临床用去白细胞血小板浓缩物的制备和质量现状

J Seghatchian, P Krailadsiri
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引用次数: 10

摘要

在合理的时间内制备无过滤的双剂量贫铀PC被认为是最经济有效的方法。该方法适用于多组分系统和生产高浓缩血小板和干血小板,最终产品中有10-15 ml血浆,病毒灭活,体外血小板功能没有明显损失。通过各种程序获得的血小板浓缩物是高度不均匀的,即使使用标准方案进行制备。因此,为了获得比较结果,生产和测试程序的标准/标准化仍然是一个具有挑战性的领域。需要把注意力集中在制备的不断增长和复杂的技术特点上,以及在生物相容性和活化因子对血小板和白细胞功能的相关影响方面使用新的过滤材料。生产过程和储存容器似乎都有助于各种细胞损伤和产生一些生物反应调节剂,如补体、细胞因子和微粒。在这方面,采用多参数分析来验证血小板质量是有意义的,因为一些血小板储存损伤的标记物对不同表面有不同的亲和力,导致错误的估计。在制备和使用干血小板、替代血小板和细菌安全产品方面还需要进一步的开发工作。输血患者的基础条件也是这方面的一个重要问题,有趣的是,高il - 8水平的患者血小板恢复明显较低。
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Current position on preparation and quality of leucodepleted platelet concentrates for clinical use

Double dose leucodepleted PC without filtration is considered to be the most cost-effective way of preparing leucodepleted PC in a reasonable time. The procedure lends itself to a multicomponent system and production of hyperconcentrate and dry platelets, with <10–15 ml plasma in final product and viral inactivation without considerable loss of in vitro platelet functions.

Platelet concentrates obtained by various procedures are highly heterogeneous, even if a standard protocol is used for the preparation. Therefore, standard/standardisation in both production and testing procedures remain a challenging area in order to obtain comparative results.

Attention needs to be focused on growing and complex technical features of preparation and on the use of new filter material in terms of biocompatibility and the related effects of activated factors on function of platelets and leucocytes. Both the production process and storage containers appear to contribute to various cellular lesion and generation of some biological response modifiers such as complements, cytokines and microparticles. In this respect it is relevant to adopt a multiparameter analysis for the validation of platelet quality as some markers of platelet storage lesion have different affinity to various surfaces, leading to false under estimation.

Further development work is still needed in preparation and usage of dry platelet, platelet alternative and bacterially safe products.

The underlying conditions of the transfused patients is also an important issue in this respect, it is interesting to note that patients with high IL8 levels have a substantially lower platelet recovery.

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