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2025, 02, v.27 181-185
脐带血临床输注专家共识
基金项目(Foundation): 国家自然科学基金项目(81770144)
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DOI:
摘要:

脐带血(hUCB)广泛应用于移植和再生医学,其临床输注流程对治疗的安全性和有效性至关重要,但目前对输注关键步骤的管控尚未形成统一标准。为规范hUCB输注过程,编写组组织各医院的临床医护专家、脐血库技术专家共同撰写了《脐带血临床输注专家共识》。本共识涵盖了冻存hUCB从脐血库运输至医院后的复苏、输注前/输注时/输注后患者处理及用药、输注不良反应及处理措施等关键过程与操作规范。共识共形成6条推荐意见,旨在为广大医务工作者及科研人员提供参考,提高hUCB输注规范性,保障患者治疗安全性和疗效。

Abstract:

Human umbilical cord blood(hUCB)is widely used in transplantation and regenerative medicine. The infusion process is crucial for the safety and efficacy of hUCB treatment. However, there is no unified standard for the control of the infusion key steps. In order to standardize the infusion process of hUCB,we organized clinical medical experts from hospitals and technical experts of cord blood banks to jointly write the "Expert consensus on clinical infusion of cord blood". This consensus covers key processes and operating instructions of using hUCB,including thawing method of cryopreserved hUCB,patient management before/during/after infusion, and management of infusion reactions. A total of 6 recommendations were formed in the consensus, aiming to provide a reference for doctors and researchers, improve the standardization of hUCB infusion, and ensure the safety and efficacy of patients.

参考文献

[1] Zhu X,Tang B,Sun Z.Umbilical cord blood transplantation:still growing and improving[J].Stem Cells Transl Med,2021,10(Suppl 2):S62-S74.

[2] Mayani H,Wagner JE,Broxmeyer HE.Broxmeyer,cord blood research,banking,and transplantation:achievements,challenges,and perspectives[J].Bone Marrow Transplant,2020,55(1):48-61.

[3] Dessels C,Alessandrini M,Pepper MS.Factors influencing the umbilical cord blood stem cell industry:an evolving treatment landscape[J].Stem Cells Transl Med,2018,7(9):643-650.

[4] Kanate AS,Majhail NS,Savani BN,et al.Indications for hematopoietic cell transplantation and immune effector cell therapy:guidelines from the american society for transplantation and cellular therapy[J].Biol Blood Marrow Transplant,2020,26(7):1247-1256.

[5] Regan DM,Wofford JD,Wall DA.Comparison of cord blood thawing methods on cell recovery,potency,and infusion[J].Transfusion,2010,50(12):2670-2675.

[6] Akel S,Regan D,Wall D,et al.Current thawing and infusion practice of cryopreserved cord blood:the impact on graft quality,recipient safety,and transplantation outcomes[J].Transfusion,2014,54(11):2997-3009.

[7] Huang L,Song GQ,Wu Y,et al.Optimal length of time of cryopreserved umbilical cord blood infusion after thawing[J].Hematology,2014,19(2):73-79.

[8] Hashimoto S,Kato K,Kai S,et al.Adverse events caused by cord blood infusion in Japan during a 5-year period[J].Vox Sang,2023,118(1):84-92.

[9] Dahlberg A,Kurtzberg J,Boelens J,et al.Guidelines for pediatric unrelated cord blood transplantation-unique considerations[J].Transplant Cell Ther,2021,27(12):968-972.

[10] Li X,Dong Y,Li Y,et al.Low-dose decitabine priming with intermediate-dose cytarabine followed by umbilical cord blood infusion as consolidation therapy for elderly patients with acute myeloid leukemia:a phase Ⅱ single-arm study[J].BMC Cancer,2019,19(1):819.

[11] World Health Organization.WHO handbook for guideline development[DB/OL].2nd Edition.2014.https://www.who.int/publications/i/item/9789241548960.

[12] 潘锋.《中国制订/修订临床诊疗指南的指导原则》由北京协和医院牵头发布[J].中国当代医药,2022,29(10):3-4.

[13] Scaradavou A,Avecilla ST,Tonon J,et al.Guidelines for cord blood unit thaw and infusion[J].Biol Blood Marrow Transplant,2020,26(10):1780-1783.

[14] Ponce DM,Politikos I,Alousi A,et al.Guidelines for the prevention and management of graft-versus-host disease after cord blood transplantation[J].Transplant Cell Ther,2021,27(7):540-544.

[15] New York Blood Center.Hemacord(HPC,cord blood)FDA package insert[DB/OL].2012 [2024-08-06].https://www.fda.gov/media/82016/download?attachment.

[16] Fact-Jacie.International standards for hematopoietic cellular therapy product collection,processing,and administration[DB/OL].8th Editor.Omaha.2021.

[17] 丁冬明,彭科琴,许琳利.受血者不规则抗体筛查在临床安全输血中的意义[J].中国实用医药,2020.15(35):91-93.

[18] 李宏科,雷鹏举,何红英,等.基于循证医学研究我国成人输血不良反应的临床特点及相关影响因素[J].中国输血杂志,2021,34(10):1117-1120.

[19] 常洪劲,许静静,李岩.临床输血不良反应原因分析及对策[J].济宁医学院学报,2016,39(4):254-257.

[20] 李晓雁,毛凯,郑拉让,等.5200例受血者中输血不良反应的危险因素及预防措施分析[J].临床医学研究与实践,2019,4(26):22-24.

[21] Ikeda K,Ohto H,Okuyama Y,et al.Adverse events associated with infusion of hematopoietic stem cell products:a prospective and multicenter surveillance study[J].Transfus Med Rev,2018,S0887-7963(18)30023-3.

[22] Ikeda K,Ohto H,Yamada-Fujiwara M,et al.Hematopoietic cell infusion-related adverse events in pediatric/small recipients in a prospective/multicenter study[J].Transfusion,2020,60(5):1015-1023.

[23] Abe T,Shimada E,Takanashi M,et al.,Antibody against immunoglobulin E contained in blood components as causative factor for anaphylactic transfusion reactions[J].Transfusion,2014,54(8):1953-1960.

[24] Kenyon M,Babic A.The European blood and marrow transplantation textbook for nurses:under the auspices of EBMT[M].Cham(CH):Springer,2018.

[25] Fang Y,Liu MJ,Zhang WW,et al.Nutrition support practices of hematopoietic stem cell transplantation centers in China's mainland[J].Curr Med Sci,2020,40(4):691-698.

[26] 刘新,姚伟涛,王莹莹,等.应用大剂量甲氨蝶呤前不同水化量在骨肉瘤患者治疗中的临床效果观察[J].河南大学学报(医学版),2022.41(3):204-207.

[27] Arya VK.Basics of fluid and blood transfusion therapy in paediatric surgical patients[J].Indian J Anaesth,2012,56(5):454-462.

[28] Dahi PB,Ponce DM,Devlin S,et al."No wash" albumin-dextran dilution for double-unit cord blood transplantation is safe with high rates of sustained donor engraftment[J].Biol Blood Marrow Transplant,2014,20(4):490-494.

[29] Barker JN,Kurtzberg J,Ballen K,et al.Optimal practices in unrelated donor cord blood transplantation for hematologic malignancies[J].Biol Blood Marrow Transplant,2017,23(6):882-896.

[30] Novak JE,Ellison DH.Diuretics in states of volume overload:core curriculum 2022[J].Am J Kidney Dis,2022,80(2):264-276.

[31] 陆茵,朱霞明,李芹,等.第三方脐血输注不良反应现状及其影响因素研究[J].中华护理杂志,2017,52(5):576-580.

[32] Memorial Sloan Kettering Cancer Center.Allogeneic stem cell transplant:a guide for patients & caregivers[DB/OL].(2021-09-07)[2024-08-06].www.mskcc.org/pe/allogeneic_guide.

[33] Poder TG,Nonkani WG,Tsakeu Leponkouo é.Blood warming and hemolysis:a systematic review with Meta-analysis[J].Transfus Med Rev,2015,29(3):172-180.

[34] 张红,李凤霞,王艳平,等.血液病患者脐血干细胞输入3小时内不良反应观察与分析[J].护理学杂志,2021,36(21):32-34.

[35] Konuma T,Ooi J,Takahashi S,et al.Cardiovascular toxicity of cryopreserved cord blood cell infusion[J].Bone Marrow Transplant,2008,41(10):861-865.

[36] Ballen K,Logan BR,Chitphakdithai P,et al.Unlicensed umbilical cord blood units provide a safe and effective graft source for a diverse population:a study of 2456 umbilical cord blood recipients[J].Biol Blood Marrow Transplant,2020,26(4):745-757.

[37] 黄璐,宋瑰琦,吴云.深低温冻存脐血复温后输注导致高血压的影响因素分析[J].护理学报,2012,19(23):1-3.

[38] Aubron C,Aries P,Le Niger C,et al.How clinicians can minimize transfusion-related adverse events?[J].Transfus Clin Biol,2018,25(4):257-261.

[39] Sarai M,Tejani AM.Loop diuretics for patients receiving blood transfusions[J].Cochrane Database Syst Rev,2015,2:CD010138.

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DOI:

中图分类号:R457.1

引用信息:

[1]《脐带血临床输注专家共识》编写组,朱莉萍,李啸扬.脐带血临床输注专家共识[J].中华保健医学杂志,2025,27(02):181-185.

基金信息:

国家自然科学基金项目(81770144)

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