Kao K J, Mickel M, Braine H G, Davis K, Enright H, Gernsheimer T, Gillespie M J, Kickler T S, Lee E J, McCullough J J
Blood Resources Branch, National Heart, Lung, and Blood Institute, Bethesda,Maryland.
Transfusion. 1995 Jan;35(1):13-9. doi: 10.1046/j.1537-2995.1995.35195090653.x.
Most previous studies on white cell (WBC) reduction by filtration have been small-scale studies conducted under tightly controlled laboratory conditions. Their results would be the ideal, rather than what might be expected during routine operation.
To obtain information on routine filtration of blood components, data have been collected from a large-scale, ongoing, multicenter clinical trial designed to determine the effectiveness of WBC reduction in or ultraviolet B radiation of platelet concentrates before transfusion in preventing platelet alloimmunization and platelet transfusion refractoriness. The WBC content of blood components both before and after filtration was determined by automated cell counters and a manual propidium iodide-staining method, respectively. Platelet and red cell losses during filtration were measured.
The average platelet losses after filtration were 24 +/- 15 percent and 20 +/- 9 percent for apheresis platelets and pooled platelets, respectively. The frequencies at which filtered platelet concentrates contained high levels of residual WBCs (> 5 x 10(6)) were 7 percent and 5 percent for apheresis platelets and pooled platelets, respectively. Further analysis of the platelet filtration data showed that greater numbers of total initial WBCs in the pooled platelets were associated with increased percentages of filtration failure (> 5 x 10(6) residual WBCs). For packed red cells, the average losses during filtration were 23 +/- 4 percent and 15 +/- 3 percent for CPDA-1 units and Adsol units, respectively. The frequencies at which filtered red cells contained > 5 x 10(6) residual WBCs were 2.7 percent for one type of filter and 0.3 percent for another type of filter.
There were significant losses of platelets during filtration, which could add to the costs of WBC reduction and lead to possible increases in donor exposures. Filtration failures still occurred, despite careful observation of the standard filtration procedures. The number of total WBCs in pooled platelets before filtration has been identified as an important factor in determining the success of WBC reduction.
以往大多数关于通过过滤减少白细胞（WBC）的研究都是在严格控制的实验室条件下进行的小规模研究。其结果是理想状态下的，而非常规操作中可能出现的情况。
为获取血液成分常规过滤的信息，已从一项大规模、正在进行的多中心临床试验中收集数据，该试验旨在确定在输血前对血小板浓缩物进行白细胞减少或紫外线B照射在预防血小板同种免疫和血小板输注无效方面的有效性。分别通过自动血细胞计数器和手动碘化丙啶染色法测定过滤前后血液成分的白细胞含量。测量过滤过程中血小板和红细胞的损失量。
对于单采血小板和混合血小板，过滤后平均血小板损失率分别为24±15%和20±9%。过滤后的血小板浓缩物中残留白细胞水平较高（>5×10⁶）的频率，单采血小板和混合血小板分别为7%和5%。对血小板过滤数据的进一步分析表明，混合血小板中初始白细胞总数较多与过滤失败百分比增加（残留白细胞>5×10⁶）相关。对于红细胞悬液，CPDA - 1单位和Adsol单位在过滤过程中的平均损失率分别为23±4%和15±3%。过滤后的红细胞中残留白细胞>5×10⁶的频率，一种滤器为2.7%，另一种滤器为0.3%。
过滤过程中血小板有显著损失，这可能增加白细胞减少的成本，并可能导致供体暴露增加。尽管仔细遵循标准过滤程序，仍会出现过滤失败情况。已确定过滤前混合血小板中的白细胞总数是决定白细胞减少成功与否的重要因素。
