Functional testing of platelet concentrates prepared from buffy coat

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Uvod: Priprema koncentrata trombocita (KT) iz jedinice cele krvi je metoda uslovljena velikim brojem faktora koji pojedinačno ili udruženo mogu imati značajan uticaj na kvalitet konačnog proizvoda. Kvalitet koncentrata trombocita određen je kriterijumima definisanim u Vodiču za pripremu, korišćenje i obezbeđenje kvaliteta Evropskog komiteta za transfuziju krvi Saveta Evrope. Cilj istraživanja je bio ispitati kvalitet KT dobijenih izdvajanjem iz “buffy coat”-a (BC) i izdvojiti faktore koji doprinose poboljšanju kvaliteta i standardizaciji KT. Materijal i metoda rada: Ispitivanje je obuhvatilo ukupno 80 KT izdvojenih iz (BC) prema standardnoj proceduri pripreme u Zavodu za transfuziju krvi u Nišu. Kvalitet KT je određivan na osnovu zapremine produkta i laboratorijskih testiranja prvog (KT1), trećeg (KT3) i petog dana skladištenja (KT5): hematoloških analiza, gasnih analiza (pO2, pCO2), pH, sterilnosti i agregacije trombocita izazvane dodavanjem 3,2; 6,4 i 9,6 μg kolagena/ mL (impedantna agregometrija). Rezultati: Postoji statistički značajno manji broj trombocita, pO2, pCO2 i pH u KT3 i KT5 (p<0,001). Osim ispunjenosti kriterijuma za broj trombocita, svi ostali parametri su u saglasnosti sa preporukama Vodiča. Agregacija trombocita za sve koncentracije kolagena je pokazala pad tokom skladištenja, sa statistički značajnom razlikom za KT3 i KT5 u odnosu na KT1 (p<0,01). Postoji statistički značajna razlika u padu aktivnosti uzoraka KT aktiviranih primenom visokih koncentracija kolegena (6,4 i 9,6 μg kolagena/ mL ) i manjih koncentracija kolagena (3,2 μg kolagena/ mL). Zaključak: Broj trombocita, posmatrani biohemijski parametri i funkcija trombocita se statistički značajno menjaju tokom perioda skladištenja. U cilju poboljšanja kvaliteta KT važno je skladištiti KT u propisanim uslovima, promeniti vrstu kese za skladištenje KT i koristiti aditivni rastvor za čuvanje trombocita umesto plazme.

Introduction: Preparation of platelet concentrate (PC) from a unit of whole blood is a method dependent on a number of factors, which alone or together, can have a significant impact on the quality of the final product. Quality of PCs is determined with criteria defined in the Guide to the preparation, use and quality assurance of the Council of European Committee for Blood Transfusion. The study aimed to analyze the quality of PCs prepared from buffy coat (BC) and to allocate the factors of improvement and standardization of the quality of PCs. Materials and methods: The study included a total of 80 PCs prepared from BC according to the standard procedure in Blood Transfusion Institute Niš. The quality of the PCs was determined according to the volume of product and testings performed on the first (PC1), the third (PC3) and the fifth day of storage (PC5). The following parameters were determined: hematological analysis, gas analysis (pO2, pCO2), pH, sterility and platelet aggregation triggered using 3,2; 6,4 and 9,6 μg collagen/mL (impedance aggregometry). Results: There are significantly lower platelet count, pO2, pCO2 and pH in PC3 and PC5 (p<0,001). Except for the fulfillment of the criteria for platelet count, all the other quality parameters are in accordance with recommended criteria. Platelet aggregation for all the concentrations of collagen has showed a decrease during the storage period, with statistically significant differences for PC3 and PC5 as compared to aggregation for PC1 (p<0,01). There is statisticaly significant decrease in activity loss between platelet concentrates triggered with higher concentration of collagen (6,4 and 9,6 μg collagen/mL) and with smaller concentration of collagen (3,2 μg collagen/mL). Conclusion: Platelet count, evaluated biochemical parameters and the platelet function changed statistically during the storage period. In order to improve the quality of PCs it is important to store the products under proper conditions, change the type of plastic bag for PC storage and use platelet additive solutions (PAS) instead of plasma.

trombociti, agregacija, kvalitet

platelets, aggregation, quality

611.018.5(043.3)

Trombociti - Doktorske disertacije

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