Chinese Expert Consensus on Preoperative Advanced Autologous Apheresis

doi:10.3969/j.issn.1671-2587.2024.02.001

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2024, Vol. 26 ›› Issue (2): 145-155.DOI: 10.3969/j.issn.1671-2587.2024.02.001

Chinese Expert Consensus on Preoperative Advanced Autologous Apheresis

Chinese Blood Transfusion Association Clinical Transfusion Management Committee

Received:2024-03-25 Online:2024-04-20 Published:2024-04-23

Abstract

Abstract: Preoperative Advanced Autologous Apheresis (AAA) is a new type of preoperative autologous blood donation. In recent years, this technology has been introduced in many hospitals across the country. However, there has yet to be a consensus or technical standard for its implementation process and quality control. To address this, the Chinese Blood Transfusion Association Clinical Transfusion Management Committee organized experts from related fields nationwide to extensively and deeply discuss the technical principles, entry requirements, indications, contraindications, operational key points, adverse reaction prevention and treatment, and blood quality evaluation and disposition of preoperative Advanced Autologous Apheresis, and jointly formulated this consensus. The aim is to better manage autologous blood for patients and to provide a basis for medical staff to implement preoperative Advanced Autologous Apheresis more safely and standardized.

Key words: Preoperative autologous blood donation, Autologous erythrocyte apheresis, Autologous platelet apheresis, Quality control, Expert consensus

CLC Number:

R457

Chinese Blood Transfusion Association Clinical Transfusion Management Committee. Chinese Expert Consensus on Preoperative Advanced Autologous Apheresis[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2024, 26(2): 145-155.

References

[1] HIGHMORE W.Practical remarks on an overlooked source of blood-supply for transfusion in post-partum hæmorrhage,suggested by a recent fatal case[J].Lancet,1874,103(2629):89-90.
[2] ZHOU J.A review of the application of autologous blood transfusion[J].Braz J Med Biol Res,2016,49(9):e5493.
[3] FRIEDMAN R,HOMERING M,HOLBERG G,et al.Allogeneic blood transfusions and postoperative infections after total hip or knee arthroplasty[J].J Bone Joint Surg Am,2014,96(4):272-278.
[4] NEWMAN E T,WATTERS T S,LEWIS J S,et al.Impact of perioperative allogeneic and autologous blood transfusion on acute wound infection following total knee and total hip arthroplasty[J].J Bone Joint Surg Am,2014,96(4):279-284.
[5] 欧阳锡林,陈冠伊. 术前自体储血技术:健康自体输血的新模式[J].中国输血杂志,2017,30(12):1321-1323.
[6] SPRAWKA N,YOUNG C,O'BRIEN B. Bombay blood type and use of red cell apheresis during pregnancy[J].Obstet Gynecol,2011,117(2 Pt 2):463-465.
[7] 刘晓敏,张雷英,徐振华,等.单采自体红细胞患者采集前后血红蛋白变化预测模型的建立[J].中国实验血液学杂志,2020,28(5):1726-1732.
[8] 杨金华,陈冠伊,吴靖辉,等.单采深度自体储血技术在低比例血型孕产妇中的应用[J].中国输血杂志,2019,32(6):528-530.
[9] FREE R J,SAPIANO M R P,CHAVEZ ORTIZ J L,et al.Continued stabilization of blood collections and transfusions in the United States:findings from the 2021 National Blood Collection and Utilization Survey[J].Transfusion,2023,63(Suppl 4):S8-S18.
[10] PEHLIC V,VOLKEN T,HOLBRO A,et al.Long-term course of haemoglobin and ferritin values in high-frequency donors of whole blood and double erythrocyte apheresis[J].Transfus Med Hemother,2021,48(2):71-78.
[11] INFANTI L.Red cell apheresis: pros and cons[J].ISBT Science Series,2018,13(1):16-22.
[12] SHI P A,NESS P M.Two-unit red cell apheresis and its potential advantages over traditional whole-blood donation[J].Transfusion,1999,39(2):218-225.
[13] GARCIA GALA J M,RODRIGUEZ VICENTE P,GONZALEZ MUÑIZ S,et al.Utility of red blood cell apheresis in autologous blood donation[J].Transfus Sci,2000,23(1):69-73.
[14] KALFON F,BEAUMONT J L,FOURNEL J J,et al.Une
stratégie transfusionnelle en neurochirurgie:hémodilution préopératoire par érythrocytaphérèse[J].Ann Françaises D’anesthésie De Réanimation,1994,13(6):798-806.
[15] HÖCKER P.Red cell apheresis in autologous preoperative blood donation[J].Transfus Apher Sci,2001,24(1):75-78.
[16] BEAUMONT J L.L'érythroaphérèse préopératoire permet-elle d'éviter la transfusion homologue?[J].Transfus Clin Biol,1994,1(3):209-213.
[17] 张宇,张艳红,陈会欣,等.单采自体储血在多节段腰椎后路椎间融合术中的应用效果研究[J].联勤军事医学,2023,9(9):753-756.
[18] 李凯旋,项伟玲,郝珂,等.择期手术患者术前自体血单采备血的应用研究[J].浙江医学,2022,44(7):724-728.
[19] 陈冠伊,王丽华,吴靖辉,等.单采深度自体储血技术在巨大神经纤维瘤手术中的临床应用研究[J].中国输血杂志,2017,30(12):1333-1336.
[20] 王彦,杨璐,潘纪春.深度自体储血在骨科关节置换术中的应用价值研究[J].临床输血与检验,2019,21(5):462-464.
[21] 王帅,王振芳,王亚,等.自体浓缩红细胞在Rh(D)阴性患者中的应用探讨[J].临床血液学杂志,2019,32(2):149-151.
[22] 周俊,晋晶,武广隆,等.成分单采技术在预存式自体输血中的应用研究[J].中国输血杂志,2016,29(3):239-242.
[23] GUYATT G H,OXMAN A D,VIST G E,et al.GRADE:an emerging consensus on rating quality of evidence and strength of recommendations[J].BMJ,2008,336(7650):924-926.
[24] BROZEK J L,AKL E A,JAESCHKE R,et al.Grading quality of evidence and strength of recommendations in clinical practice guidelines:part 2 of 3.The GRADE approach to grading quality of evidence about diagnostic tests and strategies[J].Allergy,2009,64(8):1109-1116.
[25] KIM M,KIM H S,KIM Y H,et al.Comparison of whole blood collection and double-unit erythrocytapheresis in preoperative autologous blood donation[J].Transfus Apher Sci,2013,49(3):542-547.
[26] ZHANG J L,CHEN X H,HONG J J,et al.Biochemistry of mammalian ferritins in the regulation of cellular iron homeostasis and oxidative responses[J].Sci China Life Sci,2021,64(3):352-362.
[27] HINDAWI S,BADAWI M,HUSSEIN D,et al.The impact of blood donation on blood counts and ferritin levels:a multi-center study from the Eastern Mediterranean Region[J].Transfus Apher Sci,2021,60(3):103072.
[28] MENDRONE A Jr,ARRAIS C A,ALMEIDA NETO C,et al.Impact of allogeneic 2-RBC apheresis on iron stores of Brazilian blood donors[J].Transfus Apher Sci,2009,41(1):13-17.
[29] KOMATSU F,KAJIWARA M.A pilot study of large volume apheresis of red blood cells and plasma during one donation by allogeneic blood donors[J].Transfus Sci,2000,23(1):55-61.
[30] HÖGLER W,MAYER W,MESSMER C,et al.Prolonged iron depletion after allogeneic 2-unit RBC apheresis[J].Transfusion,2001,41(5):602-605.
[31] SHERMAN L A,LIPPMANN M B,AHMED P,et al.Effect on cardiovascular function and iron metabolism of the acute removal of 2 units of red cells[J].Transfusion,1994,34(7):573-577.
[32] MEYER D,BOLGIANO D C,SAYERS M,et al.Red cell collection by apheresis technology[J].Transfusion,1993,33(10):819-824.
[33] WU J H,CHEN G Y,WANG L H,et al.Investigation on the feasibility of large-volume autologous red blood cells donation:a pilot trial in a small cohort of Chinese[J].J Clin Apher,2023,38(4):447-456.
[34] 中国国家标准化管理委员会中华人民共和国国家质量监督检验检疫总局.医院消毒卫生标准[S].2012.
[35] 中华人民共和国国务院.医疗废物管理条例[S].2003.
[36] 中华人民共和国卫生部.临床输血技术规范[S].2000.
[37] 严敏, 郁丽娜, 陈德芝, 等.自体输血[M]//赵桐茂, 杨成民, 刘进.中华输血学.第2版.北京:人民卫生出版社, 2022:494.
[38] 欧洲输血委员会.血液成分的制备、使用和质量保证指南[M].胡伟,译.第20版.北京: 人民卫生出版社, 2020:209-212.
[39] DOUKETIS J D,SPYROPOULOS A C,MURAD M H,et al.Perioperative management of antithrombotic therapy:an American college of chest physicians clinical practice guideline[J].Chest,2022,162(5):e207-e243.
[40] 中华人民共和国国家卫生和计划生育委员会.献血相关血管迷走神经反应预防和处置指南[S].2018.
[41] SMITH K J,JAMES D S,HUNT W C,et al.A randomized,double-blind comparison of donor tolerance of 400 mL,200 mL,and sham red cell donation[J].Transfusion,1996,36(8):674-680.
[42] YUAN S,GORNBEIN J,SMELTZER B,et al.Risk factors for acute,moderate to severe donor reactions associated with multicomponent apheresis collections[J].Transfusion,2008,48(6):1213-1219.
[43] IPE T S,MARQUES M B.Vascular access for therapeutic plasma exchange[J].Transfusion,2018,58(Suppl 1):580-589.
[44] 治疗性单采过程管理与质量控制专家共识编写组.治疗性单采过程管理与质量控制专家共识[J].临床输血与检验,2023,9(1):1-9.
[45] 中华人民共和国国家卫生和计划生育委员会.献血不良反应分类指南[S].2017.
[46] KESHELASHVILI K,O'MEARA A,STERN M,et al.Adverse events and retention of donors of double red cell units by apheresis[J].Blood Transfus,2016,14(5):391-399.
[47] MOOG R.Collection of red blood cell units by apheresis[J].Transfus Apher Sci,2013,48(2):141-143.
[48] GARG K,KAUR P,BEDI R K,et al.Alteration in biochemical parameters during plateletpheresis in healthy donors:a compendious analysis[J].Transfus Clin Biol,2021,28(3):239-245.
[49] 姚欢,刘晓敏,田静,等.单采自体红细胞患者发生不良反应的危险因素分析[J].陆军军医大学学报,2022,8(8):842-846.
[50] 南党斌,陈莉,雷蕾,等.单采血小板献血者不良反应的综合因素分析[J].中国输血杂志,2022,35(6):633-636.
[51] 吴洁玲. 机采献血者献血不良反应的原因及预防和处理[J].中国实用医药,2020,15(11):153-154.
[52] LOKHANDE T,THOMAS S,KUMAR G,et al.The play of citrate infusion with calcium in plateletpheresis donors[J].Indian J Hematol Blood Transfus,2021,37(2):295-301.
[53] 周虹, 赵敬湘.血浆代用品[M].//赵桐茂, 杨成民, 刘进.中华输血学.第2版.北京:人民卫生出版社, 2022:868.
[54] 王鸿捷. 献血者铁缺乏:现状与管理[J].中国输血杂志,2021,34(1):1-4.
[55] 郭瑾,施欣,王瑞,等.北京地区全血献血者铁蛋白调查分析[J].中国输血杂志,2021,34(1):4-7.
[56] 李继红,孙晨,虞菲,等.单采血小板捐献者捐献频次对血红蛋白和血清铁蛋白变化的影响[J].哈尔滨医药,2024,44(1):60-62.
[57] SWEEGERS M G,ZALPURI S,QUEE F A,et al.Ferritin measurement IN Donors-Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND'EM):study protocol for a stepped wedge cluster randomised trial[J].Trials,2020,21(1):823.
[58] TOLKIEN Z,STECHER L,MANDER A P,et al.Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults:a systematic review and meta-analysis[J].PLoS One,2015,10(2):e0117383.
[59] PIPERNO A,GIRELLI D,NEMETH E,et al.Blunted hepcidin response to oral iron challenge in HFE-related hemochromatosis[J].Blood,2007,110(12):4096-4100.
[60] MORETTI D,GOEDE J S,ZEDER C,et al.Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily doses in iron-depleted young women[J].Blood,2015,126(17):1981-1989.
[61] LIN L,VALORE E V,NEMETH E,et al.Iron transferrin regulates hepcidin synthesis in primary hepatocyte culture through hemojuvelin and BMP2/4[J].Blood,2007,110(6):2182-2189.
[62] MAST A E,SZABO A,STONE M,et al.The benefits of iron supplementation following blood donation vary with baseline iron status[J].Am J Hematol,2020,95(7):784-791.
[63] 毛凯,马怡璇,潘红春,等.新型静脉补铁剂的研究进展[J].中国新药杂志,2015,24(6):659-663.
[64] IKEDA T,TERADA R,NAGURA Y,et al.High-dose intravenous iron supplementation after preoperative autologous blood donation is useful to prevent post-donation/preoperative anemia[J].Transfus Apher Sci,2022,61(3):103348.
[65] 赵晋英,李艳伟.铁代谢红细胞系调节因子与铁稳态[J].中国生物化学与分子生物学报,2019,35(5):486-492.
[66] 中华人民共和国卫生部.全血及成分血质量要求[S].2012.
[67] 欧洲输血委员会.血液成分的制备、使用和质量保证指南[M].胡伟,译.第20版.北京: 人民卫生出版社, 2020:150-151.
[68] BOHONEK M,PETRÁS M,TUREK I,et al.Quality evaluation of frozen apheresis red blood cell storage with 21-day postthaw storage in additive solution 3 and saline-adenine-glucose-mannitol:biochemical and chromium-51 recovery measures[J].Transfusion,2010,50(5):1007-1013.
[69] CHEN Q,CHEN G Y,CHEN J M,et al.Effect of large volume red blood cell apheresis on cardiovascular functions in healthy donors[J].Eur J Clin Invest,2023,53(11):e14047.

Chinese Expert Consensus on Preoperative Advanced Autologous Apheresis

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[5]	LIANG Ruo-hu, HUANG Yan, DENG Jin-lian, et al. A Feasibility Study on Preparation of Cryoprecipitation with Dewhite Plasma [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2019, 21(2): 134-137.
[6]	DONG Hui-jun, FAN Ren-zhi, ZHOU Hong-yan, et al. Analysis of the On-spot Inspection Results of Specimens from External Quality Assessments in Hospitals of Anhui [J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2019, 21(1): 96-99.
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