2017-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/699884摘要：輸血相關急性肺傷害(transfusion-related acute lung injury, TRALI)是種嚴重的輸血反應，病人會在輸血中或輸血後六小時內發生急性吸呼窘迫症(acute respiratory distress syndrome)，嚴重者甚至會致死。歐美輸血統計均是各種輸血反應中死亡第一。如何降低TRALI的發生是十分重要的課題。TRALI致病機轉學界認為是"兩重傷害"理論("tow hit")：病人具有潛在的易受性，例如敗血症、血液病或是手術等，再加上血品中的誘引物質。而誘引輸血相關急性肺傷害的因素可以分為兩類：1)免疫調控--因捐者體內抗白血球抗體或是抗人類白血球組織抗原抗體；2) 非免疫調控--因血品保存時釋出的脂質性生理作用物質(bio-mediator)，細胞微小顆粒等。本研究目的在研發新一代的血品過濾器，既可以移除血品中的白血球以降低相關反應，同時也可吸附血品中抗體、脂質 bio-mediator、細胞微小顆粒(cellular microparticle)等。以達到降低輸血發生TRALI的風險。之前本研究團隊已成應用4T-PET NW，將傳統PP NW的血品過濾器改良，設計出可以過濾白血球之輸血過濾器，我們將此為基礎，再加上抗體吸附與聚合體/等改良，有效移除/或減少血品中的抗體、生物活性物質等可能引發TRALI之有關物質，製成新一代的輸血過濾品，提昇輸血安全。<br> Abstract: Transfusion-related acute lung injury (TRALI) is a severe complication of blood component transfusion.TRALI has been defined as new acute lung injury (ALI)/acute respiratory distress syndrome (ARDS)occurring during or within six hours after blood product administration. the TRALI incidence data in Taiwanis unavailable. Additionally, passive reporting system has been shown to significantly underestimate the trueburden of the complications. Antibodies to human leukocyte antigen (HLA) Class I and human neutrophilantigens (HNA) in donor plasma are thought as important pathogenic factors in TRALI.Clinical TRALI can be divided into two forms based on its underlying mechanisms: 1) antibody-mediatedTRALI, mainly caused by HLA or HNA antibodies 2) non-antibody-mediated TRLAI, caused bybio-mediators released during storage.The aim of this study is to use 4T-PET NW to combine with traditional PP NW as an alternative to theexisting leukocyte filtration technologies. Furthermore, the filter can be used to adsorb TRALI-inducingantibodies or biologic response modifiers (BRMs) by appropriate chemical modification, such as by coatingantibody or other polymers (ex. cellulose). The new blood filter will mitigate the life-threatening TRALI andpromote transfusion safety.輸血輸血反應輸血相關急性肺傷害輸血過濾器TransfusionTransfusion reactionTransfusion-related acute lung injury (TRALI)Blood filter