背景:指南推荐ABO相同血小板(PLT)输血。由于单供体血小板(SDP)含有ABO不相容血浆,少量ABO不相容的PLT输血后的溶血反应已升级。通过检查滴度或执行等离子体还原来避免此类事件是麻烦的。血小板添加剂溶液(PAS)的引入使得能够通过避免等凝集素的被动转移来减少这些反应。我们的目的是研究抗体滴度(抗A,在“O”SDP中添加来源处的PAS和参考生存力的质量参数,形态学,和新陈代谢。
方法:组\"0\"SDP(n=50)在标准电池分离器上制备。在无菌条件下(研究臂)在来源处添加比例为70:30的PAS(PAS:血浆)。在收集日(第0天)和第4天研究单位,并与含有100%血浆的SDP(对照臂)进行比较。添加PAS后进行效价研究。
结果:在研究组中,中位抗体滴度(抗-A,抗B)从128降低到16,在添加PAS后(P<0.001)。PAS血小板浓缩物的形态学评分较好(P<0.001)。两臂的代谢参数pO2和pCO2相似,表明单位储存良好,耗氧量稳定(P>0.05)。乳酸水平,葡萄糖消耗率,研究小组的乳酸生产率明显较低,显示了PAS的优势。
结论:O组SDP可以用PAS制备,在抗体滴度方面有益效果显着。质量参数保持良好。PAS单位的可用性使患者受益。
BACKGROUND: Guidelines recommend ABO-identical platelet (PLT) transfusions. Hemolytic reactions after a minor ABO-incompatible PLT transfusion have escalated due to single-donor platelets (SDP) containing ABO-incompatible plasma. Avoiding such events by examining titers or performing plasma reduction is cumbersome. The introduction of platelet additive solutions (PAS) has enabled to reduce these reactions by avoiding passive transfer of isoagglutinin. Our aim was to study antibody titers (anti-A, anti-B) in \"O\" SDP by adding PAS at source and the quality parameters with reference to viability, morphology, and metabolism.
METHODS: Group \"O\" SDP (n = 50) were prepared on a standard cell separator. PAS in a ratio of 70:30 (PAS: plasma) was added at source under sterile conditions (study arm). The units were studied on day of collection (day 0) and day 4 and compared with SDP containing 100% plasma (control arm). A titer study was performed after PAS addition.
RESULTS: In the study group, the median antibody titers (anti-A, anti-B) reduced from 128 to16, post-PAS addition (P < 0.001). Morphology scores were superior in PAS platelet concentrates (P < 0.001). Metabolic parameters pO2 and pCO2 were similar in the two arms signifying good unit storage and stable oxygen consumption (P > 0.05). Lactate levels, glucose consumption rate, and lactate production rates were significantly low in study arm showing the advantage of PAS.
CONCLUSIONS: O group SDPs can be prepared with PAS and the beneficial effects were significant with respect to antibody titers. Quality parameters were well maintained. Availability of PAS units has benefitted patients.