Biohemijska i funkcionalna ispitivanja kvaliteta koncentrata trombocita
Sažetak
Uvod/Cilj. 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 bio je da se ispita kvalitet KT dobijenih izdvajanjem iz “buffy coat”-a (BC) i izdvojiti faktore koji doprinose poboljšanju kvaliteta i standardizaciji KT. Metode. Ispitivanje je obuhvatilo ukupno 80 KT izdvojenih iz BC prema standardnoj proceduri pripreme u Zavodu za transfuziju krvi u Nišu. Kvalitet KT određivan je na osnovu zapremine produkta i laboratorijskih testiranja prvog (KT1), trećeg (KT3) i petog dana skladištenja (KT5). Određivan je broj trombocita, zaostalih eritrocita i leukocita, parcijalni pritisak kiseonika i ugljen-dioksida (pO2, pCO2), pH, sterilnost i agregacija trombocita izazvana dodavanjem 3,2; 6,4 i 9,6 μg kolagena/mL (impedantna agregometrija). Rezultati. Nađen je statistički značajno manji broj trombocita, pO2, pCO2 i pH u uzorcima KT3 i KT5 (p < 0,001). Osim ispu-njenosti kriterijuma za broj trombocita, svi ostali parametri bili su u saglasnosti sa preporukama Vodiča. Agregacija trombocita za sve koncentracije kolagena pokazala je pad tokom skladištenja, sa statistički značajnom razlikom za uzorke KT3 i KT5 u odnosu na uzorak KT1 (p < 0,01). Postojala je statistički značajna razlika u smanjenju aktivnosti uzoraka KT aktiviranih primenom visokih koncentracija kolegena (6,4 i 9,6 μg kolagena/mL) u odnosu na nižu koncentraciju kolagena (3,2 μg kolagena/mL). Zaključak. Broj trombocita, posmatrani biohemijski parametri i funkcija trombocita statistički se 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.
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