Tan Joanne C G, Aung Htet Htet, Marks Denese C
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.
Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Transfusion. 2025 Jan;65(1):171-184. doi: 10.1111/trf.18065. Epub 2024 Nov 18.
Whole blood (WB) is increasingly being used for resuscitation of trauma patients. Although platelet-, red blood cell (RBC)- and plasma-specific parameters in cold-stored WB are well characterized, there has been limited investigation of biological response modifiers (BRMs), which may induce adverse reactions in recipients. The aim of this study was to evaluate the quality and function of RBC, platelets, plasma proteins, and BRMs in cold-stored WB during storage.
WB (n = 24) was collected into collected into citrate-phosphate-dextrose (CPD) anticoagulant, held overnight, processed through a platelet-sparing filter, and stored at 2-6°C for 21 days. RBC, platelet, coagulation factor quality and function, and BRM concentrations were measured throughout the duration of storage.
WB was effectively leukoreduced, with 99.98% reduction in leukocyte count and 81% platelet count recovery following filtration. Five WB units were significantly lipemic, with a visible lipid layer appearing after being cold storage overnight. These were more turbid with higher hemolysis compared to non-lipemic units (p = .023). Despite a decrease in platelet count during storage (p < .001), hemostatic function as measured by thromboelastography was maintained for at least 21 days (R time and maximum amplitude; both p < .001). There was a significant increase in PF4, CD62P, and RANTES during cold storage (all p < .001).
WB retains hemostatic potential for at least 21 days of cold storage, and with further development, may be suitable for transfusion in Australia. Before implementation in Australia, quality control measures for lipemia and hemolysis would need to be defined as part of our manufacturing processes.
全血（WB）越来越多地用于创伤患者的复苏。尽管冷藏全血中血小板、红细胞（RBC）和血浆特异性参数已得到充分表征，但对可能在受者中引起不良反应的生物反应调节剂（BRM）的研究有限。本研究的目的是评估冷藏全血在储存期间红细胞、血小板、血浆蛋白和生物反应调节剂的质量和功能。
将24份全血收集到柠檬酸磷酸盐葡萄糖（CPD）抗凝剂中，保存过夜，通过血小板保留过滤器处理，并在2-6°C下储存21天。在整个储存期间测量红细胞、血小板、凝血因子的质量和功能以及生物反应调节剂的浓度。
全血有效去除白细胞，过滤后白细胞计数减少99.98%，血小板计数恢复81%。5个全血单位明显脂血，冷藏过夜后出现可见脂质层。与非脂血单位相比，这些单位更浑浊，溶血更高（p = 0.023）。尽管储存期间血小板计数下降（p < 0.001），但通过血栓弹力图测量的止血功能至少维持21天（R时间和最大振幅；均p < 0.001）。冷藏期间PF4、CD62P和RANTES显著增加（均p < 0.001）。
全血在冷藏至少21天内保持止血潜力，随着进一步发展，可能适合在澳大利亚输血。在澳大利亚实施之前，需要将脂血和溶血的质量控制措施定义为我们制造过程的一部分。
