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9年里，25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。在此期间发生了15次反应 粒细胞分离术中发生血小板增多和10例反应 程序。这项研究的目的是确定过敏原 对这些反应负责。使用皮肤测试的组合， 放射过敏吸附试验和嗜碱性粒细胞组胺释放试验， 特异性IgE介导对环氧乙烷的敏化，一种用于 对一次性塑料采集箱进行消毒，发现有10至15个 血小板采集者和10名粒细胞采集者中的8名 经历反应，但在140名无反应的对照组中没有一人。它 据估计，多达1.0%的重复采血捐赠者可能 变得对环氧乙烷敏感，并在 捐款。10个人中有两个人在 捐献的粒细胞对羟乙基淀粉的皮肤测试呈阳性， 似乎对这种红细胞沉降剂变得敏感 在分离过程中。 尽管这些反应都没有危及生命，但DTM 正在继续测试分离捐赠者对乙烯的敏感度 氧化物和羟乙基淀粉，并推迟致敏个体 来自随后的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 9 years, 25 donors undergoing apheresis procedures on the Fenwal CS-3000 device experienced acute hypersensitivity reactions. Fifteen reactions occurred during plateletpheresis and 10 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 10 to 15 plateletpheresis donors and 8 of 10 granulocytapheresis donors experiencing reactions, but in none of 140 nonreacting controls. It is estimated that as many as 1.0% of all repeat apheresis donors may become sensitized to ethylene oxide and experience symptoms during donation. Two of the 10 individuals experienced 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 DTM is continuing to test apheresis donors for sensitization to ethylene oxide and hydroxyethyl starch, and to defer sensitized individuals from subsequent CS-3000 donations.