Information
-
Patent Grant
-
6524231
-
Patent Number
6,524,231
-
Date Filed
Friday, September 3, 199925 years ago
-
Date Issued
Tuesday, February 25, 200321 years ago
-
Inventors
-
Original Assignees
-
Examiners
Agents
- Ryan; Daniel D.
- Price; Bradford R. L.
-
CPC
-
US Classifications
Field of Search
US
- 494 43
- 494 45
- 494 41
- 210 782
- 210 787
- 210 789
- 210 5121
-
International Classifications
-
Abstract
A blood separation chamber for rotation about an axis includes an interior channel, which includes a recess that extends outside the bounds of the walls establishing separation zone. The recessed interior channel permits the yields of individual blood components separated in the chamber to be. maximized without cross-contamination or contamination by other components present in the chamber.
Description
FIELD OF THE INVENTION
This invention relates to systems and methods for processing and collecting blood, blood constituents, or other suspensions of cellular material.
BACKGROUND OF THE INVENTION
Today people routinely separate whole blood, usually by centrifugation, into its various therapeutic components, such as red blood cells, platelets, and plasma.
Conventional blood processing methods use durable centrifuge equipment in association with single use, sterile processing systems, typically made of plastic. The operator loads the disposable systems upon the centrifuge before processing and removes them afterwards.
Conventional blood centrifuges are of a size that does not permit easy transport between collection sites. Furthermore, loading and unloading operations can sometimes be time consuming and tedious.
In addition, a need exists for further improved systems and methods for collecting blood components in a way that lends itself to use in high volume, on line blood collection environments, where higher yields of critically needed cellular blood components, like plasma, red blood cells, and platelets, can be realized in reasonable short processing times.
The operational and performance demands upon such fluid processing systems become more complex and sophisticated, even as the demand for smaller and more portable systems intensifies. The need therefore exists for automated blood processing controllers that can gather and generate more detailed information and control signals to aid the operator in maximizing processing and separation efficiencies.
SUMMARY OF THE INVENTION
The invention provides systems and methods for processing blood and blood constituents that lend themselves to portable, flexible processing platforms equipped with straightforward and accurate control functions.
More particularly, the invention provides a blood separation chamber for rotation about an axis. The chamber includes an interior channel, which includes a recess that extends outside the bounds of the walls establishing separation zone. The recessed interior channel permits the yields of individual blood components separated in the chamber to be maximized without cross-contamination or contamination by other components present in the chamber.
According to one aspect of the invention, the chamber includes inside and outside walls, which extend circumferentially about the axis in a spaced apart relationship to define between them a separation channel. An interior wall extends partially into the separation channel from one of the inside and outside walls toward the other one of the inside and outside walls. The partial interior wall defines a constricted channel along the other wall. The constricted channel includes a recess extending into the other wall. A first passage communicates with the separation channel one side of the recess. A second passage communicates with the separation channel on the other side of the recess.
One of the first and second passages can be configured to convey blood into the separation channel through the recess. Alternatively, one of the first and second passages can be configured to convey blood from the separation channel through the recess.
In one embodiment, the partial interior wall extends from the inside wall toward the outside wall. In this arrangement, the recess is in the outside wall and is radially spaced from the rotational axis farther than adjacent regions of the outside wall. Red blood cells can exit the separation channel through the recess. Because the recess extends beyond the outside (i.e., high-g) wall, the interface between the red blood cells and the buffy coat can be positioned very close to the high-g wall during blood processing, without spilling the contents of the buffy coat (e.g., leukocytes or platelets) into the red blood cell collection passage. The recessed exit thereby permits red blood cell yields to be maximized (in a red blood cell collection procedure) or an essentially platelet-free plasma to be collected (in a plasma collection procedure).
In one embodiment, the blood separation chamber includes a second partial interior wall extending partially into the separation channel from one of the inside and outside walls toward the other one of the inside and outside walls, to thereby define a second constricted channel along the other wall. In this arrangement, the second constricted channel can also include a second recess extending into the other wall. A third passage can communicate with the separation channel on one side of the second recess.
In one embodiment, the inside and outside walls, the partial interior wall or walls, and recess or recesses comprise a unitary formed body.
Other features and advantages of the inventions are set forth in the following specification and attached drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1
is a perspective view of a system that embodies features of the invention, with the disposable processing set shown out of association with the processing device prior to use;
FIG. 2
is a perspective view of the system shown in
FIG. 1
, with the doors to the centrifuge station and pump and valve station being shown open to accommodate mounting of the processing set;
FIG. 3
is a perspective view of the system shown in
FIG. 1
with the processing set fully mounted on the processing device and ready for use;
FIG. 4
is a right perspective front view of the case that houses the processing device shown in
FIG. 1
, with the lid closed for transporting the device;
FIG. 5
is a schematic view of a blood processing circuit, which can be programmed to perform a variety of different blood processing procedures in association with the device shown in
FIG. 1
;
FIG. 6
is an exploded perspective view of a cassette, which contains the programmable blood processing circuit shown in
FIG. 5
, and the pump and valve station on the processing device shown in
FIG. 1
, which receives the cassette for use;
FIG. 7
is a plane view of the front side of the cassette shown in
FIG. 6
;
FIG. 8
is an enlarged perspective view of a valve station on the cassette shown in
FIG. 6
;
FIG. 9
is a plane view of the back side of the cassette shown in
FIG. 6
;
FIG. 10
is a plane view of a universal processing set, which incorporates the cassette shown in
FIG. 6
, and which can be mounted on the device shown in
FIG. 1
, as shown in
FIGS. 2 and 3
;
FIG. 11
is a top section view of the pump and valve station in which the cassette as shown in
FIG. 6
is carried for use;
FIG. 12
is a schematic view of a pneumatic manifold assembly, which is part of the pump and valve station shown in
FIG. 6
, and which supplies positive and negative pneumatic pressures to convey fluid through the cassette shown in
FIGS. 7 and 9
;
FIG. 13
is a perspective front view of the case that houses the processing device, with the lid open for use of the device, and showing the location of various processing elements housed within the case;
FIG. 14
is a schematic view of the controller that carries out the process control and monitoring functions of the device shown in
FIG. 1
;
FIGS. 15A
,
15
B, and
15
C are schematic side view of the blood separation chamber that the device shown in
FIG. 1
incorporates, showing the plasma and red blood cell collection tubes and the associated two in-line sensors, which detect a normal operating condition (FIG.
15
A), an over spill condition (FIG.
15
B), and an under spill condition (FIG.
15
C);
FIG. 16
is a perspective view of a fixture that, when coupled to the plasma and red blood cell collection tubes hold the tubes in a desired viewing alignment with the in-line sensors, as shown in
FIGS. 15A
,
15
B, and
15
C;
FIG. 17
is a perspective view of the fixture shown in
FIG. 16
, with a plasma cell collection tube, a red blood cell collection tube, and a whole blood inlet tube attached, gathering the tubes in an organized, side-by-side array;
FIG. 18
is a perspective view of the fixture and tubes shown in
FIG. 17
, as being placed into viewing alignment with the two sensors shown in
FIGS. 15A
,
15
B, and
15
C;
FIG. 19
is a schematic view of the sensing station, of which the first and second sensors shown in
FIGS. 15A
,
15
B, and
15
C form a part;
FIG. 20
is a graph of optical densities as sensed by the first and second sensors plotted over time, showing an under spill condition;
FIG. 21
is an exploded top perspective view of the molded centrifugal blood processing container, which can be used in association with the device shown in
FIG. 1
;
FIG. 22
is a bottom perspective view of the molded processing container shown in
FIG. 21
;
FIG. 23
is a top view of the molded processing container shown in
FIG. 21
;
FIG. 24
is a side section view of the molded processing container shown in
FIG. 21
, showing an umbilicus to be connected the container;
FIG. 24A
is a top view of the connector that connects the umbilicus to the molded processing container in the manner shown in
FIG. 24
, taken generally along line
24
A—
24
A in
FIG. 24
;
FIG. 25
is a side section view of the molded processing container shown in
FIG. 24
, after connection of the umbilicus to container;
FIG. 26
is an exploded, perspective view of the centrifuge station of the processing device shown in
FIG. 1
, with the processing container mounted for use;
FIG. 27
is a further exploded, perspective view of the centrifuge station and processing container shown in
FIG. 26
;
FIG. 28
is a side section view of the centrifuge station of the processing device shown in
FIG. 26
, with the processing container mounted for use;
FIG. 29
is a top view of a molded centrifugal blood processing container as shown in
FIGS. 21
to
23
, showing a flow path arrangement for separating whole blood into plasma and red blood cells;
FIGS. 30
to
33
are top views of molded centrifugal blood processing containers as shown in
FIGS. 21
to
23
, showing other flow path arrangements for separating whole blood into plasma and red blood cells;
FIG. 34
is a schematic view of another blood processing circuit, which can be programmed to perform a variety of different blood processing procedures in association with the device shown in
FIG. 1
;
FIG. 35
is plane view of the front side of a cassette, which contains the programmable blood processing circuit shown in
FIG. 34
;
FIG. 36
is a plane view of the back side of the cassette shown in
FIG. 35
;
FIGS. 37A
to
37
E are schematic views of the blood processing circuit shown in
FIG. 34
, showing the programming of the cassette to carry out different fluid flow tasks in connection with processing whole blood into plasma and red blood cells;
FIGS. 38A and 38B
are schematic views of the blood processing circuit shown in
FIG. 34
, showing the programming of the cassette to carry out fluid flow tasks in connection with on-line transfer of an additive solution into red blood cells separated from whole blood;
FIGS. 39A and 39B
are schematic views of the blood processing circuit shown in
FIG. 34
, showing the programming of the cassette to carry out fluid flow tasks in connection with on-line transfer of red blood cells separated from whole blood through a filter to remove leukocytes;
FIG. 40
is a representative embodiment of a weigh scale suited for use in association with the device shown in
FIG. 1
;
FIG. 41
is a representative embodiment of another weigh suited for use in association with the device shown in
FIG. 1
;
FIG. 42
is a schematic view of flow rate sensing and control system for a pneumatic pump chamber employing an electrode to create an electrical field inside the pump chamber; and
FIG. 43
is a schematic view of a pneumatic manifold assembly, which is part of the pump and valve station shown in
FIG. 6
, and which supplies positive and negative pneumatic pressures to convey fluid through the cassette shown in FIGS.
35
and
36
.
The invention may be embodied in several forms without departing from its spirit or essential characteristics. The scope of the invention is defined in the appended claims, rather than in the specific description preceding them. All embodiments that fall within the meaning and range of equivalency of the claims are therefore intended to be embraced by the claims.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
FIG. 1
shows a fluid processing system
10
that embodies the features of the invention. The system
10
can be used for processing various fluids. The system
10
is particularly well suited for processing whole blood and other suspensions of biological cellular materials. Accordingly, the illustrated embodiment shows the system
10
used for this purpose.
I. System Overview
The system
10
includes three principal components. These are (i) a liquid and blood flow set
12
; (ii) a blood processing device
14
that interacts with the flow set
12
to cause separation and collection of one or more blood components; and (iii) a controller
16
that governs the interaction to perform a blood processing and collection procedure selected by the operator.
The blood processing device
14
and controller
16
are intended to be durable items capable of long term use. In the illustrated and preferred embodiment, the blood processing device
14
and controller
16
are mounted inside a portable housing or case
36
. The case
36
presents a compact footprint, suited for set up and operation upon a table top or other relatively small surface. The case
36
is also intended to be transported easily to a collection site.
The case
36
includes a base
38
and a hinged lid
40
, which opens (as
FIG. 1
shows) and closes (as
FIG. 4
shows). The lid
40
includes a latch
42
, for releasably locking the lid
40
closed. The lid
40
also includes a handle
44
, which the operator can grasp for transporting the case
36
when the lid
40
is closed. In use, the base
38
is intended to rest in a generally horizontal support surface.
The case
36
can be formed into a desired configuration, e.g., by molding. The case
36
is preferably made from a lightweight, yet durable, plastic material.
The flow set
12
is intended to be a sterile, single use, disposable item. As
FIG. 2
shows, before beginning a given blood processing and collection procedure, the operator loads various components of the flow set
12
in the case
36
in association with the device
14
. The controller
16
implements the procedure based upon preset protocols, taking into account other input from the operator. Upon completing the procedure, the operator removes the flow set
12
from association with the device
14
. The portion of the set
12
holding the collected blood component or components are removed from the case
36
and retained for storage, transfusion, or further processing. The remainder of the set
12
is removed from the case
36
and discarded.
The flow set
12
shown in
FIG. 1
includes a blood processing chamber
18
designed for use in association with a centrifuge. Accordingly, as
FIG. 2
shows, the processing device
14
includes a centrifuge station
20
, which receives the processing chamber
18
for use. As
FIGS. 2 and 3
show, the centrifuge station
20
comprises a compartment formed in the base
38
. The centrifuge station
20
includes a door
22
, which opens and closes the compartment. The door
22
opens to allow loading of the processing chamber
18
. The door
22
closes to enclose the processing chamber
18
during operation.
The centrifuge station
20
rotates the processing chamber
18
. When rotated, the processing chamber
18
centrifugally separates whole blood received from a donor into component parts, e.g., red blood cells, plasma, and buffy coat comprising platelets and leukocytes.
It should also be appreciated that the system
10
need not separate blood centrifugally. The system
10
can accommodate other types of blood separation devices, e.g., a membrane blood separation device.
II. The Programmable Blood Processing Circuit
The set
12
defines a programmable blood processing circuit
46
. Various configurations are possible.
FIG. 5
schematically shows one representative configuration.
FIG. 34
schematically shows another representative configuration, which will be described later.
Referring to
FIG. 5
, the circuit
46
can be programmed to perform a variety of different blood processing procedures in which, e.g., red blood cells are collected, or plasma is collected, or both plasma and red blood cells are collected, or the buffy coat is collected.
The circuit
46
includes several pump stations PP(N), which are interconnected by a pattern of fluid flow paths F(N) through an array of in line valves V(N). The circuit is coupled to the remainder of the blood processing set by ports P(N).
The circuit
46
includes a programmable network of flow paths, comprising eleven universal ports P
1
to P
8
and P
11
to P
13
and three universal pump stations PP
1
, PP
2
, and PP
3
. By selective operation of the in line valves V
1
to V
14
, V
16
to V
18
, and V
21
to
23
, any universal port P
1
to P
8
and P
11
to P
13
can be placed in flow communication with any universal pump station PP
1
, PP
2
, and PP
3
. By selective operation of the universal valves, fluid flow can be directed through any universal pump station in a forward direction or reverse direction between two valves, or an in-out direction through a single valve.
In the illustrated embodiment, the circuit also includes an isolated flow path comprising two ports P
9
and P
10
and one pump station PP
4
. The flow path is termed “isolated,” because it cannot be placed into direct flow communication with any other flow path in the circuit
46
without exterior tubing. By selective operation of the in line valves V
15
, V
19
, and V
20
, fluid flow can be directed through the pump station in a forward direction or reverse direction between two valves, or an in-out direction through a single valve.
The circuit
46
can be programmed to assigned dedicated pumping functions to the various pump stations. For example, in a preferrred embodiment, the universal pump station PP
3
can serve as a general purpose, donor interface pump, regardless of the particular blood procedure performed, to either draw blood from the donor or return blood to the donor through the port P
8
. In this arrangement, the pump station PP
4
can serve as a dedicated anticoagulant pump, to draw anticoagulant from a source through the port P
10
and to meter anticoagulant into the blood through port P
9
.
In this arrangement, the universal pump station PP
1
can serve, regardless of the particular blood processing procedure performed, as a dedicated in-process whole blood pump, to convey whole blood into the blood separator. This dedicated function frees the donor interface pump PP
3
from the added function of supplying whole blood to the blood separator. Thus, the in-process whole blood pump PP
1
can maintain a continuous supply of blood to the blood separator, while the donor interface pump PP
3
is simultaneously used to draw and return blood to the donor through the single phlebotomy needle. Processing time is thereby minimized.
In this arrangement, the universal pump station PP
2
can serve, regardless of the particular blood processing procedure performed, as a plasma pump, to convey plasma from the blood separator. The ability to dedicate separate pumping functions provides a continuous flow of blood into and out of the separator, as well as to and from the donor.
The circuit
46
can be programmed, depending upon the objectives of the particular blood processing procedure, to retain all or some of the plasma for storage or fractionation purposes, or to return all or some of the plasma to the donor. The circuit
46
can be further programmed, depending upon the objectives of the particular blood processing procedure, to retain all or some of the red blood cells for storage, or to return all or some of the red blood cells to the donor. The circuit
46
can also be programmed, depending upon the objectives of the particular blood processing procedure, to retain all or some of the buffy coat for storage, or to return all or some of the buffy coat to the donor.
In a preferred embodiment, the programmable fluid circuit
46
is implemented by use of a fluid pressure actuated cassette
28
(see FIG.
6
). The cassette
28
provides a centralized, programmable, integrated platform for all the pumping and valving functions required for a given blood processing procedure. In the illustrated embodiment, the fluid pressure comprising positive and negative pneumatic pressure. Other types of fluid pressure can be used.
As
FIG. 6
shows, the cassette
28
interacts with a pneumatic actuated pump and valve station
30
, which is mounted in the lid of the
40
of the case
36
(see FIG.
1
). The cassette
28
is, in use, mounted in the pump and valve station
30
. The pump and valve station
30
apply positive and negative pneumatic pressure upon the cassette
28
to direct liquid flow through the circuit. Further details will be provided later.
The cassette
28
can take various forms. As illustrated (see FIG.
6
), the cassette
28
comprises an injection molded body
188
having a front side
190
and a back side
192
. For the purposes of description, the front side
190
is the side of the cassette
28
that, when the cassette
28
is mounted in the pump and valve station
30
, faces away from the operator. Flexible diaphragms
194
and
196
overlay both the front side
190
and back sides
192
of the cassette
28
, respectively.
The cassette body
188
is preferably made of a rigid medical grade plastic material. The diaphragms
194
and
196
are preferably made of flexible sheets of medical grade plastic. The diaphragms
194
and
196
are sealed about their peripheries to the peripheral edges of the front and back sides of the cassette body
188
. Interior regions of the diaphragms
194
and
196
can also be sealed to interior regions of the cassette body
188
.
The cassette body
188
has an array of interior cavities formed on both the front and back sides
190
and
192
(see FIGS.
7
and
9
). The interior cavities define the valve stations and flow paths shown schematically in FIG.
5
. An additional interior cavity is provided in the back side of the cassette
28
to form a station that holds a filter material
200
. In the illustrated embodiment, the filter material
200
comprises an overmolded mesh filter construction. The filter material
200
is intended, during use, to remove clots and cellular aggregations that can form during blood processing.
The pump stations PP
1
to PP
4
are formed as wells that are open on the front side
190
of the cassette body
188
. Upstanding edges peripherally surround the open wells of the pump stations. The pump wells are closed on the back side
192
of the cassette body
188
, except for a spaced pair of through holes or ports
202
and
204
for each pump station. The ports
202
and
204
extend through to the back side
192
of the cassette body
188
. As will become apparent, either port
202
or
204
can serve its associated pump station as an inlet or an outlet, or both inlet and outlet.
The in line valves V
1
to V
23
are likewise formed as wells that are open on the front side
190
of the cassette.
FIG. 8
shows a typical valve V(N). Upstanding edges peripherally surround the open wells of the valves on the front side
190
of the cassette body
188
. The valves are closed on the back side
192
of the cassette
28
, except that each valve includes a pair of through holes or ports
206
and
208
. One port
206
communicates with a selected liquid path on the back side
192
of the cassette body
188
. The other port
208
communicates with another selected liquid path on the back side
192
of the cassette body
188
.
In each valve, a valve seat
210
extends about one of the ports
208
. The valve seat
210
is recessed below the surface of the recessed valve well, such that the port
208
is essentially flush with the surrounding surface of recessed valve well, and the valve seat
210
extends below than the surface of the valve well.
The flexible diaphragm
194
overlying the front side
190
of the cassette
28
rests against the upstanding peripheral edges surrounding the pump stations and valves. With the application of positive force uniformly against this side of the cassette body
188
, the flexible diaphragm
194
seats against the upstanding edges. The positive force forms peripheral seals about the pump stations and valves. This, in turn, isolates the pumps and valves from each other and the rest of the system. The pump and valve station
30
applies positive force to the front side
190
of the cassette body
188
for this purpose.
Further localized application of positive and negative fluid pressures upon the regions of the diaphragm
194
overlying these peripherally sealed areas serve to flex the diaphragm regions in these peripherally sealed areas. These localized applications of positive and negative fluid pressures on these diaphragm regions overlying the pump stations serve to expel liquid out of the pump stations (with application of positive pressure) and draw liquid into the pump stations (with application of negative pressure).
In the illustrated embodiment, the bottom of each pump station PP
1
to PP
4
includes a recessed race
316
(see FIG.
7
). The race
316
extends between the ports
202
and
204
, and also includes a dogleg extending at an angle from the top port
202
. The race
316
provides better liquid flow continuity between the ports
202
and
204
, particularly when the diaphragm region is forced by positive pressure against the bottom of the pump station. The race
316
also prevents the diaphragm region from trapping air within the pump station. Air within the pump station is forced into the race
316
, where it can be readily venting through the top port
202
out of the pump station, even if the diaphragm region is bottomed out in the station.
Likewise, localized applications of positive and negative fluid pressure on the diaphragm regions overlying the valves will serve to seat (with application of positive pressure) and unseat (with application of negative pressure) these diaphragm regions against the valve seats, thereby closing and opening the associated valve port. The flexible diaphragm is responsive to an applied negative pressure for flexure out of the valve seat
210
to open the respective port. The flexible diaphragm is responsive to an applied positive pressure for flexure into the valve seat
210
to close the respective port. Sealing is accomplished by forcing the flexible diaphragm to flex into the recessed valve seat
210
, to seal about the port
208
, which is flush with wall of the valve well. The flexible diaphragm forms within the recessed valve seat
210
a peripheral seal about the valve port
208
.
In operation, the pump and valve station
30
applies localized positive and negative fluid pressures to these regions of front diaphragm
104
for opening and closing the valve ports.
The liquid paths F
1
to F
38
are formed as elongated channels that are open on the back side
192
of the cassette body
188
, except for the liquid paths F
15
, F
23
, and F
24
are formed as elongated channels that are open on the front side
190
of the cassette body
188
. The liquid paths are shaded in
FIG. 9
to facilitate their viewing. Upstanding edges peripherally surround the open channels on the front and back sides
190
and
192
of the cassette body
188
.
The liquid paths F
1
to F
38
are closed on the front side
190
of the cassette body
188
, except where the channels cross over valve station ports or pump station ports. Likewise, the liquid paths F
31
to F
38
are closed on the back side
192
of the cassette body
188
, except where the channels cross over in-line ports communicating with certain channels on the back side
192
of the cassette
28
.
The flexible diaphragms
194
and
196
overlying the front and back sides
190
and
192
of the cassette body
188
rest against the upstanding peripheral edges surrounding the liquid paths F
1
to F
38
. With the application of positive force uniformly against the front and back sides
190
and
192
of the cassette body
188
, the flexible diaphragms
194
and
196
seat against the upstanding edges. This forms peripheral seals along the liquid paths F
1
to F
38
. In operation, the pump and valve station
30
applies positive force to the diaphragms
194
and
196
for this purpose.
The pre-molded ports P
1
to P
13
extend out along two side edges of the cassette body
188
. The cassette
28
is vertically mounted for use in the pump and valve station
30
(see FIG.
2
). In this orientation, the ports P
8
to P
13
face downward, and the ports P
1
to P
7
are vertically stacked one above the other and face inward.
As
FIG. 2
shows, the ports P
8
to P
13
, by facing downward, are oriented with container support trays
212
formed in the base
38
, as will be described later. The ports P
1
to P
7
, facing inward, are oriented with the centrifuge station
20
and a container weigh station
214
, as will also be described in greater detail later. The orientation of the ports P
5
to P
7
(which serve the processing chamber
18
) below the ports P
1
to P
4
keeps air from entering the processing chamber
18
.
This ordered orientation of the ports provides a centralized, compact unit aligned with the operative regions of the case
36
.
B. The Universal Set
FIG. 10
schematically shows a universal set
264
, which, by selective programming of the blood processing circuit
46
implemented by cassette
28
, is capable of performing several different blood processing procedures.
The universal set
264
includes a donor tube
266
, which is attached (through y-connectors
272
and
273
) to tubing
300
having an attached phlebotomy needle
268
. The donor tube
266
is coupled to the port P
8
of the cassette
28
.
A container
275
for collecting an in-line sample of blood drawn through the tube
300
is also attached through the y-connector
273
.
An anticoagulant tube
270
is coupled to the phlebotomy needle
268
via the y-connector
272
. The anticoagulant tube
270
is coupled to cassette port P
9
. A container
276
holding anticoagulant is coupled via a tube
274
to the cassette port P
10
. The anticoagulant tube
270
carries an external, manually operated in line clamp
282
of conventional construction.
A container
280
holding a red blood cell additive solution is coupled via a tube
278
to the cassette port P
3
. The tube
278
also carries an external, manually operated in line clamp
282
.
A container
288
holding saline is coupled via a tube
284
to the cassette port P
12
.
FIG. 10
shows the fluid holding containers
276
,
280
, and
288
as being integrally attached during manufacture of the set
264
. Alternatively, all or some of the containers
276
,
280
, and
288
can be supplied separate from the set
264
. The containers
276
,
280
, and
288
may be coupled by conventional spike connectors, or the set
264
may be configured to accommodate the attachment of the separate container or containers at the time of use through a suitable sterile connection, to thereby maintain a sterile, closed blood processing environment. Alternatively, the tubes
274
,
278
, and
284
can carry an in-line sterilizing filter and a conventional spike connector for insertion into a container port at time of use, to thereby maintain a sterile, closed blood processing environment.
The set
264
further includes tubes
290
,
292
,
294
, which extend to an umbilicus
296
. When installed in the processing station, the umbilicus
296
links the rotating processing chamber
18
with the cassette
28
without need for rotating seals. Further details of this construction will be provided later.
The tubes
290
,
292
, and
294
are coupled, respectively, to the cassette ports P
5
, P
6
, and P
7
. The tube
290
conveys whole blood into the processing chamber
18
. The tube
292
conveys plasma from the processing chamber
18
. The tube
294
conveys red blood cells from processing chamber
18
.
A plasma collection container
304
is coupled by a tube
302
to the cassette port P
3
. The collection container
304
is intended, in use, to serve as a reservoir for plasma during processing.
A red blood cell collection container
308
is coupled by a tube
306
to the cassette port P
2
. The collection container
308
is intended, in use, to receive a first unit of red blood cells for storage.
A whole blood reservoir
312
is coupled by a tube
310
to the cassette port P
1
. The collection container
312
is intended, in use, to serve as a reservoir for whole blood during processing. It can also serve to receive a second unit of red blood cells for storage.
As shown in
FIG. 10
, no tubing is coupled to the utility cassette port P
13
and buffy port P
4
.
C. The Pump and Valve Station
The pump and valve station
30
includes a cassette holder
216
. The door
32
is hinged to move with respect to the cassette holder
216
between the opened position, exposing the cassette holder
216
(shown in
FIG. 6
) and the closed position, covering the cassette holder
216
(shown in FIG.
3
). The door
32
also includes an over center latch
218
with a latch handle
220
. When the door
32
is closed, the latch
218
swings into engagement with the latch pin
222
.
As
FIG. 11
shows, the inside face of the door
32
carries an elastomeric gasket
224
. The gasket
224
contacts the back side
192
of the cassette
28
when the door
32
is closed. An inflatable bladder
314
underlies the gasket
224
.
With the door
32
opened (see FIG.
2
), the operator can place the cassette
28
into the cassette holder
216
. Closing the door
32
and securing the latch
218
brings the gasket
224
into facing contact with the diaphragm
196
on the back side
192
of the cassette
28
. Inflating the bladder
314
presses the gasket
224
into intimate, sealing engagement against the diaphragm
196
. The cassette
28
is thereby secured in a tight, sealing fit within the cassette holder
216
.
The inflation of the bladder
314
also fully loads the over center latch
218
against the latch pin
222
with a force that cannot be overcome by normal manual force against the latch handle
220
. The door
32
is securely locked and cannot be opened when the bladder
314
is inflated. In this construction, there is no need for an auxiliary lock-out device or sensor to assure against opening of the door
32
during blood processing.
The pump and valve station
30
also includes a manifold assembly
226
located in the cassette holder
216
. The manifold assembly
226
comprises a molded or machined plastic or metal body. The front side
194
of the diaphragm is held in intimate engagement against the manifold assembly
226
when the door
32
is closed and bladder
314
inflated.
The manifold assembly
226
is coupled to a pneumatic pressure source
234
, which supplies positive and negative air pressure. The pneumatic pressure source
234
is carried inside the lid
40
behind the manifold assembly
226
.
In the illustrated embodiment, the pressure source
234
comprises two compressors C
1
and C
2
. However, one or several dual-head compressors could be used as well. As
FIG. 12
shows, one compressor C
1
supplies negative pressure through the manifold
226
to the cassette
28
. The other compressor C
2
supplies positive pressure through the manifold
226
to the cassette
28
.
As
FIG. 12
shows, the manifold
226
contains four pump actuators PA
1
to PA
4
and twenty-three valve actuators VA
1
to VA
23
. The pump actuators PA
1
to PA
4
and the valve actuators VA
1
to VA
23
are mutually oriented to form a mirror image of the pump stations PP
1
to PP
4
and valve stations V
1
to V
23
on the front side
190
of the cassette
28
.
As
FIG. 22
also shows, each actuator PA
1
to PA
4
and VA
1
to VA
23
includes a port
228
. The ports
228
convey positive or negative pneumatic pressures from the source in a sequence governed by the controller
16
. These positive and negative pressure pulses flex the front diaphragm
194
to operate the pump chambers PP
1
to PP
4
and valve stations V
1
to V
23
in the cassette
28
. This, in turn, moves blood and processing liquid through the cassette
28
.
The cassette holder
216
preferably includes an integral elastomeric membrane
232
(see
FIG. 6
) stretched across the manifold assembly
226
. The membrane
232
serves as the interface between the piston element
226
and the diaphragm
194
of the cassette
28
, when fitted into the holder
216
. The membrane
232
may include one or more small through holes (not shown) in the regions overlying the pump and valve actuators PA
1
to PA
4
and V
1
to V
23
. The holes are sized to convey pneumatic fluid pressure from the manifold assembly
226
to the cassette diaphragm
194
. Still, the holes are small enough to retard the passage of liquid. The membrane
232
forms a flexible splash guard across the exposed face of the manifold assembly
226
.
The splash guard membrane
232
keeps liquid out of the pump and valve actuators PA
1
to PA
4
and VA
1
to VA
23
, should the cassette diaphragm
194
leak. The splash guard membrane
232
also serves as a filter to keep particulate matter out of the pump and valve actuators of the manifold assembly
226
. The splash guard membrane
232
can be periodically wiped clean when cassettes
28
are exchanged.
The manifold assembly
226
includes an array of solenoid actuated pneumatic valves, which are coupled in-line with the pump and valve actuators PA
1
to PA
4
and VA
1
to VA
23
. The manifold assembly
226
, under the control of the controller
16
, selectively distributes the different pressure and vacuum levels to the pump and valve actuators PA(N) and VA(N). These levels of pressure and vacuum are systematically applied to the cassette
28
, to route blood and processing liquids.
Under the control of a controller
16
, the manifold assembly
226
also distributes pressure levels to the door bladder
314
(already described), as well as to a donor pressure cuff (not shown) and to a donor line occluder
320
.
As
FIG. 1
shows, the donor line occluder
320
is located in the case
36
, immediately below the pump and valve station
30
, in alignment with the ports P
8
and P
9
of the cassette
28
. The donor line
266
, coupled to the port P
8
, passes through the occluder
320
. The anticoagulant line
270
, coupled to the port P
9
, also passes through the occluder
320
. The occluder
320
is a spring loaded, normally closed pinch valve, between which the lines
266
and
270
pass. Pneumatic pressure from the manifold assembly
234
is supplied to a bladder (not shown) through a solenoid valve. The bladder, when expanded with pneumatic pressure, opens the pinch valve, to thereby open the lines
266
and
270
. In the absence of pneumatic pressure, the solenoid valve closes and the bladder vents to atmosphere. The spring loaded pinch valve of the occluder
320
closes, thereby closing the lines
266
and
270
.
The manifold assembly
226
maintains several different pressure and vacuum conditions, under the control of the controller
16
. In the illustrated embodiment, the following multiple pressure and vacuum conditions are maintained:
(i) Phard, or Hard Pressure, and Pinpr, or In-Process Pressure are the highest pressures maintained in the manifold assembly
226
. Phard is applied for closing cassette valves V
1
to V
23
. Pinpr is applied to drive the expression of liquid from the in-process pump PP
1
and the plasma pump PP
2
. A typical pressure level for Phard and Pinpr in the context of the preferred embodiment is 500 mmHg.
(ii) Pgen, or General Pressure, is applied to drive the expression of liquid from the donor interface pump PP
3
and the anticoagulant pump PP
4
. A typical pressure level for Pgen in the context of the preferred embodiment is 150 mmHg.
(iii) Pcuff, or Cuff Pressure, is supplied to the donor pressure cuff. A typical pressure level for Pcuff in the context of the preferred embodiment is 80 mmHg.
(iv) Vhard, or Hard Vacuum, is the deepest vacuum applied in the manifold assembly
226
. Vhard is applied to open cassette valves V
1
to V
23
. A typical vacuum level for Vhard in the context of the preferred embodiment is −350 mmHg.
(vi) Vgen, or General Vacuum, is applied to drive the draw function of each of the four pumps PP
1
to PP
4
. A typical pressure level for Vgen in the context of the preferred embodiment is −300 mmHg.
(vii) Pdoor, or Door Pressure, is applied to the bladder
314
to seal the cassette
28
into the holder
216
. A typical pressure level for Pdoor in the context of the preferred embodiment is 700 mmHg.
For each pressure and vacuum level, a variation of plus or minus 20 mmHg is tolerated.
Pinpr is used to operate the in process pump PP
1
, to pump blood into the processing chamber
18
. The magnitude of Pinpr must be sufficient to overcome a minimum pressure of approximately 300 mm Hg, which is typically present within the processing chamber
18
.
Similarly, Pinpr is used for the plasma pump PP
2
, since it must have similar pressure capabilities in the event that plasma needs to be-pumped backwards into the processing chamber
18
, e.g., during a spill condition, as will be described later.
Pinpr and Phard are operated at the highest pressure to ensure that upstream and downstream valves used in conjunction with pumping are not forced opened by the pressures applied to operate the pumps. The cascaded, interconnectable design of the fluid paths F
1
to F
38
through the cassette
28
requires Pinpr-Phard to be the highest pressure applied. By the same token, Vgen is required to be less extreme than Vhard, to ensure that pumps PP
1
to PP
4
do not overwhelm upstream and downstream cassette valves V
1
to V
23
.
Pgen is used to drive the donor interface pump PP
3
and can be maintained at a lower pressure, as can the AC pump PP
4
.
A main hard pressure line
322
and a main vacuum line
324
distribute Phard and Vhard in the manifold assembly
324
. The pressure and vacuum sources
234
run continuously to supply Phard to the hard pressure line
322
and Vhard to the hard vacuum line
324
.
A pressure sensor S
1
monitors Phard in the hard pressure line
322
. The sensor S
1
controls a solenoid
38
. The solenoid
38
is normally closed. The sensor S
1
opens the solenoid
38
to build Phard up to its maximum set value. Solenoid
38
is closed as long as Phard is within its specified pressure range and is opened when Phard falls below its minimum acceptable value.
Similarly, a pressure sensor S
5
in the hard vacuum line
324
monitors Vhard. The sensor S
5
controls a solenoid
39
. The solenoid
39
is normally closed. The sensor S
5
opens the solenoid
39
to build Vhard up to its maximum value. Solenoid
39
is closed as long as Vhard is within its specified pressure range and is opened when Vhard falls outside its specified range.
A general pressure line
326
branches from the hard pressure line
322
. A sensor S
2
in the general pressure line
326
monitors Pgen. The sensor
32
controls a solenoid
30
. The solenoid
30
is normally closed. The sensor S
2
opens the solenoid
30
to refresh Pgen from the hard pressure line
322
, up to the maximum value of Pgen. Solenoid
30
is closed as long as Pgen is within its specified pressure range and is opened when Pgen falls outside its specified range.
An in process pressure line
328
also branches from the hard pressure line
322
. A sensor S
3
in the in process pressure line
328
monitors Pinpr. The sensor S
3
controls a solenoid
36
. The solenoid
36
is normally closed. The sensor S
3
opens the solenoid
36
to refresh Pinpr from the hard pressure line
322
, up to the maximum value of Pinpr. Solenoid
36
is closed as long as Pinpr is within its specified pressure range and is opened when Pinpr falls outside its specified range.
A general vacuum line
330
branches from the hard vacuum line
324
. A sensor S
6
monitors Vgen in the general vacuum line
330
. The sensor S
6
controls a solenoid
31
. The solenoid
31
is normally closed. The sensor S
6
opens the solenoid
31
to refresh Vgen from the hard vacuum line
324
, up to the maximum value of Vgen. The solenoid
31
is closed as long as Vgen is within its specified range and is opened when Vgen falls outside its specified range.
In-line reservoirs R
1
to R
5
are provided in the hard pressure line
322
, the in process pressure line
328
, the general pressure line
326
, the hard vacuum line
324
, and the general vacuum line
330
. The reservoirs R
1
to R
5
assure that the constant pressure and vacuum adjustments as above described are smooth and predictable.
The solenoids
33
and
34
provide a vent for the pressures and vacuums, respectively, upon procedure completion. Since pumping and valving will continually consume pressure and vacuum, the solenoids
33
and
34
are normally closed. The solenoids
33
and
34
are opened to vent the manifold assembly upon the completion of a blood processing procedure.
The solenoids
28
,
29
,
35
,
37
and
32
provide the capability to isolate the reservoirs R
1
to R
5
from the air lines that supply vacuum and pressure to the manifold assembly
226
. This provides for much quicker pressure/vacuum decay feedback, so that testing of cassette/manifold assembly seal integrity can be accomplished. These solenoids
28
,
29
,
35
,
37
, and
32
are normally opened, so that pressure cannot be built in the assembly
226
without a command to close the solenoids
28
,
29
,
35
,
37
, and
32
, and, further, so that the system pressures and vacuums can vent in an error mode or with loss of power.
The solenoids
1
to
23
provide Phard or Vhard to drive the valve actuators VA
1
to V
23
. In the unpowered state, these solenoids are normally opened to keep all cassette valves V
1
to V
23
closed.
The solenoids
24
and
25
provide Pinpr and Vgen to drive the in-process and plasma pumps PP
1
and PP
2
. In the unpowered state, these solenoids are opened to keep both pumps PP
1
and PP
2
closed.
The solenoids
26
and
27
provide Pgen and Vgen to drive the donor interface and AC pumps PP
3
and PP
4
. In the unpowered state, these solenoids are opened to keep both pumps PP
3
and PP
4
closed.
The solenoid
43
provides isolation of the door bladder
314
from the hard pressure line
322
during the procedure. The solenoid
43
is normally opened and is closed when Pdoor is reached. A sensor S
7
monitors Pdoor and signals when the bladder pressure falls below Pdoor. The solenoid
43
is opened in the unpowered state to ensure bladder
314
venting, as the cassette
28
cannot be removed from the holder while the door bladder
314
is pressurized.
The solenoid
42
provides Phard to open the safety occluder valve
320
. Any error modes that might endanger the donor will relax (vent) the solenoid
42
to close the occluder
320
and isolate the donor. Similarly, any loss of power will relax the solenoid
42
and isolate the donor.
The sensor S
4
monitors Pcuff and communicates with solenoids
41
(for increases in pressure) and solenoid
40
(for venting) to maintain the donor cuff within its specified ranges during the procedure. The solenoid
40
is normally open so that the cuff line will vent in the event of system error or loss of power. The solenoid
41
is normally closed to isolate the donor from any Phard in the event of power loss or system error.
FIG. 12
shows a sensor S
8
in the pneumatic line serving the donor interface pump actuator PA
3
. The sensor S
8
is a bi-directional mass air flow sensor, which can monitor air flow to the donor interface pump actuator PA
3
to detect occlusions in the donor line. Alternatively, as will be described in greater detail later, electrical field variations can be sensed by an electrode carried within the donor interface pump chamber PP
3
, or any or all other pump chambers PP
1
, PP
2
, or PP
4
, to detect occlusions, as well as to permit calculation of flow rates and the detection of air.
Various alternative embodiments are possible. For example, the pressure and vacuum available to the four pumping chambers could be modified to include more or less distinct levels or different groupings of “shared” pressure and vacuum levels. As another example, Vhard could be removed from access to the solenoids
2
,
5
,
8
,
18
,
19
,
21
,
22
since the restoring springs will return the cassette valves to a closed position upon removal of a vacuum. Furthermore, the vents shown as grouped together could be isolated or joined in numerous combinations.
It should also be appreciated that any of the solenoids used in “normally open” mode could be re-routed pneumatically to be realized as “normally closed”. Similarly, any of the “normally closed” solenoids could be realized as “normally open”.
As another example of an alternative embodiment, the hard pressure reservoir R
1
could be removed if Pdoor and Phard were set to identical magnitudes. In this arrangement, the door bladder
314
could serve as the hard pressure reservoir. The pressure sensor S
7
and the solenoid
43
would also be removed in this arrangement.
III. Other Process Control Components of the System
As
FIG. 13
best shows, the case
36
contains other components compactly arranged to aid blood processing. In addition to the centrifuge station
20
and pump and valve station
30
, already described, the case
36
includes a weigh station
238
, an operator interface station
240
, and one or more trays
212
or hangers
248
for containers. The arrangement of these components in the case
36
can vary. In the illustrated embodiment, the weigh station
238
, the controller
16
, and the user interface station
240
, like the pump and valve station
30
, are located in the lid
40
of the case
36
. The holding trays
212
are located in base
38
of the case
36
, adjacent the centrifuge station
20
.
A. Container Support Components
The weigh station
238
comprises a series of container hangers/weigh sensors
246
arranged along the top of the lid
40
. In use (see FIG.
2
), containers
304
,
308
,
312
are suspended on the hangers/weigh sensors
246
.
The containers receive blood components separated during processing, as will be described in greater detail later. The weigh sensors
246
provide output reflecting weight changes over time. This output is conveyed to the controller
16
. The controller
16
processes the incremental weight changes to derive fluid processing volumes and flow rates. The controller generates signals to control processing events based,. in part, upon the derived processing volumes. Further details of the operation of the controller to control processing events will be provided later.
The holding trays
212
comprise molded recesses in the base
38
. The trays
212
accommodate the containers
276
and
280
(see FIG.
2
). In the illustrated embodiment, an additional swing-out hanger
248
is also provided on the side of the lid
40
. The hanger
248
(see
FIG. 2
) supports the container
288
during processing. In the illustrated embodiment, the trays
212
and hanger
248
also include weigh sensors
246
.
The weigh sensors
246
can be variously constructed. In the embodiment shown in
FIG. 40
, the scale includes a force sensor
404
incorporated into a housing
400
, to which a hanger
402
is attached. The top surface
420
of hanger
402
engages a spring
406
on the sensor
404
. Another spring
418
is compressed as a load, carried by the hanger
402
, is applied. The spring
418
resists load movement of the hanger
402
, until the load exceeds a predetermined weight (e.g., 2 kg.). At that time, the hanger
402
bottoms out on mechanical stops
408
in the housing
400
, thereby providing over load protection.
In the embodiment shown in
FIG. 41
, a supported beam
410
transfers force applied by a hanger
416
to a force sensor
412
through a spring
414
. This design virtually eliminates friction from the weight sensing system. The magnitude of the load carried by the beam is linear in behavior, and the weight sensing system can be readily calibrated to ascertain an actual load applied to the hanger
416
.
B. The Controller and Operator Interface Station
The controller
16
carries out process control and monitoring functions for the system
10
. As
FIG. 14
shows schematically, the controller
16
comprises a main processing unit (MPU)
250
, which can comprise, e.g., a Pentium™ type microprocessor made by Intel Corporation, although other types of conventional microprocessors can be used. The MPU
250
is mounted inside the lid
40
of the case
36
(as
FIG. 13
shows).
In the preferred embodiment, the MPU
250
employs conventional real time multi-tasking to allocate MPU cycles to processing tasks. A periodic timer interrupt (for example, every 5 milliseconds) preempts the executing task and schedules another that is in a ready state for execution. If a reschedule is requested, the highest priority task in the ready state is scheduled. Otherwise, the next task on the list in the ready state is scheduled.
As
FIG. 14
shows, the MPU
250
includes an application control manager
252
. The application control manager
252
administers the activation of a library of at least one control application
254
. Each control application
254
prescribes procedures for carrying out given functional tasks using the centrifuge station
20
and the pump and valve station
30
in a predetermined way. In the illustrated embodiment, the applications
254
reside as process software in EPROM's in the MPU
250
.
The number of applications
254
can vary. In the illustrated embodiment, the applications
254
includes at least one clinical procedure application. The procedure application contains the steps to carry out one prescribed clinical processing procedure. For the sake of example in the illustrated embodiment, the application
254
includes three procedure applications: (1) a double unit red blood cell collection procedure; (2) a plasma collection procedure; and (3) a plasma/red blood cell collection procedure. The details of these procedures will be described later. Of course, additional procedure applications can be included.
As
FIG. 14
shows, several slave processing units communicate with the application control manager
252
. While the number of slave processing units can vary, the illustrated embodiment shows five units
256
(
1
) to
256
(
5
). The slave processing units
256
(
1
) to
256
(
5
), in turn, communicates with low level peripheral controllers
258
for controlling the pneumatic pressures within the manifold assembly
226
, the weigh sensors
246
, the pump and valve actuators PA
1
to PA
4
and VA
1
to VA
23
in the pump and valve station
30
, the motor for the centrifuge station
20
, the interface sensing station
332
, and other functional hardware of the system.
The MPU
250
contains in EPROM's the commands for the peripheral controllers
258
, which are downloaded to the appropriate slave processing unit
256
(
1
) to
256
(
5
) at start-up. The application control manager
252
also downloads to the appropriate slave processing unit
256
(
1
) to
256
(
5
) the operating parameters prescribed by the activated application
254
.
With this downloaded information, the slave processing units
256
(
1
) to
256
(
5
) proceed to generate device commands for the peripheral controllers
258
, causing the hardware to operate in a specified way to carry out the procedure. The peripheral controllers
258
return current hardware status information to the appropriate slave processing unit
256
(
1
) to
256
(
5
), which, in turn, generate the commands necessary to maintain the operating parameters ordered by the application control manager
252
.
In the illustrated embodiment, one slave processing unit
256
(
2
) performs the function of an environmental manager. The unit
256
(
2
) receives redundant current hardware status information and reports to the MPU
250
should a slave unit malfunction and fail to maintain the desired operating conditions.
As
FIG. 14
shows, the MPU
250
also includes an interactive user interface
260
, which allows the operator to view and comprehend information regarding the operation of the system
10
. The interface
260
is coupled to the interface station
240
. The interface
260
allows the operator to use the interface station
240
to select applications
254
residing in the application control manager
252
, as well as to change certain functions and performance criteria of the system
10
.
As
FIG. 13
shows, the interface station
240
includes an interface screen
262
carried in the lid
40
. The interface screen
262
displays information for viewing by the operator in alpha-numeric format and as graphical images. In the illustrated and preferred embodiment, the interface screen
262
also serves as an input device. It receives input from the operator by conventional touch activation.
C. On-Line Monitoring of Pump Flows
1. Gravimetric Monitoring
Using the weigh scales
246
, either upstream or downstream of the pumps, the controller
16
can continuously determine the actual volume of fluid that is moved per pump stroke and correct for any deviations from commanded flow. The controller
16
can also diagnose exceptional situations, such as leaks and obstructions in the fluid path. This measure of monitoring and control is desirable in an automated apheresis application, where anticoagulant has to be accurately metered with the whole blood as it is drawn from the donor, and where product quality (e.g., hematocrit, plasma purity) is influenced by the accuracy of the pump flow rates.
The pumps PP
1
to PP
4
in the cassette
28
each provides a relatively-constant nominal stroke volume, or SV. The flow rate for a given pump can therefore be expressed as follows:
where:
Q is the flow rate of the pump.
SV is the stroke volume, or volume moved per pump cycle.
T
pump
is the time the fluid is moved out of the pump chamber.
T
Fill
is the time the pump is filled with fluid, and
T
Idle
is the time when the pump is idle, that is, when no fluid movement occurs.
The SV can be affected by the interaction of the pump with attached downstream and upstream fluid circuits. This is analogous, in electrical circuit theory, to the interaction of a non-ideal current source with the input impedance of the load it sees. Because of this, the actual SV can be different than the nominal SV.
The actual fluid flow in volume per unit of time Q
Actual
can therefore be expressed as follows:
where:
Q
Actual
is the actual fluid flow in volume per unit of time.
SV
Ideal
is the theoretical stroke volume, based upon the geometry of the pump chamber. k is a correction factor that accounts for the interactions between the pump and the upstream and downstream pressures.
The actual flow rate can be ascertained gravimetrically, using the upstream or downstream weigh scales
246
, based upon the following relationship:
where:
ΔWt is the change in weight of fluid as detected by the upstream or downstream weigh scale
246
during the time period ΔT,
ρ is the density of fluid.
ΔT is the time period where the change in weight ΔWt is detected in the weigh scale
246
.
The following expression is derived by combining Equations (2) and (3):
The controller
16
computes k according to Equation (4) and then adjusts T
Idle
so that the desired flow rate is achieved, as follows:
The controller
16
updates the values for k and T
Idle
frequently to adjust the flow rates.
Alternatively, the controller
16
can change T
Pump
and/or T
Fill
and/or T
Idle
to adjust the flow rates.
In this arrangement, one or more of the time interval components T
Pump
, or T
Fill
, or T
Idle
is adjusted to a new magnitude to achieve Q
Desired
, according to the following relationship:
where:
T
n(Adjusted)
is the magnitude of the time interval component or components after adjustment to achieve the desired flow rate Q
Desired
.
T
n(NotAdjusted)
is the magnitude of the value of the other time interval component or components of T
Stroke
that are not adjusted. The adjusted stroke interval after adjustment to achieve the desired flow rate Q
Desired
is the sum of T
n(Adjusted)
and T
n(NotAdjusted)
.
The controller
16
also applies the correction factor k as a diagnostics tool to determine abnormal operating conditions. For example, if k differs significantly from its nominal value, the fluid path may have either a leak or an obstruction. Similarly, if computed value of k is of a polarity different from what was expected, then the direction of the pump may be reversed.
With the weigh scales
246
, the controller
16
can perform on-line diagnostics even if the pumps are not moving fluid. For example, if the weigh scales
246
detect changes in weight when no flow is expected, then a leaky valve or a leak in the set
264
may be present.
In computing k and T
idle
and/or T
Pump
and/or T
Fill
, the controller
16
may rely upon multiple measurements of ΔWt and/or ΔT. A variety of averaging or recursive techniques (e.g., recursive least means squares, Kalman filtering, etc.) may be used to decrease the error associated with the estimation schemes.
The above described monitoring technique is applicable for use for other constant stroke volume pumps, i.e. peristaltic pumps, etc.
2. Electrical Monitoring
In an alternative arrangement (see FIG.
42
), the controller
16
includes a metal electrode
422
located in the chamber of each pump station PP
1
to PP
4
on the cassette
28
. The electrodes
422
are coupled to a current source
424
. The passage of current through each electrode
422
creates an electrical field within the respective pump chamber PP
1
to PP
4
.
Cyclic deflection of the diaphragm
194
to draw fluid into and expel fluid from the pump chamber PP
1
to PP
4
changes the electrical field, resulting in a change in total capacitance of the circuit through the electrode
422
. Capacitance increases as fluid is draw into the pump chamber PP
1
to PP
4
, and capacitance decreases as fluid is expelled from pump chamber PP
1
to PP
4
.
The controller
16
includes a capacitive sensor
426
(e.g., a Qprox E
2
S)coupled to each electrode
422
. The capacitive sensor
426
registers changes in capacitance for the electrode
422
in each pump chamber PP
1
to PP
4
. The capacitance signal for a given electrode
422
has a high signal magnitude when the pump chamber is filled with liquid (diaphragm position
194
a
), has a low signal magnitude signal when the pump chamber is empty of fluid (diaphragm position
194
b
), and has a range of intermediate signal magnitudes when the diaphragm occupies positions between position
194
a
and
194
b.
At the outset of a blood processing procedure, the controller
16
calibrates the difference between the high and low signal magnitudes for each sensor to the maximum stroke volume SV of the respective pump chamber. The controller
16
then relates the difference between sensed maximum and minimum signal values during subsequent draw and expel cycles to fluid volume drawn and expelled through the pump chamber. The controller
16
sums the fluid volumes pumped over a sample time period to yield an actual flow rate.
The controller
16
compares the actual flow rate to a desired flow rate. If a deviance exists, the controller
16
varies pneumatic pressure pulses delivered to the actuator PA
1
to PA
4
, to adjust T
Idle
and/or T
Pump
and/or T
FIll
to minimize the deviance.
The controller
16
also operates to detect abnormal operating conditions based upon the variations in the electric field and to generate an alarm output. In the illustrated embodiment, the controller
16
monitors for an increase in the magnitude of the low signal magnitude over time. The increase in magnitude reflects the presence of air inside a pump chamber.
In the illustrated embodiment, the controller
16
also generates a derivative of the signal output of the sensor
426
. Changes in the derivative, or the absence of a derivative, reflects a partial or complete occlusion of flow through the pump chamber PP
1
to PP
4
. The derivative itself also varies in a distinct fashion depending upon whether the occlusion occurs at the inlet or outlet of the pump chamber PP
1
to PP
4
.
IV. The Blood Processing Procedures
A. Double RBC Collection Procedure (No Plasma Collection)
During this procedure, whole blood from a donor is centrifugally processed to yield up to two units (approximately 500 ml) of red blood cells for collection. All plasma constituent is returned to the donor. This procedure will, in shorthand, be called the double red blood cell collection procedure.
Prior to undertaking the double red blood cell collection procedure, as well as any blood collection procedure, the controller
16
operates the manifold assembly
226
to conduct an appropriate integrity check of the cassette
28
, to determine whether there are any leaks in the cassette
28
. Once the cassette integrity check is complete and no leaks are found, the controller
16
begins the desired blood collection procedure.
The double red blood cell collection procedure includes a pre-collection cycle, a collection cycle, a post-collection cycle, and a storage preparation cycle. During the pre-collection cycle, the set
264
is primed to vent air prior to venipuncture. During the collection cycle, whole blood drawn from the donor is processed to collect two units of red blood cells, while returning plasma to the donor. During the post-collection cycle, excess plasma is returned to the donor, and the set is flushed with saline. During the storage preparation cycle, a red blood cell storage solution is added.
1. The Pre-Collection Cycle
a. Anticoagulant Prime
In a first phase of the pre-collection cycle (AC Prime
1
), tube
300
leading to the phlebotomy needle
268
is clamped closed (see FIG.
10
). The blood processing circuit
46
is programmed (through the selective application of pressure to the valves and pump stations of the cassette) to operate the donor interface pump PP
3
, drawing anticoagulant through the anticoagulant tube
270
and up the donor tube
266
through the y-connector
272
(i.e., in through valve V
13
and out through valve V
11
). The circuit is further programmed to convey air residing in the anticoagulant tube
270
, the donor tube
266
, and the cassette and into the in-process container
312
. This phase continues until an air detector
298
along the donor tube
266
detects liquid, confirming the pumping function of the donor interface pump PP
3
.
In a second phase of the pre-collection cycle (AC Prime
2
), the circuit is programmed to operate the anticoagulant pump PP
4
to convey anticoagulant into the in-process container
312
. Weight changes in the in-process container
312
. AC Prime
2
is terminated when the anticoagulant pump PP
4
conveys a predetermined volume of anticoagulant (e.g., 10 g) into the in-process container
312
, confirming is pumping function.
b. Saline Prime
In a third phase of the pre-collection cycle (Saline Prime
1
), the processing chamber
46
remains stationary. The circuit is programmed to operate the in-process pump station PP
1
to draw saline from the saline container
288
through the in-process pump PP
1
. This creates a reverse flow of saline through the stationary processing chamber
46
toward the in-process container
312
. In this sequence saline is drawn through the processing chamber
46
from the saline container
288
into the in-process pump PP
1
through valve V
14
. The saline is expelled from the pump station PP
1
toward the in-process container
312
through valve
9
. Weight changes in the saline container
288
are monitored. This phase is terminated upon registering a predetermined weight change in the saline container
288
, which indicates conveyance of a saline volume sufficient to initially fill about one half of the processing chamber
46
(e.g., about 60 g).
With the processing chamber
46
about half full of priming saline, a fourth phase of the pre-collection cycle (Saline Prime
2
). The processing chamber
46
is rotated at a low rate (e.g., about 300 RPM), while the circuit continues to operate in the same fashion as in Saline Prime
3
. Additional saline is drawn into the pump station PP
1
through valve V
14
and expelled out of the pump station PP
1
through valve V
9
and into the in-process container
312
. Weight changes in the in-process container
312
are monitored. This phase is terminated upon registering a predetermined weight change in the in-process container
312
, which indicates the conveyance of an additional volume of saline sufficient to substantially fill the processing chamber
46
(e.g., about 80 g).
In a fifth phase of the pre-collection cycle (Saline Prime
3
), the circuit is programmed to first operate the in-process pump station PP
1
to convey saline from the in-process container
312
through all outlet ports of the separation device and back into the saline container
288
through the plasma pump station PP
2
. This completes the priming of the processing chamber
46
and the in-process pump station PP
1
(pumping in through valve V
9
and out through valve V
14
), as well as primes the plasma pump station PP
2
, with the valves V
7
, V
6
, V
10
, and V
12
opened to allow passive flow of saline. During this time, the rate at which the processing chamber
46
is rotated is successively ramped between zero and 300 RPM. Weight changes in the in process container
312
are monitored. When a predetermined initial volume of saline is conveyed in this manner, the circuit is programmed to close valve V
7
, open valves V
9
and V
14
, and to commence pumping saline to the saline container
288
through the plasma pump PP
2
, in through valve V
12
and out through valve V
10
, allowing saline to passively flow through the in-process pump PP
1
. Saline in returned in this manner from the in-process container
312
to the saline container
288
until weight sensing indicated that a preestablished minimum volume of saline occupies the in-process container
312
.
In a sixth phase of the pre-collection cycle (Vent Donor Line), the circuit is programmed to purge air from the venepuncture needle, prior to venipuncture, by operating the donor interface pump PP
3
to pump anticoagulant through anticoagulant pump PP
4
and into the in process container
312
.
In a seventh phase of the pre-collection cycle (Venipuncture), the circuit is programmed to close all valves V
1
to V
23
, so that venipuncture can be accomplished.
The programming of the circuit during the phases of the pre-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During Pre-Collection Cycle
|
(Double Red Blood Cell Collection Procedure)
|
Phase
AC Prime 1
AC Prime 2
Saline Prime 1
Saline Prime 2
Saline Prime 3
Vent Donor Line
Venipuncture
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V2
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
Pump In
|
(Stage 1)
|
∘
|
(Stage 2)
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage 1)
|
∘/&Circlesolid;
|
Pump Out
|
(Stage 2)
|
V11
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump In
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage 1)
|
∘/&Circlesolid;
|
Pump In
|
(Stage 2)
|
V13
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump Out
|
V14
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump Out
|
(Stage 1)
|
∘
|
(Stage 2)
|
V15
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump In
|
Pump Out
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V19
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V20
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump Out
|
Pump In
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
PP1
▪
▪
□
□
□
▪
▪
|
(Stage 1)
|
PP2
▪
▪
▪
▪
□
▪
▪
|
(Stage 2)
|
PP3
□
▪
▪
▪
▪
□
▪
|
PP4
▪
□
▪
▪
▪
▪
▪
|
|
Caption:
|
∘ denotes an open valve;
|
&Circlesolid; denotes a closed valve;
|
∘/&Circlesolid; denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
c. The Collection Cycle
i. Blood Prime
With venipuncture, tube
300
leading to the phlebotomy needle
268
is opened. In a first phase of the collection cycle (Blood Prime
1
), the blood processing circuit
46
is programmed (through the selective application of pressure to the valves and pump stations of the cassette) to operate the donor interface pump PP
3
(i.e., in through valve V
13
and out through valve V
11
) and the anticoagulant pump PP
4
(i.e., in through valve V
20
and out through valve V
15
) to draw anticoagulated blood through the donor tube
270
into the in process container
312
. This phase continues until an incremental volume of anticoagulated whole blood enters the in process container
312
, as monitored by the weigh sensor.
In a next phase (Blood Prime
2
), the blood processing circuit
46
is programmed to operate the in-process pump station PP
1
to draw anticoagulated blood from the in-process container
312
through the separation device. During this phase, saline displaced by the blood is returned to the donor. This phase primes the separation device with anticoagulated whole blood. This phase continues until an incremental volume of anticoagulated whole blood leaves the in process container
312
, as monitored by the weigh sensor.
B. Blood Separation while Drawing whole Blood or without Drawing whole Blood
In a next phase of the blood collection cycle (Blood Separation While Drawing Whole Blood), the blood processing circuit
46
is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
13
and out through valve V
11
); the anticoagulant pump PP
4
(i.e., in through valve V
20
and out through valve V
15
); the in-process pump PP
1
(i.e., in through valve V
9
and out through valve V
14
); and the plasma pump PP
2
(i.e., in through valve V
12
and out through valve V
10
). This arrangement draws anticoagulated blood into the in-process container
312
, while conveying the blood from the in-process container
312
into the processing chamber for separation. This arrangement also removes plasma from the processing chamber into the plasma container
304
, while removing red blood cells from the processing chamber into the red blood cell container
308
. This phase continues until an incremental volume of plasma is collected in the plasma collection container
304
(as monitored by the weigh sensor) or until a targeted volume of red blood cells is collected in the red blood cell collection container (as monitored by the weigh sensor).
If the volume of whole blood in the in-process container
312
reaches a predetermined maximum threshold before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed for another phase (Blood Separation Without Drawing Whole Blood), to terminate operation of the donor interface pump station PP
3
(while also closing valves V
13
, V
11
, V
18
, and V
13
) to terminate collection of whole blood in the in-process container
312
, while still continuing blood separation. If the volume of whole blood reaches a predetermined minimum threshold in the in-process container
312
during blood separation, but before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed to return to the Blood Separation While Drawing Whole Blood Phase, to thereby allow whole blood to enter the in-process container
312
. The circuit is programmed to toggle between the Blood Separation While Drawing Whole Blood Phase and the Blood Separation Without Drawing Whole Blood Phase according to the high and low volume thresholds for the in-process container
312
, until the requisite volume of plasma has been collected, or until the target volume of red blood cells has been collected, whichever occurs first.
C. Return Plasma and Saline
If the targeted volume of red blood cells has not been collected, the next phase of the blood collection cycle (Return Plasma With Separation) programs the blood processing circuit
46
to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
); the in-process pump PP
1
(i.e., in through valve V
9
and out through valve V
14
); and the plasma pump PP
2
(i.e., in through valve V
12
and out through valve V
10
). This arrangement conveys anticoagulated whole blood from the in-process container
312
into the processing chamber for separation, while removing plasma into the plasma container
304
and red blood cells into the red blood cell container
308
. This arrangement also conveys plasma from the plasma container
304
to the donor, while also mixing saline from the container
288
in line with the returned plasma. The in line mixing of saline with plasma raises the saline temperature and improves donor comfort. This phase continues until the plasma container
304
is empty, as monitored by the weigh sensor.
If the volume of whole blood in the in-process container
312
reaches a specified low threshold before the plasma container
304
empties, the circuit is programmed to enter another phase (Return Plasma Without Separation), to terminate operation of the in-process pump station PP
1
(while also closing valves V
9
, Vl
0
, V
12
, and V
14
) to terminate blood separation. The phase continues until the plasma container
304
empties.
Upon emptying the plasma container
304
, the circuit is programmed to enter a phase (Fill Donor Line), to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to draw whole blood from the in process container
312
to fill the donor tube
266
, thereby purge plasma (mixed with saline) in preparation for another draw whole blood cycle.
The circuit is then programmed to conduct another Blood Separation While Drawing Whole Blood Phase, to refill the in process container
312
. The circuit is programmed in successive Blood Separation and Return Plasma Phases until the weigh sensor indicates that a desired volume of red blood cells have been collected in the red blood cell collection container
308
. When the targeted volume of red blood cells has not been collected, the post-collection cycle commences.
The programming of the circuit during the phases of the collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Collection Cycle
|
(Double Red Blood Cell Collection Procedure)
|
Blood Separation
Return Plasma/
|
While Drawing Whole Blood
with Separation
|
Phase
Blood Prime 1
Blood Prime 2
(Without Drawing Whole Blood)
(Without Separation)
Fill Donor Line
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
|
V2
&Circlesolid;
&Circlesolid;
∘
∘ (&Circlesolid;)
&Circlesolid;
|
V3
∘
&Circlesolid;
∘ (&Circlesolid;)
&Circlesolid;
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
∘
∘
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Alternates with V23
|
V7
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
∘
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump In (&Circlesolid;)
|
V10
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out (&Circlesolid;)
|
V11
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump Out
Pump Out (&Circlesolid;)
Pump In
Pump In
|
V12
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In (&Circlesolid;)
|
V13
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump In
Pump In (&Circlesolid;)
Pump Out
Pump Out
|
V14
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
Pump Out (&Circlesolid;)
|
V15
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out (&Circlesolid;)
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
∘ (&Circlesolid;)
∘
∘
|
V19
∘
&Circlesolid;
∘ (&Circlesolid;)
&Circlesolid;
&Circlesolid;
|
V20
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump Out
Pump In (&Circlesolid;)
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Alternates with V6
|
PP1
▪
□
□
□ (▪)
▪
|
PP2
▪
▪
□
□ (&Circlesolid;)
▪
|
PP3
□
▪
□ (▪)
□
□
|
PP4
□
▪
□ (▪)
▪
▪
|
|
Caption:
|
∘ denotes an open valve;
|
&Circlesolid; denotes a closed valve;
|
∘/&Circlesolid; denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
D. The Post-Collection Cycle
Once the targeted volume of red blood cells has been collected (as monitored by the weigh sensor), the circuit is programmed to carry out the phases of the post-collection cycle.
1. Return Excess Plasma
In a first phase of the post-collection cycle (Excess Plasma Return), the circuit is programmed to terminate the supply and removal of blood to and from the processing chamber, while operating the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey plasma remaining in the plasma container
304
to the donor. The circuit is also programmed in this phase to mix saline from the container
288
in line with the returned plasma. This phase continues until the plasma container
304
is empty, as monitored by the weigh sensor.
2. Saline Purge
In the next phase of the post-collection cycle (Saline Purge), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
11
) to convey saline from the container
288
through the separation device, to displace the blood contents of the separation device into the in-process container
312
, in preparation for their return to the donor. This phase reduces the loss of donor blood. This phase continues until a predetermined volume of saline is pumped through the separation device, as monitored by the weigh sensor.
3. Final Return to Donor
In the next phase of the post-collection cycle (Final Return), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the blood contents of the in-process container
312
to the donor. Saline is intermittently mixed with the blood contents. This phase continues until the in-process container
312
is empty, as monitored by the weigh sensor.
In the next phase (Fluid Replacement), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the saline to the donor. This phase continues until a prescribed replacement volume amount is infused, as monitored by the weigh sensor.
In the next phase of the post-collection cycle (Empty In Process Container), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey all remaining contents of the in-process container
312
to the donor, in preparation of splitting the contents of the red blood cell container
308
for storage in both containers
308
and
312
. This phase continues until a zero volume reading for the in-process container
312
occurs, as monitored by the weigh sensor, and air is detected at the air detector.
At this phase, the circuit is programmed to close all valves and idle all pump stations, so that the phlebotomy needle
268
can be removed from the donor.
The programming of the circuit during the phases of the post-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Post-Collection Cycle
|
(Double Red Blood Cell Collection Procedure)
|
Phase
Excess Plasma Return
Saline Purge
Final Return
Fluid Replacement
Empty In Process Container
|
|
V1
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
∘
|
V2
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V4
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Alternates with V23
|
V7
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
∘
|
Alternates
|
with V23
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V11
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump In
Pump In/
Pump In
Pump In
Pump In
|
Pump Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V13
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump Out
Pump Out
Pump Out
Pump Out
|
V14
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V15
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
&Circlesolid;
∘
∘
∘
|
V19
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V20
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
∘
∘
∘
∘
&Circlesolid;
|
V23
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘
&Circlesolid;
|
Alternates
Alternates
|
with V6
with V7
|
PP1
▪
▪
▪
▪
▪
|
PP2
▪
▪
▪
▪
▪
|
PP3
□
□
□
□
□
|
PP4
▪
▪
▪
▪
▪
|
|
Caption:
|
∘ denotes an open valve;
|
&Circlesolid; denotes a closed valve;
|
∘/&Circlesolid; denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
E. The Storage Preparation Cycle
1. Split RBC
In the first phase of the storage preparation cycle (Split RBC), the circuit is programmed to operate the donor interface pump station PP
3
to transfer half of the contents of the red blood cell collection container
308
into the in-process container
312
. The volume pumped is monitored by the weigh sensors for the containers
308
and
312
.
2. Add RBC Preservative
In the next phases of the storage preparation cycle (Add Storage Solution to the In Process Container and Add Storage Solution to the Red Blood Cell Collection Container), the circuit is programmed to operate the donor interface pump station PP
3
to transfer a desired volume of red blood cell storage solution from the container
280
first into the in-process container
312
and then into the red blood cell collection container
308
. The transfer of the desired volume is monitored by the weigh scale.
In the next and final phase (End Procedure), the circuit is programmed to close all valves and idle all pump stations, so that the red blood cell containers
308
and
312
can be separated and removed for storage. The remainder of the disposable set can now be removed and discarded.
The programming of the circuit during the phases of the storage preparation cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Storage Preparation Cycle
|
(Double Red Blood Cell Collection Procedure)
|
Split RBC Between
Add Storage
Add Storage
|
RBC Collection and
Solution to
Solution to RBC
End Procedure
|
Phase
In Process Containers
In Process Container
Collection Container
(Remove Venipuncture)
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V2
∘
&Circlesolid;
∘
&Circlesolid;
|
V3
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
Alternates with
|
V11 and V4
|
V4
∘/&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Alternates with
|
V11 and V4
|
V5
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V11
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In/Pump Out
Pump In/Pump Out
Pump In/Pump Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V13
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V14
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V15
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V16
&Circlesolid;
∘
∘
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V19
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V20
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V21
&Circlesolid;
∘
∘
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
PP1
▪
▪
▪
▪
|
PP2
▪
▪
▪
▪
|
PP3
□
□
□
▪
|
PP4
▪
▪
▪
▪
|
|
Caption:
|
∘ denotes an open valve;
|
&Circlesolid; denotes a closed valve;
|
∘/&Circlesolid; denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
F. Plasma Collection (No Red Blood Cell Collection)
During this procedure, whole blood from a donor is centrifugally processed to yield up to 880 ml of plasma for collection. All red blood cells are returned to the donor. This procedure will, in shorthand, be called the plasma collection procedure.
Programming of the blood processing circuit
46
(through the selective application of pressure to the valves and pump stations of the cassette) makes it possible to use the same universal set
264
as in the double red blood cell collection procedure.
The procedure includes a pre-collection cycle, a collection cycle, and a post-collection cycle.
During the pre-collection cycle, the set
264
is primed to vent air prior to venipuncture. During the collection cycle, whole blood drawn from the donor is processed to collect plasma, while returning red blood cells to the donor. During the post-collection cycle, excess plasma is returned to the donor, and the set is flushed with saline.
1. The Pre-Collection Cycle
a. Anticoagulant Prime
In the pre-collection cycle for the plasma collection (no red blood cells) procedure, the cassette is programmed to carry out AC Prime
1
and AC Prime
2
Phases that are identical to the AC Prime
1
and AC Prime
2
Phases of the double red blood cell collection procedure.
b. Saline Prime
In the pre-collection cycle for the plasma collection (no red blood cell) procedure, the cassette is programmed to carry out Saline Prime
1
, Saline Prime
2
, Saline Prime
3
, Vent Donor Line, and Venipuncture Phases that are identical to the Saline Prime
1
, Saline Prime
2
, Saline Prime
3
, Vent Donor Line, and Venipuncture Phases of the double red blood cell collection procedure.
The programming of the circuit during the phases of the pre-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During Pre-
|
Collection Phase
|
(Plasma Collection Procedure)
|
Vent
|
AC
AC
Saline
Saline
Saline
Donor
Veni-
|
Phase
Prime 1
Prime 2
Prime 1
Prime 2
Prime 3
Line
puncture
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V2
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump
Pump
Pump In
|
Out
Out
(Stage
|
1)
|
∘
|
(Stage
|
2)
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage
|
1)
|
∘/&Circlesolid;
|
Pump
|
Out
|
(Stage
|
2)
|
V11
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump
Pump In
|
Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage
|
1)
|
∘/&Circlesolid;
|
Pump In
|
(Stage
|
2)
|
V13
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump
Pump
|
In
Out
|
V14
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump
|
Out
|
(Stage
|
1)
|
∘
|
(Stage
|
2)
|
V15
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump
|
In
|
Pump
|
Out
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V19
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V20
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump
|
Out
|
Pump
|
In
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
PP1
▪
▪
□
□
□
▪
▪
|
(Stage
|
1)
|
PP2
▪
▪
▪
▪
□
▪
▪
|
(Stage
|
2)
|
PP3
□
▪
▪
▪
▪
□
▪
|
PP4
▪
□
▪
▪
▪
▪
▪
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
2. The Collection Cycle
a. Blood Prime
With venipuncture, tube
300
leading to the phlebotomy needle
268
is opened. In a first phase of the collection cycle (Blood Prime
1
), the blood processing circuit
46
is programmed to operate the donor interface pump PP
3
(i.e., in through valve V
13
and out through valve V
11
) and the anticoagulant pump PP
4
(i.e., in through valve V
20
and out through valve V
15
) to draw anticoagulated blood through the donor tube
270
into the in process container
312
, in the same fashion as the Blood Prime
1
Phase of the the double red blood cell collection procedure, as already described.
In a next phase (Blood Prime
2
), the blood processing circuit
46
is programmed to operate the in-process pump station PP
1
to draw anticoagulated blood from the in-process container
312
through the separation device, in the same fashion as the Blood Prime
2
Phase for the double red blood cell collection procedure, as already described. During this phase, saline displaced by the blood is returned to the donor.
b. Blood Separation while Drawing whole Blood or without Drawing whole Blood
In a next phase of the blood collection cycle (Blood Separation While Drawing Whole Blood), the blood processing circuit
46
is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
13
and out through valve V
11
); the anticoagulant pump PP
4
(i.e., in through valve V
20
and out through valve V
1
S); the in-process pump PP
1
(i.e., in through valve V
9
and out through valve V
14
); and the plasma pump PP
2
(i.e., in through valve V
12
and out through valve V
10
), in the same fashion as the Blood Separation While Drawing Whole Blood Phase for the double red blood cell collection procedure, as already described. This arrangement draws anticoagulated blood into the in-process container
312
, while conveying the blood from the in-process container
312
into the processing chamber for separation. This arrangement also removes plasma from the processing chamber into the plasma container
304
, while removing red blood cells from the processing chamber into the red blood cell container
308
. This phase continues until the targeted volume of plasma is collected in the plasma collection container
304
(as monitored by the weigh sensor) or until a targeted volume of red blood cells is collected in the red blood cell collection container (as monitored by the weigh sensor).
As in the double red blood cell collection procedure, if the volume of whole blood in the in-process container
312
reaches a predetermined maximum threshold before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed to enter another phase (Blood Separation Without Drawing Whole Blood), to terminate operation of the donor interface pump station PP
3
(while also closing valves V
13
, V
11
, V
18
, and V
13
) to terminate collection of whole blood in the in-process container
312
, while still continuing blood separation. If the volume of whole blood reaches a predetermined minimum threshold in the in-process container
312
during blood separation, but before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed to return to the Blood Separation While Drawing Whole Blood Phase, to thereby refill the in-process container
312
. The circuit is programmed to toggle between the Blood Separation Phases while drawing whole blood and without drawing whole blood, according to the high and low volume thresholds for the in-process container
312
, until the requisite volume of plasma has been collected, or until the target volume of red blood cells has been collected, whichever occurs first.
c. Return Red Blood Cells/Saline
If the targeted volume of plasma has not been collected, the next phase of the blood collection cycle (Return Red Blood Cells With Separation) programs the blood processing circuit
46
to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
); the in-process pump PP
1
(i.e., in through valve V
9
and out through valve V
14
); and the plasma pump PP
2
(i.e., in through valve V
12
and out through valve V
10
). This arrangement conveys anticoagulated whole blood from the in-process container
312
into the processing chamber for separation, while removing plasma into the plasma container
304
and red blood cells into the red blood cell container
308
. This arrangement also conveys red blood cells from the red blood cell container
308
to the donor, while also mixing saline from the container
288
in line with the returned red blood cells. The in line mixing of saline with the red blood cells raises the saline temperature and improves donor comfort. The in line mixing of saline with the red blood cells also lowers the hematocrit of the red blood cells being returned to the donor, thereby allowing a larger gauge (i.e., smaller diameter) phlebotomy needle to be used, to further improve donor comfort. This phase continues until the red blood cell container
308
is empty, as monitored by the weigh sensor.
If the volume of whole blood in the in-process container
312
reaches a specified low threshold before the red blood cell container
308
empties, the circuit is programmed to enter another phase (Red Blood Cell Return Without Separation), to terminate operation of the in-process pump station PP
1
(while also closing valves V
9
, V
10
, V
12
, and V
14
) to terminate blood separation. The phase continues until the red blood cell container
308
empties.
Upon emptying the red blood cell container
308
, the circuit is programmed to enter another phase (Fill Donor Line), to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to draw whole blood from the in process container
312
to fill the donor tube
266
, thereby purge red blood cells (mixed with saline) in preparation for another draw whole blood cycle.
The circuit is then programmed to conduct another Blood Separation While Drawing Whole Blood Phase, to refill the in process container
312
. The circuit is programmed to conduct successive draw whole blood and return red blood cells/saline cycles, as described, until the weigh sensor indicates that a desired volume of plasma has been collected in the plasma collection container
304
. When the targeted volume of plasma has been collected, the post-collection cycle commences.
The programming of the circuit during the phases of the collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The
|
Collection Cycle
|
(Plasma Collection Procedure)
|
Blood
Return Red
|
Separation
Blood Cells/
|
While Drawing
Saline
|
Whole Blood
with
|
Blood
Blood
(Without
Separation
|
Prime
Prime
Drawing
(Without
Fill Donor
|
Phase
1
2
Whole Blood)
Separation)
Line
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
|
V2
&Circlesolid;
&Circlesolid;
∘
∘
&Circlesolid;
|
V3
∘
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(&Circlesolid;)
|
V4
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
∘
∘ (&Circlesolid;)
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
∘
&Circlesolid;
∘/&Circlesolid;
∘
|
Alternates
|
with V23
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump In
|
(&Circlesolid;)
|
V10
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
|
(&Circlesolid;)
|
V11
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump Out
Pump Out
Pump In
Pump In
|
(&Circlesolid;)
|
V12
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
|
(&Circlesolid;)
|
V13
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump In
Pump In
Pump Out
Pump Out
|
(&Circlesolid;)
|
V14
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
Pump Out
|
(&Circlesolid;)
|
V15
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
|
(&Circlesolid;)
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
∘
∘
∘
|
(&Circlesolid;)
|
V19
∘
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V20
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump Out
Pump In
|
(&Circlesolid;)
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Alternates
|
with V7
|
PP1
▪
□
□
□
▪
|
(▪)
|
PP2
▪
▪
□
□
▪
|
(▪)
|
PP3
□
▪
□
□
□
|
(▪)
|
PP4
□
▪
□
▪
▪
|
(▪)
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
d. The Post-Collection Cycle
Once the targeted volume of plasma has been collected (as monitored by the weigh sensor), the circuit is programmed to carry out the phases of the post-collection cycle.
3. Return Excess Red Blood Cells
In a first phase of the post-collection cycle (Remove Plasma Collection Container), the circuit is programmed to close all valves and disable all pump stations to allow separation of the plasma collection container
304
from the set
264
.
In the second phase of the post-collection cycle (Return Red Blood Cells), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey red blood cells remaining in the red blood cell collection container
308
to the donor. The circuit is also programmed in this phase to mix saline from the container
288
in line with the returned red blood cells. This phase continues until the red blood cell container
308
is empty, as monitored by the weigh sensor.
4. Saline Purge
In the next phase of the post-collection cycle (Saline Purge), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
11
) to convey saline from the container
288
through the separation device, to displace the blood contents of the separation device into the in-process container
312
, in preparation for their return to the donor. This phase reduces the loss of donor blood. This phase continues until a predetermined volume of saline in pumped through the separation device, as monitored by the weigh sensor.
5. Final Return to Donor
In the next phase of the post-collection cycle (Final Return), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the blood contents of the in-process container
312
to the donor. Saline is intermittently mixed with the blood contents. This phase continues until the in-process container
312
is empty, as monitored by the weigh sensor.
In the next phase (Fluid Replacement), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the saline to the donor. This phase continues until a prescribed replacement volume amount is infused, as monitored by the weigh sensor.
In the final phase (End Procedure), the circuit is programmed to close all valves and idle all pump stations, so that venipuncture can be terminated, and the plasma container can be separated and removed for storage. The remaining parts of the disposable set can be removed and discarded.
The programming of the circuit during the phases of the post-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Post-
|
Collection Cycle
|
(Plasma Collection Procedure)
|
Remove
|
Plasma
|
Collection
Return
Saline
Final
Fluid
End
|
Phase
Container
RBC
Purge
Return
Replacement
Procedure
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V2
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Alter-
Alter-
|
nates
nates
|
with
with
|
V23
V23
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V11
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump
Pump
Pump
Pump In
|
In
In/
In
|
Pump
|
Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V13
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump
Pump
Pump Out
|
Out
Out
|
V14
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V15
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
&Circlesolid;
&Circlesolid;
∘
∘
&Circlesolid;
|
V19
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V20
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
∘
∘
∘
∘
&Circlesolid;
|
V23
&Circlesolid;
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘
&Circlesolid;
|
Alter-
Alter-
|
nates
nates
|
with
with
|
V6
V7
|
PP1
▪
▪
▪
▪
▪
▪
|
PP2
▪
▪
▪
▪
▪
▪
|
PP3
▪
□
□
□
□
|
PP4
▪
▪
▪
▪
▪
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
G. Red Blood Cell and Plasma Collection
During this procedure, whole blood from a donor is centrifugally processed to collect up to about 550 ml of plasma and up to about 250 ml of red blood cells. This procedure will, in shorthand, be called the red blood cell/plasma collection procedure.
The portion of the red blood cells not retained for collection are periodically returned to the donor during blood separation. Plasma collected in excess of the 550 ml target and red blood cells collected in excess of the 250 ml target are also returned to the donor at the end of the procedure.
Programming of the blood processing circuit
46
(through the selective application of pressure to the valves and pump stations of the cassette) makes it possible to use the same universal set
264
used to carry out the double red blood cell collection or the plasma collection procedure.
The procedure includes a pre-collection cycle, a collection cycle, and a post-collection cycle, and a storage preparation cycle.
During the pre-collection cycle, the set
264
is primed to vent air prior to venipuncture. During the collection cycle, whole blood drawn from the donor is processed to collect plasma and red blood cells, while returning a portion of the red blood cells to the donor. During the post-collection cycle, excess plasma and red blood cells are returned to the donor, and the set is flushed with saline. During the storage preparation cycle, a red blood cell storage solution added to the collected red blood cells.
(1) The Pre-Collection Cycle
a. Anticoagulant Prime
In the pre-collection cycle for the red blood cell/plasma collection procedure, the cassette is programmed to carry out AC Prime
1
and AC Prime
2
Phases that are identical to the AC Prime
1
and AC Prime
2
Phases of the double red blood cell collection procedure.
b. Saline Prime
In the pre-collection cycle for the red blood cell/plasma collection procedure, the cassette is programmed to carry out Saline Prime
1
, Saline Prime
2
, Saline Prime
3
, Vent Donor Line, and Venipuncture Phases that are identical to the Saline Prime
1
, Saline Prime
2
, Saline Prime
3
, Vent Donor Line, and Venipuncture Phases of the double red blood cell collection procedure.
The programming of the circuit during the phases of the pre-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During Pre-
|
Collection Cycle
|
(Red Blood Cell/Plasma Collection Procedure)
|
Vent
|
AC
AC
Saline
Saline
Saline
Donor
Veni-
|
Phase
Prime 1
Prime 2
Prime 1
Prime 2
Prime 3
Line
puncture
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V2
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump
Pump
Pump In
|
Out
Out
(Stage
|
1)
|
∘
|
(Stage
|
2)
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage
|
1)
|
∘/&Circlesolid;
|
Pump
|
Out
|
(Stage
|
2)
|
V11
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump
Pump In
|
Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(Stage
|
1)
|
∘/&Circlesolid;
|
Pump In
|
(Stage
|
2)
|
V13
∘/&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump
|
Out
|
V14
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump
|
Out
|
(Stage
|
1)
|
∘
|
(Stage
|
2)
|
V15
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump In
|
Pump
|
Out
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V19
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V20
∘
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
Pump
|
Out
|
Pump In
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
∘
∘
∘
&Circlesolid;
&Circlesolid;
|
PP1
▪
▪
□
□
□
▪
▪
|
(Stage
|
1)
|
PP2
▪
▪
▪
▪
□
▪
▪
|
(Stage
|
2)
|
PP3
□
▪
▪
▪
▪
□
▪
|
PP4
▪
□
▪
▪
▪
▪
▪
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
2. The Collection Cycle
a. Blood Prime
With venipuncture, tube
300
leading to the phlebotomy needle
268
is opened. The collection cycle of the red blood cell/plasma collection procedure programs the circuit to carry out Blood Prime
1
and Blood Prime
2
Phases that are identical to the Blood Prime
1
and Blood Prime
2
Phases of the Double Red Blood Cell Collection Procedure, already described.
b. Blood Separation while Drawing whole Blood or without Drawing whole Blood
In the blood collection cycle for the red blood cell/plasma collection procedure, the circuit is programmed to conduct a Blood Separation While Drawing Whole Blood Phase, in the same fashion that the Blood Separation While Drawing Whole Blood Phase is conducted for the double red blood cell collection procedure. This arrangement draws anticoagulated blood into the in-process container
312
, while conveying the blood from the in-process container
312
into the processing chamber for separation. This arrangement also removes plasma from the processing chamber into the plasma container
304
, while removing red blood cells from the processing chamber into the red blood cell container
308
. This phase continues until the desired maximum volumes of plasma and red blood cells have been collected in the plasma and red blood cell collection containers
304
and
308
(as monitored by the weigh sensor).
As in the double red blood cell collection procedure and the plasma collection procedure, if the volume of whole blood in the in-process container
312
reaches a predetermined maximum threshold before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed to enter a phase (Blood Separation Without Whole Blood Draw) to terminate operation of the donor interface pump station PP
3
(while also closing valves V
13
, V
11
, V
18
, and V
13
) to terminate collection of whole blood in the in-process container
312
, while still continuing blood separation. If the volume of whole blood reaches a predetermined minimum threshold in the in-process container
312
during blood separation, but before the targeted volume of either plasma or red blood cells is collected, the circuit is programmed to return to the Blood Separation With Whole Blood Draw, to thereby refill the in-process container
312
. The circuit is programmed to toggle between the Blood Separation cycle with whole blood draw and without whole blood draw according to the high and low volume thresholds for the in-process container
312
, until the requisite maximum volumes of plasma and red blood cells have been collected.
c. Return Red Blood Cells and Saline
If the targeted volume of plasma has not been collected, and red blood cells collected in the red blood cell container
308
exceed a predetermined maximum threshold, the next phase of the blood collection cycle (Return Red Blood Cells With Separation) programs the blood processing circuit
46
to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
); the in-process pump PP
1
(i.e., in through valve V
9
and out through valve V
14
); and the plasma pump PP
2
(i.e., in through valve V
12
and out through valve V
10
). This arrangement continues to convey anticoagulated whole blood from the in-process container
312
into the processing chamber for separation, while removing plasma into the plasma container
304
and red blood cells into the red blood cell container
308
. This arrangement also conveys all or a portion of the red blood cells collected in the red blood cell container
308
to the donor. This arrangement also mixes saline from the container
288
in line with the returned red blood cells. The in line mixing of saline with the red blood cells raises the saline temperature and improves donor comfort. The in line mixing of saline with the red blood cells also lowers the hematocrit of the red blood cells being returned to the donor, thereby allowing a larger gauge (i.e., smaller diameter) phlebotomy needle to be used, to further improve donor comfort.
This phase can continue until the red blood cell container
308
is empty, as monitored by the weigh sensor, thereby corresponding to the Return Red Blood Cells With Separation Phase of the plasma collection procedure. Preferably, however, the processor determines how much additional plasma needs to be collected to meet the plasma target volume. From this, the processor derives the incremental red blood cell volume associated with the incremental plasma volume. In this arrangement, the processor returns a partial volume of red blood cells to the donor, so that, upon collection of the next incremental red blood cell volume, the total volume of red blood cells in the container
308
will be at or slightly over the targeted red blood cell collection volume.
If the volume of whole blood in the in-process container
312
reaches a specified low threshold before return of the desired volume of red blood cells, the circuit is programmed to enter a phase (Return Red Blood Cells Without Separation), to terminate operation of the in-process pump station PP
1
(while also closing valves V
9
, V
10
, V
12
, and V
14
) to terminate blood separation. This phase corresponds to the Return Red Blood Cells Without Separation Phase of the plasma collection procedure.
Upon returning the desired volume of red blood cells from the container
308
, the circuit is programmed to enter a phase (Fill Donor Line), to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to draw whole blood from the in process container
312
to fill the donor tube
266
, thereby purge red blood cells (mixed with saline) in preparation for another draw whole blood cycle.
The circuit is then programmed to conduct another Blood Separation While Drawing Whole Blood Phase, to refill the in process container
312
. If required, the circuit is capable of performing successive draw whole blood and return red blood cells cycles, until the weigh sensors indicate that volumes of red blood cells and plasma collected in the containers
304
and
308
are at or somewhat greater than the targeted values. The post-collection cycle then commences.
The programming of the circuit during the phases of the collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The
|
Collection Cycle
|
(Red Blood Cell/Plasma Collection Procedure)
|
Blood
Return Red
|
Separation
Blood Cells/
|
While Drawing
Saline
|
Whole Blood
with
|
Blood
Blood
(Without
Separation
|
Prime
Prime
Drawing
(Without
Fill Donor
|
Phase
1
2
Whole Blood)
Separation)
Line
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
|
V2
&Circlesolid;
&Circlesolid;
∘
∘
&Circlesolid;
|
V3
∘
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(&Circlesolid;)
|
V4
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
&Circlesolid;
&Circlesolid;
∘
∘ (&Circlesolid;)
&Circlesolid;
|
V6
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V7
&Circlesolid;
∘
&Circlesolid;
∘/&Circlesolid;
∘
|
Alternates
|
with V23
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump In
|
(&Circlesolid;)
|
V10
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
|
(&Circlesolid;)
|
V11
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump
Pump
Pump In
Pump In
|
Out
Out
|
(&Circlesolid;)
|
V12
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
|
(&Circlesolid;)
|
V13
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
|
Pump
Pump In
Pump Out
Pump Out
|
In
(&Circlesolid;)
|
V14
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
Pump Out
|
(&Circlesolid;)
|
V15
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump
Pump Out
|
Out
(&Circlesolid;)
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
∘
∘
∘
∘
|
(&Circlesolid;)
|
V19
∘
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
(&Circlesolid;)
|
V20
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Pump
Pump In
|
Out
(&Circlesolid;)
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
|
V23
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Alternates
|
with V7
|
PP1
▪
□
□
□
▪
|
(▪)
|
PP2
▪
▪
□
□
▪
|
(▪)
|
PP3
□
▪
□
□
□
|
(▪)
|
PP4
□
▪
□
▪
▪
|
(▪)
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
d. The Post-Collection Cycle
Once the targeted maximum volumes of plasma and red blood cells have been collected (as monitored by the weigh sensor), the circuit is programmed to carry out the phases of the post-collection cycle.
i. Return Excess Plasma
If the volume of plasma collected in the plasma collection container
304
is over the targeted volume, a phase of the post-collection cycle (Excess Plasma Return) is entered, during which the circuit is programmed to terminate the supply and removal of blood to and from the processing chamber, while operating the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey plasma in the plasma container
304
to the donor. The circuit is also programmed in this phase to mix saline from the container
288
in line with the returned plasma. This phase continues until the volume of plasma in the plasma collection container
304
is at the targeted value, as monitored by the weigh sensor.
ii. Return Excess Red Blood Cells
If the volume of red blood cells collected in the red blood cell collection container
308
is also over the targeted volume, a phase of the post-collection cycle (Excess RBC Return) is entered, during which the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey red blood cells remaining in the red blood cell collection container
308
to the donor. The circuit is also programmed in this phase to mix saline from the container
288
in line with the returned red blood cells. This phase continues until the volume of red blood cells in the container
308
equals the targeted value, as monitored by the weigh sensor.
iii. Saline Purge
When the volumes of red blood cells and plasma collected in the containers
308
and
304
equal the targeted values, the next phase of the post-collection cycle (Saline Purge) is entered, during which the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
11
) to convey saline from the container
288
through the separation device, to displace the blood contents of the separation device into the in-process container
312
, in preparation for their return to the donor. This phase reduces the loss of donor blood. This phase continues until a predetermined volume of saline in pumped through the separation device, as monitored by the weigh sensor.
iv. Final Return to Donor
In the next phase of the post-collection cycle (Final Return), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the blood contents of the in-process container
312
to the donor. Saline is intermittently mixed with the blood contents. This phase continues until the in-process container
312
is empty, as monitored by the weigh sensor.
In the next phase (Fluid Replacement), the circuit is programmed to operate the donor interface pump station PP
3
(i.e., in through valve V
11
and out through valve V
13
) to convey the saline to the donor. This phase continues until a prescribed replacement volume amount is infused, as monitored by the weigh sensor.
In the next phase (End Venipuncture), the circuit is programmed to close all valves and idle all pump stations, so that venipuncture can be terminated.
The programming of the circuit during the phases of the post-collection cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Post-
|
Collection Cycle
|
(Red Blood Cell/Plasma Collection Procedure)
|
End
|
Excess
Excess
Fluid
Veni-
|
Plasma
RBC
Saline
Final
Replace-
punc-
|
Phase
Return
Return
Purge
Return
ment
ture
|
|
V1
&Circlesolid;
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
|
V2
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V3
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V4
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V5
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V6
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Alternates
|
with V23
|
V7
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
&Circlesolid;
|
Alternates
Alternates
|
with V23
with V23
|
V8
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V9
∘
∘
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V10
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V11
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump In
Pump In
Pump
Pump In
Pump In
|
In/
|
Pump
|
Out
|
V12
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V13
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
∘/&Circlesolid;
∘/&Circlesolid;
&Circlesolid;
|
Pump Out
Pump Out
Pump Out
Pump Out
|
V14
&Circlesolid;
&Circlesolid;
∘
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V15
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V16
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V17
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V18
∘
&Circlesolid;
∘
∘
&Circlesolid;
|
V19
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V20
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V21
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
&Circlesolid;
|
V22
∘
∘
∘
∘
∘
&Circlesolid;
|
V23
∘/&Circlesolid;
∘/&Circlesolid;
∘
∘/&Circlesolid;
∘
&Circlesolid;
|
Alternates
Alternates
Alternates
|
with V6
with V6
with V7
|
PP1
▪
▪
▪
▪
▪
▪
|
PP2
▪
▪
▪
▪
▪
▪
|
PP3
□
□
□
□
□
▪
|
PP4
▪
▪
▪
▪
▪
▪
|
|
Caption:
|
∘denotes an open valve;
|
&Circlesolid;denotes a closed valve;
|
∘/&Circlesolid;denotes a valve opening and closing during a pumping sequence;
|
▪denotes an idle pump station (not in use); and
|
□denotes a pump station in use.
|
e. The Storage Preparation Cycle
i. RBC Preservative Prime
In the first phase of the storage preparation cycle (Prime Storage Solution), the circuit is programmed to operate the donor interface pump station PP
3
to transfer a desired volume of red blood cell storage solution from the container
280
into the in-process container
312
. The transfer of the desired volume is monitored by the weigh scale.
In the next phase (Transfer Storage Solution), the circuit is programmed to operate the donor interface pump station PP
3
to transfer a desired volume of red blood cell storage solution from the in-process container
312
into the red blood cell collection container
308
. The transfer of the desired volume is monitored by the weigh scale.
In the next and final phase (End Procedure), the circuit is programmed to close all valves and idle all pump stations, so that the plasma and red blood cell storage containers
304
and
308
can be separated and removed for storage. The remainder of the disposable set can now be removed and discarded.
The programming of the circuit during the phases of the storage preparation cycle is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit During The Storage
|
Preparation Cycle
|
(Red Blood Cell/Plasma Collection Procedure)
|
Prime Storage
Transfer Storage
|
Phase
Solution
Solution
End Procedure
|
|
V1
•
•
•
|
V2
•
∘
•
|
V3
∘
•
•
|
V4
•
∘
•
|
V5
•
•
•
|
V6
•
•
•
|
V7
•
•
•
|
V8
•
•
•
|
V9
•
•
•
|
V10
•
•
•
|
V11
∘/•
∘/•
•
|
Pump In/
Pump In/
|
Pump Out
Pump Out
|
V12
•
•
•
|
V13
•
•
•
|
V14
•
•
•
|
V15
•
•
•
|
V16
∘
∘
•
|
V17
•
•
•
|
V18
•
•
•
|
V19
•
•
•
|
V20
•
•
•
|
V21
∘
∘
•
|
V22
•
•
•
|
V23
•
•
•
|
PP1
▪
▪
▪
|
PP2
▪
▪
▪
|
PP3
□
□
▪
|
PP4
▪
▪
▪
|
|
Caption:
|
∘ denotes an open valve;
|
• denotes a closed valve;
|
∘/•denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use) ; and
|
□ denotes a pump station in use.
|
V. Interface Control
A. Underspill and Overspill Detection
In any of the above-described procedures, the centrifugal forces present within the processing chamber
18
separate whole blood into a region of packed red blood cells and a region of plasma (see
FIG. 15A
) The centrifugal forces cause the region of packed red blood cells to congregate along the outside or high-G wall of the chamber, while the region of plasma is transported to the inside or low-G wall of the chamber.
An intermediate region forms an interface between the red blood cell region and the plasma region. Intermediate density cellular blood species like platelets and leukocytes populate the interface, arranged according to density, with the platelets closer to the plasma layer than the leukocytes. The interface is also called the “buffy coat,” because of its cloudy color, compared to the straw color of the plasma region and the red color of the red blood cell region.
It is desirable to monitor the location of the buffy coat, either to keep the buffy coat materials out of the plasma or out of the red blood cells, depending on the procedure, or to collect the cellular contents of the buffy coat. The system includes a sensing station
332
comprising two optical sensors
334
and
336
for this purpose.
In the illustrated and preferred embodiment (see FIG.
13
), the sensing station
332
is located a short distance outside the centrifuge station
20
. This arrangement minimizes the fluid volume of components leaving the chamber before monitoring by the sensing station
332
.
The first sensor
334
in the station
332
optically monitors the passage of blood components through the plasma collection tube
292
. The second sensor
336
in the station
332
optically monitors the passage of blood components through the red blood cell collection tube
294
.
The tubes
292
and
294
are made from plastic (e.g. polyvinylchloride) material that is transparent to the optical energy used for sensing, at least in the region where the tubes
292
and
294
are to be placed into association with the sensing station
332
.
In the illustrated embodiment, the set
264
includes a fixture
338
(see
FIGS. 16
to
18
) to hold the tubes
292
and
294
in viewing alignment with its respective sensor
334
and
336
. The fixture
338
gathers the tubes
292
and
294
in a compact, organized, side-by-side array, to be placed and removed as a group in association with the sensors
334
and
336
, which are also arranged in a compact, side-by-side relationship within the station
332
.
In the illustrated embodiment, the fixture
338
also holds the tube
290
, which conveys whole blood into the centrifuge station
20
, even though no associated sensor is provided. The fixture
338
serves to gather and hold all tubes
290
,
292
, and
294
that are coupled to the umbilicus
296
in a compact and easily handled bundle.
The fixture
338
can be an integral part of the umbilicus
296
, formed, e.g., by over molding. Alternatively, the fixture
338
can be a separately fabricated part, which snap fits about the tubes
290
,
292
, and
294
for use.
In the illustrated embodiment (as
FIG. 2
shows), the containers
304
,
308
, and
312
coupled to the cassette
28
are suspended during use above the centrifugation station
20
. In this arrangement, the fixture
338
directs the tubes
290
,
292
, and
294
through an abrupt, ninety degree bend immediately beyond the end of the umbilicus
296
to the cassette
28
. The bend imposed by the fixture
338
directs the tubes
290
,
292
, and
294
in tandem away from the area immediately beneath the containers
304
,
308
, and
312
, thereby preventing clutter in this area. The presence of the fixture
338
to support and guide the tubes
290
,
292
, and
294
through the bend also reduces the risk of kinking or entanglement.
The first sensor
334
is capable of detecting the presence of optically targeted cellular species or components in the plasma collection tube
292
. The components that are optically targeted for detection vary depending upon the procedure.
For a plasma collection procedure, the first sensor
334
detects the presence of platelets in the plasma collection tube
292
, so that control measures can be initiated to move the interface between the plasma and platelet cell layer back into the processing chamber. This provides a plasma product that can be essentially platelet-free or at least in which the number of platelets is minimized.
For a red blood cell-only collection procedure, the first sensor
334
detects the interface between the buffy coat and the red blood cell layer, so that control measures can be initiated to move this interface back into the processing chamber. This maximizes the red blood cell yield.
For a buffy coat collection procedure (which will be described later), the first sensor
334
detects when the leading edge of the buffy coat (i.e., the plasma/platelet interface) begins to exit the processing chamber, as well as detects when the trailing edge of the buffy coat (i.e., the buffy coat/red blood cell interface) has completely exited the processing chamber.
The presence of these cellular components in the plasma, as detected by the first sensor
334
, indicates that the interface is close enough to the low-G wall of the processing chamber to allow all or some of these components to be swept into the plasma collection line (see
FIG. 15B
) This condition will also be called an “over spill.”
The second sensor
336
is capable of detecting the hematocrit of the red blood cells in the red blood cell collection tube
294
. The decrease of red blood hematocrit below a set minimum level during processing that the interface is close enough to the high-G wall of the processing chamber to allow plasma to enter the red blood cell collection tube
294
(see FIG.
15
C). This condition will also be called an “under spill.”
B. The Sensing Circuit
The sensing station
332
includes a sensing circuit
340
(see FIG.
19
), of which the first sensor
334
and second sensor
336
form a part.
The first sensor
334
includes one green light emitting diode (LED)
350
, one red LED
352
, and two photodiodes
354
and
355
. The photodiode
354
measures transmitted light, and the photodiode
355
measures reflected light.
The second sensor
336
includes one red LED
356
and two photodiodes
358
and
360
. The photodiode
358
measures transmitted light, and the photodiode
360
measures reflected light.
The sensing circuit
340
further includes an LED driver component
342
. The driver component
342
includes a constant current source
344
, coupled to the LED's
350
,
352
, and
356
of the sensors
334
and
336
. The constant current source
344
supplies a constant current to each LED
350
,
352
, and
356
, independent of temperature and the power supply voltage levels. The constant current source
344
thereby provides a constant output intensity for each LED
350
,
352
, and
356
.
The LED drive component
342
includes a modulator
346
. The modulator
346
modulates the constant current at a prescribed frequency. The modulation
346
removes the effects of ambient light and electromagnetic interference (EMI) from the optically sensed reading, as will be described in greater detail later.
The sensing circuit
340
also includes a receiver circuit
348
coupled to the photodiodes
354
,
355
,
358
, and
360
. The receiver circuit
348
includes, for each photodiode
354
,
355
,
358
, and
360
, a dedicated current-to-voltage (I-V) converter
362
. The remainder of the receiver circuit
348
includes a bandpass filter
364
, a programmable amplifier
366
, and a full wave rectifier
368
. These components
364
,
366
, and
368
are shared, e.g., using a multiplexer.
Ambient light typically contains frequency components less than 1000 Hz, and EMI typically contains frequency components above 2 Khz. With this in mind, the modulator
346
modulates the current at a frequency below the EMI frequency components, e.g., at about 2 Khz. The bandpass filter
364
has a center frequency of about the same value, i.e., about 2 Khz. The sensor circuit
340
eliminates frequency components above and below the ambient light source and EMI components from the sensed measurement. In this way, the sensing circuit
340
is not sensitive to ambient lighting conditions and EMI.
More particularly, transmitted or reflected light from the tube
292
or
294
containing the fluid to be measured is incident on photodiodes
354
and
355
(for the tube
292
) or photodiodes
358
and
360
(for tube
294
). Each photodiode produces a photocurrent proportional to the received light intensity. This current is converted to a voltage. The voltage is fed, via the multiplexer
370
, to the bandpass filter
364
. The bandpass filter
364
has a center frequency at the carrier frequency of the modulated source light (i.e., 2 Khz in the illustrated embodiment).
The sinusoidal output of the bandpass filter
364
is sent to the variable gain amplifier
366
. The gain of the amplifier is preprogrammed in preestablished steps, e.g., X
1
, X
10
, X
100
, and X
1000
. This provides the amplifier with the capability to respond to a large dynamic range.
The sinusoidal output of the amplifier
366
is sent to the full wave rectifier
368
, which transforms the sinusoidal output to a DC output voltage proportional to the transmitted light energy.
The controller
16
generates timing pulses for the sensor circuit
340
. The timing pulses comprise, for each LED, (i) a modulation square wave at the desired modulation frequency (i.e., 2 Khz in the illustrated embodiment), (ii) an enable signal, (iii) two sensor select bits (which select the sensor output to feed to the bandpass filter
364
), and (iv) two bits for the receiver circuit gain selection (for the amplifier
366
).
The controller
16
conditions the driver circuit
342
to operate each LED in an ON state and an OFF state.
In the ON state, the LED enable is set HIGH, and the LED is illuminated for a set time interval, e.g., 100 ms. During the first 83.3 ms of the ON state, the finite rise time for the incident photodiode and receiver circuit
348
are allowed to stabilize. During the final 16.7 ms of the ON state, the output of the circuit
340
is sampled at twice the modulation rate (i.e., 4 Khz in the illustrated embodiment). The sampling interval is selected to comprises one complete cycle of 60 Hz, allowing the main frequency to be filtered from the measurement. The 4 Khz sampling frequency allows the 2 Khz ripple to be captured for later removal from the measurement.
During the OFF state, the LED is left dark for 100 ms. The LED baseline due to ambient light and electromagnetic interference is recorded during the final 16.7 ms.
1. The First Sensor: Platelet/RBC Differentiation
In general, cell free (“free”) plasma has a straw color. As the concentration of platelets in the plasma increases, the clarity of the plasma decreases. The plasma looks “cloudy.” As the concentration of red blood cells in the plasma increases, the plasma color turns from straw to red.
The sensor circuit
340
includes a detection/differentiation module
372
, which analyses sensed attenuations of light at two different wavelengths from the first sensor
334
(using the transmitted light sensing photodiode
354
). The different wavelengths are selected to possess generally the same optical attenuation for platelets, but significantly different optical attentuations for red blood cells.
In the illustrated embodiment, the first sensor
334
includes an emitter
350
of light at a first wavelength (λ
1
), which, in the illustrated embodiment, is green light (570 nm and 571 nm). The first sensor
334
also includes an emitter
352
of light at a second wavelength (λ
2
), which, in the illustrated embodiment, is red light (645 nm to 660 nm).
The optical attenuation for platelets at the first wavelength (ε
platelets
λ
1
) and the optical attenuation for platelets at the second wavelength (ε
platelets
λ
2
) are generally the same. Thus, changes in attenuation over time, as affected by increases or decreases in platelet concentration, will be similar.
However, the optical attenuation for hemoglobin at the first wavelength (ε
Hb
λ
1
) is about ten times greater than the optical attenuation for hemoglobin at the second wavelength (ε
Hb
λ
2
). Thus, changes in attenuation over time, as affected by the presence of red blood cells, will not be similar.
The tube
294
, through which plasma to be sensed, is transparent to light at the first and second wavelengths.
The tube
294
conveys the plasma flow past the first and second emitters
350
and
352
.
The light detector
354
receives light emitted by the first and second emitters
350
and
352
through the tube
294
. The detector
354
generates signals proportional to intensities of received light. The intensities vary with optical attenuation caused by the presence of platelets and/or red blood cells.
The module
372
is coupled to the light detector
354
to analyze the signals to derive intensities of the received light at the first and second wavelengths. The module
372
compares changes of the intensities of the first and second wavelengths over time. When the intensities of the first and second wavelengths change over time in substantially the same manner, the module
372
generates an output representing presence of platelets in the plasma flow. When the intensities of the first and second wavelengths change over time in a substantially different manner, the module
372
generates an output representing presence of red blood cells in the plasma flow. The outputs therefore differentiate between changes in intensity attributable to changes in platelet concentration in the plasma flow and changes in intensity attributable to changes in red blood cell concentration in the plasma flow.
There are various ways to implement the module
372
. In a preferred embodiment, the detection/differentiation module
372
considers that the attenuation of a beam of monochromatic light of wavelength λ by a plasma solution can be described by the modified Lambert-Beer law, as follows:
I=I
o
e
−[(ε
Hb
λ
C
Hb
H+ε
platelets
λ
C
platelets
)d+G
platelets
λ
+G
RBC
λ
]
(1)
where:
I is transmitted light intensity.
I
o
is incident light intensity.
ε
Hb
λ
is the optical attenuation of hemoglobin (Hb) (gm/dl) at the applied wavelength.
ε
platelets
λ
is the optical attenuation of platelets at the applied wavelength.
C
Hb
is the concentration of hemoglobin in a red blood cell, taken to be 34 gm/dl.
C
platelets
is the concentration of platelets in the sample.
d is thickness of the plasma stream through the tube
294
.
G
λ
is the path length factor at the applied wavelength, which accounts for additional photon path length in the plasma sample due to light scattering.
H is whole blood hematocrit, which is percentage of red blood cells in the sample.
G
RBC
λ
and G
platelets
λ
are a function of the concentration and scattering coefficients of, respectively, red blood cells and platelets at the applied wavelengths, as well as the measurement geometry.
For wavelengths in the visible and near infrared spectrum, ε
platelets
λ
≈0, therefore:
In an over spill condition (shown in FIG.
15
B), the first cellular component to be detected by the first sensor
334
in the plasma collection line
294
will be platelets. Therefore, for the detection of platelets, Ln(T
λ
)≈G
platelets
λ
.
To detect the buffy coat interface between the platelet layer and the red blood cell layer, the two wavelengths (λ
1
and λ
2
) are chosen based upon the criteria that (i) λ
1
and λ
2
have approximately the same path length factor (G
λ
), and (ii) one wavelength λ
1
or λ
2
has a much greater optical attenuation for hemoglobin than the other wavelength.
Assuming the wavelengths λ
1
and λ
2
have the same G
λ
, Equation (2) reduces to:
Ln
(
T
λ
1
)−
Ln
(
T
λ
2
)≈
Hdc
Hb
(ε
Hb
λ
2
−ε
Hb
λ
1
) (3)
In the preferred embodiment, λ
1
=660 nm (green) and λ
2
=571 nm (red). The path length factor (G
λ
) for 571 nm light is greater than for 660 nm light. Therefore the path length factors have to be modified by coefficients α and β, as follows:
G
RBC
λ
1
=αG
RBC
λ
2
G
platelts
λ
1
=βG
platelets
λ
2
Therefore, Equation (3) can be reexpressed as follows:
Ln
(
T
λ
1
)−
Ln
(
T
λ
2
)≈
Hdc
Hb
(ε
Hb
λ
2
−ε
Hb
λ1
)+(α−1)
G
RBC
λ
1
+(β−1)
G
platelets
λ
2
(4)
In the absence of red blood cells, Equation (3) causes a false red blood cell detect with increasing platelet concentrations, as Equation (5) demonstrates:
Ln
(
T
λ
1
)−
Ln
(
T
λ
2
)=(β−1)
G
platelets
λ
1
(5)
For the detection of platelets and the interface between the platelet/red blood cell layer, Equation (4) provides a better resolution. The module
372
therefore applies Equation (4). The coefficient (β−1) can be determined by empirically measuring G
platelets
λ
1
and G
platelets
λ
2
in the desired measurement geometry for different known concentrations of platelets in prepared platelet-spiked plasma.
The detection/differentiation module
372
also differentiates between intensity changes due to the presence of red blood cells in the plasma or the presence of free hemoglobin in the plasma due to hemolysis. Both circumstances will cause a decrease in the output of the transmitted light sensing photodiode
354
. However, the output of the reflected light sensing photodiode
355
increases in the presence of red blood cells and decreases in the presence of free hemoglobin. The detection/differentiation module
372
thus senses the undesired occurrence of hemolysis during blood processing, so that the operator can be alerted and corrective action can be taken.
2. The Second Sensor: Packed Red Blood Cell Measurement
In an under spill condition (shown in FIG.
15
C), the hematocrit of red blood cells exiting the processing chamber
18
will dramatically decrease, e.g., from a targeted hematocrit of about 80 to a hematocrit of about 50, as plasma (and the buffy coat) mixes with the red blood cells. An under spill condition is desirable during a plasma collection procedure, as it allows the return of the buffy coat to the donor with the red blood cells. An under spill condition is not desired during a red blood cell-only collection procedure, as it jeopardizes the yield and quality of red blood cells that are collected for storage.
In either situation, the ability to sense when an under spill condition exists is desireable.
Photon wavelengths in the near infrared spectrum (NIR) (approximately 540 nm to 1000 nm) are suitable for sensing red blood cells, as their intensity can be measured after transmission through many millimeters of blood.
The sensor circuit
340
includes a red blood cell detection module
374
. The detection module
374
analyses sensed optical transmissions of the second sensor
336
to discern the hematocrit and changes in the hematocrit of red blood cells exiting the processing chamber
18
.
The detection module
374
considers that the attenuation of a beam of monochromatic light of wavelength λ by blood may be described by the modified Lambert-Beer law, as follows:
I=I
o
e
−[(ε
Hb
λ
c
Hb
H)d+G
RBC
λ
]
(6)
where:
I is transmitted light intensity.
I
o
is incident light intensity.
ε
Hb
λ
is the extinction coefficient of hemoglobin (Hb) (gm/dl) at the applied wavelength.
C
Hb
is the concentration of hemoglobin in a red blood cell, taken to be 34 gm/dl.
d is the distance between the light source and light detector.
G
λ
is the path length factor at the applied wavelength, which accounts for additional photon path length in the media due to light scattering.
H is whole blood hematocrit, which is percentage of red blood cells in the sample.
G
RBC
λ
is a function of the hematocrit and scattering coefficients of red blood cells at the applied wavelengths, as well as the measurement geometry.
Given Equation (6), the optical density O.D. of the sample can be expressed as follows:
The optical density of the sample can further be expressed as follows:
O.D.=O.D.
Absorption
+O.D.
Scattering
(8)
where:
O.D.
Absorption
is the optical density due to absorption by red blood cells, expressed as follows:
O.D.
Absorption
=−(ε
Hb
λ
C
Hb
H
)
d
(9)
O.D.
Scattering
is the optical density due to scattering of red blood cells, expressed as follows:
O.D.
Scattering
=G
RBC
λ
(10)
From Equation (9), O.D.
Asorption
increases linearly with hematocrit (H). For transmittance measurements in the red and NIR spectrum, G
RBC
λ
is generally parabolic, reaching a maximum at a hematocrit of between 50 and 75 (depending on illumination wavelength and measurement geometry) and is zero at hematocrits of 0 and 100 (see, e.g., Steinke et al., “Diffusion Model of the Optical Absorbance of Whole Blood,”
J. Opt. Soc. Am.,
Vol 5, No. 6, June 1988). Therefore, for light transmission measurements, the measured optical density is a nonlinear function of hematocrit.
Nevertheless, it has been discovered that G
RBC
λ
for reflected light measured at a predetermined radial distance from the incident light source is observed to remain linear for the hematocrit range of at least 10 to 90. Thus, with the second sensor
336
so configured, the detection module can treat the optical density of the sample for the reflected light to be a linear function of hematocrit. The same relationship exists for the first sensor
334
with respect to the detection of red blood cells in plasma.
This arrangement relies upon maintaining straightforward measurement geometries. No mirrors or focusing lenses are required. The LED or photodiode need not be positioned at an exact angle with respect to the blood flow tube. No special optical cuvettes are required. The second sensor
336
can interface directly with the transparent plastic tubing
294
. Similarly, the first sensor
334
can interface directly with the transparent tubing
292
.
In the illustrated embodiment, the wavelength 805 nm is selected, as it is an isobestic wavelength for red blood cells, meaning that light absorption by the red blood cells at this wavelength is independent of oxygen saturation. Still, other wavelengths can be selected within the NIR spectrum.
In the illustrated embodiment, for a wavelength of 805 nm, the preferred set distance is 7.5 mm from the light source. The fixture
338
, above described (see FIG.
18
), facilitates the placement of the tube
294
in the desired relation to the light source and the reflected light detector of the second sensor
336
. The fixture
338
also facilitates the placement of the tube
292
in the desired relation to the light source and the reflected light detector of the first sensor
334
.
Measurements at a distance greater than 7.5 mm can be made and will show a greater sensitivity to changes in the red blood cell hematocrit. However a lower signal to noise ratio will be encountered at these greater distances. Likewise, measurements at a distance closer to the light source will show a greater signal to noise ratio, but will be less sensitive to changes in the red blood cell hematocrit. The optimal distance for a given wavelength in which a linear relationship between hematocrit and sensed intensity exists for a given hematocrit range can be empirically determined.
The second sensor
336
detects absolute differences in the mean transmitted light intensity of the signal transmitted through the red blood cells in the red blood cell collection line. The detection module analyzes these measured absolute differences in intensities, along with increases in the standard deviation of the measured intensities, to reliably signal an under spill condition, as
FIG. 20
shows.
At a given absolute hematocrit, G
RBC
λ
varies slightly from donor to donor, due to variations in the mean red blood cell volume and/or the refractive index difference between the plasma and red blood cells. Still, by measuring the reflected light from a sample of a given donor's blood having a known hematocrit, G
RBC
λ
may be calibrated to yield, for that donor, an absolute measurement of the hematocrit of red blood cells exiting the processing chamber.
C. Pre-Processing Calibration of the Sensors
The first and second sensors
334
and
336
are calibrated during the saline and blood prime phases of a given blood collection procedure, the details of which have already described.
During the saline prime stage, saline is conveyed into the blood processing chamber
18
and out through the plasma collection line
292
. During this time, the blood processing chamber
18
is rotated in cycles between 0 RPM and 200 RPM, until air is purged from the chamber
18
. The speed of rotation of the processing chamber
18
is then increased to full operational speed.
The blood prime stage follows, during which whole blood is introduced into the processing chamber
18
at the desired whole blood flow rate (Q
WB
). The flow rate of plasma from the processing chamber through the plasma collection line
292
is set at a fraction (e.g., 80%) of the desired plasma flow rate (Q
P
) from the processing chamber
18
, to purge saline from the chamber
18
. The purge of saline continues under these conditions until the first sensor
334
optically senses the presence of saline in the plasma collection line
292
.
1. For Plasma Collection Procedures (Induced Under Spill)
If the procedure to be performed collects plasma for storage (e.g., the Plasma Collection Procedure or the Red Blood Cell/Plasma Collection Procedure), an under spill condition is induced during calibration. The under spill condition is created by decreasing or stopping the flow of plasma through the plasma collection line
292
. This forces the buffy coat away from the low-G side of the chamber
18
(as
FIG. 15C
) to assure that a flow of “clean” plasma exists in the plasma collection line
292
, free or essentially free of platelets and leukocytes. The induced under spill allows the first sensor
334
to be calibrated and normalized with respect to the physiologic color of the donor's plasma, taking into account the donor's background lipid level, but without the presence of platelets or leukocytes. The first sensor
334
thereby possesses maximum sensitivity to changes brought about by the presence of platelets or leukocytes in the buffy coat, should an over spill subsequently occur during processing.
Forcing an under spill condition also positions the interface close to the high-G wall at the outset of blood processing. This creates an initial offset condition on the high-G side of the chamber, to prolong the ultimate development of an over spill condition as blood processing proceeds.
2. Red Blood Cell Collection Procedures
If a procedure is to be performed in which no plasma is to be collected (e.g., the Double Unit Red Blood Cell Collection Procedure), an under spill condition is not induced during the blood purge phase. This is because, in a red blood cell only collection procedure, the first sensor
334
need only detect, during an over spill, the presence of red blood cells in the plasma. The first sensor
334
does not need to be further sensitized to detect platelets. Furthermore, in a red blood cell only collection procedure, it may be desirable to keep the interface as near the low-G wall as possible. The desired condition allows the buffy coat to be returned to the donor with the plasma and maximizes the hematocrit of the red blood cells collected.
D. Blood Cell Collection
1. Plasma Collection Procedures
In procedures where plasma is collected (e.g., the Plasma Collection Procedure or the Red Blood Cell/Plasma Collection Procedure), Q
P
is set at Q
P(Ideal)
, which is an empirically determined plasma flow rate that allows the system to maintain a steady state collection condition, with no underspills and no overspills.
Q
P(Ideal)
(in grams/ml) is a function of the anticogulated whole blood inlet flow rate Q
WB
, the anticoagulant whole blood inlet hematocrit HCT
WB
, and the red blood cell exit hematocrit HCT
RBC
(as estimated or measured), expressed as follows:
where:
ρ
plasma
is the density of plasma (in g/ml)=1.03
ρ
WB
is the density of whole blood (in g/ml)=1.05
ρ
RBC
is the density of red blood cells=1.08
Q
WB
is set to the desired whole blood inlet flow rate for plasma collection, which, for a plasma only collection procedure, is generally about 70 ml/min. For a red blood cell/plasma collection procedure, Q
WB
is set at about 50 ml/min, thereby providing packed red blood cells with a higher hematocrit than in a traditional plasma collection procedure.
The system controller
16
maintains the pump settings until the desired plasma collection volume is achieved, unless an under spill condition or an over spill condition is detected.
If set Q
P
is too high for the actual blood separation conditions, or, if due to the physiology of the donor, the buffy coat volume is larger (i.e., “thicker”) than expected, the first sensor
334
will detect the presence of platelets or leukocytes, or both in the plasma, indicating an over spill condition.
In response to an over spill condition caused by a high Q
P
, the system controller
16
terminates operation of the plasma collection pump PP
2
, while keeping set Q
WB
unchanged. In response to an over spill condition caused by a high volume buffy coat, the system controller
16
terminates operation of the plasma collection pump PP
2
, until an under spill condition is detected by the red blood cell sensor
336
. This serves to expel the buffy coat layer from the separation chamber through the red blood cell tube
294
.
To carry out the over spill response, the blood processing circuit
46
is programmed to operate the in-process pump PP
1
(i.e., drawing in through the valve V
9
and expelling out of the valve V
14
), to draw whole blood from the in-process container
312
into the processing chamber
18
at the set Q
WB
. Red blood cells exit the chamber
18
through the tube
294
for collection in the collection container
308
. The flow rate of red blood cells directly depends upon the magnitude of Q
WB
.
During this time, the blood processing circuit
46
is also programmed to cease operation of the plasma pump PP
2
for a preestablished time period (e.g., 20 seconds). This forces the interface back toward the middle of the separation chamber. After the preestablished time period, the operation of the plasma pump PP
2
is resumed, but at a low flow rate (e.g., 10 ml/min) for a short time period (e.g., 10 seconds). If the spill has been corrected, clean plasma will be detected by the first sensor
334
, and normal operation of the blood processing circuit
46
is resumed. If clean plasma is not sensed, indicating that the over spill has not been corrected, the blood processing circuit
46
repeats the above-described sequence.
The programming of the circuit to relieve an over spill condition is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit To Relive an Over
|
Spill Condition
|
(Plasma Collection Procedures)
|
|
|
V1
•
|
V2
∘
|
V3
•
|
V4
•
|
V5
∘
|
V6
•
|
V7
•
|
V8
•
|
V9
•/∘ Pump In
|
V10
•
|
V11
•
|
V12
•
|
V13
•
|
V14
•/∘ Pump Out
|
V15
•
|
V16
•
|
V17
•
|
V18
•
|
V19
•
|
V20
•
|
V21
•
|
V22
•
|
V23
•
|
PP1
□
|
PP2
▪
|
PP3
▪
|
PP4
▪
|
|
Caption:
|
∘ denotes an open valve;
|
• denotes a closed valve;
|
∘/• denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
Upon correction of an over spill condition, the controller
16
returns the blood processing circuit
46
to resume normal blood processing, but applies a percent reduction factor (%RF) to the Qp set at the time the over spill condition was initially sensed. The reduction factor (%RF) is a function of the time between over spills, i.e., %RF increases as the frequency of over spills increases, and vice versa.
If set Q
P
is too low, the second sensor
336
will detect a decrease in the red blood cell hematocrit below a set level, which indicates an under spill condition.
In response to an under spill condition, the system controller
16
resets Q
P
close to the set Q
WB
. As processing continues, the interface will, in time, move back toward the low-G wall. The controller
16
maintains these settings until the second sensor
336
detects a red blood cell hematocrit above the desired set level. At this time, the controller
16
applies a percent enlargement factor (%EF) to the Q
P
set at the time the under spill condition was initially sensed. The enlargement factor (%EF) is a function of the time between under spills, i.e., %EF increases as the frequency of under spills increases.
Should the controller
16
be unable to correct a given under or over spill condition after multiple attempts (e.g., three attempts), an alarm is commanded.
2. Red Blood Cell Only Collection Procedures
In procedures where only red blood cells and no plasma is collected (e.g., the Double Unit Red Blood Cell Collection Procedure), Q
P
is set to no greater than Q
P(Ideal)
, and Q
WB
is set to the desired whole blood inlet flow rate into the processing chamber
18
for the procedure, which is generally about 50 ml/min for a double unit red blood cell collection procedure.
It may be desired during a double unit red blood cell collection procedure that over spills occur frequently. This maximizes the hematocrit of the red blood cells for collection and returns the buffy coat to the donor with the plasma. Q
P
is increased over time if over spills occur at less than a set frequency. Likewise, Q
P
is decreased over time if over spills occur above the set frequency. However, to avoid an undesirably high hematocrit, it may be just as desirable to operate at Q
P(Ideal)
.
The system controller
16
controls the pump settings in this way until the desired red blood cell collection volume is achieved, taking care of under spills or over spills as they occur.
The first sensor
334
detects an over spill by the presence of red blood cells in the plasma. In response to an over spill condition, the system controller
16
terminates operation of the plasma collection pump to draw plasma from the processing chamber, while keeping the set Q
WB
unchanged.
To implement the over spill response, the blood processing circuit
46
is programmed (through the selective application of pressure to the valves and pump stations) to operate the plasma pump PP
2
and in-process pump PP
1
in the manner set forth in the immediately preceding Table. The red blood cells detected in the tube
292
are thereby returned to the processing chamber
18
, and are thereby prevented from entering the plasma collection container
304
.
The interface will, in time, move back toward the high-G wall. The controller
16
maintains these settings until the second sensor
336
detects a decrease in the red blood cell hematocrit below a set level, which indicates an under spill condition.
In response to an under spill condition, the system controller
16
increases Q
P
until the second sensor
336
detects a red blood cell hematocrit above the desired set level. At this time, the controller
16
resets Q
P
to the value at the time the most recent overspill condition was sensed.
3. Buffy Coat Collection
If desired, an over spill condition can be periodically induced during a given plasma collection procedure to collect the buffy coat in a buffy coat collection container
376
(see FIG.
10
). As
FIG. 10
shows, in the illustrated embodiment, the buffy coat collection container
376
is coupled by tubing
378
to the buffy port P
4
of the cassette
28
. The buffy coat collection container
376
is suspended on a weigh scale
246
, which provides output reflecting weight changes over time, from which the controller
16
derives the volume of buffy coat collected.
In this arrangement, when the induced over spill condition is detected, the blood processing circuit
46
is programmed (through the selective application of pressure to the valves and pump stations) to operate the plasma pump PP
2
(i.e., drawing in through valve V
12
and expelling out through valve V
10
), to draw plasma from the processing chamber
18
through the tube
378
, while valves V
4
and V
6
are closed and valve V
8
is opened. The buffy coat in the tube
378
is conveyed into the buffy coat collection container
376
. The blood processing circuit
46
is also programmed during this time to operate the in-process pump PP
1
(i.e., drawing in through the valve V
9
and expelling out of the valve V
14
), to draw whole blood from the in-process container
312
into the processing chamber
18
at the set Q
WB
. Red blood cells exit the chamber
18
through the tube
294
for collection in the collection container
308
.
The programming of the circuit to relieve an over spill condition by collecting the buffy coat in the buffy coat collection container
376
is summarized in the following table.
TABLE
|
|
Programming of Blood Processing Circuit To Relive an Over
|
Spill Condition by Collecting the Buffy Coat
|
(Plasma Collection Procedures)
|
|
|
V1
•
|
V2
•
|
V3
•
|
V4
∘
|
V5
•
|
V6
•
|
V7
•
|
V8
•
|
V9
•/∘ Pump In
|
V10
•/∘ Pump Out
|
V11
•
|
V12
•/∘ Pump In
|
V13
•
|
V14
•/∘ Pump Out
|
V15
•
|
V16
•
|
V17
•
|
V18
•
|
V19
•
|
V20
•
|
V21
•
|
V22
•
|
V23
•
|
PP1
□
|
PP2
□
|
PP3
▪
|
PP4
▪
|
|
Caption:
|
∘ denotes an open valve;
|
• denotes a closed valve;
|
∘/• denotes a valve opening and closing during a pumping sequence;
|
▪ denotes an idle pump station (not in use); and
|
□ denotes a pump station in use.
|
After a prescribed volume of buffy coat is conveyed into the buffy coat collection container
376
(as monitored by the weigh scale
246
), normal blood processing conditions are resumed. Over spill conditions causing the movement of the buffy coat into the tube
378
can be induced at prescribed intervals during the process period, until a desired buffy coat volume is collected in the buffy coat collection container.
VI. Another Programmable Blood Processing Circuit
A. Circuit Schematic
As previously mentioned, various configurations for the programmable blood processing circuit
46
are possible.
FIG. 5
schematically shows one representative configuration
46
, the programmable features of which have been described.
FIG. 34
shows another representative configuration of a blood processing circuit
46
′ having comparable programmable features.
Like the circuit
46
, the circuit
46
′ includes several pump stations PP(N), which are interconnected by a pattern of fluid flow paths F(N) through an array of in line valves V(N). The circuit is coupled to the remainder of the blood processing set by ports P(N).
The circuit
46
′ includes a programmable network of flow paths F
1
to F
33
. The circuit
46
′ includes eleven universal ports P
1
to P
8
and P
11
to P
13
and four universal pump stations PP
1
, PP
2
, PP
3
, and PP
4
. By selective operation of the in line valves V
1
to V
21
and V
23
to V
25
, any universal port P
1
to P
8
and P
11
to P
13
can be placed in flow communication with any universal pump station PP
1
, PP
2
, PP
3
, and PP
4
. By selective operation of the universal valves, fluid flow can be directed through any universal pump station in a forward direction or reverse direction between two valves, or an in-out direction through a single valve.
In the illustrated embodiment, the circuit
46
′ also includes an isolated flow path (comprising flow paths F
9
, F
23
, F
24
, and F
10
) with two ports P
9
and Plo and one in line pump station PP
5
. The flow path is termed “isolated,” because it cannot be placed into direct flow communication with any other flow path in the circuit
46
′ without exterior tubing. By selective operation of the in line valves V
21
and V
22
, fluid flow can be directed through the pump station PP
5
in a forward direction or reverse direction between two valves, or an in-out direction through a single valve.
Like circuit
46
, the circuit
46
′ can be programmed to assigned dedicated pumping functions to the various pump stations. In a preferrred embodiment, the universal pump stations PP
3
and PP
4
in tandem serve as a general purpose, donor interface pump, regardless of the particular blood procedure performed. The dual donor interface pump stations PP
3
and PP
4
in the circuit
46
′ work in parallel. One pump station draws fluid into its pump chamber, while the other pump station is expels fluid from its pump chamber. The pump station PP
3
and PP
4
alternate draw and expel functions.
In a preferred arrangement, the draw cycle for the drawing pump station is timed to be longer than the expel cycle for the expelling pump station. This provides a continuous flow of fluid on the inlet side of the pump stations and a pulsatile flow in the outlet side of the pump stations. In one representative embodiment, the draw cycle is ten seconds, and the expel cycle is one second. The expelling pump station performs its one second cycle at the beginning of the draw cycle of the drawing pump, and then rests for the remaining nine seconds of the draw cycle. The pump stations then switch draw and expel functions. This creates a continuous inlet flow and a pulsatile outlet flow. The provision of two alternating pump stations PP
3
and PP
4
serves to reduce overall processing time, as fluid is continuously conducted into a drawing pump station through out the procedure.
In this arrangement, the isolated pump station PP
5
of the circuit
46
′ serves as a dedicated anticoagulant pump, like pump station PP
4
in the circuit
46
, to draw anticoagulant from a source through the port P
10
and to meter anticoagulant into the blood through port P
9
.
In this arrangement, as in the circuit
46
, the universal pump station PP
1
serves, regardless of the particular blood processing procedure performed, as a dedicated in-process whole blood pump, to convey whole blood into the blood separator. As in the circuit
46
, the dedicated function of the pump station PP
1
frees the donor interface pumps PP
3
and PP
4
from the added function of supplying whole blood to the blood separator. Thus, the in-process whole blood pump PP
1
can maintain a continuous supply of blood to the blood separator, while the donor interface pumps PP
3
and PP
4
operate in tandem to simultaneously draw and return blood to the donor through the single phlebotomy needle. The circuit
46
′ thus minimizes processing time.
In this arrangement, as in circuit
46
, the universal pump station PP
2
of the circuit
46
′ serves, regardless of the particular blood processing procedure performed, as a plasma pump, to convey plasma from the blood separator. As in the circuit
46
, the ability to dedicate separate pumping functions in the circuit
46
′ provides a continuous flow of blood into and out of the separator, as well as to and from the donor.
The circuit
46
′ can be programmed to perform all the different procedures described above for the circuit
46
. Depending upon the objectives of the particular blood processing procedure, the circuit
46
′ can be programmed to retain all or some of the plasma for storage or fractionation purposes, or to return all or some of the plasma to the donor. The circuit
46
′ can be further programmed, depending upon the objectives of the particular blood processing procedure, to retain all or some of the red blood cells for storage, or to return all or some of the red blood cells to the donor. The circuit
46
′ can also be programmed, depending upon the objectives of the particular blood processing procedure, to retain all or some of the buffy coat for storage, or to return all or some of the buffy coat to the donor.
In a preferred embodiment (see FIG.
34
), the circuit
46
′ forms a part of a universal set
264
′, which is coupled to the ports P
1
to P
13
.
More particularly, a donor tube
266
′, with attached phlebotomy needle
268
′ is coupled to the port P
8
of the circuit
46
′. An anticoagulant tube
270
′, coupled to the phlebotomy needle
268
′ is coupled to port P
9
. A container
276
′ holding anticoagulant is coupled via a tube
274
′ to the port P
10
.
A container
280
′ holding a red blood cell additive solution is coupled via a tube
278
′ to the port P
3
. A container
288
′ holding saline is coupled via a tube
284
′ to the port P
12
. A storage container
289
′ is coupled via a tube
291
′ to the port P
13
. An in-line leukocyte depletion filter
293
′ is carried by the tube
291
′ between the port P
13
and the storage container
289
′. The containers
276
′,
280
′,
288
′, and
289
′ can be integrally attached to the ports or can be attached at the time of use through a suitable sterile connection, to thereby maintain a sterile, closed blood processing environment.
Tubes
290
′,
292
′, and
294
′, extend to an umbilicus
296
′ which is coupled to the processing chamber
18
′. The tubes
290
′,
292
′, and
294
are coupled, respectively, to the ports P
5
, P
6
, and P
7
. The tube
290
′ conveys whole blood into the processing chamber
18
under the operation of the in-process pump station PP
1
. The tube
292
′ conveys plasma from the processing chamber
18
′ under the operation of the plasma pump chamber PP
2
. The tube
294
′ conveys red blood cells from processing chamber
18
′.
A plasma collection container
304
′ is coupled by a tube
302
′ to the port P
3
. The collection container
304
′ is intended, in use, to serve as a reservoir for plasma during processing.
A red blood cell collection container
308
′ is coupled by a tube
306
′ to the port P
2
. The collection container
308
′ is intended, in use, to receive a unit of red blood cells for storage.
A buffy coat collection container
376
′ is coupled by a tube
377
′ to the port P
4
. The container
376
′ is intended, in use, to receive a volume of buffy coat for storage.
A whole blood reservoir
312
′ is coupled by a tube
310
′ to the port P
1
. The collection container
312
′ is intended, in use, to receive whole blood during operation of the donor interface pumps PP
3
and PP
4
, to serve as a reservoir for whole blood during processing. It can also serve to receive a second unit of red blood cells for storage.
B. The Cassette
As
FIGS. 35 and 36
show, the programmable fluid circuit
46
′ can be implemented as an injection molded, pneumatically controlled cassette
28
′. The cassette
28
′ interacts with the pneumatic pump and valve station
30
, as previously described, to provide the same centralized, programmable, integrated platform as the cassette
28
.
FIG. 35 and 36
show the cassette
28
′ in which the fluid circuit
46
′ (schematically shown in
FIG. 34
) is implemented. As previously described for the cassette
28
, an array of interior wells, cavities, and channels are formed on both the front and back sides
190
′ and
192
′ of the cassette body
188
′, to define the pump stations PP
1
to PP
5
, valve stations V
1
to V
25
, and flow paths F
1
to F
33
shown schematically in FIG.
34
. In
FIG. 36
, the flow paths F
1
to F
33
, are shaded to facilitate their viewing. Flexible diaphragms
194
′ and
196
′ overlay the front and back sides
190
′ and
192
′ of the cassette body
188
′, resting against the upstanding peripheral edges surrounding the pump stations PP
1
to PP
5
, valves V
1
to V
25
, and flow paths F
1
to F
33
. The pre-molded ports P
1
to P
13
extend out along two side edges of the cassette body
188
′.
The cassette
28
′ is vertically mounted for use in the pump and valve station
30
in the same fashion shown in FIG.
2
. In this orientation (which Fog.
36
shows), the side
192
′ faces outward, ports P
8
to P
13
face downward, and the ports P
1
to P
7
are vertically stacked one above the other and face inward.
As previously described, localized application by the pump and valve station
30
of positive and negative fluid pressures upon the diaphragm
194
′ serves to flex the diaphragm to close and open the valve stations V
1
to V
25
or to expel and draw liquid out of the pump stations PP
1
to PP
5
.
An additional interior cavity
200
′ is provided in the back side
192
′ of the cassette body
188
′. The cavity
200
′ forms a station that holds a blood filter material to remove clots and cellular aggregations that can form during blood processing. As shown schematically in
FIG. 34
, the cavity
200
′ is placed in the circuit
46
′ between the port P
8
and the donor interface pump stations PP
3
and PP
4
, so that blood returned to the donor passes through the filter. Return blood flow enters the cavity
200
′ through flow path F
27
and exits the cavity
200
′ through flow path F
8
. The cavity
200
′ also serves to trap air in the flow path to and from the donor.
Another interior cavity
201
′ (see
FIG. 35
) is also provided in the back side
192
′ of the cassette body
188
′. The cavity
201
′ is placed in the circuit
46
′ between the port P
5
and the valve V
16
of the in-process pumping station PP
1
. Blood enters the cavity
201
′ from flow path F
16
through opening
203
′ and exits the cavity
2011
into flow path F
5
through opening
205
′ The cavity
201
′ serves as another air trap within the cassette body
188
′ in the flow path serving the separation chamber
26
′. The cavity
201
′ also serves as a capacitor to dampen the pulsatile pump strokes of the in-process pump PP
1
serving the separation chamber.
C. Associated Pneumatic Manifold Assembly
FIG. 43
shows a pneumatic manifold assembly
226
′ that can be used in association with the cassette
28
′, to supply positive and negative pneumatic pressures to convey fluid through the cassette
28
′. The front side
194
′ of the diaphragm is held in intimate engagement against the manifold assembly
226
′ when the door
32
of the pump station
20
is closed and bladder
314
inflated. The manifold assembly
226
′, under the control of the controller
16
, selectively distributes the different pressure and vacuum levels to the pump and valve actuators PA(N) and VA(N) of the cassette
28
′. These levels of pressure and vacuum are systematically applied to the cassette
28
′, to route blood and processing liquids. Under the control of a controller
16
, the manifold assembly
226
also distributes pressure levels to the door bladder
314
(already described), as well as to a donor pressure cuff (also already described) and to a donor line occluder
320
(also already described). The manifold assembly
226
′ for the cassette
28
′ shown in
FIG. 43
shares many attributes with the manifold assembly
226
previously described for the cassette
28
, as shown in FIG.
12
.
Like the manifold assembly
226
, the manifold assembly
226
′ is coupled to a pneumatic pressure source
234
′, which is carried inside the lid
40
behind the manifold assembly
226
′. As in manifold assembly
226
, the pressure source
234
′ for the manifold assembly
226
comprises two compressors C
1
′ and C
2
′, although one or several dual-head compressors could be used as well. Compressor C
1
supplies negative pressure through the manifold
226
′ to the cassette
28
′. The other compressor C
2
′ supplies positive pressure through the manifold
226
′ to the cassette
28
.
As
FIG. 43
shows, the manifold
226
′ contains five pump actuators PA
1
to PA
4
and twenty-five valve actuators VA
1
to VA
25
. The pump actuators PA
1
to PA
5
and the valve actuators VA
1
to VA
25
are mutually oriented to form a mirror image of the pump stations PP
1
to PP
5
and valve stations V
1
to V
25
on the front side
190
′ of the cassette
28
′.
Like the manifold assembly
226
, the manifold assembly
226
′ shown in
FIG. 43
includes an array of solenoid actuated pneumatic valves, which are coupled in-line with the pump and valve actuators PA
1
to PA
5
and VA
1
to VA
25
.
Like the manifold assembly
226
, the manifold assembly
226
′ maintains several different pressure and vacuum conditions, under the control of the controller
16
.
As previously described in connection with the manifold assembly
226
, Phard, or Hard Pressure, and Pinpr, or In-Process Pressure are high positive pressures (e.g.,+500 mmHg) maintained by the manifold assembly
226
′ for closing the cassette valves V
1
to V
25
and to drive the expression of liquid from the in-process pump PP
1
and the plasma pump PP
2
. As before explained, the magnitude of Pinpr must be sufficient to overcome a minimum pressure of approximately 300 mm Hg, which is typically present within the processing chamber
18
. Pinpr and Phard are operated at the highest pressure to ensure that upstream and downstream valves used in conjunction with pumping are not forced opened by the pressures applied to operate the pumps.
Pgen, or General Pressure (+300 mmHg), is applied to drive the expression of liquid from the donor interface pumps PP
3
and PP
4
and the anticoagulant pump PP
5
.
Vhard, or Hard Vacuum (−350 mmHg), is the deepest vacuum applied in the manifold assembly
226
′ to open cassette valves V
1
to V
25
. Vgen, or General Vacuum (−300 mmHg), is applied to drive the draw function of each of the pumps PP
1
to PP
5
. Vgen is required to be less extreme than Vhard, to ensure that pumps PP
1
to PP
5
do not overwhelm upstream and downstream cassette valves V
1
to V
25
.
A main hard pressure line
322
′ and a main vacuum line
324
′ distribute Phard and Vhard in the manifold assembly
324
. The pressure and vacuum sources
234
′ run continuously to supply Phard to the hard pressure line
322
′ and Vhard to the hard vacuum line
324
′. A pressure sensor S
2
monitors Phard in the hard pressure line
3221
. The sensor S
2
opens and closes the solenoid
38
to build Phard up to its maximum set value.
Similarly, a pressure sensor S
6
in the hard vacuum line
324
′ monitors Vhard. The sensor S
6
controls a solenoid
43
to maintain Vhard as its maximum value.
A general pressure line
326
′ branches from the hard pressure line
322
′. A sensor S
4
in the general pressure line
326
′ monitors Pgen. The sensor S
2
controls a solenoid
34
to maintain Pgen within its specified pressure range.
A general vacuum line
330
′ branches from the hard vacuum line
324
′. A sensor S
5
monitors Vgen in the general vacuum line
330
′. The sensor S
5
controls a solenoid
45
to keep Vgen within its specified vacuum range.
In-line reservoirs R
1
to R
4
are provided in the hard pressure line
322
, the general pressure line
326
′, the hard vacuum line
324
′, and the general vacuum line
330
′. The reservoirs R
1
to R
4
assure that the constant pressure and vacuum adjustments as above described are smooth and predictable.
The solenoids
32
and
43
provide a vent for the pressures and vacuums, respectively, upon procedure completion.
The solenoids
41
,
2
,
46
, and
47
provide the capability to isolate the reservoirs R
1
to R
4
from the air lines that supply vacuum and pressure to the pump and valve actuators. This provides for much quicker pressure/vacuum decay feedback, so that testing of cassette/manifold assembly seal integrity can be accomplished.
The solenoids
1
to
25
provide Phard or Vhard to drive the valve actuators VA
1
to V
25
. The solenoids
27
and
28
provide Pinpr and Vgen to drive the in-process and plasma pumps PP
1
and PP
2
. The solenoids
30
and
31
provide Pgen and Vgen to drive the donor interface pumps actuators PA
3
and PA
4
. The solenoid
29
provides Pgen and Vgen to drive the AC pump actuator PP
5
.
The solenoid
35
provides isolation of the door bladder
314
from the hard pressure line
322
′ during the procedure. A sensor S
1
monitors Pdoor and control the solenoid
35
to keep the pressure within its specified range.
The solenoid
40
provides Phard to open the safety occluder valve
320
′. Any error modes that might endanger the donor will relax (vent) the solenoid
40
to close the occluder
320
′ and isolate the donor. Similarly, any loss of power will relax the solenoid
40
and isolate the donor.
The sensor S
3
monitors Pcuff and communicates with solenoids
36
(for increases in pressure) and solenoid
37
(for venting) to maintain the donor cuff within its specified ranges during the procedure.
As before explained, any solenoid can be operated in “normally open” mode or can be re-routed pneumatically to be operated in a “normally closed” mode, and vice versa.
D. Exemplary Pumping Functions
Based upon the foregoing description of the programming of the fluid circuit
46
implemented by the cassette
28
, one can likewise program the fluid circuit
46
′ implemented by the cassette
28
′ to perform all the various blood process functions already described. Certain pumping functions for the fluid circuit
46
′, common to various blood processing procedures, will be described by way of example.
1. Whole Blood Flow to the In-Process Container
In a first phase of a given blood collection cycle, the blood processing circuit
46
′ is programmed (through the selective application of pressure to the valves and pump stations of the cassette
28
′) to jointly operate the donor interface pumps PP
3
and PP
4
to transfer anticoagulated whole blood into the in-process container
312
′ prior to separation.
In a first phase (see FIG.
37
A), the pump PP
3
is operated in a ten second draw cycle(i.e., in through valves V
12
and V
13
, with valves V
6
, V
14
, V
18
, and V
15
closed) in tandem with the anticoagulant pump PP
5
(i.e., in through valve V
22
and out through valve V
21
) to draw anticoagulated blood through the donor tube
270
into the pump PP
3
. At the same time, the donor interface pump PP
4
is operated in a one second expel cycle to expel (out through valve V
7
) anticoagulant blood from its chamber into the process container
312
′ through flow paths F
20
and F
1
(through opened valve V
4
).
At the end of the draw cycle for pump PP
3
(see FIG.
37
B), the blood processing circuit
46
′ is programmed to operate the donor interface pump PP
4
in a ten second draw cycle(i.e., in through valves V
12
and V
14
, with valves V
13
, V
18
, and V
18
closed) in tandem with the anticoagulant pump PP
5
to draw anticoagulated blood through the donor tube
270
into the pump PP
4
. At the same time, the donor interface pump PP
3
is operated in a one second expel cycle to expel (out through valve V
6
) anticoagulant blood from its chamber into the process container
312
′ through the flow paths F
20
and F
1
(through opened valve V
4
).
These alternating cycles continue until an incremental volume of anticoagulated whole blood enters the in process container
312
′, as monitored by a weigh sensor. As
FIG. 37C
shows, the blood processing circuit
46
′ is programmed to operate the in-process pump station PP
1
(i.e., in through valve V
1
and out through valve V
16
) and the plasma pump PP
2
(i.e., in through valve V
17
and out through valve V
11
, with valve V
9
opened and valve V
10
closed) to convey anticoagulated whole blood from the in-process container
312
into the processing chamber
18
′ for separation, while removing plasma into the plasma container
304
(through opened valve V
9
) and red blood cells into the red blood cell container
308
(through open valve V
2
), in the manner previously described with respect to the circuit
46
. This phase continues until an incremental volume of plasma is collected in the plasma collection container
304
(as monitored by the weigh sensor) or until a targeted volume of red blood cells is collected in the red blood cell collection container (as monitored by the weigh sensor). The donor interface pumps PP
3
and PP
4
toggle to perform alternating draw and expel cycles as necessary to keep the volume of anticoagulated whole blood in the in-process container
312
′ between prescribed minimum and maximum levels, as blood processing proceeds.
2. Red Blood Cell Return with In-Line Addition of Saline
When it is desired to return red blood cells to the donor (see FIG.
37
D), the blood processing circuit
46
′ is programmed to operate the donor interface pump station PP
3
in a ten second draw cycle(i.e., in through valve V
6
, with valves V
13
and V
7
closed) to draw red blood cells from the red blood cell container
308
′ into the pump PP
3
(through open valves V
2
, V
3
, and V
5
, valve V
10
being closed). At the same time, the donor interface pump PP
4
is operated in a one second expel cycle to expel (out through valves V
14
and V
18
, with valves V
12
and V
21
closed) red blood cells from its chamber to the donor through the filter cavity
200
′.
At the end of the draw cycle for pump PP
3
(see FIG.
37
E), the blood processing circuit
46
′ is programmed to operate the donor interface pump PP
4
in a ten second draw cycle(i.e., in through valve V
7
, with valves V
6
and V
14
closed) to draw red blood cells from the red blood cell container
308
′ into the pump PP
4
. At the same time, the donor interface pump PP
3
is operated in a one second expel cycle to expel (out through valves V
13
and V
18
, with valve V
12
closed) red blood cells from its chamber to the donor through the filter chamber
200
′. These alternating cycles continue until a desired volume of red blood cells are returned to the donor.
Simultaneously, valves V
24
, V
20
, and V
8
are opened, so that the drawing pump station PP
3
or PP
4
also draws saline from the saline container
288
′ for mixing with red blood cells drawn into the chamber. As before explained, the in line mixing of saline with the red blood cells raises the saline temperature and improves donor comfort, while also lowering the hematocrit of the red blood cells.
Simultaneously, the in-process pump PP
1
is operated (i.e., in through valve V
1
and out through valve V
16
) and the plasma pump PP
2
(i.e., in through valve V
17
and out through valve V
11
, with valve V
9
open) to convey anticoagulated whole blood from the in-process container
312
into the processing chamber for separation, while removing plasma into the plasma container
304
, in the manner previously described with respect to the fluid circuit
46
.
3. In-Line Addition of Red Blood Cell Additive Solution
In a blood processing procedure where red blood cells are collected for storage (e.g., the Double Red Blood Cell Collection Procedure or the Red Blood Cell and Plasma Collection Procedure) the circuit
46
′ is programmed to operate the donor interface pump station PP
3
in a ten second draw cycle(in through valves V
15
and V
13
, with valve V
23
opened and valves V
8
, V
12
and V
18
closed) to draw red blood cell storage solution from the container
280
′ into the pump PP
3
(see FIG.
38
A). Simultaneously, the circuit
46
′ is programmed to operate the donor interface pump station PP
4
in a one second expel cycle(out through valve V
7
, with valves V
14
and V
18
closed) to expel red blood cell storage solution to the container(s) where red blood cells reside (e.g., the in-process container
312
(through open valve V
4
) or the red blood cell collection container
308
′ (through open valves V
5
, V
3
, and V
2
, with valve V
10
closed).
At the end of the draw cycle for pump PP
3
(see FIG.
38
B), the blood processing circuit
46
′ is programmed to operate the donor interface pump PP
4
in a ten second draw cycle(i.e., in through valve V
14
, with valves V
7
, V
18
, V
12
, and V
13
closed) to draw red blood cell storage solution from the container
280
′ into the pump PP
4
. At the same time, the donor-interface pump PP
3
is operated in a one second expel cycle to expel (out through valve V
6
, with valves V
13
and V
12
closed) red blood cell storage solution to the container(s) where red blood cells reside. These alternating cycles continue until a desired volume of red blood cell storage solution is added to the red blood cells.
4. In-Line Leukocyte Depletion
Circuit
46
′ provides the capability to conduct on-line depletion of leukocytes from collected red blood cells. In this mode (see FIG.
39
A), the circuit
46
′ is programmed to operate the donor interface pump station PP
3
in a ten second draw cycle(in through valve V
6
, with valves V
13
and V
12
closed) to draw red blood cells from the container(s) where red blood cells reside (e.g., the in-process container
312
′ (through open valve V
4
) or the red blood cell collection container
308
(through open valves V
5
, V
3
, and V
2
, with valve V
10
closed) into the pump PP
3
. Simultaneously, the circuit
46
′ is programmed to operate the donor interface pump station PP
4
in a one second expel cycle(out through valve V
14
, with valves V
18
and V
8
closed and valves V
15
and V
25
opened) to expel red blood cells through tube
291
′ through the in-line leukocyte depletion filter
293
′ to the leukocyte-depleted red blood cell storage container
289
′.
At the end of the draw cycle for pump PP
3
(see FIG.
39
B), the blood processing circuit
46
′ is programmed to operate the donor interface pump PP
4
in a ten second draw cycle(i.e., in through valve V
7
, with valves V
14
and V
18
closed) to draw red blood cells from the container
312
′ or
308
′ into the pump PP
4
. At the same time, the donor interface pump PP
3
is operated in a one second expel cycle to expel (out through valve V
13
, with valve V
12
closed and valves V
15
and V
25
opened) red blood cells through tube
291
′ through the in-line leukocyte depletion filter
293
′ to the leukocyte-depleted red blood cell storage container
289
′. These alternating cycles continue until a desired volume of red blood cells are transfered through the filter
293
into the container
289
′.
5. Staged Buffy Coat Harvesting
In circuit
46
(see FIG.
5
), buffy coat is collected through port P
4
, which is served by flow line F
4
, which branches from flow line F
26
, which conveys plasma from the plasma pump station PP
2
to the plasma collection container
304
(also see FIG.
10
). In the circuit
46
′ (see FIG.
34
), the buffy coat is collected through the port P
4
from the flow path F
6
as controlled by valve V
19
. The buffy coat collection path bypasses the plasma pump station PP
2
, keeping the plasma pump station PP
2
free of exposure to the buffy coat, thereby keeping the collected plasma free of contamination by the buffy coat components.
During separation, the system controller (already described) maintains the buffy coat layer within the separation chamber
18
′ at a distance spaced from the low-G wall, away from the plasma collection line
292
(see FIG.
15
A). This allows the buffy coat component to accumulate during processing as plasma is conveyed by operation of the plasma pump PP
2
from the chamber into the plasma collection container
304
′.
To collect the accumulated buffy coat component, the controller opens the buffy coat collection valve V
19
, and closes the inlet valve V
17
of the plasma pump station PP
2
and the red blood cell collection valve V
2
. The in-process pump PP
1
continues to operate, bringing whole blood into. the chamber
18
′. The flow of whole blood into the chamber
18
′ moves the buffy coat to the low-G wall, inducing an over spill condition) (see FIG.
15
B). The buffy coat component enters the plasma collection line
292
′ and enters flow path F
6
through the port P
6
. The circuit
46
′ conveys the buffy coat component in F
6
through the opened valve V
19
directly into path F
4
for passage through the port P
4
into the collection container
376
′.
The valve V
19
is closed when the sensing station
332
senses the presence of red blood cells. The plasma pumping station PP
2
can be temporarily operated in a reverse flow direction (in through the valve V
11
and out through the valve V
17
, with valve V
9
opened) to flow plasma from the collection container
302
′ through the tube
292
′ toward the separation chamber, to flush resident red blood from the tube
292
′ back into the separation chamber. The controller can resume normal plasma and red blood cell collection, by opening the red blood cell collection valve V
2
and operating the plasma pumping station PP
2
(in through valve V
17
and out through valve V
11
) to resume the conveyance of plasma from the separation chamber to the collection container
302
′.
Over spill conditions causing the movement of the buffy coat for collection can be induced at prescribed intervals during the process period, until a desired buffy coat volume is collected in the buffy coat collection container.
6. Miscellaneous
As
FIG. 43
shows in phantom lines, the manifold assembly
226
′ can include an auxiliary pneumatic actuator A
AUX
selectively apply P
HARD
to the region of the flexible diaphragm that overlies the interior cavity
201
′ (see FIG.
35
). As previously described, whole blood expelled by the pumping station PP
1
(by application of P
HARD
by actuator PA
2
), enters flow path F
5
through openings
203
′ and
205
′ into the processing chamber
18
′. During the next subsequent stroke of the PP
1
, to draw whole blood into the pumping chamber PP
1
by application of V
GEN
by actuator PA
2
, residual whole blood residing in the cavity
201
′ is expelled into flow path F
5
through opening
205
′, and into the processing chamber
18
′ by application of P
HARD
by A
AUX
. The cavity
201
′ also serves as a capacitor to dampen the pulsatile pump strokes of the in-process pump PP
1
serving the separation chamber
18
′.
It is desirable to conduct seal integrity testing of the cassette
28
′ shown in
FIG. 35 and 36
prior to use. The integrity test determines that the pump and valve stations within the cassette
28
′ function without leaking. In this situation, it is desirable to isolate the cassette
28
′ from the separation chamber
26
′. Valves V
19
and V
16
(see
FIG. 34
) in circuit
264
′ provide isolation for the whole blood inlet and plasma lines
292
′ and
296
′ of the chamber
18
′. To provide the capability of also isolating the red blood cell line
294
′, an extra valve fluid actuated station V
26
can be added in fluid flow path F
7
serving port P
7
. As further shown in phantom lines in
FIG. 43
, an addition valve actuator VA
26
can be added to the manifold assembly
26
′, to apply positive pressure to the valve V
26
, to close the valve V
26
when isolation is required, and to apply negative pressure to the valve V
26
, to open the valve when isolation is not required.
VII. Blood Separation Elements
A. Molded Processing Chamber
FIGS. 21
to
23
show an embodiment of the centrifugal processing chamber
18
, which can be used in association with the system
10
shown in FIG.
1
.
In the illustrated embodiment, the processing chamber
18
is preformed in a desired shape and configuration, e.g., by injection molding, from a rigid, biocompatible plastic material, such as a non-plasticized medical grade acrilonitrile-butadiene-styrene (ABS).
The preformed configuration of the chamber
18
includes a unitary, molded base
388
. The base
388
includes a center hub
120
. The hub
120
is surrounded radially by inside and outside annular walls
122
and
124
(see FIGS.
21
and
23
). Between them, the inside and outside annular walls
122
and
124
define a circumferential blood separation channel
126
. A molded annular wall
148
closes the bottom of the channel
126
(see FIG.
22
).
The top of the channel
126
is closed by a separately molded, flat lid
150
(which is shown separated in
FIG. 21
for the purpose of illustration). During assembly, the lid
150
is secured to the top of the chamber
18
, e.g., by use of a cylindrical sonic welding horn.
All contours, ports, channels, and walls that affect the blood separation process are preformed in the base
388
in a single, injection molded operation. Alternatively, the base
388
can be formed by separate molded parts, either by nesting cup shaped subassemblies or two symmetric halves.
The lid
150
comprises a simple flat part that can be easily welded to the base
388
. Because all features that affect the separation process are incorporated into one injection molded component, any tolerance differences between the base
388
and the lid
150
will not affect the separation efficiencies of the chamber
18
.
The contours, ports, channels, and walls that are preformed in the base
388
can vary. In the embodiment shown in
FIGS. 21
to
23
, circumferentially spaced pairs of stiffening walls
128
,
130
, and
132
emanate from the hub
120
to the inside annular wall
122
. The stiffening walls
128
,
130
,
132
provide rigidity to the chamber
18
.
As seen in
FIG. 23
, the inside annular wall
122
is open between one pair
130
of the stiffening walls. The opposing stiffening walls form an open interior region
134
in the hub
120
, which communicates with the channel
126
. Blood and fluids are introduced from the umbilicus
296
into and out of the separation channel
126
through this region
134
.
In this embodiment (as
FIG. 23
shows), a molded interior wall
136
formed inside the region
134
extends entirely across the channel
126
, joining the outside annular wall
124
. The wall
136
forms a terminus in the separation channel
126
, which interrupts flow circumferentially along the channel
126
during separation.
Additional molded interior walls divide the region
124
into three passages
142
,
144
, and
146
. The passages
142
,
144
, and
146
extend from the hub
120
and communicate with the channel
126
on opposite sides of the terminus wall
136
. Blood and other fluids are directed from the hub
120
into and out of the channel
126
through these passages
142
,
144
, and
146
. As will be explained in greater detail later, the passages
142
,
144
, and
146
can direct blood components into and out of the channel
126
in various flow patterns.
The underside of the base
388
(see
FIG. 22
) includes a shaped receptacle
179
. Three preformed nipples
180
occupy the receptacle
179
. Each nipple
180
leads to one of the passages
142
,
144
,
146
on the opposite side of the base
388
.
The far end of the umbilicus
296
includes a shaped mount
178
(see FIGS.
24
and
24
A). The mount
178
is shaped to correspond to the shape of the receptacle
179
. The mount
178
can thus be plugged into the receptacle
179
(as
FIG. 25
shows). The mount
178
includes interior lumens
398
(see FIG.
24
A), which slide over the nipples
180
in the hub
120
, to couple the umbilicus
296
in fluid communication with the channel
126
.
Ribs
181
within the receptacle
179
(see
FIG. 22
) uniquely fit within a key way
183
formed on the mount
178
(see
FIG. 24A
) The unique fit between the ribs
181
and the key way
183
is arranged to require a particular orientation for plugging the shaped mount
178
into the shaped receptacle
179
. In this way, a desired flow orientation among the umbilicus
296
and the passages
142
,
144
, and
146
is assured.
In the illustrated embodiment, the umbilicus
296
and mount
178
are formed from a material or materials that withstand the considerable flexing and twisting forces, to which the umbilicus
296
is subjected during use. For example, a Hytrel® polyester material can be used.
This material, while well suited for the umbilicus
296
, is not compatible with the ABS plastic material of the base
388
, which is selected to provide a rigid, molded blood processing environment. The mount
178
thus cannot be attached by conventional by solvent bonding or ultrasonic welding techniques to the receptacle
179
.
In this arrangement (see FIGS.
24
and
25
), the dimensions of the shaped receptacle
179
and the shaped mount
178
are preferably selected to provide a tight, dry press fit. In addition, a capturing piece
185
, formed of ABS material (or another material compatible with the material of the base
388
), is preferably placed about the umbilicus
296
outside the receptacle in contact with the peripheral edges of the receptacle
179
. The capturing piece
185
is secured to the peripheral edges of the receptacle
179
, e.g., by swaging or ultrasonic welding techniques. The capturing piece
185
prevents inadvertent separation of the mount
178
from the receptacle
181
. In this way, the umbilicus
296
can be integrally connected to the base
388
of the chamber
18
, even though incompatible plastic materials are used.
The centrifuge station
20
(see
FIGS. 26
to
28
) includes a centrifuge assembly
48
. The centrifuge assembly
48
is constructed to receive and support the molded processing chamber
18
for use.
As illustrated, the centrifuge assembly
48
includes a yoke
154
having bottom, top, and side walls
156
,
158
,
160
. The yoke
154
spins on a bearing element
162
attached to the bottom wall
156
. An electric drive motor
164
is coupled via an axle to the bottom wall
156
of the collar
154
, to rotate the yoke
154
about an axis
64
. In the illustrated embodiment, the axis
64
is tilted about fifteen degrees above the horizontal plane of the base
38
, although other angular orientations can be used.
A rotor plate
166
spins within the yoke
154
about its own bearing element
168
, which is attached to the top wall
158
of the yoke
154
. The rotor plate
166
spins about an axis that is generally aligned with the axis of rotation
64
of the yoke
154
.
The top of the processing chamber
18
includes an annular lip
380
, to which the lid
150
is secured. Gripping tabs
382
carried on the periphery of the rotor plate
166
make snap-fit engagement with the lip
380
, to secure the processing chamber
18
on the rotor plate
166
for rotation.
A sheath
182
on the near end of the umbilicus
296
fits into a bracket
184
in the centrifuge station
20
. The bracket
184
holds the near end of the umbilicus
296
in a non-rotating stationary position aligned with the mutually aligned rotational axes
64
of the yoke
154
and rotor plate
166
.
An arm
186
protruding from either or both side walls
160
of the yoke
154
contacts the mid portion of the umbilicus
296
during rotation of the yoke
154
. Constrained by the bracket
184
at its near end and the chamber
16
at its far end (where the mount
178
is secured inside the receptacle
179
), the umbilicus
296
twists about its own axis as it rotates about the yoke axis
64
. The twirling of the umbilicus
296
about its axis as it rotates at one omega with the yoke
154
imparts a two omega rotation to the rotor plate.
166
, and thus to the processing chamber
18
itself.
The relative rotation of the yoke
154
at a one omega rotational speed and the rotor plate
166
at a two omega rotational speed, keeps the umbilicus
296
untwisted, avoiding the need for rotating seals. The illustrated arrangement also allows a single drive motor
164
to impart rotation, through the umbilicus
296
, to the mutually rotating yoke
154
and rotor plate
166
. Further details of this arrangement are disclosed in Brown et al U.S. Pat. No. 4,120,449, which is incorporated herein by reference.
Blood is introduced into and separated within the processing chamber
18
as it rotates.
In one flow arrangement (see FIG.
29
), as the processing chamber
18
rotates (arrow R in FIG.
29
), the umbilicus
296
conveys whole blood into the channel
126
through the passage
146
. The whole blood flows in the channel
126
in the same direction as rotation (which is counterclockwise in FIG.
29
). Alternatively, the chamber
18
can be rotated in a direction opposite to the circumferential flow of whole blood, i.e., clockwise. The whole blood separates as a result of centrifugal forces in the manner shown in FIG.
15
A. Red blood cells are driven toward the high-G wall
124
, while lighter plasma constituent is displaced toward the low-G wall
122
.
In this flow pattern, a dam
384
projects into the channel
126
toward the high-G wall
124
. The dam
384
prevents passage of plasma, while allowing passage of red blood cells into a channel
386
recessed in the high-G wall
124
. The channel
386
directs the red blood cells into the umbilicus
296
through the radial passage
144
. The plasma constituent is conveyed from the channel
126
through the radial passage
142
into umbilicus
296
.
Because the red blood cell exit channel
386
extends outside the high-g wall
124
, being spaced further from the rotational axis than the high-g wall, the red blood cell exit channel
386
allows the positioning of the interface between the red blood cells and the buffy coat very close to the high-g wall
124
during blood processing, without spilling the buffy coat into the red blood cell collection passage
144
(creating an over spill condition). The recessed exit channel
386
thereby permits red blood cell yields to be maximized (in a red blood cell collection procedure) or an essentially platelet-free plasma to be collected (in a plasma collection procedure).
In an alternative flow arrangement (see FIG.
30
), the umbilicus
296
conveys whole blood into the channel
126
through the passage
142
. The processing chamber
18
rotates (arrow R in
FIG. 30
) in the same direction as whole blood flow (which is clockwise in FIG.
30
). Alternatively, the chamber
18
can be rotated in a direction opposite to the circumferential flow of whole blood, i.e., clockwise. The whole blood separates as a result of centrifugal forces in is the manner shown in FIG.
15
A. Red blood cells are driven toward the high-G wall
124
, while lighter plasma constituent is displaced toward the low-G wall
122
.
In this flow pattern, the dam
384
(previously described) prevents passage of plasma, while allowing passage of red blood cells into the recessed channel
386
. The channel
386
directs the red blood cells into the umbilicus
296
through the radial passage
144
. The plasma constituent is conveyed from the opposite end of the channel
126
through the radial passage
146
into umbilicus
296
.
In another alternative flow arrangement (see FIG.
31
), the umbilicus
296
conveys whole blood into the channel
126
through the passage
144
. The processing chamber
18
is rotated (arrow R in
FIG. 31
) in the same direction as blood flow (which is clockwise in FIG.
31
). Alternatively, the chamber
18
can be rotated in a direction opposite to the circumferential flow of whole blood, i.e., counterclockwise. The whole blood separates as a result of centrifugal forces in the manner shown in FIG.
15
A. Red blood cells are driven toward the high-G wall
124
, while lighter plasma constituent is displaced toward the low-G wall
122
.
In this flow pattern, a dam
385
at the opposite end of the channel
126
prevents passage of plasma, while allowing passage of red blood cells into a recessed channel
387
. The channel
387
directs the red blood cells into the umbilicus
296
through the radial passage
146
. The plasma constituent is conveyed from the other end of the channel
126
through the radial passage
142
into umbilicus
296
. In this arrangement, the presence of the dam
384
and the recessed passage
386
(previously described) separates incoming whole blood flow (in passageway
144
) from outgoing plasma flow (in passageway
142
). This flow arrangement makes possible the collection of platelet-rich plasma, if desired.
In another alternative flow arrangement (see FIG.
32
), the passage
144
extends from the hub
120
into the channel
126
in a direction different than the passages
142
and
146
. In this arrangement, the terminus wall
136
separates the passages
142
and
146
, and the passage
144
communicates with the channel
126
at a location that lays between the passages
142
and
146
. In this arrangement, the umbilicus
296
conveys whole blood into the channel
126
through the passage
146
. The processing chamber
18
is rotated (arrow R in
FIG. 32
) in the same direction as blood flow (which is clockwise in FIG.
32
). Alternatively, the chamber
18
can be rotated in a direction opposite to the circumferential flow of whole blood, i.e., counterclockwise. The whole blood separates as a result of centrifugal forces in the manner shown in FIG.
15
A. Red blood cells are driven toward the high-G wall
124
, while lighter plasma constituent is displaced toward the low-G wall
122
.
In this flow pattern, the passage
144
conveys plasma from the channel
126
, while the passage
142
conveys red blood cells from the channel
126
.
As previously mentioned, in any of the flow patterns shown in
FIGS. 28
to
32
, the chamber
18
can be rotated in the same direction or in an opposite direction to circumferential flow of whole blood in the channel
126
. Blood separation as described will occur in either circumstance. Nevertheless, it has been discovered that, rotating the chamber
18
in the same direction as the flow of whole blood in the channel
126
during separation, appears to minimize disturbances due, e.g., Coriolis effects, resulting in increased separation efficiencies.
EXAMPLE
Whole blood was separated during various experiments into red blood cells and plasma in processing chambers
18
like that shown in FIG.
28
. In one chamber (which will be called Chamber
1
), whole blood circumferentially flowed in the channel
126
in the same direction as the chamber
18
was rotated (i.e., the chamber
18
was rotated in a counterclockwise direction). In the other chamber
18
(which will be called Chamber
2
), whole blood circumferentially flowed in the channel
126
in a direction opposite to chamber rotation (i.e., the chamber
18
was rotated in a clockwise direction). The average hematocrit for red blood cells collected were measured for various blood volume samples, processed at different combinations of whole blood inlet flow rates and plasma outlet flow rates. The following Tables summarize the results for the various experiments.
TABLE 1
|
|
(Flow in the Same Direction as Rotation)
|
Number of Blood
Average Hematocrit of
|
Samples
Average Whole Blood
Red Blood Cells
|
Processed
Hematocrit (%)
Collected
|
|
7
45.4
74.8
|
4
40
78.8
|
|
TABLE 2
|
|
(Flow in the Opposite Direction as Rotation)
|
Number of Blood
Average Hematocrit of
|
Samples
Average Whole Blood
Red Blood Cells
|
Processed
Hematocrit (%)
Collected
|
|
3
43.5
55.5
|
2
42.25
58.25
|
|
Tables 1 and 2 show that, when blood flow in the chamber is in the same direction as rotation, the hematocrit of red blood cells is greater than when blood flow is in the opposite direction. A greater yield of red blood cells also means a greater yield of plasma during the procedure.
FIG. 33
shows a chamber
18
′ having a unitary molded base
388
′ like that shown in
FIGS. 21
to
23
, but in which two flow paths
126
′ and
390
are formed. The flow paths
126
′ and
390
are shown to be concentric, but they need not be. The chamber
18
′ shares many other structural features in common with the chamber
18
shown in FIG.
23
. Common structural features are identified by the same reference number marked with an asterisk.
The base
388
′ includes a center hub
120
′ which is surrounded radially by the inside and outside annular walls
122
′ and
124
′, defining between them the circumferential blood separation channel
126
′. In this embodiment, a second inside annular wall
392
radially surrounds the hub
120
′. The second circumferential blood separation channel
390
is defined between the inside annular walls
122
′ and
392
. This construction forms the concentric outside and inside separation channels
126
′ and
390
.
An interruption
394
in the annular wall
122
′ adjacent to the dam
384
′ establishes flow communication between the outside channel
126
′ and the inside channel
390
. An interior wall
396
blocks flow communication between the channels
126
′ and
390
at their opposite ends.
As the processing chamber
18
′ rotates (arrow R in FIG.
33
), the umbilicus
296
conveys whole blood into the outside channel
126
′ through the passage
144
′. The whole blood flows in the channel
126
′ in the same direction as rotation (which is counterclockwise in FIG.
33
). Alternatively, the chamber
18
′ can be rotated in a direction opposite to the circumferential flow of whole blood, i.e., clockwise. The whole blood separates in the outside channel
126
′ as a result of centrifugal forces in the manner shown in FIG.
15
A. Red blood cells are driven toward the high-G wall
124
′, while lighter plasma constituent is displaced toward the low-G wall
122
′.
As previously described, the dam
384
′ prevents passage of plasma, while allowing passage of red blood cells into a channel
386
′ recessed in the high-G wall
124
′. The channel
386
′ directs the red blood cells into the umbilicus
296
through the radial passage
142
′. The plasma constituent is conveyed from the channel
126
′ through the interruption
394
into the inside separation channel
390
.
The plasma flows circumferentially flow through the inside channel
390
in a direction opposite to the whole blood in the outside channel
126
′. Platelets remaining in the plasma migrate in response to centrifugal forces against the annular wall
124
′. The channel
390
directs the plasma constituent to the same end of the chamber
18
′ where whole blood is initially introduced. The plasma constituent is conveyed from the channel
390
by the passage
146
′.
VIII. Other Blood Processing Functions
The many features of the invention have been demonstrated by describing their use in separating whole blood into component parts for storage and blood component therapy. This is because the invention is well adapted for use in carrying out these blood processing procedures. It should be appreciated, however, that the features of the invention equally lend themselves to use in other blood processing procedures.
For example, the systems and methods described, which make use of a programmable cassette in association with a blood processing chamber, can be used for the purpose of washing or salvaging blood cells during surgery, or for the purpose of conducting therapeutic plasma exchange, or in any other procedure where blood is circulated in an extracorporeal path for treatment.
Features of the invention are set forth in the following claims.
Claims
- 1. A blood separation chamber for rotation about an axis comprisinga low-G wall and a high-G wall extending circumferentially about the axis in a spaced apart relationship to define between them a separation channel, a partial interior wall extending partially into the separation channel from the low-G wall toward the high-G wall, to thereby define a constricted channel along the high-G wall, the constricted channel including a recess extending into the high-G wall, a first passage communicating with the separation channel on one side of the recess, and a second passage communicating with the separation channel on the other side of the recess, and a full interior wall extending across the separation channel to define a terminus in the separation channel circumferentially spaced from the partial interior wall.
- 2. A blood separation chamber according to claim 1 wherein the recess is radially spaced from the rotational axis farther than adjacent regions of the high-G wall.
- 3. A blood separation chamber according to claim 1wherein one of the first and second passages is configured to convey blood into the separation channel through the recess.
- 4. A blood separation chamber according to claim 1wherein one of the first and second passages is configured to convey blood from the separation channel through the reess.
- 5. A blood separation chamber according to claim 1wherein both of the first and second passages are configured to convey blood from the separation channel.
- 6. A blood separation chamber according to claim 1wherein the first passage is configured to convey blood into the separation channel through the recess, and wherein the second passage is configured to convey blood from the separation channel.
- 7. A blood separation chamber according to claim 1further including a second partial interior wall extending partially into the separation channel from one of the low-G and high-G walls toward the other one of the low-G and high-G walls, to thereby define a second constricted channel along the other wall.
- 8. A blood separation chamber according to claim 7wherein the second constricted channel includes a second recess extending into the other wall.
- 9. A blood separation chamber according to claim 8further including a third passage communicating with the separation channel on one side of the second recess.
- 10. A blood separation chamber according to claim 1wherein the low-G and high-G walls, the first partial interior wall, and recess comprise a unitary formed body.
- 11. A blood separation chamber according to claim 1wherein the low-G and high-G walls, the first partial interior wall, the recess, and the first and second passages comprise a unitary formed body.
US Referenced Citations (43)
Foreign Referenced Citations (4)
Number |
Date |
Country |
197 06 997 |
Aug 1998 |
DE |
WO8900084 |
Jan 1989 |
WO |
WO9822165 |
May 1998 |
WO |
WO984938 |
Nov 1998 |
WO |