Heaton W A, Holme S, Smith K, Brecher M E, Pineda A, AuBuchon J P, Nelson E
American Red Cross Blood Services, Mid-Atlantic Region/Eastern Virginia Medical School, Norfolk.
Br J Haematol. 1994 Jun;87(2):363-8. doi: 10.1111/j.1365-2141.1994.tb04923.x.
A new, in-line high-efficiency 3-5 log10 leucodepletion filter system (Leukotrap RC system) was used to investigate the effect of pre-storage white cell removal on the quality of AS-3 red cell concentrates stored for 42 d at 4 degrees C. Median residual white cell content was 4 x 10(5) when filtration was performed at 22 degrees C within 8 h of phlebotomy (n = 20) and 3.2 x 10(4) when filtration was performed at 4 degrees C 12-24 h after phlebotomy (n = 24). None exceeded 1 x 10(6) WBC per red cell product. Filtration was rapid (median 28 min), and red cell loss averaged (mean +/- 1 SD) 6.4 +/- 0.7%. In a paired study design, post-transfusion recoveries of 42 d stored red cells in the filtered units averaged 84 +/- 6% v 82 +/- 8% for unfiltered units (P < 0.05) and post-storage haemolysis. ATP, osmotic fragility, K+ and pH were significantly (P < 0.05) better in the filtered units. Reduced glycolytic activity was also observed in the filtered units, and there was a correlation between osmotic fragility, glucose consumption, and lactate produced in standard units that was not present in leucodepleted units. In conclusion, this study suggests that leucodepletion of AS-3 red cell concentrates prior to storage results in better maintenance of the integrity of the red cell membrane with reduced glycolytic activity. There was a modest improvement in post-infusion viability sufficient to offset the filtration-induced loss and to result in an equivalent red cell product.
采用一种新型在线高效3 - 5 log10白细胞去除过滤系统（Leukotrap RC系统），研究储存前去除白细胞对在4℃储存42天的AS - 3红细胞浓缩物质量的影响。在采血后8小时内于22℃进行过滤时（n = 20），残余白细胞含量中位数为4×10⁵，而在采血后12 - 24小时于4℃进行过滤时（n = 24），残余白细胞含量中位数为3.2×10⁴。每个红细胞制品的白细胞数均未超过1×10⁶。过滤速度很快（中位数为28分钟），红细胞损失平均为（均值±1标准差）6.4±0.7%。在配对研究设计中，过滤组中储存42天的红细胞输注后回收率平均为84±6%，未过滤组为82±8%（P < 0.05），且过滤组储存后的溶血情况也更好。过滤组中的ATP、渗透脆性、钾离子和pH值均显著更好（P < 0.05）。在过滤组中还观察到糖酵解活性降低，并且在标准组中存在的渗透脆性、葡萄糖消耗和乳酸产生之间的相关性在白细胞去除组中不存在。总之，本研究表明，储存前对AS - 3红细胞浓缩物进行白细胞去除可更好地维持红细胞膜的完整性，同时降低糖酵解活性。输注后活力有适度改善，足以抵消过滤引起的损失，并产生等效的红细胞制品。
