• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2019.tde-29112019-152520
Document
Author
Full name
Mario Ivo Serinolli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2001
Supervisor
Committee
Llacer, Pedro Enrique Dorlhiac (President)
Guerra, Celso Carlos Campos
Bydlowski, Sergio Paulo
Chiattone, Carlos Sérgio
Giglio, Auro Del
Title in Portuguese
Estudo do método da extração da camada leucoplaquetária na produção de hemocomponentes: avaliação clínica e laboratorial
Keywords in Portuguese
Ensaios clínicos controlados
Métodos
Reprodutibilidade de resultados
Transfusão de componentes sanguíneos/métodos
Abstract in Portuguese
Dentre os métodos para a obtenção de hemocomponentes destaca-se o método do plasma rico em plaquetas (PRP), o mais utilizado no Brasil, e o método da extração da camada leucoplaquetárla (ECLP), muito utilizado na Europa. Este estudo tem por objetivo descrever, padronizar e validar o método da ECLP e compara-lo através de parâmetros laboratoriais e estudo clínico com o método do PRP. A metodologia do estudo constitui-se de quatro etapas. Na primeira foram coletadas 88 bolsas triplas CPDA1, sendo os componentes obtidos pelo método do PRP. Na segunda etapa validou-se o método da ECLPT automatizado com bolsas triplas CPD-SAGM tipo "top and bottom"(TAB), bem como a produção de plaquetas a partir de um conjunto de 4 e 5 unidades de CLP. Na terceira etapa do estudo validou-se o método da ECLPQ com bolsas quádruplas CPD-SAGM TAB e produção de CP a partir de uma unidade de CLP. O estudo clínico foi realizado na quarta etapa deste trabalho, após implantação na rotina do Hemocentro do método da ECLP escolhido por comparação dos estudos descritos na segunda e terceira etapas deste trabalho. Os resultados foram respectivamente para o PRP ECLPT e ECLPQ: Hb total por unidade de CH: µ=64,6±6,3 g/bolsa, µ=58.4±5,0 g/bolsa e µ=53,5±8.6 g/bolsa (p < 0,05); recuperação de hemoglobina no CH: 108,3±4,3. 89,2±9,5% e 90,5±1 ,7 (p=0,0001); leucócitos no CH: µ=3.0±0,9 x109, µi=0,8±0,6 x109 e µ=0,5±0,3 x109 (p < 0,05); depleção de leucócitos no CH µ=85,2±12,8%, µ=76.8±14,0% e µ=74,8±14,6% (p=0,0001); volume de plasma µ=174.6±26,3 ml, µ=203,9±17,0 ml e µ=214,5±22,1 ml (p=0,0001); recuperação de plasma: µ=72±3,9%, µ=73,9±2,4%, µ=79,1±6,2% ( p < 0,05); plaquetas no CP: µ=7.3±1,5 x 1010, µ=7.2±1,3 x 1010, µ=6.8±0.8 x 1010 (p > 0,05); "swirling" do CP: µ=3,0±0,1, µ=2,6±0,5 e µ=3,0±0,0 (p=0,0001); pH no CP: µ=7,4±0,2, µ=6,9±0,2 e µ=7,3±0.1; leucócitos no CP: µ=36,1±20, 9.1±4,3x106 e µ=1,1±0.5x106 (p < 0,0001). Os resultados do estudo clínico demonstraram que 2.4% dos episódios de transfusão com CH-ECLP foram acompanhados de reações adversas vs 8,0% com CH-PRP (p=0,001), resultando em "odds ratio" de 3,46 vezes (IC 95%, 2,34 a 5,12). Nos pacientes que receberam CP-ECLP apresentaram reações transfusionais em 11,8% vs 16,7% nos pacientes que receberam CP-PRP (p > 0,05). Concluímos que o sistema Optipress® com a utilização de bolsas TAB quádruplas permite adequada padronização e operacionalização em nosso meio, melhorando a qualidade dos componentes obtidos que possuem menor quantidade de leucócitos e plasma, proporcionando benefícios clínicos com menor incidência de reações adversas pós-transfusionais
Title in English
Clinical and laboratory evaluation of buffy-coat removal method for hemocomponents production
Keywords in English
Ensaios clínicos controlados
Métodos
Reprodutibilidade de resultados
Transfusão de componentes sanguíneos/métodos
Abstract in English
Among the methods to obtaín blood components detach platelet rich plasma (PRP), which is the most used in Brazil, and the buffy-coat removal (BC), widely used in Europe. The purpose of this study is not only to describe, standardize and validate the BC but algo to compare its method with the PRP. This study had four phases. In the first one, 88 CPDA-1 triple blood uníts were collected and its components obtained by PRP method. In the second phase, BC automated system (OptipressrTM) using CPD-SAGM triple top and bottom (TAB) blood units was validated (BCT), as well as platelets concentrate (PC) production from pool of four or five buffy-coat units. In the third study phase, BC method with quadruple CPD-SAGM TAB blood units (BCQ) and PC production from one buffy-coat unir was validated. Clinical evaluation was performed in the fourth phase, after Introducing the BC method in the routine of Hemocentro de São Paulo. Adverse transfusion reactions to blood components obtained from BC method were compared to those from PRP method. The results for PRP, BCT and BCQ were total Hb per RBC unit: µ =64.6±6.3g/unit, µ =58.4±5.0g/unit and µ =53.5t8.6g/unit (p < 0.01); percentage of hemoglobin recovery from a RBC unit: µ =108.3±4.3, 89.2±9.5 and .90.5±11.7 (p=0.0001); residual leukocytes in the RBC unit µ =3.0±0.9 x 109, 0.8±0.6 x 109 and 0,5±0.3 x109 (p < 0.05); leukocyte depletion in the RBC unit: µ =85.0±12.8%, µ =76.8t14.0% and µ=74.8±14.6% (p=0,0001) plasma volume: µ =174 ± 26.3ml, µ =203.9 ± 17.0 ml and µ=214.5 ± 22.1ml (p=0.0001); plasma recovery: µ=72±3.9%, µ=73.9±2.4% and µ=79.1±6.2% (P < 0.05); platelets in platelet concentrates( PC): µ=7.3±1.5 x 1010, µ=7.2±.13 x 1010, and µ=6.8±0.8 x 1010 (p > 0.05); swirling of PC: µ=3.0±0.1, µ=2.6±0.5 and µ=3.0±0.0 (p=0.0001); pH in PC: µ=7.4±0.2, Ø=6.9±0.2 and µ =7.3±0.11 residual leukocytes in PC: µ=36.1±20.8 x 106, µ =9.1±4.3 x 106 and 1.1±0.5 x 106. Clinical study's results showed that 2.4% of the transfusion episodes with BC-RBCs were accompanied of adverse reactions vs. 8% with PRP-RBCs (p=0.001), resulting in "odds-ratio" of 3.46 times (CI 95%- 2.34 to 5.12). Patients that received BC-PC had transfusion reactions of 1 1.8% vs. 16.7% in the ones who received PRP-PC IP > 0,05). We conclude that the OptipressTM system with quadruple TAB blood units allows adequate standardíze and use in our blood center, improving the quality of the components obtained because of lower quantlty of leukocytes and plasma comparing to PRP method, providing clinical benefits with lower rate of posttransfusion adverse reactions
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
MarioIvoSerinolli.pdf (12.71 Mbytes)
Publishing Date
2019-11-29
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.