应用血细胞分离机采集ABO血型不合供者的外周血干细胞

为了探索应用血细胞分离机采集ABO血型主要和(或)次要不合的供者外周血造血干细胞的得率及不去除红细胞或血浆用于干细胞移植的可行性,采用CobeSpectra(Version6.1)血细胞分离机的自动干细胞采集程序对9例异基因外周血造血干细胞供者进行采集,其中ABO血型主要不合4例,次要不合2例,主要次要均不合3例。对ABO血型主要不合及主要、次要均不合的供者每循环收集的细胞成分和血浆的量分别作相应调整。输注前从产品袋中留取标本检查有核细胞计数、单个核细胞比例、CD34 细胞计数和细胞的成活率(台盼蓝拒染率)。输入时对受者采取一系列保护肾功能的措施。液体总量控制在4000毫升/日。结果显示:除1例因供者体重远大于受者经1次采集即可满足移植所需细胞量外,其余供者均经2次采集收集到足够的有核细胞直接回输给受者或冰冻保存备用。共采集PBSC17次,平均每次获得有核细胞3.77×1010个,单个核细胞占97%-99%。CD34 细胞数平均为8.62×106/kg,细胞拒染率均为100%。ABO血型主要不合及主要、次要均不合的供者每次采集的PBSC产品中含压积红细胞8-10ml,ABO血型次要不合供者每次采集的PBSC产品中含血浆80-120ml,不去除红细胞及血浆,直接回输给受者。无1例出现溶血性输血反应,造血功能均获得重建。结论:采用CobeSpectra血细

Collection of Peripheral Blood Stem Cells from ABO Incompatible Allogeneic Donors by Using Blood Cell Separator

To evaluate the yield of the blood cell separator for collection of peripheral blood stem cells (PBSC) from ABO major and (or) minor incompatible allogeneic donors and the feasibility of PBSC component infusion to the recipients without removal of erythrocytes or plasma, the Cobe Spectra (Version 6.1) blood cell separator was utilized to collect PBSC component from 9 allogeneic donors. Of all the donors, 4 were ABO major incompatible, 2 were minor incompatible and the other 3 were both major and minor incompatible to corresponding recipients. In each cycle, different amount of PBSC component was harvested, and the variable volume plasma chased the cells into the bag was adjusted according to the ABO incompatibility. The nucleated cell count, percentage of mononuclear cell, number of CD34(+) cell and percentage of viable cell (trypan blue excluding rate) in the component were detected. At the time of infusion, a series of protective measures to the renal function of recipients were taken. The results showed that apheresis was twice performed on these eight donors to collected enough PBSC for transplantation or cryopreservation, except one apheresis was enough for cell amount needed by transplantation, as the donor's body weight was much heavier than that of the recipient. Altogether 17 apheresises were performed, the mean yield of nucleated cells was 3.77 x 10(10), in which 97% to 99% were mononuclear cells (MNC). The harvested number of CD34(+) cell was 8.62 x 10(6)/kg. All the trypan blue exclusion rate was 100%. In ABO major incompatible or both major and minor incompatible component, there were 8 - 10 ml packed erythrocytes; in ABO minor incompatible component, there were 80 - 120 ml of plasma. These components were infused into the recipients without removal of erythrocytes or plasma and no haemolytic reaction was observed in any recipient, and their hematopoietic functions soon recovered. Results suggest that enough PBSC can be acquired by using blood cell separator Cobe Spectra (Version 6.1), with the modified separation factors, and the collected PBSC component can be safely infused into the ABO incompatible recipients without removal of erythrocytes or plasma.