ETIOLOGY OF ALLERGIC REACTIONS IN PLATELETPHERESIS DONORS

1984年2月，DTM从手动转为自动血小板 收集技术，为此获取了四个自动化单元 分离装置。在接下来的7年里，18名捐赠者接受了 Fenwal CS-3000设备上的分离程序经历了急性 超敏反应。血小板采集术中发生的十种反应 在粒细胞分离过程中发生9例反应。这个 这项研究的目的是确定导致这些疾病的过敏原 反应。使用皮肤测试，辐射过敏吸附测试， 和嗜碱性粒细胞组胺释放试验，特异性IgE介导的致敏 到环氧乙烷，一种用于对塑料一次性分离进行消毒的气体 试剂盒，在10名血小板捐赠者中发现了8名，在9名捐献者中发现了7名 粒细胞分离供者出现反应，但在140例非 反应控制。据估计，多达1.0%的重复 分离捐赠者可能会对环氧乙烷和经验敏感 在捐献过程中出现过敏症状。9个人中的两个人经历了 粒细胞捐献过程中的反应皮肤测试呈阳性 羟乙基淀粉，似乎对这个红细胞变得敏感 分离过程中的沉淀剂。 尽管这些反应都没有危及生命，但暗淡的是 继续测试分离捐赠者对环氧乙烷的敏感度 羟乙基淀粉，并推迟致敏个体从随后 CS-3000捐赠。

In February, 1984, the DTM converted from manual to automated platelet collection techniques, acquiring for this purpose four automated cell separation devices. During the next 7 years, 18 donors undergoing apheresis procedures on the Fenwal CS-3000 device experienced acute hypersensitivity reactions. Ten reactions occurred during plateletpheresis and 9 reactions occurred during granulocytapheresis procedures. The purpose of this study was to identify the allergen responsible for these reactions. Using a combination of skin tests, radioallergosorbent tests, and basophil histamine release assays, specific IgE- mediated sensitization to ethylene oxide, a gas used to sterilize the plastic disposable apheresis kits, was found in 8 of 10 plateletpheresis donors and 7 of 9 granulocytapheresis donors experiencing reactions, but in none of 140 non- reacting controls. It is estimated that as many as 1.0% of all repeat apheresis donors may become sensitized to ethylene oxide and experience allergic symptoms during donation. Two of the 9 individuals experiencing reactions during granulocyte donations had positive skin tests to hydroxyethyl starch, and appeared to become sensitized to this red cell sedimenting agent during apheresis. Although none of these reactions have been life-threatening, the DIM is continuing to test apheresis donors for sensitization to ethylene oxide and hydroxyethyl starch, and to defer sensitized individuals from subsequent CS-3000 donations.