Title (srp)

Uticaj termina inaktivacije patogena primenom riboflavina i ultravioletnog ozračenja na integritet konstituenata plazme u zamrznutoj svežoj plazmi

Author

Jovičić-Gojkov, Dragana, 1967-

Contributor

Vučetić, Dušan, 1961-
Arsenijević, Nebojša, 1958-
Bálint, Béla, 1952-
Vojvodić, Danilo, 1963-

Description (eng)

Treatment of frozen fresh plasma (FFP) with riboflavin and ultraviolet (UV) radiationinhibits the replication of nucleic acids of pathogens and leukocytes (Le). The MirasolPathogen Reduction System (Mirasol-PRT), unlike other pathogen inactivation systemsmainly used in pooled plasma, is used to inactivate individual FFP units and platelets,which are then ready for immediate clinical use. This study compared the effect of theMirasol-PRT system on the protein content in FFP if it is "inactivated" immediately afterseparation from the whole blood unit, and before storage and if it is treated after storage ina frozen state, ie. after thawing, and immediately before application. Plasma unitsseparated from whole blood by centrifugation are: a) inactivated and frozen - previousinactivation [PI] or control group and b) immediately frozen, and after a certain time,thawed and inactivated - subsequent inactivation [SI] or experimental group. Inactivationwas performed with Mirasol-PRT system. The following biochemical parameters weretested using appropriate laboratory techniques and adequate equipment: urea, creatinine(Cr), total bilirubin (TB), triglycerides (Tgl), cholesterol (Chol), potassium (K), sodium(Na), iron (Fe), aspartate aminotransferase (AST), alanine aminotransferase (ALT),gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), osmotic pressure(Osm-P), total proteins and albumins, immune parameters (IgM, IgG, IgA) andcomplement components C3 and C4, with CH50 activity and procoagulant (FII, FV, FVII,FVIII, FIX, FX) and anticoagulant (antithrombin III (АТ-III), protein C (PC), protein S(PS) и α2-antiplasmin (α2-AP)) factors. Our results show that there is no significantchange in the final concentrations of biochemical parameters - proteins, immunoglobulinsand other constituents in both groups. The expected decrease in coagulation factor levelsis present in both groups, as already shown in other papers. Finally, good recovery ofnatural inhibitors was found without significant differences between groups except fotАТ-III which recovery is better in experimental group. We have thus shown that thesubsequent inactivation of FFP, according to the needs of patients, ie the appropriateblood groups, is not inferior to the classical method of previous inactivation, whichinvolves randomly selected units. Such a protocol would significantly reduce the cost ofuse of relatively expensive technology because the FFP would be inactivated targeted, fora specific patient, not randomly. It would also avoid the possibility of rejecting previouslyinactivated plasma units in case they are positive for markers оf transfusion transmittedinfections.

Description (srp)

Tretman zamrznute sveže plazme (ZSP) riboflavinom i ultravioletnim (UV)zračenjem inhibira replikaciju nukleinskih kiselina patogena i leukocita (Le).Sistem za redukciju patogena Mirasol (Mirasol-PRT) se, za razliku od ostalihsistema za inaktivaciju patogena koji se uglavnom primenjuju kod pulirane plazme,koristi za inaktivaciju pojedinačnih jedinica ZSP i trombocita, koje su posletoga spremne za neposrednu kliničku upotrebu. U ovoj studiji je upoređen efekatMirasol-PRT sistema na sadržaj proteina u ZSP ako se ona „inaktiviše”neposredno posle izdvajanja iz jedinice cele krvi, a pre skladištenja i ukoliko jetretirana nakon skladištenja u zamrznutom stanju, tj. posle odmrzavanja, aneposredno pre aplikacije. Jedinice plazme izdvojene iz cele krvicentrifugiranjem su: a) inaktivisane i zamrznute - prethodna inaktivacija [PI]ili kontrolna grupa i b) odmah zamrznute, a posle određenog vremena, odmrznute iinaktivisane - naknadna inaktivacija [NI] ili eksperimentalna grupa.Inaktivacija je urađena Mirasol-PRT sistemom. Korišćenjem odgovarajućihlaboratorijskih tehnika i adekvatne opreme ispitivani su sledeći biohemijskiparametri: urea, kreatinin (Cr), ukupni bilirubin (TB), trigliceridi (Tgl),holesterol (Chol), kalijum (K), natrijum (Na), gvožđe (Fe), aspartataminotransferaza (AST), alanin-aminotransferaza (ALT), gama glutamiltranspeptidaza (GGT), laktat-dehidrogenaza (LDH), osmotski pritisak (Osm-P),ukupni proteini (ukupni) i albumini, imunski parametri (IgM, IgG, IgA ikomponente komplementa C3 i C4, uz aktivnost CH50) i prokoagulantni (FII, FV,FVII, FVIII, FIX, FX) i inhibitorni (AT-III, protein C (PC), protein S (PS) i α2-antiplazmin (α2-AP)) faktori hemostaze. Naši rezultati pokazuju da nemaznačajne promene u finalnim koncentracijama biohemijskih parametara –proteina, imunoglobulina i ostalih konstituenata u obema grupama. Očekivanosniženje nivoa faktora koagulacije prisutno je u obe grupe, kako je to već pokazanou drugim radovima. Najzad, utvrđen je dobar oporavak inhibitora koagulacije bezznačajnijih razlika između grupa osim za AT-III koji ima bolji oporavak ueksperimentalnoj grupi. Ovim smo pokazali da naknadna inaktivacija ZSP, premapotrebama pacijenata, dakle odgovarajućih krvnih grupa, nije inferiorna u odnosuna klasičan način prethodne inaktivacije koja podrazumeva nasumično izabranejedinice. Ovakav protokol bi značajno smanjio troškove primene relativno skupetehnologije, jer bi se ZSP inaktivisala ciljano, za konkretnog bolesnika, a nenasumično. Takođe bi se izbegla mogućnost odbacivanja prethodno inaktivisanihjedinica plazme u slučaju da na testiranju budu pozitivne na markere transfuzijomprenosivih infekcija.

Description (srp)

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Object languages

Serbian

Date

2021

Rights

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