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Shiri Y, Golmohammadi Zahuri M, Jafarpouri M R, Deyhim M R. ‎ An Overview of Alternative Platelet Storage Methods: From Room Temperature to Cold Storage and Freezing. bloodj 2026; 23 (2) :156-172
URL: http://bloodjournal.ir/article-1-1636-fa.html
شیری یاشار، گل محمدی ظهوری مهرناز، جعفرپوری محمدرضا، دیهیم محمدرضا. مروری بر روش‌های جایگزین نگهداری پلاکت : از نگهداری در دمای اتاق تا نگهداری در سرما و انجماد. فصلنامه پژوهشی خون. 1405; 23 (2) :156-172

URL: http://bloodjournal.ir/article-1-1636-fa.html


دانشیار مرکز تحقیقات انتقال خون ـ مؤسسه عالی آموزشی و پژوهشی طب انتقال خون
چکیده:   (247 مشاهده)
سابقه و هدف 
نگهداری پلاکت‌ها در دمای 24-20 درجه سانتی‌گراد، روش استانداردی است که در مراکز انتقال خون مورد استفاده قرار می گیرند. پلاکت‌ها در طول نگهداری در این شرایط دچار آسیب ذخیره پلاکتی (PSL) می شوند، ضمن این که ریسک آلودگی باکتریایی نیز در این روش وجود دارد. به منظور رفع این محدودیت‌ها، محققان به دنبال روش‌های جایگزین نگهداری پلاکت می‌باشند. این مقاله به مرور روشهای جایگزین و مقایسه آن¬ها با یکدیگر می‌پردازد. 
مواد و روش‌ها
در این مطالعه مروری، مطالعات مرتبط با روش‌های نگهداری پلاکت جستجو شد و متون مقالات و مراجع مربوطه بررسی، شناسایی و استخراج گردید. کلید واژه‌های انگلیسی (platelet storage ، platelet concentrate، platelet storage in room temperature ، cold storage ، cryopreservation ، lyophilization ، Platelet additive solution) مرتبط با موضوع  در پایگاه‌های داده SID، Scopus، Web of Science، PubMed، موتور جستجوی Google و Google Scholar در بازه زمانی ۱۹۵۴ تا 2025 جستجو شد و در نهایت 93 مقاله مورد استفاده قرار گرفت. سؤال اصلی در این پژوهش این است که آیا روش‌های دیگر نگهداری پلاکت با توجه به مزایا و محدودیت‌هایی که دارا می‌باشند می توانند از نظر کاربرد بالینی در مقایسه با نگهداری پلاکت در دمای اتاق (روش استاندارد) جایگزین گردند؟
یافته‌ها
نگهداری پلاکت‌ها در سرما (6-1 درجه سانتی‌گراد) با کاهش متابولیزم و کاهش ریسک آلودگی باکتریایی همراه است و هر چند پلاکت‌ها عملکرد هموستاتیک قوی‌تری دارند ولی کاهش بقا پس از تزریق یکی از محدودیت‌های آن می‌باشد. روش لیوفیلیزاسیون، امکان نگهداری طولانی ‌مدت پلاکت‌ها را در دمای محیط فراهم می کند، هر چند بقا پلاکت‌های لیوفیلیزه پس از تزریق کوتاه می‌باشد. منجمدسازی نیز امکان ذخیره‌سازی طولانی مدت پلاکت‌ها را فراهم کرده، اما به تجهیزات پیشرفته و انجام مراحل آماده‌سازی تخصصی نیاز دارد، به علاوه، پلاکت‌ها دچار تغییرات ساختاری جدی می‌گردند. استفاده از محلول‌های افزودنی پلاکت (PAS) نیز به عنوان راهکاری مؤثر برای کاهش وابستگی به پلاسما، کاهش واکنش‌های آلرژیک و تب‌زا و هم‌چنین بهبود شرایط متابولیکی مطرح می‌باشد، هر چند بهینه‌سازی نوع و غلظت آن نیازمند پژوهش‌های بیشتری است. 
نتیجه گیری            
روش‌های لیوفیلیزاسیون ، محدودیت‌هایی شامل هزینه بالا و زمانبر بودن تولید فرآیند را به همراه داشته، در عین حال شواهد کافی برای استفاده ایمن از این روش‌ها هنوز در دسترس نمی‌باشد. استفاده از پلاکت‌های منجمد شده در موارد خونریزی شدید و در شرایط جنگی زمانی که دسترسی کافی به فرآورده پلاکتی نباشد به عنوان جایگزین پیشنهاد می‌گردد. برای استفاده از PAS نیاز به مطالعات بیشتری می‌باشد. با این وجود، نگهداری پلاکت در24-20 درجه سانتی‌گراد به علت بقا مناسب پلاکت‌ها پس از تزریق، هم‌چنان به عنوان روش مرجع می‌باشد. 
واژه‌های کلیدی: پلاکت‌ها، منجمدسازی، محلول‌ها
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نوع مطالعه: مروري | موضوع مقاله: انتقال خون

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