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Background:
Autologous platelet-rich plasma (PRP) can be used either to prevent platelets (PLTs) from lesions during extracorporeal circulation or for wound therapy, when processed into PLT gel. The aim of this study was to evaluate the PLT sequestration abilities of a new-generation autotransfusion device.
Study design and methods:
In this expe...
Context in source publication
Context 1
... PRP2 is used for the collection of PRP and PPP in separate PRP and PPP bags. When either of the two protocols is completed, the other blood components in the whole blood are transferred back to the retransfusion bag. The sequestration protocol we selected to use in this study was PRP2. A schematic illustration of the apheresis cycle is shown in Fig. ...
Citations
... is subject established scientific and rigorous in vitro and in vivo models and adopted strict variable control methods to study the relationship between autologous reinfusion of red blood cells and CD8+ T cell proliferation [11]. rough basic and effective cell experiments and biochemical characterization methods, it has been proved that the membrane proteins CD28 and MHC on the surface of autologous reinfused red blood cells can bind to CD8+T cells, thereby promoting the proliferation of CD8+T cells and inhibiting the malignant transformation of liver cancer. ...
Autologous blood transfusion is an important blood protection measure. Red blood cells have a certain degree of immunogenicity and their surface membrane proteins CD28 and MHC can participate in the immune response and interact with CD8+ T cells. We build a cell model with a transwell system. The binding characteristics of RBCs and CD8+ T cells were observed with a fluorescent confocal microscope. The content of the inflammatory factor TNF-α and IFN-γ produced was analyzed by ELISA. The proliferation characteristics of CD8+ T cells were analyzed by CFSE staining, and the content of CD3+CD8+ T cells was analyzed by flow cytometry. Cell migration and invasion experiments were used to analyze the malignant metastasis ability of liver cancer cells. The expression of vimentin, E-cadherin, and β-catenin was analyzed by Western blot. We establish a liver cancer model in rats and group them for autologous blood transfusion. The content of CD3+CD8+T cells in the blood of each group of rats was analyzed by flow cytometry. Western blot was used to analyze the expression of vimentin, E-cadherin, and β-catenin in the liver tissues of rats in each group. The red blood cells in the autologous reinfusion blood and CD8+ T cells have an obvious combination. The degree of combination of the two is related to the expression of CD28 and MHC. If CD28 and MHC are expressed at the same time, the combination of the two cells will be high, the proliferation of CD8+ T cells will increase, and the expression of inflammatory factors will also increase, while the expression of the three proteins that are positively correlated with the activity of cancer cells will decrease. If only one of CD28 and MHC is normally expressed, the result is contrary to the situation where both membrane proteins are normally expressed. Our project has proved that autologous infusion of red blood cell surface membrane proteins CD28 and MHC combined with CD8+ T cells can promote the proliferation of CD8+ T cells to inhibit the malignant transformation of liver cancer.
... The plasma elimination rates are calculated according to the following equation: Elimination rate (%) = 100 − 100 × ((V WRBC × (1 − Hct WRBC /100) × C WRBC )/(V TB × (1 − Hct TB /100) × C TB )), where V TB × (1 − Hct TB /100) is the volume of the supernatant in the test blood, while V WRBC × (1 − Hct WRBC /100) represents the volume of the supernatant in the produced washed RBC (mL). C WRBC and C TB are the concentrations of the respective substance in the supernatant of the produced washed RBCs [36]. ...
Patient Blood Management (PBM) is a patient-centered, systemic and evidence-based approach. Its target is to manage and to preserve the patient’s own blood. The aim of PBM is to improve patient safety. As indicated by several meta-analyses in a systematic literature search, the cell salvage technique is an efficient method to reduce the demand for allogeneic banked blood. Therefore, cell salvage is an important tool in PBM. Cell salvage is widely used in orthopedic-, trauma-, cardiac-, vascular and transplant surgery. Especially in cases of severe bleeding cell salvage adds significant value for blood supply. In cardiac and orthopedic surgery, the postoperative use for selected patients at the intensive care unit is feasible and can be implemented well in practice. Since the retransfusion of unwashed shed blood should be avoided due to multiple side effects and low quality, cell salvage can be used to reduce postoperative anemia with autologous blood of high quality. Implementing quality management, compliance with hygienic standards as well as training and education of staff, it is a cost-efficient method to reduce allogeneic blood transfusion. The following article will discuss the possibilities, legal aspects, implementation and costs of using cell salvage devices in an intensive care unit.
... Furthermore, alpha-fetoprotein, phosphatidylglycerol, fetal squamous epithelial cells, and some inflammatory factors can be entirely removed from the blood to reduce the risk of amniotic fluid embolism [18]. ...
Background:
Obstetric hemorrhage is the leading cause of maternal mortality globally, especially in China. The key to a successful rescue is immediate and rapid blood transfusion. Autotransfusion has become an integral part of clinical blood transfusion, with intraoperative cell salvage (IOCS) being the most widely used.
Aim:
To investigate the application of IOCS in cesarean section.
Methods:
A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study. They were divided into the observation (43 cases) and control (44 cases) groups using the random number table method. The patients in both groups underwent lower-segment cesarean section. The patients in the control group were treated with traditional allogeneic blood transfusion, whereas those in the observation group were treated with IOCS. Hemorheology [Red blood cell count, platelet volume, and fibrinogen (FIB)] and coagulation function (partial prothrombin time, prothrombin time (PT), platelet count, and activated coagula-tion time) were measured before and 24 h after transfusion. In the two groups, adverse reactions, such as choking and dyspnea, within 2 h after cesarean section were observed.
Results:
Before and after transfusion, no significant differences in hemorheology and coagulation function indices between the two groups were observed (P > 0.05). About 24 h after transfusion, the erythrocyte count, platelet ratio, and FIB value significantly decreased in the two groups (P < 0.05); the PLT value significantly decreased in the two groups; the activated partial thromboplastin time, PT, and activated clotting time significantly increased in the two groups (P < 0.05); and no statistical differences were observed in hemorheology and coagulation function indices between the two groups (P > 0.05). Furthermore, there was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).
Conclusion:
In patients undergoing cesarean section, intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.
... In addition, the suction forces (-150 to -400 millibars) used during cell salvage are associated with a risk of physical alteration of both erythrocytes and platelets. 7 Although the concept of autologous platelet transfusion described in the current study is attractive and might help decrease the need for allogeneic platelets and the risk associated with their transfusion, clinical studies are needed before determining the value of this approach for a few reasons. ...
... However, allergic reactions, electrolyte disorders or infections will inevitably occur [9,10]. Compared with allogeneic blood transfusion, storage autotransfusion is a safe, effective, economical, and straightforward way of blood transfusion, which can greatly reduce the risk of transfusion-related complications [11,12]. ...
Objective:
To ivestigate the effect of stored autotransfusion on the electrolytes and postoperative complications in patients undergoing elective orthopedic surgery.
Methods:
A total of 76 cases of patients undergoing elective orthopedic surgery were randomly divided into an observation group (38 cases, taking stored autotransfusion) and a control group (38 cases, taking allogeneic blood transfusion) according to a random number table method. The intraoperative-related indexes (intraoperative blood loss, autologous or allogeneic blood transfusion volume, urine volume, and length of hospital stay), electrolyte levels before and 48 hours after the operation, routine blood and coagulation function were compared between the two groups, and the postoperative complications related to blood transfusion were recorded.
Results:
The length of hospital stay of the observation group was significantly lower than that of the control group (P<0.05). The concentrations of K+ and Na+ in the control group 48 h after the operation were higher than those before the operation and than those in the observation group, while the concentration of Ca2+ was lower than that before the operation and that in the observation group (all P<0.05). The levels of Hb, RBC, and HCT in the control group 48 h after the operation were lower than those before the operation and those in the observation group (all P<0.05). The levels of WBC in the two groups 48 h after the operation were significantly higher, but those in the observation group were lower than those in the control group (all P<0.05). There were no significant changes in Pt, APTT, D-D, and FIB levels between the two groups. There were no significant changes in Pt, APTT, D-D, and FIB levels 48 hours after the operation compared with those before the operation (P>0.05). The incidence of postoperative complications caused by blood transfusion in the observation group was lower than that in the control group (P<0.05).
Conclusion:
Storage autotransfusion can effectively balance the electrolyte level and reduce the incidence of complications in patients undergoing elective orthopedic surgery. This is worthy of clinical application.
... Three types of autotransfusion devices utilizing either a Latham bowl, Baylor bowl, or closed-spiral chamber, showed only 50%-60% platelet recovery, 51 which was consistently lower than that for conventional centrifugation. 52 The platelet recovery performance of autotransfusion devices will have to be significantly improved before they could provide a practical alternative to specialized cell processors or manual centrifugation. ...
Madeleine Lu, Dalia L Lezzar, Eszter Vörös, Sergey S Shevkoplyas Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA Abstract: Millions of blood components including red blood cells, platelets, and granulocytes are transfused each year in the United States. The transfusion of these blood products may be associated with adverse clinical outcomes in some patients due to residual proteins and other contaminants that accumulate in blood units during processing and storage. Blood products are, therefore, often washed in normal saline or other media to remove the contaminants and improve the quality of blood cells before transfusion. While there are numerous methods for washing and volume reducing blood components, a vast majority utilize centrifugation-based processing, such as manual centrifugation, open and closed cell processing systems, and cell salvage/autotransfusion devices. Although these technologies are widely employed with a relatively low risk to the average patient, there is evidence that centrifugation-based processing may be inadequate when transfusing to immunocompromised patients, neonatal and infant patients, or patients susceptible to transfusion-related allergic reactions. Cell separation and volume reduction techniques that employ centrifugation have been shown to damage blood cells, contributing to these adverse outcomes. The limitations and disadvantages of centrifugation-based processing have spurred the development of novel centrifugation-free methods for washing and volume reducing blood components, thereby causing significantly less damage to the cells. Some of these emerging technologies are already transforming niche applications, poised to enter mainstream blood cell processing in the not too distant future. Keywords: washing, volume reduction, red blood cells, platelets, granulocytes, transfusion
Objective:
To observe the effect of collecting and retransfusing autologous platelet rich plasma (aPRP) on the amount of allogeneic blood usage in total arch replacement (Sun's surgery) and the outcomes 30 days after surgery.
Design:
A prospective, randomized trial.
Setting:
A tertiary university hospital specialized in cardiovascular diseases.
Participants:
The study comprised 120 patients undergoing Sun's surgery for Stanford type A acute aortic dissection.
Interventions:
aPRP was harvested before incision and was re-transfused after heparin neutralization for patients in the treatment group.
Measurements and main results:
There was no significant difference in preoperative demographic data between the 2 study groups. Intraoperative transfusions of erythrocyte (p = 0.009), plasma (p = 0.017), cryoprecipitate (p = 0.002), and platelets (p < 0.001) in the treatment group were reduced significantly. In addition, less blood loss was observed in the treatment group (p = 0.002). The durations of postoperative mechanical ventilation (p = 0.029) and hospitalization (p = 0.002) of the treatment group were significantly shorter. There were no statistically significant differences in the length of intensive care unit stay, the incidence of complications, and mortality 30 days after surgery.
Conclusion:
In total arch replacement (Sun's surgery), collecting and retransfusing aPRP reduced intraoperative transfusions of erythrocyte, plasma, and cryoprecipitate and decreased the duration of postoperative mechanical ventilation and hospitalization. This technique had no significant effect on the incidence of complications and mortality 30 days postoperatively.
Die maschinelle Autotransfusion (MAT) ist eine effektive Methode, um die Transfusion von Fremdblut zu reduzieren. Dies wird durch eine Reihe von Metaanalysen belegt, wie eine systematische Literaturrecherche ergab. Die Methode findet insbesondere in der Orthopädie/Unfallchirurgie, der Herz-Thorax-Chirurgie, Gefäßchirurgie und der Abdominal‑/Transplantationschirurgie Anwendung. Eine Retransfusion von ungewaschenem Wund- oder Drainageblut ist nicht zulässig. Nach Bestrahlung des Wundbluts kann die MAT auch in der Tumorchirurgie angewendet werden. Bei massivem Blutverlust trägt die MAT vielfach dazu bei, überhaupt ausreichend kompatibles Blut für Transfusionen bereitstellen zu können. Für Zeugen Jehovas werden manche Operationen erst damit ermöglicht. Eine potenzielle Anwendung ist das Waschen von Fremdblutkonserven, um z. B. kaliumbedingte Arrhythmien abzuwenden, oder die Bereitstellung autologer Thrombozyten. Neben der Verträglichkeit ist v. a. die hohe Vitalität und Funktionsfähigkeit der ungelagerten autologen Erythrozyten ein Vorteil. In einer Stellungnahme hat der Arbeitskreis Blut des Bundesministeriums für Gesundheit 2014 MAT-Blut als Arzneimittel definiert und dem Arzneimittelgesetz (AMG) unterstellt. Nur über strenge Vorgaben, die in der aktuellen Novelle der Hämotherapierichtlinien festgelegt sind, ist eine „erlaubnisfreie Gewinnung und Anwendung von Blut im Rahmen der maschinellen Autotransfusion (MAT)“ weiterhin möglich. Zentrale Bedeutung gewinnen das Qualitätsmanagement der MAT und insbesondere Qualitätskontrollen. Diese beinhalten Kontrollen des Produkthämatokrits bei jeder MAT-Anwendung sowie monatliche gerätebezogene Kontrollen der Eiweiß- bzw. Albuminelimination und des Produkthämatokrits bzw. der Erythrozytenausbeute. Eine Testung auf Infektionsmarker ist nicht erforderlich. Die Anwendung von MAT muss bei den zuständigen Behörden angemeldet werden.
