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通过利用热控技术减少体外肺灌注恢复过程中的血液浪费。

Decreasing blood wastage during ex vivo lung perfusion recovery through utilization of thermal control technology.

机构信息

Perfusion Services, UChicago Medicine, Chicago, Illinois, USA.

Department of Surgery, Section of Cardiac Surgery, University of Chicago, Chicago, Illinois, USA.

出版信息

J Card Surg. 2022 Dec;37(12):5011-5018. doi: 10.1111/jocs.17147. Epub 2022 Nov 9.

DOI:10.1111/jocs.17147
PMID:36349705
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10099649/
Abstract

BACKGROUND

The Organ Care System (OCS) is a revolutionary ex vivo organ perfusion technology that can potentially expand the organ retrieval range. The OCS Lung device uses packed red blood cells (pRBC) with a proprietary solution. We report the ability to reduce blood waste during this procedure by using a thermal packaging solution in conjunction with the OCS platform.

METHODS

We retrospectively reviewed all OCS Lung recoveries performed by our recovery team, using pRBCfrom May 2019 to January 2021. Initially, units were stored using passive refrigeration with the Performance cooler at a temperature range of 1-6°C for 4 h. Subsequently, thermal control technology with the ProMed cooler was utilized to maintain the same temperature range for 72 h.

RESULTS

Twenty-three recoveries were initiated with 63 pRBC. The Performance cooler was used for 8, while the ProMed cooler for 13. 37.5% of pRBC transported with the Performance cooler was used within the validated time range, while 25.0% were used beyond the validated time range based on clinical judgment. In addition, 37.5% of pRBC transported with the Performance cooler were returned to the institution after canceled recoveries with an estimated loss of $1800; the ProMed cooler had no wastage.

CONCLUSIONS

This study showed that using an advanced thermal packaging solution facilitates proper storage of pRBC and represents an advancement for extended donor lung preservation. The elimination of blood wastage in this initial study portends ongoing benefits for the limited blood supply and reduced cost.

摘要

背景

器官保存系统(OCS)是一种革命性的离体器官灌注技术,它有可能扩大器官获取范围。OCS 肺设备使用携带专用溶液的浓缩红细胞(pRBC)。我们报告了在该过程中通过使用热包装溶液与 OCS 平台结合来减少血液浪费的能力。

方法

我们回顾性地审查了我们的复苏团队在 2019 年 5 月至 2021 年 1 月期间进行的所有 OCS 肺复苏。最初,单位使用 Performance 冷却器在 1-6°C 的温度范围内被动冷藏 4 小时。随后,使用 ProMed 冷却器利用热控制技术将温度范围维持在 72 小时。

结果

23 例复苏开始时使用了 63 单位 pRBC。Performance 冷却器用于 8 例,ProMed 冷却器用于 13 例。在经过验证的时间范围内,使用 Performance 冷却器运输的 37.5%的 pRBC,而根据临床判断,25.0%的 pRBC超出了经过验证的时间范围。此外,由于取消了复苏,37.5%的使用 Performance 冷却器运输的 pRBC 被送回机构,估计损失 1800 美元;ProMed 冷却器没有浪费。

结论

本研究表明,使用先进的热包装解决方案有助于正确储存 pRBC,代表了延长供体肺保存的进步。在这项初步研究中消除血液浪费预示着对有限的血液供应和降低成本的持续益处。

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More sophisticated than a drink cooler or an old sphygmomanometer but still not adequate for prehospital blood: A market review of commercially available equipment for prehospital blood transport and administration.比饮料冷却器或旧血压计更复杂,但仍不足以用于院前输血:商业上可用于院前血液运输和管理的设备的市场评估。
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Prehospital administration of blood products: experiences from a Finnish physician-staffed helicopter emergency medical service.院前血制品的使用:来自芬兰配备医师的直升机紧急医疗服务的经验。
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Expansion of hospital-based blood collections in the face of COVID-19 associated national blood shortage.在 COVID-19 导致全国性血液短缺的情况下,扩大医院内的血液采集。
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Survival in adult lung transplantation: where are we in 2020?成人肺移植的存活率:2020 年我们处于什么位置?
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Lancet Respir Med. 2019 Nov;7(11):975-984. doi: 10.1016/S2213-2600(19)30200-0. Epub 2019 Aug 1.