Possible role of artificial oxygen carriers in transfusion medicine: a retrospective analysis on the current transfusion practice.
Possible role of artificial oxygen carriers in transfusion medicine: a retrospective analysis on the current transfusion practice.
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DOI：
10.1111/j.1525-1594.2008.00696.x
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发表时间：
2009-02
影响因子：
2.4
通讯作者：
F. Yoshiba;A. Kawaguchi;O. Hyodo;T. Kinoue;S. Inokuchi;S. Kato
中科院分区：
文献类型：
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作者：
F. Yoshiba;A. Kawaguchi;O. Hyodo;T. Kinoue;S. Inokuchi;S. Kato
人工氧载体（AOC）作为红细胞（RBC）在同源输血（Tx）中的替代品正在开发中。AOC缺乏表面抗原，无需进行abo分型和抗体筛选（T/S）。病原体的消除使其更加安全，长期的稳定性使其可以无处不在地储存以备紧急使用。为了描述AOC的效用，我们回顾了东海大学和日本红十字会目前的Tx实践。东海大学医院急诊科一直在使用O(+)Rh（+）红细胞治疗出血性休克患者。在损伤后60分钟内接受红细胞的患者生存率明显高于晚60分钟或60分钟接受红细胞的患者。红十字会血液中心为138个罕见血型的紧急请求提供了411个单位的红细胞。我们的分析表明，如果最初的6个单位有AOC， 96%的此类请求可以被覆盖，以避免紧急供体分配、准备和Tx。在订购T/S的2079例外科病例中，只有29%实际上需要Tx，这使得70%的T/S不必要。因为只有7.4%需要9个单元或更多，所以如果AOC可用于最初的8个单元，那么回顾起来可以避免92%以上的T/S和Tx。结果表明，AOC可能在各种情况下都很有用，可以减轻当前Tx实践中的问题、关注点和技术负担。由于预期的效用主要基于物理特性，因此即使生物来源的红细胞可用，AOC仍可能具有优势。
Artificial oxygen carriers (AOC) are under development as a substitute for red blood cells (RBC) in homologous transfusion (Tx). The lack of surface antigen in AOC makes ABO-typing and antibody-screening (T/S) unnecessary. Pathogen elimination renders it much safer, and long-term stability allows ubiquitous storage for emergency use. To delineate the utility of AOC, we retrospectively examined current Tx practices in Tokai University and the Japanese Red Cross Society. The emergency department of Tokai University Hospital has been using O(+)Rh(+) RBC in patients with hemorrhagic shock before Tx becomes available. Those who received the RBCs within 60 min of injury had a significantly higher survival rate than those who received it later (> or =60 min). The Red Cross Blood Center provided 411 units of RBC for 138 urgent requests for rare blood types. Our analysis suggests that if an AOC were available for the initial six units, 96% of such requests could have been covered to avoid urgent donor allocation, preparation, and Tx. Among 2079 surgical cases who ordered T/S, only 29% actually required Tx, rendering >70% of the T/S unnecessary. Because only 7.4% required nine units or more, more than 92% of T/S and Tx could have been avoided in retrospect if an AOC were available for the initial eight units. The results suggest that an AOC might be useful in various situations to alleviate problems, concerns, and technical burden in the current Tx practices. Because the expected utility is based mainly on physical characteristics, AOC may remain advantageous even when biogenetically derived RBC becomes available.