Tardtong P, Chuansumrit A, Stabanswadigan S, Chiewsilp P, Isarangkura P
Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1993;24 Suppl 1:195-7.
Single donor cryoprecipitate was prepared by blood cell separator for treatment of hemophilia A and von Willebrand patients to reduce a risk of transfusion associated HIV infection. A total of 7 plasmapheresis (range 1-1.5 plasma volume) was performed in 4 donors. Then fresh frozen plasma (FFP) was processed to cryoprecipitate and cryoprecipitate removed plasma (CRP). Donors were replaced with 0.9% normal saline solution (NSS) and 5% albumin for the first donation or their own CRP and 5% albumin for the second and third donation. After plasmapheresis total protein, albumin, IgG, IgA and IgM were below normal level in 71.43% (5/7), 14.3% (1/7), 28.57% (2/7), 14.3% (1/7) and 28.57% (2/7), respectively. All of these parameters returned to normal level within 3 days. Factor VIII:C was decreased after plasmapheresis in all donors and the low level of F VIII:C returned to normal within 24 hours. The donor was not exposed to any harmful effect. Donor reactions observed were mild. One donor was chilled due to unwarmed replacement solution. When this donor donated for the second time and was replaced with prewarmed replacement solution, no reaction was observed. We conclude that a preparation of single donor cryoprecipitate by plasmapheresis is safe and can reduce a risk of transfusion associated HIV infection. The donors are not at risk as the result of changes in the measured plasma protein and factor VIII:C level following plasmapheresis.
使用血细胞分离机制备单供体冷沉淀，用于治疗甲型血友病和血管性血友病患者，以降低输血相关HIV感染风险。对4名供体进行了总共7次血浆置换（置换血量为1 - 1.5个血浆容积）。然后将新鲜冰冻血浆（FFP）加工制成冷沉淀和冷沉淀去除血浆（CRP）。首次献血时，用0.9%生理盐水溶液（NSS）和5%白蛋白替代供体血液，第二次和第三次献血时，用其自身的CRP和5%白蛋白替代。血浆置换后，71.43%（5/7）的供体总蛋白、14.3%（1/7）的供体白蛋白、28.57%（2/7）的供体IgG、14.3%（1/7）的供体IgA和28.57%（2/7）的供体IgM低于正常水平。所有这些参数在3天内恢复到正常水平。所有供体血浆置换后因子VIII:C均降低，且低水平的F VIII:C在24小时内恢复正常。供体未受到任何有害影响。观察到的供体反应较轻。一名供体因置换液未加温而感到寒冷。该供体第二次献血时使用加温后的置换液，未观察到反应。我们得出结论，通过血浆置换制备单供体冷沉淀是安全的，并且可以降低输血相关HIV感染风险。血浆置换后所测血浆蛋白和因子VIII:C水平的变化不会使供体面临风险。
