Fournel J J, Zingsem J, Riggert J, Muylle L, Müller N, Köhler M, Beaumont J L, Baeten M, Eckstein R, van Waeg G
Centre d'Hémobiologie-Transfusion Pitié-Salpêtrière, Paris, France.
Transfusion. 1997 May;37(5):487-92. doi: 10.1046/j.1537-2995.1997.37597293878.x.
Residual white cells (WBCs) cause serious side effects in platelet transfusion. An in-line WBC-reduction system based on fluidized particle bed technology was recently developed as a modification of an existing plateletpheresis system.
In an investigational phase, three flow profiles were evaluated using prototype software in five centers, each using their standard conditions. In the confirmatory phase, the released software was tested in three centers. WBCs were counted in two full Nageotte grids (dilution 1-in-5).
With the prototype software, WBC levels were always below 1 x 10(6) per procedure (median, 25,000/procedure; n = 314). One profile proved to be superior to the other two with respect to platelet yield and residual WBCs, and it was incorporated in the released WBC-reduction system, together with a built-in process control. Median residual WBCs in these WBC-reduction system components not rejected by the process control were 19,000 per procedure (n = 211/225 total), with 99.5 percent of the platelet components having less than 1 x 10(6) WBCs.
The protocol selected in the initial phase, now available as a WBC-reduction system, results in platelet concentrates with very low residual WBC levels. This satisfies even the most stringent criteria for WBC reduction in platelets, without the platelet loss typically seen with conventional fiber filtration.
残余白细胞(WBCs)在血小板输注中会引发严重的副作用。一种基于流化颗粒床技术的在线白细胞去除系统最近作为现有血小板单采系统的改进而被开发出来。
在研究阶段,使用原型软件在五个中心评估了三种流动剖面,每个中心都采用其标准条件。在验证阶段,对发布的软件在三个中心进行了测试。在两个完整的纳盖奥特计数板(稀释比例为1:5)中对白细胞进行计数。
使用原型软件时,每次操作的白细胞水平始终低于1×10⁶(中位数为每次操作25,000;n = 314)。就血小板回收率和残余白细胞而言,一种剖面被证明优于其他两种,并且它与内置的过程控制一起被纳入发布的白细胞去除系统。在这些未被过程控制拒收的白细胞去除系统组件中,每次操作的残余白细胞中位数为19,000(n = 211/总共225),99.5%的血小板成分白细胞含量低于1×10⁶。
在初始阶段选择的方案,现在作为白细胞去除系统可用,可产生残余白细胞水平极低的血小板浓缩物。这甚至满足了血小板白细胞减少最严格的标准,且没有传统纤维过滤常见的血小板损失。