WO2016043003A1 - 血液成分分離装置 - Google Patents
血液成分分離装置 Download PDFInfo
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- WO2016043003A1 WO2016043003A1 PCT/JP2015/074099 JP2015074099W WO2016043003A1 WO 2016043003 A1 WO2016043003 A1 WO 2016043003A1 JP 2015074099 W JP2015074099 W JP 2015074099W WO 2016043003 A1 WO2016043003 A1 WO 2016043003A1
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- blood
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Images
Classifications
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/0209—Multiple bag systems for separating or storing blood components
- A61M1/0236—Multiple bag systems for separating or storing blood components with sampling means, e.g. sample bag or sampling port
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/02—Blood transfusion apparatus
- A61M1/024—Means for controlling the quantity of transfused blood, e.g. by weighing the container and automatic stopping of the transfusion after reaching a determined amount
- A61M1/0245—Means for controlling the quantity of transfused blood, e.g. by weighing the container and automatic stopping of the transfusion after reaching a determined amount combined with blood container shaking means
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3693—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits using separation based on different densities of components, e.g. centrifuging
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/38—Removing constituents from donor blood and storing or returning remainder to body, e.g. for transfusion
- A61M1/382—Optimisation of blood component yield
- A61M1/385—Optimisation of blood component yield taking into account of the patient characteristics
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B04—CENTRIFUGAL APPARATUS OR MACHINES FOR CARRYING-OUT PHYSICAL OR CHEMICAL PROCESSES
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- B04B11/02—Continuous feeding or discharging; Control arrangements therefor
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- B—PERFORMING OPERATIONS; TRANSPORTING
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- B04B5/0442—Radial chamber apparatus for separating predominantly liquid mixtures, e.g. butyrometers with means for adding or withdrawing liquid substances during the centrifugation, e.g. continuous centrifugation
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- C—CHEMISTRY; METALLURGY
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- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
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- A61M2230/20—Blood composition characteristics
- A61M2230/207—Blood composition characteristics hematocrit
Definitions
- the present invention relates to a blood component separation device for collecting platelets from blood.
- blood is collected mainly by collecting only platelets and the other components are returned to the blood donor (donor).
- a blood component separation apparatus equipped with a centrifuge is used. Yes.
- Patent Document 1 collects a target number of platelets by performing a plurality of cycles of platelet collection operation for separating blood collected from a donor and collecting platelets. is doing.
- the recommended number of cycles or recommended treatment blood volume (hereinafter recommended treatment volume) of the above-mentioned platelet collection operation is the hematocrit value of the donor's blood and the blood of the donor's blood. It is determined based on the predicted platelet recovery rate calculated from the platelet concentration. However, the recovery rate of platelets actually collected as a preparation varies depending on the sex of the donor due to the difference in circulating blood volume between men and women and the difference in blood flow status.
- Patent Document 1 does not disclose anything to change the recommended cycle number or recommended processing amount of the platelet collection operation according to the sex of the blood donor.
- an object of the present invention is to provide a blood component separation device that can reliably collect a target number of platelets regardless of the donor's gender. .
- One aspect of the present invention made to solve the above-described problems is a blood component separation apparatus that collects platelets by separating a plurality of blood components from blood collected from a blood donor, and the hematocrit value of the blood and the blood Calculating a predicted platelet recovery rate from the platelet concentration, and calculating a recommended processing amount of the blood recommended for collecting a target number of platelets based on the calculated predicted platelet recovery rate;
- the calculation unit has the predicted platelet recovery rate calculated from an arbitrary hematocrit value and an arbitrary platelet concentration when the blood donor is a female than the case where the blood donor is a male. It is characterized by reducing the value ⁇ .
- the predicted platelet recovery rate can be accurately calculated according to the sex of the blood donor. Therefore, the target number of platelets can be reliably collected regardless of the sex of the donor.
- the predetermined value ⁇ increases as the recommended amount of blood treatment increases.
- a centrifuge step for introducing the blood into a centrifuge and separating the blood into a plurality of blood components; b) plasma of the separated blood components together with the blood in the centrifuge A circulating flow step to be introduced; and c) after the circulating flow step, the supply of the blood to the centrifuge is stopped, only the plasma is introduced into the centrifuge, and the plasma is further circulated for a predetermined time. Thereafter, the circulation speed is accelerated to separate and collect platelets by the centrifuge, and d) a circulation / acceleration step for collecting, and d) returning blood components not collected after the circulation / acceleration step to the donor. It is preferable that the steps a) to d) are performed as one cycle, and the calculation unit calculates a recommended cycle number as the recommended blood processing amount.
- platelets can be separated from other blood components with high accuracy. Since the timing for collecting high-concentration platelets is optimized, more platelets can be collected efficiently. Furthermore, since the recommended number of cycles is calculated based on the predicted platelet recovery rate according to the sex of the donor, the target number of platelets can be reliably collected regardless of the donor's gender.
- the blood in the separation container is separated into a plurality of blood components by rotating the separation container around the axis while supplying the blood into the annular separation container, and the blood is separated. It is preferable to collect platelets from a plurality of blood components.
- platelets can be accurately separated from other blood components with a simple apparatus configuration.
- a target number of platelets can be reliably collected regardless of the sex of the donor.
- FIG. 2 is a block diagram illustrating a control system of the blood component separation device according to Embodiment 1.
- FIG. It is a figure which shows the structure of a centrifuge bowl.
- 3 is a flowchart illustrating the operation of the blood component separation device according to the first embodiment. It is a flowchart which shows the effect
- the blood component separation device of this embodiment has a blood component separation circuit 1.
- the blood component separation circuit 1 has a primary blood collection circuit 5 including a blood collection needle 2, a primary blood collection bag Y7 for collecting primary blood, a sampling port 3, and a primary blood collection line 4.
- the blood component separation circuit 1 has a centrifuge bowl E1.
- the centrifuge bowl E1 includes a rotor (not shown) having a blood storage space therein, a centrifuge bowl driving device 14 that is a rotation driving means for rotating the rotor, an inlet (first port) E1a, and an outlet (second port). ) E1b, and separates blood into a plurality of blood components by rotation of the rotor.
- the blood component separation circuit 1 stores a blood component separated by the centrifuge bowl E1, a plasma bag (first container) Y1, a temporary storage bag (second container) Y2, and an intermediate platelet bag (third container). Y3.
- the blood component separation circuit 1 has a first line, a second line, a third line, a fourth line, a fifth line, a sixth line, and a seventh line.
- the first line is for connecting the blood collection needle 2 and the centrifuge bowl E1, and from the donor tube T1, the first blood pump P1, the tube T2, the tube T3a, the first on-off valve V1, the tube T3b, and the tube T4. Composed.
- the second line is for connecting the centrifuge bowl E1 and the plasma bag Y1, and includes a tube T5, a tube T6a, a second on-off valve V2, and a tube T6b.
- the third line is for connecting the plasma bag Y1 and the first line.
- the fourth line is for connecting the centrifuge bowl E1 and the temporary storage bag Y2, and includes a tube T5, a tube T15, a tube T11a, a fifth on-off valve V5, and a tube T11b.
- the fifth line is for connecting the temporary storage bag Y2 and the first line, and includes a tube T12, a tube T13b, a sixth on-off valve V6, and a tube T13a.
- the sixth line is for connecting the temporary storage bag Y2 and the first line.
- the seventh line is for connecting the centrifuge bowl E1 and the platelet intermediate bag Y3 and includes a tube T5, a tube T15, a tube T16, a tube T17a, an eighth on-off valve V8, and a tube T17b.
- a blood collection needle 2 which is a collection means for collecting whole blood (blood) from a donor (donor), is connected to the first port of the first blood pump P1 by a donor tube T1.
- the first blood collection bag Y7 is connected to a blood collection needle through a first blood collection line 4 from a branch portion provided on the donor tube T1.
- the initial blood collection bag Y7 further includes a sampling port 3 for transferring the collected initial blood to a test container (not shown).
- the sampling port 3 includes a main body portion, a needle portion 6, and a cover portion 7 that covers the needle portion. Consists of. Further, a clamp 8 for opening and closing the line is provided on the initial blood collection line 4.
- the tube T2 connected to the second port of the first blood pump P1 is branched into two tubes T3a and T13a.
- the tube T3a is connected to the first port of the first on-off valve V1, and the first on-off valve V1 is connected to the first port.
- the 2 ports are connected to the tube T3b.
- the tube T3b is branched into two tubes T4 and T10a, and the tube T4 is connected to an inlet E1a of a centrifuge bowl E1 that is a centrifuge for separating the collected blood into a plurality of blood components.
- the centrifuge bowl E1 is disposed on the centrifuge bowl driving device 14 and is driven to rotate.
- the blood collection needle 2 and the inlet E1a which is the inlet side of the centrifugal bowl E1 are connected to the first line (donor tube T1, first blood pump P1, tube T2, tube T3a, first on-off valve V1, tube T3b). Are connected by a tube T4).
- the pressure sensor C1 is connected to the donor tube T1.
- the tube T5 connected to the outlet E1b of the centrifugal bowl E1 is branched into a tube T15 and a tube T6a.
- the tube T6a is connected to the first port of the second on-off valve V2, and the second port of the second on-off valve V2 is connected to the tube T6b.
- the tube T6b is connected to the second port Y1b of the plasma bag Y1.
- the outlet E1b of the centrifugal bowl E1 and the plasma bag Y1 are connected by a second line (tube T5, tube T6a, second on-off valve V2, tube T6b).
- a second line tube T5, tube T6a, second on-off valve V2, tube T6b.
- the first port Y1a on the output side of the plasma bag Y1 is connected to the tube T8a.
- the tube T8a is connected to the first port of the third on-off valve V3.
- the second port of the third on-off valve V3 is connected to the tube T8b, and the tube T8b is connected to the tube T9.
- the tube T9 is connected to the second port of the second blood pump P2.
- the first port of the second blood pump P2 is connected to the tube T10b, and the tube T10b is connected to the second port of the fourth on-off valve V4.
- the first port of the fourth on-off valve V4 is connected to the tube T10a.
- the tube T10a is connected to an intermediate position between the tube T3b and the tube T4 constituting the first line. That is, the plasma bag Y1 and the first line are connected by a third line (tube T8a, third on-off valve V3, tube T8b, tube T9, second blood pump P2, tube T10b, fourth on-off valve V4, tube T10a). It is connected. Thereby, the plasma bag Y1 is connected so as to selectively communicate with the inlet side or the outlet side of the centrifuge bowl E1.
- the tube T15 branched from the tube T5 is further branched into a tube T11a and a tube T16.
- the tube T11a is connected to the first port of the fifth on-off valve V5, and the second port of the fifth on-off valve V5 is connected to the tube T11b.
- the tube T11b is connected to the second port Y2b of the temporary storage bag Y2. That is, the outlet E1b of the centrifugal bowl E1 and the temporary storage bag Y2 are connected by the fourth line (tube T5, tube T15, tube T11a, fifth open / close valve V5, tube T11b).
- the first port Y2a of the temporary storage bag Y2 is connected to the tube T12 and branches into the tube T13b and the tube T14a.
- the tube T13b is connected to the first port of the sixth on-off valve V6, and the second port of the sixth on-off valve V6 is connected to the tube T13a.
- the tube T13a is connected to an intermediate position between the tube T2 and the tube T3a constituting the first line.
- the first port of the second blood pump P2 is connected to the tube T10b, and the tube T10b is connected to the first port of the fourth on-off valve V4.
- the second port of the fourth on-off valve V4 is connected to the tube T10a.
- the tube T10a is connected to an intermediate position between the tube T3b and the tube T4 constituting the first line. That is, the temporary storage bag Y2 and the first line are the fifth line (tube T12, tube T13b, sixth open / close valve V6, tube T13a), and sixth line (tube T12, tube T14a, seventh open / close valve V7, Tube T14b, tube T9, second blood pump P2, tube T10b, fourth open / close valve V4, and tube T10a).
- Temporary storage bag Y2 is connected to selectively communicate with the inlet side or outlet side of centrifugal bowl E1.
- the tube T16 branched from the tube T15 is further branched into two tubes T17a and T18a.
- the tube T17a is connected to the first port of the eighth on-off valve V8, and the second port of the eighth on-off valve V8 is connected to the tube T17b.
- the tube T17b is connected to the first port Y3a on the input side of the platelet intermediate bag Y3.
- the tube T18a branched from the tube T16 is connected to the first port of the ninth on-off valve V9, and the second port of the ninth on-off valve V9 is connected to the tube T18b.
- the tube T18b is connected to the airbag Y4.
- the outlet E1b of the centrifugal bowl E1 and the platelet intermediate bag Y3 are connected by the seventh line (tube T5, tube T15, tube T16, tube T17a, eighth on-off valve V8, tube T17b).
- the platelet intermediate bag Y3 is connected to communicate with the outlet side of the centrifuge bowl E1.
- a turbidity sensor C2 and a pressure sensor C3 for detecting the concentration of platelets are attached to a tube T5 connected to the outlet E1b of the centrifugal bowl E1.
- the turbidity sensor C2 detects the degree to which the plasma passing through the tube T5 becomes turbid with platelets.
- an interface sensor C4 for detecting the interface position of the buffy coat layer BC (see FIG. 3) formed in the centrifugal bowl E1 is attached to the peripheral portion where the centrifugal bowl E1 is attached.
- the tube T20a is connected to the first port of the tenth on-off valve V10, and the tenth on-off
- the second port of the valve V10 is connected to the tube T20b.
- the tube T21 is connected to the first port that is the output side of the third blood pump P3.
- the second port on the input side of the third blood pump P3 is connected to the platelet preservation solution bottle by the bottle needle 10 via the sterilizing filter 9.
- the tube T20b is connected to the platelet bag Y5 via the leukocyte removal filter 11.
- an airbag Y6 is connected to the platelet bag Y5.
- the output port of the ACD pump P4 is connected in the middle of the donor tube T1.
- the input port of the ACD pump P4 is connected to the output port of the sterilization filter 12.
- the input port of the sterilization filter 12 is connected to the ACD storage bottle by the bottle needle 13.
- the control unit 15 provided in the blood component separation device of the present embodiment is configured by a microcomputer, for example, and includes a first blood pump P1, a second blood pump P2, and a third blood pump.
- the valve V4, the fifth on-off valve V5, the sixth on-off valve V6, the seventh on-off valve V7, the eighth on-off valve V8, the ninth on-off valve V9, the tenth on-off valve V10, and the donor computation simulator 30 are electrically connected. ing.
- the detection signals from the sensors C1, C2, C3, and C4 are input to the control unit 15 as needed.
- the control unit 15 controls the operation / stop, rotation direction (forward / reverse rotation) and rotation speed of each pump P1, P2, P3, and P4 based on these detection signals and the like, and each on-off valve as necessary. Controls the opening / closing of V1, V2, V3, V4, V5, V6, V7, V8, V9, V10 and the operation of the centrifugal bowl drive device 14.
- the control unit 15 inputs and outputs information with the donor calculation simulator 30.
- the donor calculation simulator 30 predicts the platelet recovery rate based on the hematocrit value of blood collected from the donor and the platelet concentration of blood collected from the donor (the number of platelets predicted for the number of platelets in the blood to be processed). Number ratio). Based on the predicted platelet recovery rate calculated as described above, the donor computation simulator 30 recommends the number of cycles for platelet collection operation (a series of steps for separating blood collected from a donor and collecting platelets). Alternatively, the recommended processing amount is calculated.
- the donor calculation simulator 30 is an example of the “calculation unit” in the present invention.
- constituent material of the tube examples include various thermoplastic elastomers such as polyvinyl chloride, polyethylene, polypropylene, polyester such as PET and PBT, ethylene-vinyl acetate copolymer (EVA), polyurethane, and polyester elastomer.
- polyvinyl chloride is particularly preferred.
- Polyvinyl chloride provides sufficient flexibility and flexibility, is easy to handle, and is suitable for clogging with a clamp or the like.
- a polymer obtained by polymerizing or copolymerizing olefin or diolefin such as soft polyvinyl chloride, polyolefin, ethylene, propylene, butadiene, and isoprene in which DEHP is used as a plasticizer
- olefin or diolefin such as soft polyvinyl chloride, polyolefin, ethylene, propylene, butadiene, and isoprene in which DEHP is used as a plasticizer
- EVA ethylene-vinyl acetate copolymer
- PET, PBT, PCGT, etc. can be used.
- polyvinyl chloride is particularly preferable, but a container that stores platelet PLT preferably has excellent gas permeability in order to improve the storage stability of platelet PLT, such as polyolefin and DnDP plasticized polyvinyl chloride. It is preferable to use a sheet having a reduced thickness.
- FIG. 3 shows the structure of the centrifuge bowl E1.
- the right side from the center line is a sectional view, and the left side is an external view.
- An inflow port E1a and an outflow port E1b are formed in the fixed portion 20, which is a fixed portion that does not rotate.
- a cover 17 and an inflow pipe 18 extending downward are connected to the fixed portion 20.
- the side wall 21, the outer shell 22, the inner shell 23, and the bottom plate 16 are rotatably held integrally with these fixed portions.
- the bottom plate 16 is adsorbed to the centrifugal bowl driving device 14 (see FIG. 1) and is given a rotational force by the centrifugal bowl driving device 14.
- FIG. 3 shows a state in which whole blood is supplied from the inflow port E1a into the centrifuge bowl E1 and blood components are separated by centrifugal force.
- the red blood cell layer (RBC layer), the white blood cell layer (WBC layer), the buffy coat layer (BC layer), the platelets in descending order of specific gravity due to centrifugal force.
- a layer (PLT layer) and a plasma layer (PPP layer) are formed.
- PPP layer a plasma layer
- the white blood cell layer and the platelet layer are difficult to separate because of their specific gravity. Therefore, there exists a buffy coat layer including a leukocyte layer and a platelet layer.
- the breakdown of whole blood is about 55% for plasma PPP, about 43.2% for red blood cell RBC, about 1.35% for white blood cell WBC, and about 0.45% for platelet PLT.
- the donor calculation simulator 30 determines the recommended number of cycles for the platelet collection operation.
- the donor calculation simulator 30 calculates a predicted platelet recovery rate according to gender from the blood count value of blood preliminarily collected from the donor, and based on the calculated platelet recovery rate calculated in this way, the platelet recovery rate is calculated. Calculate the recommended number of cycles for sampling operations.
- the blood component separation device starts blood collection as follows. The details of the method for calculating the recommended number of cycles for platelet collection operation by the donor calculation simulator 30 will be described later.
- FIG. 6 is a diagram showing a blood collection start process (first process).
- a white display indicates an operating state
- a black display indicates a stopped state.
- a white display indicates an open state
- a black display indicates a closed state.
- the priming step (S1) in FIG. 4 is performed.
- the ACD pump P4 and the first blood pump P1 are driven, and ACD liquid for preventing blood coagulation is supplied to the centrifugal bowl E1 through the opened first on-off valve V1, and the centrifugal bowl E1, 1 Priming step (S1) of blood pump P1 or the like is performed.
- the priming is a process in which an ACD liquid is attached in advance to a portion in contact with blood such as in the donor tube T1, the first blood pump P1, and the centrifuge bowl E1 so that the blood does not coagulate when flowing. From the priming process, the centrifuge bowl drive device 14 rotates the centrifuge bowl E1 at a predetermined rotation speed.
- the blood collection needle 2 is punctured into the blood donor and the collection of whole blood is started (S2).
- the blood donor 2 is punctured into the blood donor, and then the primary blood is collected in the primary blood collection bag Y7 (see FIG. 1) in the primary blood collection circuit.
- the branch portion provided on the donor tube T1 is initially configured to connect the blood collection needle 2 and the initial blood collection line 4 (see FIG. 1).
- the initial blood collection line 4 is closed by the clamp 8 (see FIG. 1), and a flow path on the first blood pump P1 side of the donor tube T1 is secured.
- the ACD pump P4 is driven, the ACD liquid is supplied to the donor tube T1, mixed with the whole blood, and the whole blood is supplied to the centrifuge bowl E1.
- whole blood is supplied to the rotating centrifuge bowl E1, it is pushed by the plasma PPP from the outflow passage 19 (see FIG. 3) located at the inner periphery of the centrifuge bowl E1, and as shown in FIG. Air (indicated by a dotted line) in the centrifuge bowl E1 flows out.
- the air that has flowed out is stored in the airbag Y4 through the opened ninth on-off valve V9.
- the whole blood is separated into each component by applying a centrifugal force to the supplied whole blood in the bowl.
- the ninth on-off valve V9 is closed and the second on-off valve V2 is opened as shown in FIG. Open and store the plasma PPP overflowing from the centrifuge bowl E1 in the plasma bag Y1.
- the third on-off valve V3 is opened and the second blood pump P2 is opened.
- the fourth on-off valve V4 is opened to collect whole blood from the blood donor, and the plasma PPP stored in the plasma bag Y1 is mixed with the whole blood and supplied to the centrifuge bowl E1.
- This is the third step (critical flow step) (S5).
- This is the critical flow period TE shown in FIG.
- the critical flow process is an example of the “circulation flow process” in the present invention.
- the interface sensor C4 detects that the interface between the buffy coat layer (BC layer) and the red blood cell layer (RBC layer) in FIG. 3 has come to a predetermined position (S6: YES), as shown in FIG.
- the first on-off valve V1 is closed, the second on-off valve V2, the third on-off valve V3, the fourth on-off valve V4 are opened, and the second blood pump P2 is driven.
- the plasma PPP passes through the third on-off valve V3, the second blood pump P2, the fourth on-off valve V4, the centrifugal bowl E1, and the second on-off valve V2, and then returns to the plasma bag Y1 again. (4th process) is performed. This is the circulation period TF shown in FIG.
- the current cycle is the last cycle. If the current cycle is not the last cycle (S7: NO), the sixth open / close valve V6 is opened and the state in which the first blood pump P1 is driven is maintained.
- the collected whole blood is stored in Y2 (S11). In other words, the collection of whole blood is continued by storing the whole blood collected in the temporary storage bag Y2.
- the whole blood is continuously collected until the circulation / acceleration process is completed or until a predetermined amount of time is reached.
- the final cycle S7: YES
- the first blood pump P1 is stopped and blood collection is stopped (S8).
- the circulation rate is made faster than the critical flow step, and the plasma PPP is allowed to pass through the centrifuge bowl E1 at a rate of about 100 ml / min for about 30 to 40 seconds. Circulate.
- the particulate matter concentration in the buffy coat layer BC of FIG. 3 is reduced, and the white blood cells WBC having a higher specific gravity than the platelet PLT are deposited outside the buffy coat layer (BC layer). That is, the platelet layer (PLT layer) and the white blood cell layer (WBC layer) can be more clearly separated.
- the process enters the acceleration process (fifth process) in the circulation / acceleration process shown in FIG.
- the acceleration process by controlling the rotation speed of the second blood pump P2, the rotation speed is gradually increased to gradually increase the flow rate of the plasma PPP.
- the flow rate is increased starting from 100 ml / min, and the flow rate of plasma PPP is accelerated until platelet PLT flows out.
- This is the acceleration period TG shown in FIG.
- the circulation process and the acceleration process are combined and expressed as a circulation / acceleration process (S9, S12).
- the platelet PLT gains a force in the ascending direction and is released from the outflow passage 19 to the outside of the centrifugal bowl E1.
- the white blood cell layer (WBC layer) and the red blood cell layer (RBC layer) having a large specific gravity do not leave the outflow passage 19 because the centrifugal force is stronger.
- FIG. 20 shows changes in the concentration of platelet PLT, leukocyte WBC, and red blood cell RBC.
- the horizontal axis represents the time course at the time of collection of platelet PLT, and the vertical axis represents the concentration of the blood cell component that flows out.
- outflow period TA there is an outflow of platelet PLT (outflow period TA)
- the outflow amount of platelet PLT gradually increases, and gradually decreases when the maximum flow rate is exceeded.
- leukocytes gradually increase in outflow and decrease gradually after the maximum flow rate.
- step S9 and step S12 are shown in FIG. 5 as a flowchart showing the operation of the blood component separation device.
- the platelet outflow period TA includes a low concentration period TB in which low-concentration platelet liquid PC flows out first, followed by a high concentration period TC in which high-concentration platelet liquid PC flows out, and then again low-concentration platelets.
- the liquid PC can be divided into low concentration periods TD.
- low-concentration platelet liquid PC is not necessary.
- the turbidity sensor C2 detects the platelet PLT, that is, when it is determined that it is the low concentration period TB (S21: YES)
- the second on-off valve V2 Is closed
- the fifth on-off valve V5 is opened
- the platelet liquid PC in the low concentration period TB of FIG. 20 is stored in the temporary storage bag Y2 (S22).
- the low-concentration platelet liquid PC is stored in the temporary storage bag Y2 in a state of being mixed with the whole blood.
- the first blood pump P1 is kept in a driving state, and the whole blood collected from the blood donor continues to be stored in the temporary storage bag Y2.
- the temporary storage bag Y2 is used as a buffy coat bag simultaneously with the whole blood bag.
- the turbidity sensor C2 detects that the platelet liquid PC has a high concentration, it is determined that it is the high concentration period TC (S23: YES), and as shown in FIG. 11, the fifth on-off valve V5 Is closed and the eighth on-off valve V8 is opened. Thereby, the high concentration platelet liquid PC flowing out during the high concentration period TC can be stored in the platelet intermediate bag Y3 (S24).
- the amount of the high-concentration platelet liquid PC stored in the platelet intermediate bag Y3 is easily adjusted by controlling the valve opening time of the eighth on-off valve V8 based on the flow rate of the platelet liquid PC flowing out from the centrifugal bowl E1. can do.
- the rotation of the centrifugal bowl E1 is stopped, the sixth on-off valve V6 and the fifth on-off valve V5 are closed, the first on-off valve V1 and the ninth on-off valve V9 are opened, and the first blood pump P1 is reversely rotated.
- the blood return to return the blood remaining in the centrifuge bowl E1 to the donor is started.
- the reverse rotation speed of the first blood pump P1 is driven at a double speed of the normal rotation speed to shorten the blood return time.
- the second blood pump P2 is driven to return the plasma PPP that has been excessively collected and stored in the plasma bag Y1.
- the blood stored in the temporary storage bag Y2 also opens the seventh on-off valve V7, drives the second blood pump P2, and simultaneously flows into the centrifuge bowl E1 through the fourth on-off valve V4 (S14). ).
- the third on-off valve V3 is closed so that the fluid does not flow into the plasma bag Y1.
- the ninth on-off valve V9 is closed and the second on-off valve V2 is turned on. Open and store the plasma PPP overflowing from the centrifuge bowl E1 in the plasma bag Y1.
- This cycle is normally performed for 3 or 4 cycles until a predetermined amount of platelet PLT is secured based on the recommended number of platelet collection operations calculated by the donor computation simulator 30. For example, since the recommended number of platelet collection operations for the platelet collection operation is calculated as 3 cycles by the donor computation simulator 30, when the cycle ends in 3 cycles, the circulation cycle TF2 and the acceleration period TG2 of the second cycle are executed in parallel. Blood is collected and whole blood is stored in the temporary storage bag Y2. At the time of blood collection in the third cycle, the blood in the temporary storage bag Y2 is mixed with whole blood and supplied to the centrifuge bowl E1. In the third cycle, blood is not collected during the circulation period TF3 and the acceleration period TG3. This is because there is no fourth cycle.
- the tenth on-off valve V10 is opened, and the platelet bag PC and the platelet preservation solution stored in the platelet intermediate bag Y3 are passed through the leukocyte removal filter 11 to the platelet bag. Inject into Y5. At this time, the air present in the platelet bag Y5 moves to the airbag Y6.
- the third blood pump P3 is driven and connected to the platelet storage liquid bottle.
- the platelet preservation solution remaining in the platelet preservation solution bottle is injected into the platelet bag Y 5 through the sterilization filter 9 and the leukocyte removal filter 11.
- the high-concentration platelet liquid PC that has been filtered and remains in the leukocyte removal filter 11 is collected.
- the two tubes of the platelet bag Y5 are sealed. Thereby, the platelet bag Y5 in which the high-concentration platelet liquid PC is stored is completed.
- the preparation platelet recovery rate (the ratio of the number of platelets actually collected in the platelet bag Y5 as a preparation to the number of platelets in the blood to be treated) varies depending on the sex. That is, the preparation platelet recovery rate tends to be smaller when the donor is a woman than when the donor is a male, even if the donors are the same cycle donors (donors with the same number of platelet collection operations). .
- the gender difference (predetermined value ⁇ ) in the preparation platelet recovery rate tends to increase.
- the 2-cycle donor is 2%
- the 3-cycle donor is 4%
- the 4-cycle donor is 5%
- the predetermined value ⁇ is increased as the number of platelet collection operations increases. Will grow.
- the donor calculation simulator 30 changes the value of the predicted platelet recovery rate according to gender. That is, the donor calculation simulator 30 calculates the predicted platelet recovery rate calculated from an arbitrary blood count value (hematocrit value and platelet concentration of pre-collected blood) when the blood donor is a female than when the blood donor is a male. Is also reduced by a predetermined value ⁇ . For example, the donor calculation simulator 30 calculates the predicted platelet recovery rate for an arbitrary blood count value as X% when the blood donor is male, while (X ⁇ )% when the blood donor is female. And calculate. X and ⁇ are arbitrary numbers of 0 or more.
- the donor calculation simulator 30 calculates the recommended number of cycles for the platelet collection operation based on the predicted platelet recovery rate calculated according to gender in this way. Thereby, in men and women with the same blood count, the recommended number of cycles or recommended throughput of the platelet collection operation can change.
- the HCT value hematocrit value
- the PLT value platelet concentration
- the predicted platelet recovery rate is conventionally 78% regardless of gender, and the recommended number of cycles for platelet collection operation is determined based on the predicted platelet recovery rate, and the predicted PLT number ( The estimated number of platelets collected) was calculated.
- the recommended number of cycles for platelet collection operation is determined to be 3 times regardless of whether the blood donor is male or the blood donor is female.
- the number of PLTs was calculated as 2.04 ⁇ 10 11 pieces (indicated as “2.04 ⁇ 10e11 pieces” in the figure), which is close to the lower limit of the target number of units (10 units).
- the expected number of PLT products (the number of platelets actually collected in the platelet bag Y5) Is 2.04 ⁇ 10 11 when the male is a male, but 1.93 ⁇ 10 11 when the blood donor is a female (indicated as “1.93 ⁇ 10e11” in the figure). I have. That is, although blood was processed according to the recommended number of cycles for collecting platelets, 10 units of platelets could be collected when the donor was male, while 10 units of blood when the donor was female. Platelets could not be collected.
- the unit is used when the blood donor is a woman due to the influence of the difference in the circulating blood volume between men and women and the difference in the blood flow situation. There was a risk of cracking.
- the donor calculation simulator 30 calculates, for example, 78% when the blood donor is a male, based on the blood count value, while the blood donor For example, 74% is calculated for a female. Then, the donor computation simulator 30 calculates the recommended number of cycles for the platelet collection operation and the predicted number of PLTs based on the predicted platelet recovery rate.
- the donor calculation simulator 30 calculates the recommended cycle number three times and the predicted PLT number 2.04 ⁇ 10 11 .
- the donor computation simulator 30 predicts that the predicted PLT number is 1.93 ⁇ 10 11 and a unit break occurs when the recommended cycle number is 3 times. Therefore, the recommended cycle number is calculated as 4 times and the predicted PLT number is calculated as 2.50 ⁇ 10 11 .
- the range of the predetermined value ⁇ can be set as shown in FIG. 24, for example.
- the range of the predetermined value ⁇ is set for one to five cycle donors.
- the upper limit value of the predetermined value ⁇ increases.
- “3-cycle donor” is a case where the recommended number of platelet collection operations is calculated as 3 if the blood donor is a male.
- a value obtained by subtracting 0 to 6.0% from the predicted platelet recovery rate when the blood donor is a male is set as the predicted platelet recovery rate.
- the blood component separation apparatus of the present embodiment calculates a predicted platelet recovery rate from the hematocrit value and platelet concentration of blood collected from a blood donor, and based on the calculated predicted platelet recovery rate. And a donor calculation simulator 30 for calculating a recommended cycle number (recommended blood treatment amount) recommended for collecting a target number of platelets. Then, the donor calculation simulator 30 calculates a predicted platelet recovery rate calculated from an arbitrary hematocrit value and an arbitrary platelet concentration when the blood donor is a female, by a predetermined value ⁇ smaller than when the blood donor is a male. .
- the predetermined value ⁇ increases as the predicted platelet recovery rate decreases and the recommended number of cycles increases. Therefore, regardless of the number of cycles and the sex of the donor, the target number of platelets can be reliably collected.
- the blood component separation apparatus of the present embodiment includes: a) a centrifugal separation step of introducing the blood into a centrifuge and separating the blood into a plurality of blood components; and b) centrifugal separation of plasma among the separated blood components.
- a blood return step for returning blood to the donor, and the steps a) to d) are performed as one cycle.
- platelets can be accurately separated from other blood components. Since the timing for collecting high-concentration platelets is optimized, more platelets can be collected efficiently.
- Example 2 The method of changing the value of the predicted platelet recovery rate according to sex as described above can also be applied to the belt-type continuous centrifuge 50, which is another aspect of the blood component separation device.
- the continuous centrifuge 50 includes an annular rotor 52, a motor 54 coupled to the rotor 52, and an annular (annular belt shape) integrally disposed with the rotor 52 inside the rotor 52.
- the blood collected from the blood donor is filled into the separation container 56 and the fluid chamber 58. Specifically, as shown in FIG. 26, blood flows into the separation container 56 through the inflow pipe 66 by the inflow pump 64.
- the collection pump 68 is activated, blood flows from the inlet portion 70 toward the outlet portion 72 in the counterclockwise direction (counterclockwise direction) in the separation container 56 shown in FIG.
- the entrance portion 70 and the exit portion 72 are blocked by a wall 73.
- each component of the blood is stratified in the descending order of density, that is, in the order of red blood cells, white blood cells, platelets, and plasma. That is, as shown in FIG. 26, a layer of red blood cells RBC is formed along the outer wall of the separation container 56, and a layer of plasma PPP is formed along the inner wall of the separation container 56. A layer of platelet PLT and white blood cell WBC is formed between the layer of red blood cells RBC and the layer of plasma PPP.
- the plasma PPP flows through the first passage 76 to a position downstream of the barrier 78 (right side in FIG. 26) and is removed through the collection line 80.
- the red blood cell RBC flows through the second passage 82 to a position downstream of the barrier 78 and is removed through the collection line 84.
- the platelet PLT and the white blood cell WBC remain at a position upstream of the barrier 78 (left side in FIG. 26).
- the remaining platelet PLT flows into the fluid chamber 58 through the collection line 86 together with the white blood cells WBC.
- the platelet PLT and the white blood cell WBC are deposited in the fluid chamber 58.
- the platelet PLT is deposited at a position farther from the inlet 88 of the fluid chamber 58 than the white blood cell WBC. In this way, a deposited layer of platelet PLT is formed in the fluid chamber 58.
- the white blood cells WBC are deposited in the fluid chamber 58 between the inlet 88 and the platelet PLT deposition layer.
- the platelet PLT deposited in this manner is collected from the fluid chamber 58 and collected and stored in a predetermined container. In this manner, the platelet PLT is collected from the blood in the continuous centrifuge 50.
- the donor calculation simulator 62 calculates the predicted platelet recovery rate calculated from an arbitrary blood count value in the case where the blood donor is a woman, as described above. In this case, the predetermined value ⁇ is made smaller than the case where the blood donor is male. Based on the predicted platelet recovery rate according to the gender thus calculated, the donor computation simulator 62 recommends a recommended blood processing amount (a blood processing recommended for collecting a target number of platelets). Amount).
- the donor calculation simulator 62 increases the recommended blood processing volume for men and women with the same blood count value when the blood donor is a female, compared with when the blood donor is a male. For example, when the recommended blood processing amount when the blood donor is a male is 1500 ml, the recommended blood processing amount when the blood donor is a female is 1580 ml.
- the predetermined value ⁇ increases as the predicted platelet recovery rate decreases and the recommended blood processing amount increases.
- the blood component separation apparatus of the present embodiment calculates a predicted platelet recovery rate from the hematocrit value and platelet concentration of blood collected from a blood donor, and based on the calculated predicted platelet recovery rate. And a donor calculation simulator 62 for calculating a recommended blood processing amount recommended for collecting a target number of platelets. Then, the donor calculation simulator 62 calculates a predicted platelet recovery rate calculated from an arbitrary hematocrit value and an arbitrary platelet concentration when the blood donor is a female, by a predetermined value ⁇ smaller than when the blood donor is a male. .
- the predetermined value ⁇ increases as the predicted platelet recovery rate decreases and the recommended amount of blood treatment increases. Therefore, the target number of platelets can be reliably collected regardless of the blood processing amount and the donor's gender.
- the blood component separation apparatus of the present embodiment rotates the separation container 56 around the rotation axis AA while supplying the blood into the annular separation container 56, whereby the blood in the separation container 56 is divided into a plurality of pieces. Blood components are separated, and platelets are collected from the separated blood components. Thereby, platelets can be accurately separated from other blood components with a simple apparatus configuration.
- the buffy coat bag and the whole blood bag are used as the temporary storage bag Y2, but the buffy coat bag and the whole blood bag may be provided in parallel as separate bags.
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Abstract
Description
図1に示すように、本実施例の血液成分分離装置は、血液成分分離回路1を有する。血液成分分離回路1は、採血針2と、初流血を採取するための初流血採取バッグY7、サンプリングポート3、初流血採取ライン4とからなる初流血採取回路5を有する。
前記のように性別に応じて予測血小板回収率の値を変える手法は、血液成分分離装置の他の態様であるベルト方式の連続型遠心機50にも適用できる。
15 制御部
E1 遠心ボウル
Y1 血漿バッグ(第1の容器)
Y2 一時貯留バッグ(第2の容器)
Y3 血小板中間バッグ(第3の容器)
Y4 エアバッグ
Y5 血小板バッグ
Y6 エアバッグ
C2 濁度センサ
C4 界面センサ
P1 第1血液ポンプ
P2 第2血液ポンプ
P3 第3血液ポンプ
V1 第1開閉弁
V2 第2開閉弁
V3 第3開閉弁
V4 第4開閉弁
V5 第5開閉弁
V6 第6開閉弁
V7 第7開閉弁
V8 第8開閉弁
V9 第9開閉弁
V10 第10開閉弁
T1~21 チューブ
PLT 血小板
PC 血小板液
PPP 血漿
RBC 赤血球
WBC 白血球
30 ドナー演算シミュレータ
50 連続型遠心機
52 ローター
54 モータ
56 分離容器
58 流体チャンバ
62 ドナー演算シミュレータ
Claims (4)
- 供血者より採取した血液から複数の血液成分を分離して血小板を採取する血液成分分離装置において、
前記血液のヘマトクリット値と前記血液の血小板濃度とから予測血小板回収率を算出し、算出した前記予測血小板回収率をもとに、目標の単位数の血小板を採取するために推奨される前記血液の推奨処理量を算出する演算部を有し、
前記演算部は、任意の前記ヘマトクリット値と任意の前記血小板濃度とから算出される前記予測血小板回収率を、前記供血者が女性の場合には前記供血者が男性の場合よりも所定値α小さくすること、
を特徴とする血液成分分離装置。 - 請求項1の血液成分分離装置において、
前記血液の推奨処理量が多くなるに従い、前記所定値αは大きくなること、
を特徴とする血液成分分離装置。 - 請求項1または2の血液成分分離装置において、
a)前記血液を遠心分離器に導入し、複数の血液成分に分離する遠心分離工程と、
b)分離された血液成分のうち血漿を前記遠心分離器内に前記血液と共に導入する循環フロー工程と、
c)前記循環フロー工程の後、前記血液の前記遠心分離器への供給を停止して、前記遠心分離器に血漿のみを導入し、所定時間さらに血漿を循環させた後、循環速度を加速することにより血小板を前記遠心分離器により分離し、採取する循環・加速工程と、
d)前記循環・加速工程の後、採取しなかった血液成分について前記供血者へ返血する返血工程と、を行い、
前記a)~d)の工程を1つのサイクルとして行うものであり、
前記演算部は、前記血液の推奨処理量として推奨サイクル数を算出すること、
を特徴とする血液成分分離装置。 - 請求項1または2の血液成分分離装置において、
前記血液を環状の分離容器内に供給しながら前記分離容器を軸中心に回転させることにより、前記分離容器内の前記血液を複数の血液成分に分離させ、分離させた前記複数の血液成分から血小板を採取すること、
を特徴とする血液成分分離装置。
Priority Applications (4)
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US15/510,592 US10518007B2 (en) | 2014-09-19 | 2015-08-26 | Blood component separation device |
EP15842039.8A EP3195886B1 (en) | 2014-09-19 | 2015-08-26 | Blood component separation device |
US16/680,819 US11623033B2 (en) | 2014-09-19 | 2019-11-12 | Blood component separation device |
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US10112003B2 (en) | 2012-03-27 | 2018-10-30 | Terumo Kabushiki Kaisha | Blood component separation device |
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US11065629B2 (en) * | 2011-11-21 | 2021-07-20 | Pneumatic Scale Corporation | Centrifuge system for separating cells in suspension |
WO2018053217A1 (en) | 2016-09-16 | 2018-03-22 | Fenwal, Inc. | Blood separation systems and methods employing centrifugal and spinning membrane separation techniques |
US11311823B2 (en) | 2019-03-05 | 2022-04-26 | Fenwal, Inc. | Collection of mononuclear cells and peripheral blood stem cells |
EP3741404B1 (en) | 2019-05-23 | 2023-08-30 | Fenwal, Inc. | Centrifugal separation and collection of red blood cells or both red blood cells and plasma |
EP3741460B1 (en) | 2019-05-23 | 2023-09-27 | Fenwal, Inc. | Adjustment of target interface location between separated fluid components in a centrifuge |
US11957998B2 (en) * | 2019-06-06 | 2024-04-16 | Pneumatic Scale Corporation | Centrifuge system for separating cells in suspension |
EP3791904B1 (en) | 2019-09-16 | 2022-02-09 | Fenwal, Inc. | Dynamic adjustment of algorithms for separation and collection of blood components |
US11969536B2 (en) | 2019-12-12 | 2024-04-30 | Fenwal, Inc. | Systems enabling alternative approaches to therapeutic red blood cell exchange and/or therapeutic plasma exchange |
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US20200078501A1 (en) | 2020-03-12 |
EP3195886A1 (en) | 2017-07-26 |
JPWO2016043003A1 (ja) | 2017-06-29 |
US11623033B2 (en) | 2023-04-11 |
EP3195886B1 (en) | 2019-09-25 |
JP6542781B2 (ja) | 2019-07-10 |
US20170296718A1 (en) | 2017-10-19 |
US10518007B2 (en) | 2019-12-31 |
EP3195886A4 (en) | 2018-04-11 |
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