Automatic depletion with Spectra Optia allows a safe 16% reduction of red blood cell pack consumption in exchanged sickle cell anemia patients
Automatic depletion with Spectra Optia allows a safe 16% reduction of red blood cell pack consumption in exchanged sickle cell anemia patients
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DOI：
10.1111/trf.15188
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发表时间：
2019-05-01
期刊：
影响因子：
2.9
通讯作者：
Joly, P.
中科院分区：
文献类型：
--
作者：
Hequet, O.;Poutrel, S.;Joly, P.
慢性红细胞交换（RBCX）经常用于预防镰状细胞贫血患者的并发症，但匹配的红细胞包（RBCP）的缺乏是一个严重的问题。本研究的主要目的是比较Spectra Optia（SO）器械（具有自动消耗步骤）和之前的Cobe Spectra（CSP）器械在RBCX期间使用的RBCP数量。研究设计和方法前瞻性分析了50例镰状细胞性贫血患者在长期输血计划下使用自动耗竭步骤（SO/DE）进行的300次SO治疗的性能和安全性。确定了与未耗尽的SO装置和CSP装置相比，使用该方案节省的RBCP数量。结果SO/DE方案似乎是安全的，因为只有5%和17%的疗程的特征分别是血压显著降低和心率增加（2级不良事件）。单采后红细胞压积和剩余细胞分数达到预期值。SO/DE方案所需的RBCP比无消耗的SO少16%，每例患者每年平均节省12个RBCP，比CSP器械少13%。有趣的是，对于具有高总血容量和/或高单采前红细胞压积的患者，节省更重要。结论对于慢性输血计划下的镰状细胞性贫血患者来说，SO/DE方案是一种高效、安全且具有成本效益的方法。
BACKGROUND Chronic red blood cell exchanges (RBCXs) are frequently used to prevent complications in patients with sickle cell anemia, but the scarcity of matched red blood cell packs (RBCPs) is a serious concern. The main goal of this study was to compare the number of RBCPs used during RBCXs between the Spectra Optia (SO) device (with the automatic depletion step) and the former Cobe Spectra (CSP) device. STUDY DESIGN AND METHODS The performances and safety of 300 SO sessions using the automatic depletion step (SO/DE) in 50 patients with sickle cell anemia under a chronic transfusion program over a 1-year period were prospectively analyzed. The numbers of RBCPs saved using this protocol compared to the SO device without depletion and to the CSP device were determined. RESULTS The SO/DE protocol appeared to be safe, as only 5% and 17% of the sessions were characterized by a significant decrease in blood pressure and increase in heart rate (grade 2 adverse events), respectively. Postapheresis hematocrit and fraction of cells remaining reached expected values. The SO/DE protocol required 16% fewer RBCPs compared to SO without depletion, allowing a mean saving of 12 RBCPs per patient and per year and 13% fewer compared to CSP device. Interestingly, the saving was more important for patients with high total blood volume and/or high preapheresis hematocrit. CONCLUSION The SO/DE protocol is an efficient, safe and cost-effective procedure for patients with sickle cell anemia under a chronic transfusion program.