Oksanen K, Ebeling F, Kekomäki R, Elonen E, Sahlstedt L, Volin L, Myllylä G
Finnish Red Cross Blood Transfusion Service, Helsinki, Finland.
Vox Sang. 1994;67(4):356-61. doi: 10.1111/j.1423-0410.1994.tb01273.x.
We closely observed 86 transfusions to multitransfused hematologic patients with leukocyte-depleted platelet concentrates (PCs) prepared from buffy coats (BC PCs), filtered either prior to storage (BC1) or after 3-4 days' storage (BC3). The patients were first given, randomly, either BC1 or BC3, and were thereafter used as their own controls by giving them the two BC types alternately. The results were compared with an earlier study on standard platelet-rich plasma (PRP) PCs (46 transfusions to 23 patients) and leukocyte-depleted PRP PCs (23 transfusions to 12 patients). There was no difference in adverse reactions between BC1 and BC3 PCs, but BC PCs caused significantly fewer and milder adverse reactions than PRP PCs. Febrile reactions (FTR) occurred in 4.6%, urticarial skin reactions in 21%, and pulmonary reactions in 0% of BC PC transfusions (17, 29 and 0% of patients). The mean corrected increments (CI) at 16-18 h were higher after BC1 PCs than BC3 PCs (10.3 vs. 8.0, p = 0.046). We conclude that adverse reactions are reduced by use of BC PCs. Prestorage leukocyte depletion may improve platelet increments.
我们密切观察了86次对多次输血的血液学患者进行的输血，这些患者输注的是由 Buffy 层制备的白细胞去除血小板浓缩物（PCs），即 BC PCs，其过滤操作要么在储存前（BC1）进行，要么在储存3 - 4天后（BC3）进行。患者首先被随机给予BC1或BC3，之后通过交替给予这两种BC类型使其自身作为对照。结果与一项早期关于标准富血小板血浆（PRP）PCs（对23名患者进行46次输血）和白细胞去除PRP PCs（对12名患者进行23次输血）的研究进行了比较。BC1和BC3 PCs之间的不良反应没有差异，但BC PCs引起的不良反应明显比PRP PCs少且轻。BC PC输血中发热反应（FTR）发生率为4.6%，荨麻疹皮肤反应发生率为21%，肺部反应发生率为0%（患者发生率分别为17%、29%和0%）。BC1 PCs输血后16 - 18小时的平均校正增加值（CI）高于BC3 PCs（10.3对8.0，p = 0.046）。我们得出结论，使用BC PCs可减少不良反应。储存前白细胞去除可能会改善血小板增加值。
