The present invention concerns a device and a procedure for the manufacture, storage, transportation and administration of blood products (or blood components or blood constituents or blood preparations within the meaning of the Medical Products Act AMG and the German Transfusion Law TFG) after withdrawal of blood, either as whole blood donation as well as by haemapheresis, without the need for clean room laboratories. In particular it relates to a closed blood collection and processing system as well as a system for the storage, the transportation and the administration of blood products and a corresponding legally conformant and GMP-compliant procedure for the withdrawal, manufacture, storage, transportation and administration of blood products without the need for clean room laboratories. In a very particular manner, the present invention relates to the manufacture, storage, transportation and administration of completely aliquoted blood products which are directly applicable to the patient like for example autologous serum eye drops or other drugs composed of blood products without the need for clean room laboratories.
The present invention thus in particular relates to a closed blood collection and processing system for the manufacture, storage, transportation and administration of autologous serum eye drops in a legally conformant and GMP-compliant manner for which no clean room laboratory is required.
Said device and said procedure can be applied to the withdrawal and processing of blood obtained from autologous or allogeneic blood donors, i.e. for blood of autologous or allogeneic origin. Thereby, if required, for blood of autologous or allogeneic origin, further means for sterilization may be provided at or in the device, e.g. in the form of liquids provided within said device.
Said device and said procedure may be utilized both after a whole blood donation as well as after haemapheresis.
Similarly, the device and the procedure are equally suited for human and animal patients, and in particular for vertebrates.
The present invention thus describes for the first time a possibility to manufacture drugs from autologous or allogeneic blood or from components thereof which can be aliquoted and directly administered to the patient by the patient himself or another person or to an animal, preferably a vertebrate, without further auxiliary tools.
This is of particular importance for patients with certain eye diseases, since the manufacture of autologous serum eye drops in a legally conformant and GMP-compliant manner is time-consuming and expensive, most of all due to the need for a clean room laboratory for the aliquoting and filling of autologous serum eye drops in suitable means of administration.
The term “blood products” is understood to mean: Blood preparations within the meaning of the Medical Products Act, sera from blood within the meaning of the Medical Products Act as well as blood ingredients or blood components or blood preparations which are intended for the manufacture of active agents or drugs.
The term “blood donor” is understood to mean: A human or an animal, preferably a vertebrate, whom a certain amount of blood or blood components is collected from to be used as active agent or drug, or for the manufacture of active agents or drugs or other products which are intended for an application in humans or animals.
The term “blood” or “whole blood”, respectively, is understood to mean: Blood of a human or an animal, preferably a vertebrate, containing all native blood components, after a blood donation.
The term “blood components” is understood to mean: All components which can be derived from blood or whole blood, respectively, by manual or mechanical separation procedures or be produced directly by haemapheresis.
The term “haemapheresis” is understood to mean: The separation of blood or whole blood into various blood components using cell separators with extracorporeal circulation immediately at the blood donor, whereby the non-required blood components are immediately returned back to the donor.
The term “blood serum” or “serum” is understood to mean: Any part or the blood or whole blood, respectively, which after blood coagulation remains as liquid, protein-rich but cell-poor supernatant.
The term “own serum” or “autologous serum” is understood to mean: Own blood serum of the respective individual patient obtained after an autologous blood donation.
The term “eye drops” (oculoguttae) is understood to mean: A dosage form of medicinal products intended for use on or in the eye.
The term “autologous serum eye drops” is understood to mean: Eye drops which are produced from autologous serum.
The term “predonation sampling” is understood to mean: Removal of at least 15 ml of the initial blood volume of the blood donation in order to reduce bacterial contamination of the blood or whole blood during the blood collection procedure. In general, the predonation sampling is conducted using a predonation sampling bag.
The abbreviation “GMP” is understood to mean: good manufacturing practice guidelines followed during the manufacture of drugs, medicinal products, active agents as well as the manufacture of food and feed products.
The expert skilled in the art knows how to conduct legally conformant and GMP-compliant blood donation procedures, either as whole blood donation or also by haemapheresis (see e.g. German Transfusion Law TFG including Guidelines, or Annex 1 of EU Guidelines for good manufacturing practice). Similarly, the manufacture of blood components and blood products in a legally conformant and GMP-compliant manner is known to those skilled in the art. The same applies to the manufacture of eye drops. This applies to both human as well as veterinary medicine.
An important issue in the implementation of a blood collection and for the manufacture of blood products is the choice of a suitable container. Even though prior art knows numerous containers suitable to receive blood as disclosed in DE 1 065 138 A1 (Company. B. Braun, AT 15.6.1956) or U.S. Pat. No. 5,224,937 (NPBI, AT 21.06.1991), or also a system for blood withdrawal and blood collection as e.g. disclosed in DE 1 123 800 (Fenwal Laboratories, Inc., AT 12.2.1957). These however possess no suitable administration means allowing a direct, i.e. without auxiliary tools, administration of the drug generated from the blood product within the device to the patient, or the systems concerned are no closed systems in the sense that the system is not opened apart from the step of blood collection from the blood donor and the step of application to the patient.
The state of the art is therefore insufficient with respect to the availability of a suitable device for a simple, legally conformant and GMP-compliant manufacture, storage, transportation and most of all administration of blood products, in particular for eye drops produced from blood or blood serum.
In accordance with the regulations of the European Pharmacopoea (Pharmacopoea Europaea, Ph. Eur.), eye drops always have to be produced under sterile conditions. As pharmacy-only medication, these may in Germany only be dispensed in pharmacies. Eye drops are either available in single-dose vials made of plastic or in eye drop bottles made of special glass (amber Type I glass). In addition to industrial manufacturing, eye drops may also be prepared on prescription in pharmacies according to the respective formulation issued by the physician. For this purpose however, a clean room laboratory is required which is usually not available in pharmacies.
A particular problem is currently the manufacture, storage, transportation and administration of eye drops from blood serum in a legally conformant and GMP-compliant manner. These eye drops, especially in the form of autologous serum eye drops, play an important role in the treatment of eye diseases. Typical application fields of these eye drops fabricated from autologous serum are the treatment of dryness and irritation of the eye, glaucoma, inflammations of the conjunctiva (conjunctivitis) and cornea inflammations (keratitis).
Autologous serum is however meanwhile also applied successfully for other ophthalmological purposes. According to information presented in the annual report 2003 of the Rechts der Isar (Right hand side of the River Isar) Hospital of the TU Munich, as treatment of retinal hole formation in the region of greatest visual acuity (macula foramina), also gluing with autologous serum is meanwhile performed routinely, i.e. autologous serum is used as adhesive.
Other fields of application in which eye drops produced from serum of the donor himself (denoted as own or autologous serum) or from serum of other donors (denoted as allogeneic serum) proved to be successful in the last approximately 10 years are listed in “Eigenserum and alternative Blutprodukte zur Behandlung von Augenoberflächenerkrankungen” by G. Geerling et al. in “Der Ophthalmologe” 7, 2008, page 623ff and page 644ff, and concern a large number of eye diseases and ocular surface disorders.
At present, autologous serum eye drops are for example manufactured in England, where autologous blood donations are submitted to national clean room laboratories where they are processed into autologous serum eye drops, divided into aliquots, filled and subsequently returned to the attending physician. This procedure is time-consuming and expensive. A production of autologous serum eye drops in the blood establishment itself (e.g. blood bank) is so far impossible, since these establishments in the majority of cases possess none of the legally required clean room laboratories.
The aim of the present invention is therefore to overcome the aforementioned disadvantages of the prior art and to provide a device and a procedure in which and by which from blood of a blood donor medicinal products comprising blood or blood products in the widest sense like for example blood serum can be produced directly within said device and under continuous closure of said device (after filling and until administration) without the need of a clean room laboratory. The device thereby should be such that said drugs produced from blood or blood products can subsequently be applied directly from elements of said device and without further auxiliary means. In addition, said device and said procedure should be designed in such a way that the desired blood product can be produced as well from a whole blood donation as also by haemapheresis. The device and procedure should be designed in such a way that they are suitable for a use in human as well as in animal patients.
The aim is solved according to the present invention by a device according to claim 1. In particular, the device includes a sampling unit (1) and at least one collection and separation unit (5), which is characterized in that the device comprises at least one application unit (10), whereby sampling unit (1), collection and separation unit (5) and the at least one application unit (10) are connected with each other in fluid communication.
With respect to the procedure concerned, the aim is solved according to this invention by the subject matter of claim 15.
With the device described in the present invention and the procedure described herein, blood products such as for example serum or autologous serum eye drops or similar medicinal products obtained from blood or blood components can be produced, stored, transported and thus made available to the patients in a legally conformant and GMP-compliant manner within a short time and little use of personnel and material costs in each medical facility with a blood or autologous blood donation facility. This equally applies to whole blood donations as well as to haemaphereses, both for human as well as for animal patients.
The invention is characterized in that after the filling of the device with blood (preferably autologous blood), no further opening of the device takes place which would lead to conditions considered as unsterile (apart from the administration of the blood product manufactured according to this invention to the patient, like for example autologous blood serum eye drops when instilled in the eye). This means that the procedure of the present invention is designed such that a legally conformant and GMP-compliant (e.g. “Annex 1 of the EU Guidelines for good manufacturing practice” or “Gesetz zur Regelung des Transfusionswesens”, German transfusion law TFG) manufacture of blood products like for example said eye drops from the blood of allogeneic donors or autologous donors is ensured.
The device and procedure of the present invention therefore allow for the first time the direct manufacture of autologous serum eye drops at the location of the donation itself in compliance with all legal provisions.
It is immediately apparent to the expert in this field that the device according to this invention can be utilized with materials suitable for this purpose.
Embodiment examples are illustrated in the
An additional embodiment example is illustrated in
In the following, the figures are described in more detail:
A further advantageous—not graphically illustrated—embodiment provides for the use of further agents (like for example an anticoagulants to obtain blood plasma, or for example a diluent for the dilution of the blood product obtained, or for example one or more pharmaceutically acceptable substances). Choice and arrangement of these further components are determined by the respective blood product desired and immediately apparent to the expert in this field.
Another particularly preferred—not graphically illustrated—embodiment example shows the provision of a barrier, for example in the form of a sling, a node, a clamp, a sphere, a cone, a valve, an encapsulated break-off part or a section intended to be bent and broken immediately in front of the discharge opening of the sampling unit (1) into the at least one collection and separation unit (5). To allow the influx of blood, the sphere, the cone, the encapsulated break-off part or the section intended to be bent and broken is then manually pushed into the at least one collection and separation unit (5) and retained here since the cross section of the feed line (6) is designed smaller than the cross section of the sampling unit (1). A similar barrier is preferably provided at the junction between the at least one collection and separation unit (5) and the feed line (6), in order to prevent the unintentional or untimely transfer of blood or blood components from the at least one collection and separation unit (5) into said feed line (6).
For those skilled in the art it is immediately apparent that the device according to this invention can be realized by the utilization of materials which are suitable and approved to be used for the collection, storage, transportation and administration of blood or blood products.
In the case that a variety of application unit is provided, every single unit is also preferably equipped with an opening means (11) and a means for a marking (12).
Another particularly advantageous—not graphically depicted—embodiment example provides in addition the following modifications:
A further particularly preferred—not graphically depicted—embodiment example provides in addition the following modifications:
Suitable materials for the device of this invention are for example, but not limited to:
Suitable sampling units are for example, but not limited to:
Suitable agents provided in additional containers of the device which are connected with the units (1, 5 or 10) in fluid communication for the production of drugs from blood or blood products, are for example, but not limited to:
Suitable separation means between the units (1, 5, 10) of the device are for example, but not limited to:
Suitable methods or tools for the sterile separation of plastic tubes or plastic hoses etc. are for example, but not limited to:
List of Single Process Steps:
Further steps may optionally be added, if required, and comprise the aliquoting in the case that a variety of application units (14) is used, the control of sterility (which is for example facilitated by providing a collection means which allows to conduct a predonation sampling (2)), the storage of the application unit which is filled with the desired blood product, for example using frozen storage at approximately −20° C., or a storage for administration within 12 to 24 hours at 4° C. and discarding of the application dose in the case of non-utilization within the intended time period. A transport of the application unit filled with the desired blood product is equally possible.
(1) Sampling unit
(2) Collecting means to perform predonation sampling
(5) Collection and separation unit
(6) Feed line
(7) Additional collection and separation unit
(8) Additional feed line
(10) Application unit
(11) Opening means
(12) Means for a marking
(13) Connecting bridge
(14) Variety of application units
(15) Rearmost application unit
(16) Terminal container
Number | Date | Country | Kind |
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10 2009 022 793.8 | May 2009 | DE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP2010/057344 | 5/27/2010 | WO | 00 | 2/16/2012 |