Leukocyte Filter Filtration Process

Introduction

With the continuous improvement of medical technology, the scope of clinical transfusion and component transfusion treatment is expanding, and people pay more attention to blood quality, transfusion efficacy and transfusion safety. Conventional transfusion mode is no longer suitable for clinical requirements. At present, various common blood and blood components contain a large number of leukocytes and inflammatory cytokines, which can often cause non-hemolytic fever and allogeneic immune reactions. The use of disposable leukocyte filters to remove leukocytes can reduce and avoid graft-versus-host disease and viral infection caused by transfusion, prevent or eliminate transfusion-related immunosuppression syndrome, reduce transfusion-related thrombocytopenia, prolong organ transplant rejection, and enhance the treatment effect of malignant tumors. The removal principle is that when leukocytes pass through the filter disc, they are removed by mechanical blocking and adsorption, while red blood cells with smooth surface and strong deformation ability can pass through the filter with a pore size of 3μm.

The filtration effect and blood quality of blood are affected by many reasons such as environment, flow rate, operating action amplitude, leukocyte deformation and easy crushing of red blood cells when passing through the filter.

Therefore, it is particularly important to overcome the above factors, ensure the quality of the leukocyte filtration process and the clinical transfusion treatment effect, and ensure the safety of transfusion. Here are some experiences in the leukocyte filtration process.

Guarantee of working environment

(1) Storage of blood samples. Immediately store the collected fresh blood or prepared suspended red blood cells in a refrigerator at 2~6°C and perform filtering operations within 3~24 hours.

(2) Pay attention to temperature changes. The filtration operation must be carried out in the leukocyte filter cabinet. When the temperature reaches 2~10°C, start the leukocyte filtration of the blood; during the blood filtration process, pay attention to the temperature changes of the leukocyte filter cabinet at any time and keep temperature records.

(3) Pay attention to aseptic operation. Before each work, a dedicated person should turn on the air disinfection equipment for 30~40 minutes, and start the laminar flow device at the same time. After work, clean the clean room (table) and wipe the work surface, instruments and floor with 1:1000 new chlorhexidine. If contaminated by blood, they should be disinfected in time. Ventilate and sterilize with air for 30~40min.

Mix thoroughly and pay attention to the flow rate

To ensure uniform blood flow rate during the filtration process and prevent excessive red blood cell concentration from clogging the filter disc or slow flow rate, the blood in the mother bag must be gently and thoroughly mixed and then hung in the leukocyte filter cabinet. The hanging height is just enough to make the target transfer bag lie flat on the table (check the sample barcode and blood bag barcode for consistency before performing leukocyte filtration operation). Adjust the blood flow rate control switch so that the blood flow rate in the drip bucket can be identified by the naked eye (140~180 drops/min). 200ml whole blood is filtered within 8~10min; 300ml whole blood is filtered within 10~15min; 400ml whole blood is filtered within 15~20min and then heat-sealed and sent to a (4±2) °C refrigerator for storage.

Gentle operation to prevent hemolysis

During the filtration operation, pay attention to the gentle handling of blood. Do not use too much force when removing excess air in the target bag. The position of the target bag and the mother bag should be at the same level as much as possible to prevent shaking, excessive pressure and excessive flow rate from causing red blood cell fragmentation and hemolysis.

Pay attention to process control to ensure the quality of blood components

All blood component preparation labels must be clear and complete, and firmly affixed during the entire preparation process; the blood donation barcode must be checked before the original bag and transfer bag are separated; all relevant records must be kept during the preparation of all blood components. After the preparation is completed, it should be handed over to the blood supply department in time for storage according to different varieties and handover records should be kept. Medical waste should be handled in a timely manner (daily production and daily clearance), and records should be kept. Blood components should be prepared using a joint bag or a sterile take-over machine. Without destroying the closed system, blood components must be prepared outside the clean room, or the take-over machine can be used for docking and then filtering.

Conclusion

Transfusion of whole blood or blood components containing leukocytes will cause non-hemolytic fever, HLA alloimmunization, transfusion-related viral infection, and post-transfusion graft-versus-host disease and other transfusion side effects.

Leukocyte-removing transfusion filters provide a simple and effective method for selectively filtering leukocytes from blood.

Studies have shown that the clinical efficacy of filters that remove leukocytes from whole blood before storing blood components has been clinically verified and fully affirmed. Integrating leukocyte-removing filters into multi-link blood bag systems to first filter out leukocytes from whole blood and then separate and store blood components is the most commonly used method. After the filtered whole blood is separated from the blood components, leukocyte-removing red blood cell suspension and plasma can be obtained at the same time. To ensure the quality of blood, the above requirements must be met during the filtration process to ensure the safety of clinical transfusion.

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