供体红细胞输血在DCD肝移植中应用的技术改进和效果

Technical improvement and effect of donor red blood cell transfusion in liver transplantation with donation after citizen death

目的探讨公民逝世后捐献(DCD)供体血液采集的改进方法和效果。方法回顾性收集2020年5月至2021年1月期间四川大学华西医院移植团队对供体血液采集及处理方法改进前即Ⅰ期临床试验以及2021年9月至2021年11月期间血液采集及处理方法改进后的供体的临床病理资料。结果与Ⅰ期临床试验数据比较,改进技术之后,血液采集量和经过自体回收机过滤、离心、洗涤之后获得浓缩红细胞悬液量以及获得红细胞悬液量/kg体质量更多(P<0.05)。此外,与库存红细胞悬液的成分比较,经过改进技术后获得的红细胞悬液的p H值、钠离子和氯离子浓度均更高(P<0.05)且钾离子浓度均<1 mmol/L,无一例乳酸浓度>15 mmol/L。结论经过改进技术后能增加供体红细胞血液的采集量,其生化、电解质等指标较库存血更加符合生理要求。

Objective To explore modified methods and outcomes of collection of donor blood from donation after citizen death(DCD). Method The clinicopathologic data of 26 DCD donors underwent phase Ⅰ clinical trials and6 patients who received donor blood by modified collection technique from May 2020 to November 2021 in the West China Hospital of Sichuan University were collected retrospectively. Results Compared with the data of 26 DCD donors at phase Ⅰ clinical trials, after the modified collection technique, the blood collection volume, the concentrated red blood cells following filtration, centrifugation, and the amount of concentrated red blood cell/kg body mass were more(P<0.05).In addition, compared with the components of stored red blood cell suspension, the pH value, sodium and chloride ions concentrations of the red blood cell suspension obtained after modified collection technique were higher(P<0.05), the potassium ion concentration was <1 mmol/L, and the lactic acid concentration of none of blood was >15 mmol/L.Conclusion The adoption of the modified collection technique increases the amount of donor red blood collected, and its biochemical and electrolyte indicators are more in line with physiological requirements than those of stored blood.