背景:创伤对低滴度O组全血(LTOWB)的需求正在增加。全血(WB)血小板保留(WB-SP)过滤器可以减少白细胞(LR),同时保留血小板的数量和功能;然而,在美国WB必须在收集后的8小时内进行过滤并放置在寒冷的地方。较长的处理窗口将促进LR-WB的改善的物流和供应,以满足日益增长的医疗需求。本研究评估了将过滤时间从<8h增加到<12h对LR-WB质量的影响。
方法:从健康供体收集30个WB单位。对照单元在收集的8小时内过滤,测试单元在收集的12小时内过滤。在整个21天的储存期间测试WB。溶血,WBC内容,成分恢复和WB质量的25个额外的标志物进行了测试,包括血液学和代谢标志物,红细胞形态,聚集测定法,血栓弹力图,和p-选择素。
结果:残留白细胞含量有0个失败,溶血或pH,武器之间的组件回收没有差异。观察到代谢参数几乎没有差异,但小的效应大小表明这些并不具有临床意义。整个储存趋势相似,过滤时间不影响血液学参数。血小板活化和聚集,或止血能力。
结论:我们的研究表明,将过滤时间从收集的8小时延长至12小时不会显着影响LR-WB的质量。血小板的表征表明储存损伤没有加剧。延长从收集到过滤的时间将改善美国的LTOWB库存。本文受版权保护。保留所有权利。
Demand for low-titer Group O whole blood (LTOWB) is increasing for trauma. The whole blood (WB) platelet-sparing (WB-SP) filter enables leukoreduction (LR) while retaining platelet quantity and function; however, in the United States WB must be filtered and placed in the cold within 8 h of collection. A longer processing window would facilitate improved logistics and supply of LR-WB to meet the growing medical need. This study evaluated the impact of increasing filtration timing from <8 h to <12 h on the quality of LR-WB.
Thirty WB units were collected from healthy donors. Control units were filtered within 8 h and test units within 12 h of collection. WB was tested throughout 21 days of storage. Hemolysis, WBC content, component recovery, and 25 additional markers of WB quality were tested including hematologic and metabolic markers, RBC morphology, aggregometry, thromboelastography, and p-selectin.
There were 0 failures for residual WBC content, hemolysis, or pH, and no differences in component recovery between arms. Few differences in metabolic parameters were observed, but the small effect size suggests these are not clinically significant. Trends throughout storage were similar and filtration timing did not impact hematological parameters, platelet activation and aggregation, or hemostatic capacity.
Our studies showed that extending filtration timing from 8 to 12 h from the collection does not significantly impact the quality of LR-WB. Characterization of the platelets demonstrated that storage lesions were not exacerbated. Extending the time from collection to filtration will improve LTOWB inventory in the United States.