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比较两种获取用于β-地中海贫血输血治疗的浓缩红细胞的替代方法。

Comparison of Two Alternative Procedures to Obtain Packed Red Blood Cells for β-Thalassemia Major Transfusion Therapy.

机构信息

Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.

Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

出版信息

Biomolecules. 2021 Nov 4;11(11):1638. doi: 10.3390/biom11111638.

DOI:10.3390/biom11111638
PMID:34827635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8615631/
Abstract

β-thalassemia major (βTM) patients require frequent blood transfusions, with consequences that span from allogenic reactions to iron overload. To minimize these effects, βTM patients periodically receive leucodepleted packed red blood cells (P-RBCs) stored for maximum 14 days. The aim of this study was to compare two alternative routine procedures to prepare the optimal P-RBCs product, in order to identify differences in their content that may somehow affect patients' health and quality of life (QoL). In method 1, blood was leucodepleted and then separated to obtain P-RBCs, while in method 2 blood was separated and leucodepleted after removal of plasma and buffycoat. Forty blood donors were enrolled in two independent centers; couples of phenotypically matched whole blood units were pooled, divided in two identical bags and processed in parallel following the two methods. Biochemical properties, electrolytes and metabolic composition were tested after 2, 7 and 14 days of storage. Units prepared with both methods were confirmed to have all the requirements necessary for βTM transfusion therapy. Nevertheless, RBCs count and Hb content were found to be higher in method-1, while P-RBCs obtained with method 2 contained less K, iron and storage lesions markers. Based on these results, both methods should be tested in a clinical perspective study to determine a possible reduction of transfusion-related complications, improving the QoL of βTM patients, which often need transfusions for the entire lifespan.

摘要

重型 β 地中海贫血(βTM)患者需要频繁输血,由此产生的后果包括异体反应和铁过载。为了最大限度地减少这些影响,βTM 患者定期接受白细胞去除的浓缩红细胞(P-RBC)输注,这些 P-RBC 保存时间最长为 14 天。本研究旨在比较两种常规方法来制备最佳的 P-RBC 产品,以确定它们在成分上的差异,这些差异可能会以某种方式影响患者的健康和生活质量(QoL)。在方法 1 中,血液先进行白细胞去除,然后分离以获得 P-RBC,而在方法 2 中,血液在去除血浆和白细胞层后进行分离和白细胞去除。40 名献血者在两个独立的中心入组;对表型匹配的全血单位进行配对,将其分成两个相同的袋子,并按照两种方法平行处理。在储存 2、7 和 14 天后测试了生化特性、电解质和代谢成分。两种方法制备的单位均符合βTM 输血治疗的所有要求。然而,方法 1 中的 RBC 计数和 Hb 含量更高,而方法 2 获得的 P-RBC 中 K、铁和储存损伤标志物含量较低。基于这些结果,应从临床角度对这两种方法进行测试,以确定是否可以减少输血相关并发症,从而改善βTM 患者的生活质量,这些患者通常需要终生输血。

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Impact of the preparation method of red cell concentrates on transfusion indices in thalassemia patients: A randomized crossover clinical trial.红细胞浓缩液制备方法对地中海贫血患者输血指标的影响:一项随机交叉临床试验。
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