Institute of Medicine, Chung Shan Medical University, 110, Sec. 1, Chien-Kuo N. road, 40203Taichung, Taiwan; Taichung Blood Center, Taiwan Blood Services Foundation, Taichung, Taiwan.
Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
Transfus Clin Biol. 2021 Feb;28(1):44-50. doi: 10.1016/j.tracli.2020.10.010. Epub 2020 Nov 20.
Platelet transfusion is required to treat haemo-oncology or trauma patients. Platelet apheresis (PA) performed with apheresis equipment has increased rapidly in recent years. Leucocyte-reduced platelet apheresis (LRPA) can reduce the risk of platelet refractoriness and febrile nonhemolytic transfusion reactions (FNHTRs) for transfusion. Accordingly, this study aimed to investigate and compare the platelet metabolic and functional responses between PA performed with Haemonetics and LRPA performed with Trima Accel cell separator.
The qualities of platelets collected through PA and LRPA were evaluated in terms of visual appearance, morphology, platelet-aggregation changes, metabolic activities, and bacterium-screening test during 5-day storage. Statistical analyses included two-sample t-test and generalised estimating equation(GEE) method.
During 5-day storage in LRPA, residual leucocytes were all <1.0×10, and the parameters of platelet function were as follows: platelet aggregated to agonists such as adenosine 5'-diphosphate (ADP) and collagen, and the extent of shape change and pO showed no statistically significant difference between PA and LRPA. The hypotonic shock reaction (HSR) on days 0, 1, and 3 were significantly higher in LRPA than in PA (71.78±6.92 vs. 64.10±7.42; P=0.002; 71.53±8.98 vs. 62.96±9.84; P=0.007; 68.05±7.28 vs. 57.76±6.80; P<0.0001, respectively). Values of mean platelet volume (MPV) were statistically larger in PA than in LRPA on days 0, 1, and 3. On day 5, the swirling score was higher in LRPA than in PA. The mean lactate levels had no statistically significant difference between PA and LRPA. Moreover, no growth was observed through bacterium-screening test conducted on 40 samples.
Comparison of LRPA and PA products collected from the Trima Accel and Haemonetics automated blood-collection systems, respectively, revealed that both products possessed good platelet qualities even though additional processes are needed to reduce leucocytes. Furthermore, investigating the outcomes of other apheresis instruments with focus on the safety of donors, products, and recipients is necessary.
血小板输注是治疗血液肿瘤或创伤患者的必要手段。近年来，使用血细胞分离机进行的血小板单采术（PA）迅速增加。白细胞减少的血小板单采术（LRPA）可以降低血小板输注的耐药性和发热性非溶血性输血反应（FNHTR）的风险。因此，本研究旨在调查和比较使用 Haemonetics 进行的 PA 和使用 Trima Accel 细胞分离机进行的 LRPA 之间的血小板代谢和功能反应。
通过视觉外观、形态学、血小板聚集变化、代谢活性和 5 天储存期间的细菌筛查试验评估通过 PA 和 LRPA 采集的血小板质量。统计分析包括两样本 t 检验和广义估计方程（GEE）方法。
在 LRPA 中储存 5 天期间，残留白细胞均<1.0×10，血小板功能参数如下：血小板聚集到激动剂如二磷酸腺苷（ADP）和胶原，形态变化和 pO 的程度在 PA 和 LRPA 之间无统计学差异。在第 0、1 和 3 天的低渗休克反应（HSR）在 LRPA 中显著高于 PA（71.78±6.92 与 64.10±7.42；P=0.002；71.53±8.98 与 62.96±9.84；P=0.007；68.05±7.28 与 57.76±6.80；P<0.0001）。在第 0、1 和 3 天，PA 的平均血小板体积（MPV）值明显大于 LRPA。在第 5 天，LRPA 的漩涡评分高于 PA。PA 和 LRPA 的平均乳酸水平无统计学差异。此外，对 40 个样本进行细菌筛查试验，未观察到生长。
分别比较从 Trima Accel 和 Haemonetics 自动化血液采集系统采集的 LRPA 和 PA 产品，结果表明，尽管需要额外的过程来减少白细胞，但两种产品都具有良好的血小板质量。此外，有必要调查其他血细胞分离机的结果，重点关注供者、产品和受者的安全性。
