Raster Johannes, Jacob Michelle, Greinacher Andreas, Aurich Konstanze
Institut für Immunologie und Transfusionsmedizin, Abteilung Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany.
Transfus Med Hemother. 2022 Feb 4;49(5):280-287. doi: 10.1159/000521217. eCollection 2022 Sep.
Plasma transfusion is one of the basic treatments in patients with major blood loss. The anti-A and anti-B antibodies contained in the plasma demand ABO blood group compatibility. This is limiting the use of plasma in emergency situations and can cause a shortage in the supply of plasma of certain blood groups. We developed a method for anti-A and anti-B depletion by adsorbing plasma isoagglutinins using red blood cells.
Three units of fresh frozen plasma were thawed after quarantine storage, pooled, and an aliquot of red cell concentrate was added. After 2 h of incubation at room temperature antibody-red-cell complexes were removed by centrifugation, the isoagglutinin-depleted plasma was split into three units and deep frozen. Isoagglutinin titers, free hemoglobin, residual red cells, clotting factor activity, and sterility of plasma units were determined after isoagglutinin depletion and a double freeze-thawing procedure.
Anti-B titers in group A plasma were reduced from values of 1:64 to 1:1 or lower, anti-A titers in group B plasma decreased from values of 1:128 to at least 1:16. Postprocedure clotting factor activities were preserved with 88.0 ± 7.3% (factor V), 106.9 ± 11.4% (factor VIII), and 84.0 ± 7.5% (factor XI) fulfilling the quality control requirements. No residual red cells were found, but free hemoglobin slightly increased to 53.7 ± 5.2 μmol/L. All units were sterile.
We described a method for the production of anti-A- and anti-B-depleted plasma in a closed system that uses standard equipment. The resulting isoagglutinin-depleted plasma may allow for blood group independent plasma transfusion.
血浆输注是大出血患者的基本治疗方法之一。血浆中所含的抗A和抗B抗体需要ABO血型相容。这限制了血浆在紧急情况下的使用，并可能导致某些血型的血浆供应短缺。我们开发了一种通过使用红细胞吸附血浆同种凝集素进行抗A和抗B去除的方法。
三单位新鲜冰冻血浆在检疫储存后解冻，合并，并加入一份红细胞浓缩液。在室温下孵育2小时后，通过离心去除抗体 - 红细胞复合物，将去除同种凝集素的血浆分成三单位并深度冷冻。在去除同种凝集素和双重冻融程序后，测定血浆单位的同种凝集素滴度、游离血红蛋白、残留红细胞、凝血因子活性和无菌性。
A组血浆中的抗B滴度从1:64降至1:1或更低，B组血浆中的抗A滴度从1:128降至至少1:16。术后凝血因子活性得以保留，因子V为88.0±7.3%，因子VIII为106.9±11.4%，因子XI为84.0±7.5%，符合质量控制要求。未发现残留红细胞，但游离血红蛋白略有增加至53.7±5.2μmol/L。所有单位均无菌。
我们描述了一种在封闭系统中使用标准设备生产去除抗A和抗B血浆的方法。由此产生的去除同种凝集素的血浆可能允许进行不依赖血型的血浆输注。
