Klüter H, Dörges L, Maass E, Wagner T, Bartels H, Kirchner H
Institute of Immunology and Transfusion Medicine, University of Lübeck School of Medicine, Germany.
Ann Hematol. 1996 Aug;73(2):85-9. doi: 10.1007/s002770050206.
Random-donor platelet concentrates (PC) prepared from pooled buffy coats have recently been described as an alternative method for platelet preparation. We evaluated such PCs in the clinical setting compared with a standard PC from platelet apheresis. PCs were prepared either from pools of buffy coats (BC-PC) or from single donors (SD-PC) with the cell separator CS-3000 plus. PCs were stored for up to 5 days before transfusion. We compared fresh PC (day 1) with stored (day 2-3) and long-stored PC (day 4-5). For analysis, platelet increment in the recipient was determined immediately and 16-22 h (mean 20 h) after transfusion, corrected for total body area and transfused platelets (CCI). A total of 316 PCs were administered to 36 thrombocytopenic patients suffering from various hematological disorders. Patients with detectable HLA or platelet-specific antibodies or splenomegaly were excluded from the study. Mean platelet content of the PC was 262 x 10(9) for BC-PC and 251 x 10(9) for SD-PC. The 20-h CCI after transfusion of fresh PC was slightly higher with BC-PC than with SD-PC (14.5 versus 11.9; p = 0.19), but values did not differ significantly between the two types of PC on any day of storage. For BC-PC, 20-h CCI decreased with further storage by 30% (10.2; p = 0.02). For SD-PC a decrease by 9% was not significant. In conclusion, platelet concentrates prepared from pools of buffy coats showed excellent transfusion results when administered fresh, but storage decreased the CCI by 30%. No significant difference from PCs from plateletpheresis was observed on any day of storage. Both types of platelet concentrates were capable of sufficient platelet increment even when stored for up to 5 days.
近期，由混合白膜层制备的随机供者血小板浓缩物（PC）被描述为一种血小板制备的替代方法。我们在临床环境中对这类PC与单采血小板制备的标准PC进行了评估。PC由白膜层池（BC-PC）或使用CS-3000 plus细胞分离仪从单采供者（SD-PC）制备。PC在输血前储存长达5天。我们比较了新鲜PC（第1天）与储存PC（第2 - 3天）以及长期储存PC（第4 - 5天）。为进行分析，在输血后立即以及输血后16 - 22小时（平均为20小时）测定受者的血小板增加值，并根据体表面积和输注的血小板进行校正（校正计数增量，CCI）。总共向36名患有各种血液系统疾病的血小板减少患者输注了316份PC。有可检测到的HLA或血小板特异性抗体或脾肿大的患者被排除在研究之外。BC-PC的PC平均血小板含量为262×10⁹，SD-PC为251×10⁹。新鲜PC输血后20小时的CCI，BC-PC略高于SD-PC（14.5对11.9；p = 0.19），但在储存的任何一天，两种类型的PC之间的值均无显著差异。对于BC-PC，随着进一步储存，20小时CCI下降了30%（10.2；p = 0.02）。对于SD-PC，下降9%不显著。总之，由白膜层池制备的血小板浓缩物新鲜输注时显示出优异的输血效果，但储存会使CCI降低30%。在储存的任何一天，均未观察到与单采血小板制备的PC有显著差异。即使储存长达5天，两种类型的血小板浓缩物都能够实现足够的血小板增加值。
