Re:열모의고사 14에 질문있어서요 ^^ 가르쳐주세요 ㅎ

[김나래]

답변 드립니다... 밑에 첨부한 내용은 wikipedia에서 참고한 내용인데요

Blood transfusion을 위해 혈액을 준비할 때 왜 leukoreduction을 하는지에 대해 나와있습니다.

빨간색으로 표시한 부분이구요...

그러니까 febrile nonhemolytic reaction이라고 했으면 더 정확한 질문이 됐을라나요?

여튼... neutrophil 때문에 때론 열성 부작용을 일으키기도 한다는 거 알고 계실 것입니다.

그걸 이유로 답이 d가 된 것 같습니다.

도움이 되셨길...

Processing of blood prior to transfusion

Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations. Examples include:

• Component separation: red cells, plasma and platelets are separated into different containers and stored in appropriate conditions so that their use can be adapted to the patient's specific needs. Red cells work as oxygen transporters, plasma is used as a supplement of coagulation factors, and platelets are transfused when their number is very scarce or their function severely impaired. Blood components are usually prepared by centrifugation. Centrifuge force makes the red cells, leukocytes, plasma and platelets form different layers into the blood bag, according to their different densities. Then, the blood bag is processed to separate those layers into their final container. Temperature also plays a capital role into component storage: plasma must be frozen as soon as possible −18 °C (−0.4 °F) or colder, red cells must be refrigerated (1-6°C, 34-43°F) and platelets are kept in continuous shaking platforms at room temperature (20-24°C, 36-75°F). There are several component preparation techniques, but two methods are common for Whole Blood derived platelets: the platelet rich plasma separation technique (mostly used in the USA) and the coat technique (outside the USA).
• Leukoreduction, also known as Leukodepletion is the removal of white blood cells from the blood product by filtration. Leukoreduced blood is less likely to cause alloimmunization (development of antibodies against specific blood types), and less likely to cause febrile transfusion reactions. Also, leukoreduction greatly reduces the chance of cytomegalovirus (CMV) transmission. Leukoreduced blood is appropriate for:
  • Chronically transfused patients
  • Potential transplant recipients
  • Patients with previous febrile nonhemolytic transfusion reactions
  • CMV seronegative at-risk patients for whom seronegative components are not available

Some blood banks routinely leukoreduce all collected blood. There is some evidence that this reduces the risk of CJD transmission.

• Irradiation. In patients who are severely immunosuppressed and at risk for transfusion-associated graft-versus-host disease, transfused red cells may be subjected to irradiation with a targeted dose of 25 Gy, at least 15 Gy, to prevent the donor T lymphocytes from dividing in the recipient.^[8] Irradiated blood products are appropriate for:
  • Patients with hereditary immune deficiencies
  • Patients receiving blood transfusions from relatives in directed-donation programs
  • Patients receiving large doses of chemotherapy, undergoing stem cell transplantation, or with AIDS (controversial).
• CMV screening. Cytomegalovirus, or CMV, is a virus which infects white blood cells. Many people are asymptomatic carriers. In patients with significant immune suppression (e.g. recipients of stem cell transplants) who have not previously been exposed to CMV, blood products that are CMV-negative are preferred. Leukoreduced blood products sometimes substitute for CMV-negative products, since the removal of white blood cells removes the source of CMV transmission (see leukoreduction above). The target for leukoreduction is <5x10^6 residual leukocytes for a full unit of Red Blood Cells, and the same amount of unfiltered blood has on the order of 10^9 leukocytes, so this reduces but does not elimate the risk.

[강효찬]

^.^ 역시 대단하십니다....

[유현e]

감사합니다 ^^

[김나래]

저도 몰라서 찾아봤어요.^^;;