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采用血浆混合并结合氨甲喋呤/长波紫外线病原体灭活技术以提高治疗性血浆单位的标准化和安全性。

Plasma pooling in combination with amotosalen/UVA pathogen inactivation to increase standardisation and safety of therapeutic plasma units.

机构信息

Regional Blood Transfusion Center, Lodz, Poland.

Medical Laboratory SYNEVO, Lodz, Poland.

出版信息

Transfus Med. 2021 Apr;31(2):136-141. doi: 10.1111/tme.12763. Epub 2021 Mar 8.

Abstract

OBJECTIVES

Assessment of the impact of pooling five single-donor plasma (SDP) units to obtain six pathogen-reduced therapeutic plasma (PTP) units on standardisation and the retention of labile coagulation factors.

BACKGROUND

SDP shows a high inter-donor variability with potential implications for the clinical treatment outcome. Additionally, there is still an existing risk for window-period transmissions of blood borne pathogens including newly emerging pathogens.

METHODS/MATERIALS: Five ABO-identical SDP units were pooled, treated with the INTERTCEPT™ Blood System (Cerus Corporation, U.S.A.) and split into six PTP units which were frozen and thawed after 30 days. The variability in volume, labile coagulation factor retention and activity was assessed.

RESULTS

The variability of volumes between the PTP units was reduced by 46% compared to SDP units. The variability in coagulation factor content between the PTP units was reduced by 63% compared to SDP units. Moderate, but significant losses of coagulation factors (except for vWF) were observed in PTPs compared to SDPs.

CONCLUSION

The pooling of five SDP units to obtain six PTP units significantly increases product standardisation with potential implications for safety, economics as well as transfusion-transmitted pathogen safety, making it an interesting alternative to quarantine SDP (qSDP) and pathogen-reduced SDP.

摘要

目的

评估将五个单供体血浆 (SDP) 单位汇集以获得六个病原体减少的治疗性血浆 (PTP) 单位对标准化和不稳定凝血因子保留的影响。

背景

SDP 显示出供体间的高度变异性,这可能对临床治疗结果产生影响。此外,仍然存在窗口期传播血液传播病原体的风险,包括新出现的病原体。

方法/材料:将五个 ABO 相同的 SDP 单位汇集,用 INTERTCEPT™ 血液系统(美国 Cerus 公司)处理,然后将其分成六个 PTP 单位,在 30 天后冷冻和解冻。评估体积、不稳定凝血因子保留和活性的变异性。

结果

与 SDP 单位相比,PTP 单位之间的体积变异性降低了 46%。与 SDP 单位相比,PTP 单位之间凝血因子含量的变异性降低了 63%。与 SDP 相比,PTP 中观察到凝血因子(除 vWF 外)中度但显著丢失。

结论

将五个 SDP 单位汇集以获得六个 PTP 单位,可显著提高产品标准化程度,这可能对安全性、经济性以及输血传播病原体安全性产生影响,使其成为检疫 SDP (qSDP) 和病原体减少 SDP 的有趣替代方案。

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