用于浓缩血小板的去白细胞滤器质量评价

目的考察用于浓缩血小板(PCs)的去白细胞滤器的化学性能及过滤前后血小板质量的变化情况。方法按照中华人民共和国医药行业标准《一次性使用去白细胞滤器》(YY0329-2009)制备检验液,测定还原物质、金属离子、酸碱度、蒸发残渣、紫外吸光度和溶血率,并对ABO血型相匹配的PCs进行手工汇集和过滤,测定过滤前后的血小板数量、pH、白细胞数量、血小板平均体积(MPV)和血小板低渗休克相对变化率。结果滤器的化学性能指标和溶血率均符合我国行业标准要求,血小板回收率为(89.99±5.37)%,剩余白细胞数为(0.93±0.58)×106个,血小板低渗休克相对变化率为(2.75±4.93)%。过滤前后pH值和MPV无明显变化。结论该种用于PCs的去白细胞滤器具有血小板回收率高、白细胞残留少的特点,对血小板功能无显著影响,能安全有效地去除PCs中的白细胞。     

去白细胞滤器的应用观察

白细胞在库存血液中是一种不需要的成分，因为白细胞在离体24小时后功能几乎丧失贻尽。输用大量的丧失生物功能的白细胞，会给病人带来很多副作用，如白细胞抗体引起的发热反应、过敏反应、HLA免疫反应及CMV和HTI。A-1等病毒的传播以及输血引起免疫抑制、移植物抗宿主病(GVHD)等。本文用日本Sepcell-R500去白细胞滤器及南京双威实业公司研制的超细玻璃纤维去白细胞滤器滤过全血、去除白细胞。通过试验证明，应用去白细胞滤器是提高医院医疗护理水平和减少白细胞等不需要的血液成分所致输血副作用的有力措施，现将结果报告如下。     

血小板型白细胞过滤器制备多袋汇集浓缩血小板的去白效果分析

目的探讨血小板型白细胞过滤器制备多袋汇集浓缩血小板的去白效果。方法对混合浓缩血小板进行白细胞过滤,观察过滤前后的血小板、白细胞、红细胞、游离血红蛋白的变化。结果采用血小板型白细胞过滤器,混合浓缩血小板过滤后白细胞去除率为99.5%,血小板回收率为88.5%。过滤前后红细胞、游离血红蛋白无较明显变化,但过滤后血小板制品中混入的白细胞数明显减少。结论多袋汇集浓缩血小板经去白后,血小板的回收率较高,白细胞的混入量大大降低,提高了血小板输注的安全性,值得临床上推广应用。     

无菌接驳型白细胞滤器在血站应用中的改进

去白细胞血液成份的制备中,常由于一次离心后的血浆中会混有少量的红细胞,须进行二次离心,这种多次离心正是引起溶血的原因之一,为此,笔者对滤器结构和血液制备方法进行了改进,减少了红细胞在制备过程中的离心次数,通过检测改进前、后过滤的红细胞悬液的游离血红蛋白,表明改进后的白细胞滤器可显著减少红细胞悬液的溶血,报告如下。1材料与方法1.1材料改进前的白细胞滤器二联白细胞滤器(图1)、改进后的白细胞滤器三联袋白细胞滤器(图2)、无菌接管连接机(德国费森尤斯公司)、VIS723型分光光度仪(山东高密分析仪器厂),离心机(美国贝克曼公司)…     

994CF-E在线滤器去白细胞的MCS+血小板采集

目的　对密闭管路中连接去白细胞滤器采集少白细胞浓缩血小板 (leuco depletedplateletconcentrates,LDP PCs)的机采技术进行随机性前瞻测试。方法　应用MCS +机型、C5版本LDP采集程序和 994CF E管路 ,采集过程中血小板以 8～ 10ml/min连续性低速滤除WBC获得LDP PCs。结果　LDP PCs的血小板均值为 (2 .76± 0 .37)× 10 11/袋 ,采集效率 (5 8.1± 7.7) % ,采集成功率 77%。LDP PCs中WBC残余均值 0 .76× 10 5/袋 ,95 %可信度的残余WBC分布区间为 (0 .4 9～ 1.0 4 )× 10 5/袋 ,10 0 %PCs产品残余的WBC <1× 10 6/袋 ,其中 87.5 %的产品残余WBC <1× 10 5/袋。滤器去白细胞效率 99.3%。结论　 994CF E采集技术可以获得优质的少白细胞浓缩血小板。     

白细胞滤器在临床输血中的应用

在临床输血的发热不良反应中，非溶血性输血反应发生率高达15％－37％，这主要是由于多次输注含有白细胞的血液成分，产生HLA同种免疫反应及粒细胞同种免疫反应所致。因此，减少白细胞的输入，是降低非溶血性输血反应发生率的关键。本文将国产一次性滤除白细胞输血器(简称白细胞滤器)应用于临床，取得了较好的效果，现报告如下。     

去白细胞的浓缩红细胞在消化系统疾病患者中的应用

本院自 1996年开始试用经白细胞过滤器过滤的浓缩红细胞以来 ,至今已在临床中输用了 815 0Ｕ ,占总用血量的2 4 .3% ,明显减少了输血不良反应及输血相关疾病 ,取得了良好效果。笔者于 1999年～ 2 0 0 0年将去白细胞的浓缩红细胞应用于消化系统疾病患者 ,现报告如下。1　材料与方法1 1　病例分组　从 1999年 1月～ 2 0 0 0年 12月利用计算机产生的随机数进行随机化分组抽取 12 8例次使用白细胞过滤器的消化系统疾病患者 (以下简称过滤组 ) ,以相同例次相同病种的未使用白细胞过滤器的病例作为对照组 (以下简称对照组 ) ,输血量在 3～ 8Ｕ ,年…     

去白细胞滤器在悬浮红细胞过滤中的效果评价

血液成分中的WBC可以引起许多不良反应,如非溶血性发热输血反应（FNHTR）、人类白细胞抗原（HLA）同种免疫等,通过各种方法减除血液成分中的白细胞来预防这些输血不良反应.目前最有效、最常用的清除WBC方法是过滤法,其特点是清除率高,残留WBC少,有效成分回收率高等.现对我中心在2004-06以来将去白细胞滤器应用于悬浮红细胞过滤中的效果评价报告如下.     

Extension of platelet concentrate storage

Extension of the storage time of platelet concentrates in a satellite bag which is part of a new blood bag system was studied by reinfusing autologous 51Cr-labeled platelets into normal volunteers, and measuring postinfusion platelet counts and bleeding times in patients requiring platelet transfusions. This satellite bag, made of polyvinylchloride plasticized with a new agent, was found to protect platelet concentrates against fall of pH better than other containers studied. This protection was felt to be due to the greater gas permeability of the new plastic. Mean in vivo recovery and half-life (greater than 31% and 3.3 days, respectively) of autologous reinfused platelets were satisfactory following 5 days of storage. Following 7 days of storage, mean recovery was 41 percent and half-life was 2.8 days. Peripheral platelet count increments in patients following platelet transfusions with concentrates stored 4 to 7 days in the new plastic were comparable to increments following transfusion of platelets stored 2 to 3 days in the other plastics studied. Bleeding times shortened in three of four patients receiving platelet concentrates stored from 4 to 6 days in the new plastic. Platelet concentrates stored in the new bag at 20 to 24 degrees C with flat-bed or elliptical agitation could be transfused for up to 5 days following phlebotomy with acceptable clinical results. The new plastic container is promising for storage of platelet concentrates for up to 7 days. Due to the higher pH of 50-ml platelet concentrates stored in bags made with the new plastic, the concentrates were superior at any storage interval to those stored in bags made of the other plastics studied.     

Efficacy of Epstein-Barr virus removal by leukoreduction of red blood cells

BACKGROUND: Epstein-Barr virus (EBV) infection results in life-long carriage of latent virus in B lymphocytes in the majority of the adult population, including blood donors. The removal of EBV from red blood cell (RBC) components by leukoreduction was assessed. STUDY DESIGN AND METHODS: Sixteen randomly selected fresh AS-5 units were leukoreduced by filtration. B lymphocytes from preleukoreduction specimens and mononuclear cells (MNCs) from postleukoreduction specimens were assayed for EBV DNA with sensitive real-time polymerase chain reaction (PCR). RESULTS: EBV genomes were detected in CD19+ B cells in 14 of 16 preleukoreduced RBC units. EBV genomic copy number in the units ranged from 0.18 to 96.84 per 10(5) B lymphocytes representing approximately 135 to 72,630 total EBV genomes per bag. Leukoreduction rendered all but one unit EBV-negative by PCR. The lone PCR-positive unit after leukoreduction amplified 1.2 EBV genome copies from MNCs recovered from the entire unit of leukoreduced RBCs; this unit had the highest EBV viral load before leukoreduction (72,630 EBV genomes). CONCLUSIONS: These results indicate that a 4-log reduction of EBV genomic copy number can be achieved with leukoreduction of RBC units and renders most RBC units EBV-negative by sensitive PCR.     

Effects of storage and leukoreduction on lymphocytes and Epstein-Barr virus genomes in platelet concentrates

BACKGROUND: Epstein-Barr virus (EBV) persists in infected B lymphocytes in blood donors. Lymphocytes are viable during platelet (PLT) storage. The effects of storage and leukoreduction on lymphocytes and EBV genomes are evaluated.
STUDY DESIGN AND METHODS: Forty nonleukoreduced PLT concentrates were stored at 20 to 24°C for up to 7 days. EBV genomes in B cells were quantified on Days 1 and 5. Viable white blood cells (WBCs) and T and B cells were quantified in 10 of 40 units on Days 1, 3, 5, and 7 of storage. For the leukoreduction study, four pools of PLTs were leukoreduced within 24 hours of collection. B cells from before leukoreduction and all peripheral blood mononuclear cells from after leukoreduction were assayed for EBV.
RESULTS: Viable WBCs and T cells were stable whereas viable B cells were reduced to 71% of the Day 1 level by Day 5. A total of 31 of 37 (83.8%) units were EBV positive. Although EBV genomes remained stable in most units, 12 of 37 units demonstrated a median of 5.1 (range 2- to 134)-fold increase in EBV genomes per 10⁵ B cells on Day 5. For the leukoreduction study, EBV genomes were detected in four of four pools before leukoreduction with a median of 3.8 (range, 0.2-93.6) EBV genomes per 10⁵ B cells. EBV genomes were not detected in any of the postleukoreduction specimens.
CONCLUSIONS: Seventy percent of B lymphocytes are viable on Day 5 of PLT storage. Although the mean number of EBV genomes remained stable, a subset of units had increased EBV genomes during storage. Leukoreduction removed polymerase chain reaction–detectable EBV genomes from PLT pools.     

Efficacy and safety of a polyester leukocyte removal filter for whole blood and red cell concentrate filtration

Patients receiving multiple whole blood transfusions often experience adverse clinical symptoms caused by leukocytes. In the present study, the efficacy and safety of a polyester filter for leukocytes (Sepacell R-500) was evaluated. Donor units of whole blood and red cell concentrate stored for varying lengths of time were filtered. Emphasis was placed on humoral parameters indicative of release and/or activation reactions of granulocytes (neutral proteinase elastase, lysozyme, aggregation, chemiluminescence) and erythrocytes (lactate dehydrogenase, plasma haemoglobin). Nonspecific adsorption effects were investigated by plasma protein determinations (albumin, alpha 2-macroglobulin). A complete blood cell count as well as values of haemoglobin and haematocrit were determined. Sepacell R-500 proved to be a highly efficient filter to the leukocyte depletion of blood. Our results of erythrocyte and granulocyte related humoral parameters provided no significant evidence of filtration mediated activation or releasing reactions of clinical consequence.