Centrifugation-free washing: A novel approach for removing immunoglobulin A from stored red blood cells.
Centrifugation-free washing: A novel approach for removing immunoglobulin A from stored red blood cells.
复制标题
免离心洗涤：一种从储存的红细胞中去除免疫球蛋白 A 的新方法。
DOI：
10.1002/ajh.25026
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发表时间：
2018
影响因子：
12.8
通讯作者：
Shevkoplyas,SergeyS
中科院分区：
文献类型：
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作者：
Vörös,Eszter;Piety,NathanielZ;Strachan,BrionyC;Lu,Madeleine;Shevkoplyas,SergeyS
免疫球蛋白A （IgA）缺乏的受者可用水洗红细胞（rbc）检测。医院血库通常使用的基于离心的细胞处理机不能始终将IgA降至推荐水平以下，因此经常需要进行两次洗涤。在这里，我们描述了一个简单、便携、一次性系统的原型，该系统能够在不离心的情况下洗涤储存的红细胞，同时在单次运行中将IgA降至0.05 mg/dL以下。从红细胞单位（n= 8，白细胞减少，4 - 6周保存时间）中提取的样品用生理盐水稀释至10%的红细胞压积，然后使用原型洗涤系统或常规离心洗涤。通过测量几个关键的体外质量指标，对两种洗涤方法的效率进行了量化和比较。该冲洗系统的原型能够以300 mL/小时的速度处理储存的红细胞，产生具有43±3%红细胞压积和86±7%细胞回收率的冲洗红细胞悬浮液。总的来说，两种洗涤方法在大多数测量参数上表现相似，将游离血红蛋白浓度降低了4倍，将总游离蛋白浓度降低了10倍。重要的是，新的洗涤系统将IgA水平降低到0.02±0.01 mg/mL，比传统离心产生的浓度低5倍。这一概念验证研究表明，对于洗涤储存的红细胞，可能不需要离心。一种简单的、一次性的、无需离心的洗涤系统在小型医疗机构和资源有限的环境中可能特别有用，这些环境可能无法获得基于离心的细胞处理器。
Washed red blood cells (RBCs) are indicated for immunoglobulin A (IgA) deficient recipients. Centrifugation‐based cell processors commonly used by hospital blood banks cannot consistently reduce IgA below the recommended levels, hence double washing is frequently required. Here, we describe a prototype of a simple, portable, disposable system capable of washing stored RBCs without centrifugation, while reducing IgA below 0.05 mg/dL in a single run. Samples from RBC units (n= 8, leukoreduced, 4‐6 weeks storage duration) were diluted with normal saline to a hematocrit of 10%, and then washed using either the prototype washing system, or via conventional centrifugation. The efficiency of the two washing methods was quantified and compared by measuring several key in vitro quality metrics. The prototype of the washing system was able to process stored RBCs at a rate of 300 mL/hour, producing a suspension of washed RBCs with 43 ± 3% hematocrit and 86 ± 7% cell recovery. Overall, the two washing methods performed similarly for most measured parameters, lowering the concentration of free hemoglobin by >4‐fold and total free protein by >10‐fold. Importantly, the new washing system reduced the IgA level to 0.02 ± 0.01 mg/mL, a concentration 5‐fold lower than that produced by conventional centrifugation. This proof‐of‐concept study showed that centrifugation may be unnecessary for washing stored RBCs. A simple, disposable, centrifugation‐free washing system could be particularly useful in smaller medical facilities and resource limited settings that may lack access to centrifugation‐based cell processors.