JP2015134219A - System and method for collecting platelets and predicting plasma reinfusion - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood processing system for collecting plasma-reduced platelets and predicting plasma reinfusion.SOLUTION: The blood processing system comprises a vein access device 24, a blood component separation device 12, a first blood reinfusion line 28, a recirculation line 43, and a second blood reinfusion line 93. The vein access device uses a first pump P1 to collect blood from a subject and reinfuses the blood components to the subject. The blood component separation device separates the collected blood into first blood components and second blood components, and transfers the first blood components to a first blood component bag 18. The first blood reinfusion line connects fluidly the vein access device and the blood component separation device. The recirculation line connects the first blood component container and the separation device. The second blood reinfusion line connects fluidly the first blood component container and the first blood reinfusion line, and reinfuses the first blood components in the first blood container to the subject.

Description

  The present invention relates to systems and methods for blood processing and blood component collection, and more particularly to systems and methods for predicting platelet collection and plasma return.

  Apheresis is a procedure that can separate and collect individual blood components from whole blood temporarily removed from a subject. Typically, whole blood is drawn through a needle inserted into a subject's arm vein and introduced into a cell separator such as a centrifuge bowl. Once whole blood is separated into its various components, one or more components are removed from the centrifuge bowl. The remaining components can be returned to the subject along with compensation liquid to make up the volume of the removed components. This blood removal and return process continues until the desired amount of component has been collected, at which point the process stops. An important feature of apheresis is that components that are processed but not desired are returned to the donor. The blood components that are separated may include high density components such as red blood cells, intermediate density components such as platelets or white blood cells, and lower density components such as plasma.

Among the various blood component products obtained by apheresis, the demand for plasma-reduced platelets is rapidly increasing. This is especially true for cancer treatments where the patient needs to receive more platelets with reduced hematopoietic function but does not require the patient to transfuse the plasma used to suspend the platelets. This is because of the development. Platelets are large cell fragments located in the bone marrow called megakaryocytes, and basically contribute to hemostasis by performing a coagulation action. Platelets also play a role in tissue repair. The normal platelet count in adults is between 150,000 and 400,000 / mm ³ . Platelet counts less than 20,000 / mm ³ cause various troubles such as spontaneous bleeding.

  Platelets have a short half-life of 4-6 days and the number of donors is limited. Therefore, it is important to collect the necessary amount of platelets with the highest yield from whole blood supplied by the donor in the production of plasma-reduced platelet preparations. In addition, leukocyte contamination in plasma-reduced platelet preparations can cause serious medical complications such as GNH reaction. It is therefore very important to keep leukocyte contamination levels as low as possible while efficiently collecting platelets. Various techniques have been developed for this purpose. For example, after whole blood has been collected and centrifuged in a centrifuge to higher density, intermediate density and lower density components, and plasma has been collected (a so-called retrieval step), the “surge” technique Is used to supply plasma in a centrifuge at a surge flow rate (eg, the flow rate increases over time). By performing a surge, platelets can be preferably separated from intermediate density components (mainly present as a buffy coat containing a mixture of platelets and leukocytes), and plasma-reduced platelet products are more Produced in increased yield.

Instead of using surge technology, the platelet layer is centrifuged by a layer “extrusion” method in which anticoagulated whole blood is introduced into the bowl until the platelet layer is extruded, or by using a combination of surge and extrusion methods. Can be extracted from the machine. After collecting the desired components, the remaining blood components, mainly containing red blood cells and citrated plasma, are returned to the donor (so-called “return” step).

  As noted above, in many blood apheresis means and applications, unwanted components (eg, components that are not collected) are returned to the donor. In addition to contamination concerns (eg contamination such as microparticles returned to the donor), subject comfort should also be considered. For example, returning the citrate plasma too rapidly to the subject or returning too much citrate plasma to the subject at one time results in significant discomfort to the patient. Furthermore, it should be noted that it limits the volume of fluid outside the body (eg, extracorporeal volume) and / or the reduction of fluid inside the body (eg, loss in blood vessels).

  According to one embodiment of the invention, a method is provided for plasma-reduced platelet collection and prediction of plasma return. Whole blood is first removed from the donor, anticoagulated and introduced into the separation chamber. The separation chamber separates the anticoagulated whole blood into several blood components. The method then transfers plasma separated from the anticoagulated whole blood to the plasma container and returns the first volume of plasma from the plasma container to the donor. The method repeats the removal, anticoagulation, introduction, and transfer steps to fill the separation device with additional anticoagulated whole blood.

  Once anticoagulated whole blood is introduced into the separation chamber (eg, fills the chamber), the method removes platelet rich plasma (“PRP”) from the separation chamber (eg, the surge eluting method and / or (Or using a surge from plasma) and then into a PRP container. The method can return blood components remaining in the separation chamber to the donor, and the removal and anticoagulation and introduction steps can be repeated again to partially fill the separation device with anticoagulated whole blood. Once the separation device is partially filled, the method reintroduces PRP from the PRP container to the separation chamber, transfers plasma from the separation chamber to the plasma container, and reprocesses and separates the reintroduced PRP. Create an enlarged layer of platelets in the device.

  According to certain embodiments, the method predicts the return of plasma and returns the plasma in the plasma container to the donor, while introducing the PRP into the separation chamber and / or reprocessing the PRP. The method repeats the removal, anticoagulation and introduction steps to fill the separation chamber, removes an enlarged layer of platelets in the separation device using a surge eluting method, and the platelets are transferred to the platelet container. You can do so. The method can then return blood components left in the separation chamber to the donor.

  According to related embodiments, the method can also be performed from the plasma container during the dead time, during which time the apheresis procedure being performed has not removed blood or blood components from the donor or returned blood to the donor. Plasma can be returned to the donor. Further, the method can calculate extracorporeal volume and / or intravascular loss, and the first volume of plasma returning to the donor is based at least in part on the calculated extracorporeal volume or intravascular loss.

  According to another embodiment of the present invention, a system for collecting plasma-reduced platelets and predicting return of plasma includes a venous access device, a blood component separator, a first return line, a recirculation Line, and a second blood return line. The venous access device is configured to remove whole blood from a subject in a first volume and return blood components to the subject using a first pump. A blood component separation device (eg, a centrifuge bowl) separates the removed blood into a first blood component (eg, plasma) and a second blood component (eg, platelets), and the first blood component is the first blood component. Transferred to the bag and configured to transfer the second blood component to the second blood component bag.

  The first blood return line is configured to fluidly connect the venous access device and the blood component separator and return blood components left in the separator to the subject. The recirculation line connects the first blood component container and the separation device. The second blood return line is configured to fluidly connect the first blood component container and the first blood return line and return the first blood component in the first blood container to the subject. The first blood component in the first blood component container can also be reintroduced into the separation chamber by a recirculation line and a recirculation pump.

  The first pump may return the first blood component in the first blood component container as well as the blood component left in the separation device to the subject. The separation device can also separate the whole blood into a third blood component (eg, red blood cells) in addition to the first and second blood components, and the blood component left in the separation device removes the third blood component. May be included.

  In certain embodiments, the second blood component may be removed from the separation device by a surge eluting method. The surge elutriation method includes reintroducing the first blood component into the blood component separation device while accelerating it through the reintroduction line until the second blood component is removed from the blood component separation device. The second blood component may be platelets, and a predetermined amount of platelets is collected in the second blood container, and the plasma reduced platelet product is extracted from the separator to the blood component separator. And can be reintroduced.

  The system can also include an anticoagulant line and a reintroduction line. The anticoagulant line is connected to an anticoagulant source and can introduce anticoagulant into the removed blood. The reintroduction line may fluidly connect the second blood component bag and the blood component separator. The second blood component in the second blood component bag is a blood component when a second volume of whole blood is removed from the subject to create an enlarged layer of the second blood component in the blood component separator. It can be reintroduced into the separation device. The expanded layer of the second blood component can be removed from the blood component separation device using a surge-ltriation method.

  When the second blood component is reintroduced into the blood component separator and / or during dead time, the system can return the first blood component to the subject. The system may also include a controller that calculates at least one of extracorporeal volume and intravascular loss. The system can return blood through a second return line of a fixed volume of the first blood component based on the calculated extracorporeal volume or intravascular loss.

  According to a further embodiment of the present invention, a system for collecting plasma-reduced platelets comprises: (1) means for removing a first volume of whole blood from a subject and returning blood components to the subject; 2) Blood component separation means for separating the taken blood into a first blood component and a second blood component, (3) means for taking out the first volume of whole blood, blood component separation means, and separation means First blood return means in fluid connection with means for returning blood components left therein to the subject; (4) recirculation means in fluid connection between the second blood component container and the separation means; and (5) A second blood return means for fluidly connecting the first blood component means and the first blood return means may be included. The blood component separating means may be configured to transfer the first blood component to the first blood component bag and transfer the second blood component to the second blood component bag. The recirculation means may reintroduce the second blood component in the second blood component container into the separation means. The second blood return means may be configured to return the first blood component in the first blood container to the subject.

  The means for withdrawing whole blood may include a first pump configured to return the first blood component in the first blood component container to the subject. The first pump may also return blood components left in the separation means to the subject.

  According to further embodiments, the system may include a controller for controlling the flow of liquid in the system. The controller repeatedly removes whole blood from the donor to the separation means, repeatedly extracts the first and second blood components from the separation means, and repeats the first blood component to the subject using the second blood return means. Blood can be returned and the components left in the separation means can be repeatedly returned to the subject using the first blood return means. Furthermore, after a predetermined amount of the second blood component is sequestered in the second blood component container, the second blood component from the second blood component container can be reintroduced into the separating means. The controller can also calculate extracorporeal volume and / or intravascular loss, and the amount of plasma returned using the second return means is based (at least in part) on the extracorporeal volume and / or intravascular loss.

  Further, the system may also include means for introducing an anticoagulant into the removed whole blood, and the reintroduction means fluidly connects the second blood component bag and the blood component separation means. When the second volume of whole blood is removed from the subject to create an enlarged layer of the second blood component in the blood component separating means, the second blood component in the second blood component bag is blood component separated. It can be reintroduced into the means. The expanded layer of the second blood component can be removed from the blood component separation means using a surge and eluting method. Additionally or alternatively, the second blood component may be platelets and the second blood component is blood component separating means after a predetermined amount of platelets has been collected in the second blood component container. The platelet product with reduced plasma can be extracted from the separation means.

  In a further embodiment, a method for collecting plasma reduced platelets and predicting plasma return is provided. Whole blood is first removed from the source, anticoagulated, and introduced into the separation chamber. The separation chamber separates the anticoagulated whole blood into several blood components. The method transfers plasma separated from anticoagulated whole blood to a plasma container and returns a first volume of plasma from the plasma container to the source. The method repeats the steps of removal, anticoagulation, introduction and transfer and fills the separation device with additional anticoagulated whole blood.

  Once anticoagulated whole blood is introduced into the separation chamber (eg, to fill the chamber), the method extracts platelet rich plasma (“PRP”) from the separation chamber (eg, the surge eluting method). And / or using a plasma surge) and into the PRP container. The method can return blood components left in the separation chamber to the source and remove and repeat the anticoagulation and introduction steps again to partially fill the separation device with anticoagulated whole blood. obtain. Once the separation device is partially filled, the method reintroduces the PRP from the PRP container into the separation chamber, transfers the plasma from the separation chamber to the plasma container, and an expanded layer of platelets in the separation device The re-introduced PRP may be reprocessed to create

  According to certain embodiments, the method can predict the return of plasma and can return the plasma in the plasma container to the source while re-introducing the PRP into the separation chamber and / or PRP. Reprocess. The method then repeats the removal, recoagulation and introduction steps one more time to fill the separation chamber, remove the enlarged layer in the separation chamber using a surge elutriation method, and transfer the platelets to the platelet container. Is done. The method may return blood components left in the separation chamber to the source.

  According to related embodiments, the method may also return plasma from the plasma container to the source during the dead time. Further, the method may calculate extracorporeal volume and / or intravascular loss, and the first volume of plasma returned to the source is based at least in part on the calculated extracorporeal volume or intravascular loss. obtain.

  In a further embodiment, the method of collecting plasma reduced platelets comprises removing whole blood from a source, introducing an anticoagulant into whole blood removed from the source, and anticoagulated whole. Introducing blood into the separation chamber may be included. The separation chamber can eventually separate the anticoagulated whole blood into several blood components. The method may transfer plasma separated from anticoagulated whole blood to a plasma container, return a first volume of plasma from the plasma container to a source, and repeat the above steps. Further, the method may also extract platelet rich plasma from the separation chamber into a platelet rich plasma container and remove remaining blood components from the separation chamber.

  The foregoing features of the invention will be more readily understood by reference to the following detailed description, taken in conjunction with the accompanying drawings, in which:

FIG. 1 is a circuit diagram of an apheresis machine according to an embodiment of the present invention. FIG. 2 is a circuit diagram of a disposable system for use with the machine of FIG. 1 according to one embodiment of the present invention. 3 is a side view of a centrifuge bowl for use with the machine of FIG. 1 according to one embodiment of the present invention. FIG. 4 is a flowchart depicting a method for collecting plasma-reduced platelets from a donor and predicting plasma return according to one embodiment of the present invention.

  With reference to FIGS. 1 and 2, the apheresis device 10 separates anticoagulated whole blood into its constituent components, as described in US Pat. No. 3,145,713, incorporated herein by reference. Therefore, a blood component separation device such as a standard Latham type centrifuge 11 is used. Other types of separation chambers such as non-limiting examples of integral blow molded centrifuge bowls as described in US Pat. Nos. 4,983,156 and 4,943,273, incorporated herein by reference, and Separation devices can also be used. The centrifuge 11 includes a rotating bowl 12 and a steady inflow port and steady outflow ports PT1 and PT2 that are typically tightly coupled to the bowl interior by a rotary seal 74 (see FIG. 3). When the valve V1 is open, the inflow port PT1 of the centrifuge 11 is fluidly connected to the venous access device 24 (eg, a phlebotomy needle) via a blood micro-aggregate filter, a tube 28 and a Y connector 30. If whole blood is first collected and delivered, the venous access device 24 is replaced with a whole blood bag (not shown). Tube 28 is compatible with blood, which is similar to all tubes in device 10. The outflow port PT2 of the centrifuge 11 selectively couples with the first container 18 labeled as plasma suspended from the weigh scale 33 by the tube 36, valve V2 and tube 37. The second container 20 labeled platelets selectively binds to the outflow port PT2 via the tube 36, valve V3 and tube 39. In addition, the third container 22, labeled as platelet storage, selectively couples to the outflow port PT2 via tube 36, valve V4 and tube 35. Both the second container 20 and the third container 22 can also be suspended by weighing scales 67 and 77, respectively. As will be described in more detail below, certain embodiments also include a tube 93 fluidly connected with one end to the plasma container 18 (via connector 94) and the other end to tube 41 (via connector 95). May be included. Tube 93 may be used to return the citrated plasma in plasma container 18 to the donor while processing dead time and / or whole blood in centrifuge 11.

  The bag or container 16 that stores the anticoagulant is fluidly connected to the venous access device / phlebotomy needle 24 via a bacterial filter F 2, a tube 32 and a Y connector 30. The bacteria filter F2 prevents any bacteria in the anticoagulant (ACD) container 16 from entering the system at all. Containers 16, 18, 20 and 22 are preferably plastic bags made of blood compatible materials. Peristaltic pumps P1, P2 and P3, along with valves V1, V2, V3 and V4, are signals generated by line sensor 14, donor pressure monitor (DPM) M1, system pressure monitor (SPM) M2 and air detectors D1, D2 and D3. It reacts to control the flow direction and flow rate in the apparatus 10. Air detectors D1, D2 and D3 detect the absence and presence of liquid. Pressure monitors M1 and M3 monitor the pressure level in the apparatus 10. The line sensor 14 is an optical sensor and detects the presence of blood components passing through the line sensor 14 from the outflow port PT2.

  In the starting operation, pumps P1 and P3 are energized to prepare tube 28 of device 10 with anticoagulant from container 16. The anticoagulant passes through the filter F2 and the Y connector 30 before reaching the air detector D1. The air detector D1 senses the presence of the anticoagulant in D1 and ends the anticoagulant preparation operation. During the preparatory operation, valve V2 is opened and sterile air is expelled from bowl 12 by the anticoagulant entering the top port PT3 of plasma container 18. The venous access device 24 is inserted into the donor and the removal step is ready to begin.

  FIG. 4 is a flow chart depicting a method for collecting blood components from a subject and predicting return of citrated plasma to the subject according to one embodiment of the present invention. In retrieval step 401, whole blood is removed from the subject, typically at a flow rate of 80 ml / min, and mixed with anticoagulant using pumps P1 and P3 (step 402) (see FIGS. 1-2). it can). The pump P3 mixes the anticoagulant from the container 16 with the whole blood from the subject or the whole blood stored in the bag. When the valve V1 is opened, the anticoagulated whole blood passes through the tube 28 and the blood filter F1 before being pumped into the separation device 12 through the inflow port PT.

  Whole blood is introduced into the bottom of the separation device 12 through a supply tube (not shown) (step 403 in FIG. 4). The ratio of anticoagulant: whole blood is typically about 1:10. The operation of each of the pumps and valves in the apheresis device 10 can be performed according to a desired protocol under the control of a controller (not shown) which can be, for example, a microprocessor.

  Referring to FIG. 3, the centrifuge 11 has a fixed inflow port PT1 and a fixed outflow port PT2. To collect the separated fractions, the rotary seal 74 fluidly connects the steady inflow port PT1 to the lower interior of the bowl 12 and fluidly connects the outflow port PT2 to the higher portion of the bowl interior. The core 72 occupies a volume coaxial with the interior of the bowl 12 and provides a separation region between the wall of the core 72 and the outer wall 70 of the bowl.

  As the bowl rotates, the centrifugal force separates the anticoagulated whole blood contained in the bottom of the bowl into red blood cells (RBC), white blood cells (WBC), platelets and plasma. The rotation speed of the bowl 12 can be selected, for example, in the range of 4,000 to 6,000 rpm, and is typically 4,800 rpm. The blood is separated into different fractions depending on the component density. A higher density component, ie, RBC 60, is pushed to the outer wall 70 of the bowl 12, while a lower density plasma 66 is located near the core 72. The buffy coat 61 is formed between the plasma 66 and the RBC 60. The buffy coat is composed of platelets 64, a platelet transfer layer 68 and an inner layer of WBC, and an outer layer of WBC62. Plasma 66 is the component closest to the outflow port from the separation region, and when additional anti-coagulated whole blood enters the bowl 12 through the inflow port PT1, it first leaves the bowl 12 through the outflow port PT2. It is a liquid component. As plasma 66 leaves the bowl 12, it is transferred to the plasma container 18 through lines 36 and 37 (step 404 of FIG. 4).

  Returning to FIG. 1, the separated plasma passes through the line sensor 14, the tube 36, the three-way T-connector 26 and the valve V <b> 2 (open state) and enters the first container 18. Plasma entering the first container 18 is removed from the container 18 by the pump P2 through the tube 42, valve V5 (open state), Y connector 92 and tube 40, and passes through the Y connector 91 and line 41. Recirculate to bowl 12 through inlet port PT1. The recirculating plasma dilutes the anticoagulated whole blood entering the bowl 12 so that blood components can be more easily separated. In order to monitor each layer of blood component as it gradually advances coaxially from the outer wall 70 of the bowl 12 toward the core 72, the light sensor 21 monitors the shoulder portion of the bowl 12. Applies to The optical sensor 21 can be placed at a position where a buffy coat reaching a specific diameter can be detected, and the step of removing whole blood from the donor 401 and the step of introducing whole blood into the bowl 402 is responsive to the detection. Can end.

  As described in co-pending “Apheresis Device and Method for Making Blood Products”, which is hereby incorporated by reference, in US patent application Ser. No. 09 / 392,880 filed Sep. 9, 1999, The amount of whole blood processed by bowl 12 may be varied in response to at least one of the properties associated with whole blood, such as hematocrit value, platelet count, total amount of blood or white blood cells and the like. As described above, variable control can be implemented by microcomputer control. Alternatively, each of them can be performed manually.

  As mentioned above, certain embodiments of the present invention predict the return of plasma and prevent the return of large volumes at the end of the apheresis process (e.g., to improve patient comfort). Return plasma (eg, citrated plasma) in the plasma container at various intervals. Finally, the system 10 can stop the retrieval step (step 401) and return a portion or all of the plasma contained in the plasma container 18 to the donor. In particular, once the withdrawal step (step 401) stops, the apheresis system 10 reverses the direction of withdrawal / return of pump P1, opens valve V6, removes plasma from plasma container 18 through outlet port PT4, and Plasma can be returned to the patient / donor via lines 93 and 28.

  The volume of plasma returned to the patient / donor in this step depends on factors including but not limited to extracorporeal volume (“ECV”) and / or intravascular loss (“IVD”). For example, the controller calculates ECV or IVD based on data from the previous cycle (eg, the previous cycle in the apheresis procedure or the cycle from the previous procedure), and ECV / IVD calculates the theoretical total blood volume (“ TBV ") (e.g., as estimated from donor properties such as donor sex, size, and weight). If system 10 (eg, controller / microprocessor) determines that ECV / ID exceeds a predetermined percentage of TBV, system 10 stops retrieval (eg, step 401) and plasma as described above. To return blood. Additionally or alternatively, when the volume of plasma separated from the ongoing cycle is equal to the volume of whole blood that is still withdrawn to complete the bowl, the system 10 returns the plasma ( Step 405) is started. In the plasma return step (step 405), to maintain and / or improve blood separation, the centrifuge 11 continues to rotate and plasma can circulate in the bowl 12 (eg, pump P2 and line 42). Using).

  By stopping the retrieval step (step 401) and initiating the anticoagulated plasma return step (step 405), the system 10 can significantly reduce ECV and IVD. In addition, the expected plasma return process also ensures that return of citrate plasma to the patient / donor is performed over multiple steps with a sufficient time interval (eg, several minutes) between steps. . As discussed above, this helps improve patient comfort and reduces the risks associated with returning citrated plasma to the patient / donor.

  Once the plasma return step is complete, the system continues to remove whole blood from the patient / donor (eg, to complete filling the bowl) (step 406) and extract platelets from the separation chamber 11 / bowl 12 To do. In step 407 of FIG. 4, platelets are extracted from the bowl 12 into the container. When extracting platelets from the bowl 12, various methods are utilized including, but not limited to, dwell, surge and / or extrusion methods. For illustrative purposes, platelet extraction based on dwell and surge techniques will now be described in detail.

  When whole blood is introduced into centrifuge 11 at step 406 of FIG. 4, valve V1 is closed and pump P1 is stopped, blood is no longer taken from the donor, and dwelling begins. During dwell, pump P2 recirculates plasma 66 through bowl 12 at a moderate flow rate (eg, 100 ml / min in FIG. 4) for about 20-30 seconds. At this flow rate, the buffy coat 61 is diluted and spread by the plasma, but the platelets do not leave the bowl 12. The dilution of the buffy coat causes heavier white blood cells to deposit further out of the buffy coat, resulting in a better separation between the lighter platelet layer 64 and the heavier white blood cell layer 62. As a result, the transition layer 68 is reduced. The dwell period also stabilizes the flow rate pattern in the bowl 12 and gives more time for the microbubbles to leave the bowl 12 and be expelled.

  After the dwell, the surge step begins. During the surge, the rate of the pump P2 that recirculates the plasma is increased in increments of 5-10 ml / min until a platelet surge rate of about 200-250 ml / min is reached. The platelet surge rate is such a rate that platelets leave the bowl 12 but red blood cells or white blood cells do not. The plasma present in the bowl becomes turbid due to platelets, and this turbidity is detected by the line sensor 14. The line sensor 14 comprises an LED that emits light through the blood component leaving the bowl 12 and a photodetector that receives light after passing through the component. The amount of light received by the photodetector is correlated with the concentration of liquid passing through the line.

  When platelets first leave the bowl 12, the line sensor outputs a start of decrease. Valve V3 opens and bubble V2 closes, and platelets are collected in container 20. When most of the platelets are removed from the bowl 12, the turbidity of the liquid present in the bowl is reduced. This decrease in turbidity is detected by line 14, at which time valve V3 is closed.

  During all dead times (eg, when no whole blood is removed from the patient / donor, all times when the centrifuge 11 is stopped, etc.), the system 10 will remove the plasma contained in the plasma bag 18 from the patient / donor. It is important to note that you can return to the blood. For example, when the system 10 removes / extracts platelets from the centrifuge bowl 12 and / or in the dwell step described above, the system 10 also transfers plasma contained in the container 18 to the patient / donor as in the method described above. (E.g., pump P1 is reversed and plasma is removed via line 93).

  When return of plasma occurs in a surge process (eg, recirculation of plasma through bowl 12), both withdrawal / return pump P1 and recirculation pump P2 remove plasma from platelet container 18, and valves V5 and V7 Both can be opened. A withdrawal / return pump P1 removes plasma through tube 93 and a recirculation pump P2 removes plasma through tube. To prevent different plasmas from mixing and interfering with each other, the valve V8 (FIG. 2) located between the connectors 91 and 95 can be closed.

  After the platelets are collected, a blood return step 409 (see FIG. 4) is started. During the blood return step, the rotation of the bowl 12 is stopped, and the blood component remaining in the bowl 12 opens the valve V1 to reverse the rotation of the pump P1 and returns the blood to the donor via the venous access device 24. Is done. Valve V2 is also opened to allow air to enter the centrifuge bowl upon return of blood. The plasma from container 18 dilutes blood components left in bowl 12. That is, the pump P2 opens the valve V2, mixes the components that are left in the bowl 12 and the plasma, and dilutes the red blood cell components to be returned with plasma, thereby speeding up the blood return time. When the blood component to be returned in the bowl is returned to the donor, the blood return step 409 ends.

Referring to FIG. 4, a step of removing whole blood from a donor (step 401), a step of introducing an anticoagulant into whole blood (step 402), a step of introducing whole blood into a separation chamber (step 403), plasma Of blood to the plasma container 18 (step 404), returning blood to the patient / donor (step 405), continuing to remove whole blood (step 406), extracting platelets from the separation chamber The steps (Step 407), returning the plasma (Step 408), and returning the remaining components to the donor are repeated until the desired volume of platelets is sequestered into the container 20 (Step 410). ). Typically, steps 401-409 are repeated 2-4 floors to process about 450-500 ml of whole blood per cycle. The concentration of isolated platelets is typically about 1.5 × 10 ⁶ cells / μl.

  The system reprocesses the platelets in the container 20 by reintroducing the platelets (platelet rich plasma) in the container 20 into the bowl 12 (step 412 in FIG. 4). Platelet reintroduction forms a layer of platelets several times larger than that obtained by processing a single cycle of anticoagulated whole blood. For example, in certain embodiments, the platelet layer volume is approximately equal to the average capacity of a single cycle multiplied by the number of platelet sequestration cycles plus one. Platelet is taken out from the port PT5 of the container 20 by the pump P2 through the tube 43, the valve V6 (open state), the Y connector 92, and the tube 40, and from the inflow port PT1 to the bowl 12 through the Y connector 91 and the line 41. And flows in. To minimize contact between platelets and bowl 12, bowl 12 is partially filled with anticoagulated whole blood removed from donor 401 in step 411 of FIG. 4 prior to platelet reintroduction. obtain. Whole blood forms a cell bed at the edge of the bowl 12 that acts as a buffer between the edge of the bowl and the platelets to reduce platelet aggregation. Additionally or alternatively, the addition of anticoagulated whole blood to the separation chamber is caused to advance the platelets towards the erration radius upon platelet reintroduction, or platelet separation and platelets After platelet reintroduction to standardize the conditions for starting the extraction.

  Platelets that are reintroduced into the bowl 12 and reprocessed are platelet rich plasma (PRP) (platelets suspended in plasma), and the centrifugal force in the bowl 12 excludes platelets suspended in PRP. And thereby free the plasma. This liberated plasma leaves the bowl 12 and is transferred to the plasma container 18 as additional liquid (eg, additional PRP, plasma, anticoagulated whole blood, etc.) enters the bowl 12.

  Once the platelets are reprocessed to form a plasma-reduced platelet product (described in more detail below), the system can return the plasma in container 18 back to the patient / donor (step 413). . For example, when platelets from container 20 are reintroduced into bowl 12, system 10 opens valve V7 and removes plasma from port PT4 of container 18 through line 93 using removal / return pump P1. The plasma can be removed and returned to the patient / donor through line 28 and venous access device 24. System 10 may remove whole blood from the patient / donor at step 414 and fill bowl 12 with anticoagulated whole blood.

For example, using a surge or extrusion method, the plasma reduced platelet concentrate is extracted from the platelet layer present in bowl 12 (step 415 of FIG. 4). The plasma-reduced platelet preparation is isolated to the container 22 via the line sensor 14, the tube 36, the three-way T connector 26, and the valve V4 (open state). Platelet product concentrations typically range from 2.6 × 10 ⁶ μl to 5.2 × 10 ⁶ μl, which is sequestered when anticoagulated whole blood is processed in a single cycle. 2 to 3 times the platelet concentration. Once the plasma reduced platelet concentrate is extracted from the bowl 12 and collected in the container 22, the system 10 returns the total blood components left in the bowl 12 and the total plasma left in the plasma container 18. Blood (step 416 in FIG. 4).

  It should be noted that surge elutriation techniques can use a variety of liquids other than plasma to extract platelets and / or plasma-reduced platelets from the separation chamber (e.g., saline can be used). ). Furthermore, platelets that are reintroduced into the separation chamber can be anticoagulated again to prevent platelets from clotting / aggregating. For example, the platelet collection bag 20 or the plasma-reduced platelet product bag 22 may contain a certain amount of anticoagulant so that it mixes with the anticoagulant when the platelets and / or plasma-reduced platelet product is removed from the separation chamber. Can be refilled. Additionally or alternatively, sufficient anticoagulant may be added when whole blood is removed from the subject so that sufficient anticoagulant is still present in the platelets before the platelets are reprocessed. In another scenario, the amount of anticoagulant added to whole blood and / or extracted platelets should be considered in view of subject safety. In particular, the amount of anticoagulant should be limited to prevent large amounts of anticoagulant from being returned to the subject.

  Once platelet and plasma reduced platelet preparations are collected, a platelet storage solution can be added to help store and maintain the platelets for later use. The preservation solution can be added to platelets and the collected platelet product (eg, from a separation bag or storage container 96), or to the platelet collection bag 20, and the plasma reduced platelet product bag 22 is pre-added with the additive solution. I can keep it.

  By predicting the total amount of plasma returned to the donor and returning the plasma in multiple steps, various embodiments of the present invention provide various advantages over the prior art. For example, by not returning all plasma at the end of the procedure, various embodiments of the present invention can reduce patient discomfort and the risks associated with returning large amounts of citrated plasma. Furthermore, by returning plasma during the dead time, certain embodiments of the present invention can reduce the total time of the procedure and the ECV / IVD ratio for the entire time during the procedure. Furthermore, because plasma can be returned during processing and the ECV / IVD ratio is greatly reduced, various embodiments of the present invention require that saline (or other compensation fluid) be returned to the patient to reduce ECV. There is no.

  Although the embodiments described above describe returning plasma to a patient / donor, it is not necessary to return all plasma. For example, certain embodiments of the present invention may store a portion of collected plasma. In such an embodiment, the plasma is filtered using F3 and stored in a filtered plasma container 97.

  When more plasma-reduced platelets are needed, each of the above steps can be repeated until the desired amount of plasma-reduced platelet preparation is collected. In various embodiments, plasma can be added to a plasma reduced platelet preparation to bring plasma reduced platelets to a predetermined amount or concentration.

  While the above-described embodiment removes whole blood from the patient / donor and returns unwanted components back to the donor, other embodiments of the invention arrive in use as a donor-free process. For example, if whole blood is initially stored and supplied to the separation device 11, the venous access device 24 is replaced with a whole blood bag (not shown) as described above. In such an embodiment, the plasma from the plasma container 18 and the blood components left in the separation device 11 may be one or more storage bags / containers (eg, all in one container or separate containers). Or returned to a whole blood bag. Such an embodiment would also have advantages over the prior art due to the significantly reduced processing time (eg, because plasma is transferred to the container during the dead time).

  The described embodiments of the present invention are intended to be examples only, and various changes and modifications will be apparent to those skilled in the art. Such changes and modifications are intended to be within the scope of the present invention.

The present invention includes the following inventions.
Invention 1
A method of collecting plasma-reduced platelets and predicting the return of plasma,
a) removing whole blood from the donor;
b) introducing an anticoagulant into whole blood taken from the donor;
c) introducing anticoagulated whole blood into a separation chamber, wherein the separation chamber separates the anticoagulated whole blood into several blood components;
d) transferring the plasma separated from the anticoagulated whole blood to a plasma container;
e) returning the first volume of plasma from the plasma container to the donor;
f) repeating steps a to d;
g) extracting platelet rich plasma from the separation chamber into a platelet rich plasma container; and h) returning blood components left in the separation chamber to the donor.
Invention 2
i) repeating steps a to c to partially fill the separator with anticoagulated whole blood;
j) reintroducing platelet rich plasma from the platelet rich plasma container into the separation chamber;
k) transferring plasma from the separation chamber to the plasma container; and l) reprocessing the reintroduced platelet-rich plasma to create an expanded layer of platelets in the separation device. The method according to 1.
Invention 3
m) The method of invention 2, further comprising the step of returning the plasma from the plasma container to the donor while reprocessing the platelet rich plasma.
Invention 4
m) The method of invention 2, further comprising the step of returning the plasma from the plasma container to the donor while reintroducing the platelet rich plasma into the separation chamber.
Invention 5
m) removing an enlarged layer of platelets in the separation device using surge eluting, allowing the platelets to be transferred to the platelet container; and n) removing blood components left in the separation chamber. The method of invention 2, further comprising the step of returning blood to the donor.
Invention 6
6. The method of invention 5, further comprising the step of returning plasma from the plasma container to the donor during the dead time.
Invention 7
Calculating either the extracorporeal volume or the intravascular loss, wherein the volume of plasma returned during step (e) is based at least in part on the calculated extracorporeal volume or intravascular loss. The method according to invention 1, further comprising:
Invention 8
The method of invention 1, wherein the step of extracting platelet-rich plasma from the separation chamber comprises extracting the platelet-rich plasma by surge elution.
Invention 9
9. The method of invention 8, wherein the step of extracting platelet rich plasma from the separation chamber by surge eluting comprises surged with plasma.
Invention 10
A system for collecting plasma-reduced platelets and predicting return of plasma,
A venous access device for removing a first volume of whole blood from a subject using a first pump and returning blood components to the subject using a first pump;
A blood component separator for separating the removed blood into a first blood component and a second blood component (where the blood component separator is configured to transfer the first blood component to the first blood component bag and the second blood component Configured to transfer a blood component of a second blood component bag);
A first blood return line fluidly connecting the venous access device and the blood component separation device for returning blood components left in the separation device to the subject;
A recirculation line connecting the first blood component container and the separation device, wherein the first blood component in the first blood component container is reintroduced into the separation chamber through the recirculation line and the recirculation pump ); And a second blood return configured to fluidly connect the first blood component container and the first return line to return the first blood component in the first blood container to the subject. A system containing a line.
Invention 11
The system of claim 10, wherein the first pump returns the first blood component in the first blood component container to the subject.
Invention 12
The system of claim 10, wherein the first pump returns blood components left in the separation device to the subject.
Invention 13
The system according to invention 10, wherein the separation device is a centrifuge bowl.
Invention 14
The system according to invention 10, wherein the first blood component is plasma and the second blood component is platelets.
Invention 15
The system according to invention 10, wherein the separation device separates whole blood into a third blood component in addition to the first blood component and the second blood component.
Invention 16
16. The system according to invention 15, wherein the blood component left in the separation device comprises a third blood component.
Invention 17
16. The system according to invention 15, wherein the third blood component is red blood cells.
Invention 18
The system according to invention 10, wherein the second blood component is removed from the separation device by a surge elutriation method.
Invention 19
The invention wherein the surge elutriation method is reintroduced with increasing flow rate through the recirculation line to the blood component separator until the second blood component is removed from the blood component separator. 18. The system according to 18.
Invention 20
11. The system of invention 10, further comprising an anticoagulant line coupled to an anticoagulant source, wherein the anticoagulant line introduces the anticoagulant into the removed blood.
Invention 21
The second blood component is platelets, and after the predetermined amount of platelets is collected in the second blood component container, the second blood component is reintroduced into the blood component separator, thereby separating the device The system according to invention 10, wherein platelets with reduced plasma can be extracted from the blood.
Invention 22
Further comprising a recirculation line for fluidly connecting the second blood component bag and the blood component separator, wherein a second volume of whole blood in the second blood component bag is removed from the subject. The second blood component is reintroduced into the blood component separator, thereby creating an enlarged layer of the second blood component in the blood component separator, and the enlarged layer of the second blood component is a surge elt. The system according to invention 10, wherein the system is removed from the blood component separation device using a relation method.
Invention 23
23. The system of invention 22, wherein the first blood component in the first blood component container is returned to the subject when the second blood component is reintroduced into the blood component separator.
Invention 24
The system of claim 10, wherein the first blood component in the first blood component container is returned to the subject during the dead time.
Invention 25
A controller, wherein the controller calculates at least one of the extracorporeal volume and the intravascular loss, and the system calculates a quantity of the first vascular component based on the at least partially calculated extracorporeal volume or intravascular loss. The system according to claim 10, wherein the blood is returned through the second blood return line.
Invention 26
A system for collecting plasma-reduced platelets and predicting return of plasma,
Means for removing a first volume of whole blood from the subject and returning blood components to the subject;
Blood component separating means for separating the blood taken into the first blood component and the second blood component (where the blood component separating means transfers the first blood component to the first blood component bag, Configured to transfer blood components to a second blood component bag);
A first blood return means configured to fluidly connect the means for taking out the first volume of whole blood and the blood component separation means, and to return the blood component remaining in the separation means to the subject. ;
A recirculation means for coupling the second blood component container and the separation means, wherein the recirculation means reintroduces the second blood component in the second blood component container to the separation means; and A system comprising a second blood return means configured to fluidly connect the blood component container and the first blood return means and to return the first blood component in the first blood container to the subject.
Invention 27
27. The system of invention 26, wherein the means for removing whole blood includes a first pump, the first pump configured to return the first blood component in the first blood component container to the subject.
Invention 28
28. A system according to invention 27, wherein the first pump is configured to return blood components left in the separating means back to the subject.
Invention 29
A controller for controlling the flow of fluid through the system, wherein the controller repeatedly removes whole blood from the donor and introduces it into the separation means, extracting the first and second blood components from the separation means; The second blood return means is used to return the first blood component in the first blood component container to the patient, and the first blood return means is used to return the component left in the separation means to the patient. The second blood component from the second blood component container is transferred to the separation means after the second blood component having a predetermined volume is isolated to the second blood component container. 27. System according to invention 26, reintroduced.
Invention 30
The controller calculates at least one of extracorporeal volume and intravascular loss, and the amount of blood component returned using the second return means is based at least in part on at least one of the extracorporeal volume and intravascular loss. The system according to claim 29.
Invention 31
27. The system according to invention 26, wherein the first blood component is plasma and the second blood component is platelets.
Invention 32
27. The system of invention 26, wherein the separating means separates whole blood into a third blood component in addition to the first and second blood components.
Invention 33
The system of invention 32, wherein the blood component left in the separating means comprises a third blood component.
Invention 34
The system of invention 32, wherein the third blood component is red blood cells.
Invention 35
27. The system of invention 26, wherein the second blood component is removed from the separation device using a surge elutriation method.
Invention 36
The surge eluting method is reintroduced with increasing flow rate through the recirculation means to the blood component separation means until the second blood component is removed from the blood component separation means. 36. The system according to invention 35, comprising:
Invention 37
27. The system according to invention 26, further comprising means for introducing an anticoagulant into the removed whole blood.
Invention 38
Platelets in which the second blood component is platelets and a predetermined amount of platelets is collected in the second blood component container and then reintroduced into the blood component separation means, thereby reducing the plasma from the separation device The system of invention 26, wherein the formulation is extracted.
Invention 39
Re-introducing means for fluidly connecting the second blood component bag and the blood component separating means, the second blood in the second blood component bag when a second amount of whole blood is removed from the subject The component is reintroduced into the blood component separation means, thereby creating an enlarged layer of the second blood component in the blood component separation means, and using the surge eluting method, the enlarged layer of the second blood component 27. The system according to invention 26, wherein is removed from the blood component separation means.
Invention 40
A method for collecting plasma-reduced platelets and predicting return of plasma, comprising:
a) removing whole blood from the source;
b) introducing an anticoagulant into whole blood taken from the source;
c) introducing anticoagulated whole blood into a separation chamber, wherein the separation chamber separates the anticoagulated whole blood into several blood components;
d) transferring the plasma separated from the anticoagulated whole blood to a plasma container;
e) returning the first volume of plasma from the plasma container to the source;
f) repeating steps a to d;
g) extracting platelet rich plasma from the separation chamber into a platelet rich plasma container; and h) returning blood components left in the separation chamber to the source.
Invention 41
i) repeating steps a to c to partially fill the separator with anticoagulated whole blood;
j) reintroducing platelet rich plasma from the platelet rich plasma container into the separation chamber;
k) transferring plasma from the separation chamber to the plasma container; and l) reprocessing the reintroduced platelet-rich plasma to create an expanded layer of platelets in the separation device. 41. The method according to 40.
Invention 42
m) The method of invention 41, further comprising the step of returning plasma from the plasma container to the source while reprocessing the platelet rich plasma.
Invention 43
m) The method of invention 41, further comprising the step of returning plasma from the plasma container to the source while reintroducing the platelet rich plasma into the separation chamber.
Invention 44
m) removing an enlarged layer of platelets in the separation device using surge eluting, allowing the platelets to be transferred to the platelet container; and n) removing blood components left in the separation chamber. 42. The method of invention 41, further comprising the step of returning blood to the source.
Invention 45
45. The method of invention 44, further comprising the step of returning plasma from the plasma container to the source during the dead time.
Invention 46
Calculating either the extracorporeal volume or the intravascular loss, wherein the volume of plasma returned during step (e) is based at least in part on the calculated extracorporeal volume or intravascular loss. 41. The method of invention 40, further comprising:
Invention 47
41. The method of invention 40, wherein the step of extracting platelet rich plasma from the separation chamber comprises extracting the platelet rich plasma by surge elution.
Invention 48
48. The method of invention 47, wherein the step of extracting platelet rich plasma from the separation chamber by surge eluting comprises surged with plasma.
Invention 49
A method for collecting plasma-reduced platelets comprising:
a) removing whole blood from the source;
b) introducing an anticoagulant into whole blood taken from the source;
c) introducing anticoagulated whole blood into a separation chamber, wherein the separation chamber separates the anticoagulated whole blood into several blood components;
d) transferring the plasma separated from the anticoagulated whole blood to a plasma container;
e) returning the first volume of plasma from the plasma container to the source;
f) repeating steps a to d;
g) extracting platelet rich plasma from the separation chamber into a platelet rich plasma container; and h) removing blood components left from the separation chamber.

Claims (23)

A method for controlling the operation of a system for collecting plasma-reduced platelets comprising:
The system is
An access device connected to the first line;
An anticoagulant line connecting the anticoagulant source to the first line;
A first pump located in the first line;
A separation device coupled to a first line for separating whole blood into a first blood component and a second blood component, the first blood component into a first container, and a second blood A separation device configured to send the components to a second container;
A recirculation line connecting the first container and the separation device;
A second pump located in the recirculation line; and a second line connecting the first container and the first line;
Containing
The method comprises
a) controlling the operation of the first pump in a first direction;
b) introducing an anticoagulant into the first line through the anticoagulant line;
c) causing the separation device to separate the anticoagulated whole blood into a first component and a second component;
d) transferring a first blood component separated from the anticoagulated whole blood to a first container;
e) controlling the operation of the first pump in the second direction to transfer a first volume of the first blood component from the first container through the second line to the first line;
f) repeating steps a) to e);
g) extracting a second blood component from the separator into a second container; and h) controlling the operation of the first pump in a second direction to remove the blood component left in the separator. Transferring to one line;
Containing. i) repeating steps a) to c) to partially fill the separator with anticoagulated whole blood;
j) reintroducing a second blood component from the second container into the separation chamber;
k) transferring the first blood component from the separation chamber to the first container; and l) reprocessing the reintroduced second blood component to remove the second blood component in the separation device. The method of claim 1, further comprising controlling the operation of the system by creating an enlarged layer. m) While reprocessing the second blood component, the first blood component is controlled from the first container through the second line to the first line by controlling the operation of the first pump in the second direction. The method of claim 2, further comprising controlling the operation of the system by transferring. m) controlling the operation of the system by transferring the first blood component from the first container through the second line to the first line while reintroducing the second blood component into the separator. The method according to claim 2, further comprising: m) removing an enlarged layer of the second blood component in the separation device using a surge elutriation method so that the second blood component is transferred to the second container; and n 3.) further comprising controlling the operation of the system by controlling the operation of the first pump in a second direction to transfer blood components left in the separator to the first line. The method described in 1.   Controlling the operation of the system by controlling the operation of the first pump in the second direction and transferring the first blood component from the first container through the second line to the first line during the dead time. 6. The method of claim 5, further comprising controlling.   Calculating any one of an extracorporeal volume and an intravascular loss, wherein the volume of the first blood component transferred during step (e) is at least partially calculated The method of claim 1, further comprising a step as based on:   The method of claim 1, wherein the step of extracting the second blood component from the separation device comprises extracting the second blood component by surge elutriation.   9. The method of claim 8, wherein the step of extracting the second blood component from the separation device by surge eluting includes surged by the first blood component.   The method according to claim 1, wherein the separation device is a centrifuge bowl.   The method according to any one of claims 1 to 10, wherein the first blood component is plasma and the second blood component is platelets.   The method according to any one of claims 1 to 11, wherein the separation device separates whole blood into a third blood component in addition to the first blood component and the second blood component.   13. The method of claim 12, wherein the blood component left in the separation device comprises a third blood component.   14. The method of claim 13, wherein the third blood component is red blood cells. A method for controlling the operation of a system for collecting plasma-reduced platelets comprising:
The system is
An access device connecting the whole blood source to the first line;
An anticoagulant line connecting the anticoagulant source to the first line;
A first pump located in the first line;
A separation device connected to the first line, the first container and the second container, wherein the separation device separates whole blood into a plurality of blood components;
A recirculation line connecting the first container and the separation device; and a second pump arranged in the recirculation line;
Containing
The method comprises
a) controlling the operation of the first pump in a first direction towards the separator and transferring the liquid through the first line towards the separator;
b) introducing an anticoagulant into the first line through the anticoagulant line;
c) causing the separation device to separate the anticoagulated whole blood into blood components;
d) transferring the plasma separated from the anticoagulated whole blood to a first container;
e) Control the operation of the first pump in a second direction opposite the first direction to transfer a first volume of plasma from the first container through the second line to the first line. Step;
f) repeating steps a) to e);
g) extracting platelet rich plasma from the separator into a second container; and h) controlling the operation of the first pump in a second direction to remove blood components left in the separator in the first Transferring to the line;
Containing. i) repeating steps a to c to partially fill the separator with anticoagulated whole blood;
j) reintroducing platelet rich plasma from the second container into the separation chamber;
k) transferring the plasma from the separation chamber to the first container; and l) operating the system by reprocessing the reintroduced platelet-rich plasma to create an expanded layer of platelets in the separation device 16. The method of claim 15, further comprising controlling. m) While reprocessing the platelet rich plasma, controlling the operation of the first pump in the second direction to transfer the plasma from the first container through the second line to the first line. The method of claim 16, further comprising controlling actuation. m) While reintroducing the platelet rich plasma into the separator, the operation of the first pump is controlled in the second direction to transfer the plasma from the first container through the second line to the first line. The method of claim 16, further comprising controlling the operation of the system by steps. m) removing the enlarged layer of platelets in the separator using surge eluting, allowing the platelets to be transferred to the second container; and n) operating the first pump. 17. The method of claim 16, further comprising controlling the operation of the system by controlling in a second direction and transferring blood components left in the separation device to the first line.   During the dead time, controlling the operation of the system by controlling the operation of the first pump in the second direction and transferring the plasma from the first container through the second line to the first line. 20. The method of claim 19, further comprising:   Calculating any one of an extracorporeal volume and an intravascular loss, wherein the volume of plasma transferred during step (e) is based at least in part on the calculated extracorporeal volume or intravascular loss. 16. The method of claim 15, further comprising controlling the operation of the system by steps.   16. The method of claim 15, wherein the step of extracting platelet rich plasma from the separation device comprises extracting platelet rich plasma by surge elutriation. 23. The method of claim 22, wherein the step of extracting platelet rich plasma from the separation device by surge eluting comprises surged by plasma.

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