plasma (FFP), were isolated by sequential centrifugation. RBCs were stored at 4°C, FFP at -80°C, and PC at 22°C or at 4°C. Components were assayed throughout their storage times for blood gases, chemistry and CBC, hemostatic function as well as platelet (PLT) and RBC integrity.

RESULTS

Component processing following PRT resulted in a significant drop in platelet recovery. Most PRT-PC bags fell below AABB guidelines for platelet count. PRT-PC also showed a decrease in clot strength and decreased aggregometry response. Platelet caspases were activated by PRT. Storage at 4°C improved platelet function. In PRT-FFP, prothrombin time and partial thromboplastin time (PT and aPTT) were prolonged; factors V, VII, VIII, and XI, protein C, and fibrinogen were significantly decreased. Free hemoglobin was elevated two-fold in PRT-RBC.

CONCLUSION

Blood components isolated by the PRP method from PRT-treated WB result in a high percentage of PC that fail to meet AABB guidelines. FFP also shows diminished coagulation capacity. However, PRT-RBC are comparable to control-RBC. PRT-WB retains acceptable hemostatic function but alternatives to the PRP method of component separation may be more suitable.

摘要

背景

本研究评估了经病原体减少技术(PRT)处理的新鲜全血(FWB)中血小板富血浆(PRP)方法处理的血液成分。还研究了储存温度对 PRT 处理的血小板浓缩物(PCs)的影响。

研究设计和方法

在柠檬酸盐磷酸盐葡萄糖抗凝剂中用核黄素和紫外线对 FWB 进行 PRT。PRT 后,通过连续离心分离 RBC、PC 和用于新鲜冷冻血浆(FFP)的血浆。RBC 在 4°C 下储存,FFP 在-80°C 下储存,PC 在 22°C 或 4°C 下储存。在整个储存时间内对血液气体、化学和 CBC、止血功能以及血小板(PLT)和 RBC 完整性进行测定。

结果

PRT 后组件处理导致血小板回收率显著下降。大多数 PRT-PC 袋的血小板计数低于 AABB 指南。PRT-PC 的凝块强度也降低,聚集仪反应降低。血小板半胱氨酸蛋白酶被 PRT 激活。4°C 储存可改善血小板功能。在 PRT-FFP 中,凝血酶原时间和部分凝血活酶时间(PT 和 aPTT)延长;因子 V、VII、VIII 和 XI、蛋白 C 和纤维蛋白原显著减少。PRT-RBC 中的游离血红蛋白增加了两倍。

结论

从 PRT 处理的 WB 中通过 PRP 方法分离的血液成分导致无法满足 AABB 指南的高比例 PC。FFP 也显示出凝血能力下降。然而,PRT-RBC 与对照 RBC 相当。PRT-WB 保留可接受的止血功能,但组件分离的 PRP 方法的替代方法可能更合适。

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