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冷储存血小板的体外止血功能

In vitro Hemostatic Functions of Cold-Stored Platelets.

作者信息

Kirschall Johanna, Uzun Günalp, Bakchoul Tamam, Marini Irene

机构信息

Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, Tuebingen, Germany.

Center for Clinical Transfusion Medicine Tuebingen, Tuebingen, Germany.

出版信息

Transfus Med Hemother. 2023 Nov 16;51(2):94-100. doi: 10.1159/000533735. eCollection 2024 Apr.

Abstract

BACKGROUND

Transfusion of platelets is a life-saving medical strategy used worldwide to treat patients with thrombocytopenia as well as platelet function disorders.

SUMMARY

Until the end of 1960s, platelets were stored in the cold because of their superior hemostatic functionality. Cold storage of platelets was then abandoned due to better posttransfusion recovery and survival of room temperature (RT)-stored platelets, demonstrated by radioactive labeling studies. Based on these findings, RT became the standard condition to store platelets for clinical applications. Evidence shows that RT storage increases the risk of septic transfusion reactions associated with bacterial contamination. Therefore, the storage time is currently limited to 4-7 days, according to the national guidelines, causing a constant challenge to cover the clinical request. Despite the enormous efforts made to optimize storage conditions of platelets, the quality and efficacy of platelets still decrease during the short storage time at RT. In this context, during the last years, cold storage has seen a renaissance due to the better hemostatic functionality, reduced risk of bacterial contamination, and potentially longer storage time.

KEY MESSAGES

In this review, we will focus on the impact of cold storage on the in vitro platelet functions as promising alternative storage temperature for future medical applications.

摘要

背景

输注血小板是一种在全球范围内用于治疗血小板减少症以及血小板功能障碍患者的挽救生命的医疗策略。

总结

直到20世纪60年代末,由于血小板具有卓越的止血功能,一直被冷藏保存。然而,放射性标记研究表明,室温(RT)保存的血小板在输血后的恢复和存活情况更好,因此随后放弃了血小板的冷藏保存。基于这些发现,RT成为临床应用中储存血小板的标准条件。有证据表明,RT储存会增加与细菌污染相关的败血症输血反应风险。因此,根据国家指南,目前血小板的储存时间限制在4至7天,这给满足临床需求带来了持续挑战。尽管在优化血小板储存条件方面付出了巨大努力,但在RT下短时间储存期间,血小板的质量和功效仍会下降。在此背景下,近年来,由于具有更好的止血功能、降低细菌污染风险以及可能更长的储存时间,冷藏保存再度兴起。

关键信息

在本综述中,我们将重点关注冷藏保存对体外血小板功能的影响,作为未来医学应用中一种有前景的替代储存温度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56e9/10996062/0271545ac38a/tmh-2024-0051-0002-533735_F01.jpg

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