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三级护理医院中血小板添加剂溶液悬浮单采血小板:迈向通用单供体血小板的一步。

Platelet additive solution suspended apheresis platelets in a tertiary care hospital: A step toward universal single donor platelets.

作者信息

Chowdhry Mohit, Agrawal Soma, Prakash Bindu, Thakur Uday Kumar, Mishra Manoj

机构信息

Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, India.

出版信息

Asian J Transfus Sci. 2022 Jul-Dec;16(2):238-244. doi: 10.4103/ajts.ajts_145_21. Epub 2022 May 26.

Abstract

BACKGROUND

Transfusion of ABO-compatible single donor platelets (SDP) is preferable for better outcomes over group switchover SDP. The use of SDP containing ABO-incompatible plasma is associated with a risk of allergic and acute hemolytic transfusion reactions. Moreover, high titer O group donors SDP impose a further threat to patient safety. Platelet additive solution (PAS) is used worldwide for the storage of platelets which reduces plasma volume available in SDP. SSP + (Macopharma) is one such PAS which can provide improved availability, logistical management, decrease wastage, and improvement in patient safety. The aim of this study was to assess the feasibility of using PAS to obtain low titer SDP units which can be utilized across a larger patient population and to study quality control parameters of these units.

MATERIALS AND METHODS

The study was performed in the department of Transfusion Medicine from June 2017 to January 2018 after clearance from the Institutional Review Board. The study design comprised two cohorts (A and B). In cohort A, the temporal trend of changes in the quality parameters was tested and analyzed for PAS modified and unmodified products on days 1, 5 and 7. In cohort B, the original plasma from the SDP donors of all blood group donors except the AB group was tested for antibody titers before (prepreparation) and after modification (postpreparation) by PAS.

RESULTS

In cohort A, in the control group, there was a significant change in the mean platelet volume, potassium, and bicarbonate levels from day 1 to day 7, whereas no significant change in the biochemical parameters was noted in the study group where PAS was used. In cohort B, on comparing the anti-A and anti-B, before and after modification of SDP with PAS, there was a significant reduction in the median titers across all the groups studied.

CONCLUSION

PAS added SDP is an efficient strategy to reduce the ABO-antibody levels significantly. PAS added SDP also helps in the better inventory management of available groups.

摘要

背景

为获得更好的治疗效果,输注ABO血型相合的单采血小板(SDP)优于血型转换的SDP。使用含有ABO血型不相合血浆的SDP会有发生过敏和急性溶血性输血反应的风险。此外,高滴度O型供者的SDP对患者安全构成进一步威胁。血小板添加剂溶液(PAS)在全球范围内用于血小板储存,这减少了SDP中可用的血浆量。SSP +(Macopharma公司)就是这样一种PAS,它可以提高可得性、改善后勤管理、减少浪费并提高患者安全性。本研究的目的是评估使用PAS获得低滴度SDP单位的可行性,这些单位可用于更广泛的患者群体,并研究这些单位的质量控制参数。

材料与方法

本研究于2017年6月至2018年1月在输血医学科进行,经机构审查委员会批准。研究设计包括两个队列(A和B)。在队列A中,测试并分析了在第1天、第5天和第7天PAS改良和未改良产品质量参数变化的时间趋势。在队列B中,对除AB血型组外所有血型供者的SDP供者的原始血浆在通过PAS改良前(制备前)和改良后(制备后)进行抗体滴度检测。

结果

在队列A中,对照组从第1天到第7天平均血小板体积、钾和碳酸氢盐水平有显著变化,而在使用PAS的研究组中生化参数未观察到显著变化。在队列B中,比较用PAS改良SDP前后的抗A和抗B,所有研究组中中位数滴度均显著降低。

结论

添加PAS的SDP是一种有效策略,可显著降低ABO抗体水平。添加PAS的SDP也有助于更好地管理可用血型的库存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2da6/9855201/dbfd203a02b0/AJTS-16-238-g001.jpg

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