Dinh Mai T P, Iqbal Mubasher, Abhishek Kumar, Lam Fong W, Shevkoplyas Sergey S
Department of Biomedical Engineering, University of Houston, Houston, Texas 77204, USA.
Division of Pediatric Critical Care Medicine, Baylor College of Medicine, Houston, Texas 77030, USA.
Biomicrofluidics. 2024 Dec 17;18(6):061504. doi: 10.1063/5.0226060. eCollection 2024 Dec.
Platelet transfusion is a lifesaving therapy intended to prevent and treat bleeding. However, in addition to platelets, a typical unit also contains a large volume of supernatant that accumulates multiple pro-inflammatory contaminants, including residual leukocytes, microaggregates, microparticles, antibodies, and cytokines. Infusion of this supernatant is responsible for virtually all adverse reactions to platelet transfusions. Conventional methods for removing residual leukocytes (leukoreduction) and reducing the volume of transfused supernatant (volume reduction) struggle to mitigate these risks holistically. Leukoreduction filters can remove leukocytes and microaggregates but fail to reduce supernatant volume, whereas centrifugation can reduce volume, but it is ineffective against larger contaminants and damages platelets. Additionally, platelet purification based on these methods is often too logistically complex, time-consuming, and labor-intensive to implement routinely. Emerging microfluidic technologies offer promising alternatives through passive separation mechanisms that enable cell separation with minimal damage and drastically reduced instrumentation size and facility requirements. This review examines recent innovations in microfluidic cell separation that can be used for leukoreduction and volume reduction of platelets. It begins by defining the performance requirements that any separation method must meet to successfully replace conventional methods currently used to perform these tasks. Standard performance metrics are described, including leukocyte depletion efficiency, degree of volume reduction, processing throughput, and platelet recovery. Finally, the review outlines the primary challenges that must be overcome to enable simple-to-use, disposable microfluidic devices capable of both reducing the platelet unit volume and removing pro-inflammatory contaminants, while preserving most functional platelets for transfusion.
血小板输注是一种旨在预防和治疗出血的挽救生命的疗法。然而，除了血小板外，一个典型的单位剂量还含有大量的上清液，其中积累了多种促炎污染物，包括残留白细胞、微聚集体、微粒、抗体和细胞因子。输注这种上清液几乎是导致血小板输注所有不良反应的原因。传统的去除残留白细胞（白细胞滤除）和减少输注上清液体积（体积减少）方法难以全面减轻这些风险。白细胞滤除过滤器可以去除白细胞和微聚集体，但无法减少上清液体积，而离心可以减少体积，但对较大污染物无效且会损害血小板。此外，基于这些方法的血小板纯化在日常实施中通常在后勤方面过于复杂、耗时且劳动强度大。新兴的微流控技术通过被动分离机制提供了有前景的替代方案，这种机制能够以最小的损伤实现细胞分离，并大幅减小仪器尺寸和设施要求。本综述探讨了可用于血小板白细胞滤除和体积减少的微流控细胞分离方面的最新创新。首先定义了任何分离方法要成功替代当前用于执行这些任务的传统方法必须满足的性能要求。描述了标准性能指标，包括白细胞去除效率、体积减少程度、处理通量和血小板回收率。最后，本综述概述了要实现能够减少血小板单位体积并去除促炎污染物，同时保留大多数功能性血小板用于输注的易于使用的一次性微流控设备必须克服的主要挑战。
