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2024年血小板制品与实践国际调查

The 2024 international survey of platelet products and practice.

作者信息

Ohto Hitoshi, Flegel Willy A, van der Meer Pieter F, Ngoma Alain M, Nollet Kenneth E, Choudhury Nabajyoti, Legler Tobias J

机构信息

Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.

Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA.

出版信息

Transfus Apher Sci. 2025 Apr;64(2):104086. doi: 10.1016/j.transci.2025.104086. Epub 2025 Feb 11.

Abstract

BACKGROUND

Previously, two international surveys have addressed the wider application of platelet collection by apheresis technology and practical issues of platelet transfusion.

STUDY DESIGN AND METHODS

A questionnaire was sent to persons with leadership roles related to blood banking and transfusion medicine in their countries/areas/centers, to document the implementation of modern technologies for platelet manufacturing, preservation, and transfusion risk reduction.

RESULTS

Responses to the questionnaire finally came from 52 contributors in 40 countries/areas. Adult platelet doses ranged between 2.0×10 and 3.0×10 (median 2.5×10). In approximately 10 % of centers, apheresis platelets comprised more than 90 % of the platelet inventory. More than 70 % of centers adopted universal or near universal leukocyte-reduction by filtration, apheresis, or both. Almost 20 % of centers irradiated all platelet products. Cold-stored platelets were rarely reported; only 3 centers produce such components for 1 % to 5 % of their supply. The use of platelet additive solution was reported by 18 responders (45 %), mainly in Europe, USA, and Australasia. Bacterial detection systems were reported by 18 responders from around the globe. One fatality was reported after transfusion of a platelet product contaminated with Bacillus cereus, whereas no sequelae were observed after transfusion of >350 platelet products contaminated by Cutibacteriae. Pathogen-reduction/pathogen-inactivation technology has been adopted in 15 centers, with little or no extended expiration period. Export of platelets across national borders was extremely rare.

CONCLUSION

With this addition to the literature on platelet transfusion, considerable heterogeneity in collection, processing, and transfusion can be seen across the globe, through which readers may adopt, and adapt, best practices for their unique local circumstances.

摘要

背景

此前,两项国际调查探讨了单采技术在血小板采集方面的更广泛应用以及血小板输注的实际问题。

研究设计与方法

向各国/地区/中心负责血库和输血医学的领导人员发送了一份问卷,以记录血小板制备、保存和降低输血风险的现代技术的实施情况。

结果

最终收到了来自40个国家/地区的52名受访者的回复。成人血小板剂量在2.0×10至3.0×10之间(中位数为2.5×10)。在大约10%的中心,单采血小板占血小板库存的90%以上。超过70%的中心通过过滤、单采或两者结合采用了普遍或近乎普遍的白细胞去除法。近20%的中心对所有血小板制品进行辐照。很少有中心报告使用冷存血小板;只有3个中心生产的此类成分占其供应量的1%至5%。18名受访者(45%)报告使用了血小板添加剂溶液,主要在欧洲、美国和澳大拉西亚。来自全球各地的18名受访者报告了细菌检测系统。有1例因输注被蜡样芽孢杆菌污染的血小板制品后死亡,而输注超过350份被痤疮丙酸杆菌污染的血小板制品后未观察到后遗症。15个中心采用了病原体灭活/减活技术,有效期延长很少或没有延长。跨国界出口血小板极为罕见。

结论

随着这篇关于血小板输注文献的补充,全球在采集、处理和输注方面存在相当大的异质性,读者可据此采用并调整适合其独特当地情况的最佳实践。

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