Department of Hematology and Blood Transfusion, Military University Hospital, Prague, Czech Republic.
Department of Military Internal Medicine and Military Hygiene, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic.
Transfusion. 2023 May;63(5):1067-1073. doi: 10.1111/trf.17313. Epub 2023 Mar 20.
Pathogen reduction technology (PRT) may improve the safety of RBCs for transfusion. As the Czech Republic considers PRT, we asked what effects riboflavin and UV light PRT pre-freezing has on the post-thaw recovery and properties of cryopreserved RBCs (CRBCs) after deglycerolization and liquid storage.
24 Group O whole blood (WB) units were leukoreduced and then treated with riboflavin and UV light PRT (Mirasol, Terumo BCT, USA) before cryopreservation (T-CRBC); 20 similarly-collected units were untreated controls (C-CRBC). Units were processed to RBCs and then cryopreserved with 40% glycerol (wt/vol), frozen at -80°C, stored >118 days, reconstituted as deglycerolized RBC units in AS-3, and stored at 4 ± 2°C for 21 days. One treated unit sustained massive hemolysis during the post-thaw wash process and was removed from data analysis. The remaining units were assessed pre-PRT, post-PRT, and post-thaw-wash on days 0, 7, 14, and 21 for hematocrit, volume, hemoglobin per transfusion unit, pH, % hemolysis, hemoglobin in the supernatant, potassium, phosphorus, NH , osmolality, ATP, and 2,3-diphosphoglycerate.
PRT with leukoreduction caused a 5% loss of RBC followed by a 24% freeze-thaw-wash related loss for a total 28% loss but treated units contained an average of 45 g of hemoglobin, meeting European Union guidelines for CRBC. T-CRBCs displayed higher post-wash hemolysis, potassium, and ammonia concentrations, and lower ATP at the end of storage.
Cryopreserved RBCs from Riboflavin and UV light-treated WB meet the criteria for clinical use for 7 days after thawing and provide additional protection against infectious threats.
病原体减少技术（PRT）可能提高输血用红细胞的安全性。由于捷克共和国正在考虑 PRT，我们询问了在预冻前使用核黄素和紫外线 PRT 对解冻后恢复和甘油化后液态储存的冷冻保存红细胞（CRBC）的特性的影响。
24 个 O 型全血（WB）单位经过白细胞减少处理，然后用核黄素和紫外线 PRT（美国 Terumo BCT 的 Mirasol）进行冷冻保存前处理（T-CRBC）；20 个相同采集的单位为未处理对照（C-CRBC）。单位被处理成 RBC 并在 40%甘油（重量/体积）中冷冻，在-80°C 下冷冻，储存>118 天，在 AS-3 中重建为去甘油化 RBC 单位，并在 4°C±2°C下储存 21 天。一个处理过的单位在解冻后清洗过程中发生严重溶血，从数据分析中删除。剩余的单位在 PRT 前、PRT 后和解冻后清洗后的第 0、7、14 和 21 天进行评估，用于评估红细胞比容、体积、每单位输血的血红蛋白、pH 值、%溶血、上清液中的血红蛋白、钾、磷、NH3、渗透压、ATP 和 2,3-二磷酸甘油酸。
白细胞减少处理加上 PRT 导致 RBC 丢失 5%，随后冷冻-解冻-清洗损失 24%，总丢失率为 28%，但处理过的单位平均含有 45g 血红蛋白，符合欧盟对 CRBC 的指南。T-CRBC 在解冻后清洗后的溶血、钾和氨浓度较高，储存结束时 ATP 较低。
从核黄素和紫外线处理的 WB 制备的冷冻保存 RBC 在解冻后 7 天内符合临床使用标准，并提供了对传染性威胁的额外保护。
