The present disclosure generally relates to medical systems and methods for separating heterogeneous suspensions of autologous cells into various fractions, such as platelet fractions or mononuclear cell fractions, for therapeutic point-of-care use. Specifically, an embodiment relates to methods and systems for the separation and concentration of mononuclear cell suspensions from whole bone marrow aspirates (BMA) or whole blood.
Separation of heterogeneous cell suspensions such as marrow or blood may be done by centrifugation. Particles suspended in fluid are subject to two forces: frictional force from the fluid on the particles, which push the particles up and keep them from precipitating out of solution; and, a gravitational force, which pulls the particles down and out of solution. Centrifugation increases the force on all particles and induces their separation based on the particle's sedimentation velocity, radius (size), and the viscosity of the surrounding fluid. The sedimentation velocity for a given particle is directly proportional to the difference in the mass density of said particles and that of the fluid in which it is suspended. It is also directly proportional to the square of the radius of each particle.
Most systems for the production of mononuclear cells (MNC) or platelets from whole blood or BMA use centrifugation. Some use a single step process which captures the cells of interest inside a compartment within the centrifugation tube. Others use a two-step process whereby a significant portion of the red blood cells (RBC) are pelleted in the first centrifugation step, discarded, and the supernatant is spun a second time under higher force to pellet total nucleated cells (TNC) and platelets.
Features and advantages of embodiments of the present invention will become apparent from the appended claims, the following detailed description of one or more example embodiments, and the corresponding figures. Where considered appropriate, reference labels have been repeated among the figures to indicate corresponding or analogous elements.
In the following description, numerous specific details are set forth but embodiments of the invention may be practiced without these specific details. Well-known circuits, structures and techniques have not been shown in detail to avoid obscuring an understanding of this description. “An embodiment”, “various embodiments” and the like indicate embodiment(s) so described may include particular features, structures, or characteristics, but not every embodiment necessarily includes the particular features, structures, or characteristics. Some embodiments may have some, all, or none of the features described for other embodiments. “First”, “second”, “third” and the like describe a common object and indicate different instances of like objects are being referred to. Such adjectives do not imply objects so described must be in a given sequence, either temporally, spatially, in ranking, or in any other manner.
Applicant determined separation of a mixture of particles suspended in the same fluid using centrifugation alone is effective when there is a large difference in the mass density of the particles and their radius. However, for particles of similar size and density, centrifugal separation is less efficient, even with sequential centrifugation steps.
Applicant determined an undesirable component of MNC and platelet separation by centrifugation (at least in some situations) is the high concentration of RBC in the final concentrate. This high concentration of RBC is due, at least in part, to the above mentioned inefficiency.
Excess RBCs can elicit an undesirable inflammatory response and decrease the healing rate in sites with low perfusion by the accumulation of cellular debris and intracellular components released upon RBC lysis. The mass density of red blood cells changes with centrifugation and packing; however, the mass density is never significantly higher than the mass density of white blood cells (MNC). The mass density of MNC is 1040 kg/m3, the mass density of RBC pellets changes with its packing density so that a 100% preparation of RBC has a density of 1110 kg/m3, the density of a 90% preparation is 1090 kg/m3, and that of 70% is 1070 kg/m3. Due to this, Applicant determined the use of centrifugation alone for fractionating heterogeneous physiological cell mixtures requires a trade-off between MNC yield and RBC content. An increase in MNC yield forces an undesirable concentration of RBC in the same layer while eliminating RBC significantly decreases the yield of MNC.
In addition, Applicant determined centrifugation-based systems require the use of an apparatus capable of applying a centrifugal force no less than 1000×g. Using conventional technology, this requirement limits the point-of-care use of such devices within the operating room by impeding their use within the sterile field, forcing the BMA to leave the sterile field. This creates a risk for contamination and crowds the operating room by requiring floor space for the equipment.
However, an embodiment solves these issues by offering a compact, self-contained, sterile packaged device with a simplified interface for usage. The device is designed such that the bone marrow aspirate is maintained in a sealed portion of the device that does not allow contact with the mechanical mechanisms of the device. The device itself includes materials that are able to allow for sterilization through ethylene oxide or gamma radiation sterilization. The device can be opened in the sterile field and plugged into an outlet. The OR staff then connects the bone marrow aspirate syringe to the device using a standard connection, and then activates the machine (e.g., by a push-button). The device then enters an automated process to remove the red blood cells from the aspirate, and then to concentrate the remaining cellular content into a smaller volume of plasma, and eject this cell-rich component into another syringe which has been connected to the device.
As explained above, an embodiment eliminates (or at least reduces) the need for in-depth knowledge and user interaction with the device, eliminates the contamination threat of crossing the sterile barrier, reduces the space needed in the OR as it can be pulled off a shelf and utilized on an as needed basis, and then can be either discarded or recycled.
An embodiment functions via the following steps. Step (1) includes the intake of bone marrow aspirate. Step (2) includes removing RBCs or erythrocytes using one of any variety of methods, including low speed centrifugation, addition of a flocculent and allowing sedimentation, enhanced flow flocculation, and the like. Step (3) includes the reduced RBC plasma and cell suspension decanted or otherwise transferred to a chamber for concentration and filtration (see, e.g.,
The flow rate into the chamber can be controlled by controlling the speed of the piston travel. The piston can vary in speed to accommodate the difference in cross section area of the intake chamber when the piston is engaged in the filter support grate 909 versus when the piston has cleared the filter support grate, as shown in the respective figures. Additionally, the travel rate of the piston can also vary to vary the flow rate as a function of distance from the filter support grate, either to control the dispersion of the solution or to reduce burden on the drive mechanism. In this embodiment, the un-concentrated solution enters the chamber at a rate between 0.25 ml/s and 5 ml/s. Such a flow rate may be programmed into a controller-based system described below.
The process may be automated by a controller in cooperation with at least one motor, such as a step motor. A stepper motor or step motor or stepping motor may be a brushless DC electric motor that divides a full rotation into a number of equal steps. The motor's position can then be commanded to move and hold at one of these steps without any feedback sensor (an open-loop controller). While stepper motors are used in some embodiments, in other embodiments flow rate and volume that has flowed may be assessed with sensors such as infrared sensors, phototransistors, and the like.
The input flow rate and target volume is set in the software, after which the input piston is moved to start the inflow of fluid into the intake chamber. At each step, a loop completes (not shown in flow chart) during which the software checks to determine if it is time for a step to be taken per the input flow rate. If it is time, a step is taken. After each step, the software checks to determine if the desired volume of fluid has been moved. In one embodiment of the invention, the volume is calculated based on the number of steps taken and calculation factors for conversion of the number of pump steps into volume of fluid. In another embodiment, this is done with a sensor that monitors the position of the piston. If not, the motor is again stepped (using the same logic loop to check maintain the flow rate). If the fluid level has been met, the software proceeds to the next state. The next step starts with setting the filtration flow rate and volume. During filtration, both pistons are moved using the same loop structure for maintaining the piston speed and managing the volume of fluid movement. Upon exit of the filtration move loop, the backflush flow rate and volume are set. A move loop is then used to gain maintain the piston speed and volume of fluid moved. After backflush, a safeguard is included to ensure that an output syringe (or other fluid vessel) is attached. In the figure, this is achieved by a confirmation button press when the syringe is attached. As with the intake syringe confirmation, in other embodiments, this may be a mechanical switch. In another embodiment, this portion is replaced by a mechanical switch that is activated with the attachment of a syringe. In yet other embodiments, this can be replaced by an optical sensor or another method for detecting the presence of the output syringe. At various times the movement of pistons is simultaneous (i.e. the piston may not necessarily start and/or stop movement at the same time but they are both moving at one point in time). This occurs at, for example, between
While not depicted in the figures, other embodiments of the invention exist.
For example, the existing images depict a mechanically translated piston. However, a flexible membrane connecting the filter grate to a piston could be utilized to eliminate seal drag.
As discussed in the figures, a belted pulley system connected to motors is shown in the existing images. However, motors could be directly coupled to the threaded drive rod, could be coupled through gears or sprockets and chains, or other methods of coupling. Other devices such as hydraulic or pneumatic cylinders may be utilized.
The figures also depict a filter grate system supporting the filter. In an embodiment the filter media has a support structure integral to it. In such a case, there is no need for protrusions and recesses, so the piston can have a flat face.
In an embodiment the second filtration step requires forcing material across a semi-permeable/selectively permeable membrane. An embodiment uses two piston features on either side of the membrane in a sealed cylinder. The motion of the pistons draws the vacuum which pulls the solution into the filter chamber and across the filter, as well as controls the output of the cell concentrate into the output syringe. However, other methods for inducing this flow include elastic bellows type mechanisms in which a flexible outer surface is utilized instead of the rigid cylinder. Similar pistons are used, now with less drag, and create the same vacuum and pressure to move the fluid between the chambers.
An air bladder is used in some embodiments. It starts in an inflated position. As it is deflated via vacuum, it draws in the fluid. Likewise, the vacuum is reversed to fill the bladder again, forcing material out of the chamber. This would again be advantageous at eliminating drag of the piston on the cylinder wall.
Another embodiment includes a peristaltic pump which forces fluid through the filter and into a flexible chamber, presumably of a rubber type material. Upon complete filtration, a valve opens on the inlet side, and the pressurized chamber initiates the back flow to release the cellular content and flow material into an outlet chamber.
Other combinations of mechanically driven mechanisms to pressurize/induce vacuum to move fluid on either side of the permeable membrane could also be used.
Referring now to
In turn, application processor 910 can couple to a user interface/display 920 (e.g., touch screen display). Such a display may provide prompts such as those describe in
A universal integrated circuit card (UICC) 940 comprises a subscriber identity module, which in some embodiments includes a secure storage to store secure user information. System 900 may further include a security processor 950 (e.g., Trusted Platform Module (TPM)) that may couple to application processor 910. A plurality of sensors 925, including one or more multi-axis accelerometers may couple to application processor 910 to enable input of a variety of sensed information such as motion and other environmental information (or other sensors such as phototransistors to monitor fluid flow or sensors to count a number of steps of a step motor). In addition, one or more authentication devices may be used to receive, for example, user biometric input for use in authentication operations.
As further illustrated, a near field communication (NFC) contactless interface 960 is provided that communicates in a NFC near field via an NFC antenna 965. While separate antennae are shown, understand that in some implementations one antenna or a different set of antennae may be provided to enable various wireless functionalities.
A power management integrated circuit (PMIC) 915 couples to application processor 910 to perform platform level power management. To this end, PMIC 915 may issue power management requests to application processor 910 to enter certain low power states as desired. Furthermore, based on platform constraints, PMIC 915 may also control the power level of other components of system 900.
To enable communications to be transmitted and received such as in one or more IoT networks, various circuitries may be coupled between baseband processor 905 and an antenna 990. Specifically, a radio frequency (RF) transceiver 970 and a wireless local area network (WLAN) transceiver 975 may be present. In general, RF transceiver 970 may be used to receive and transmit wireless data and calls according to a given wireless communication protocol such as 3G or 4G wireless communication protocol such as in accordance with a code division multiple access (CDMA), global system for mobile communication (GSM), long term evolution (LTE) or other protocol. In addition a GPS sensor 980 may be present, with location information being provided to security processor 950 for use as described herein when context information is to be used in a pairing process. Other wireless communications such as receipt or transmission of radio signals (e.g., AM/FM) and other signals may also be provided. In addition, via WLAN transceiver 975, local wireless communications, such as according to a Bluetooth™ or IEEE 802.11 standard can also be realized.
Referring now to
First processor 1070 further includes a memory controller hub (MCH) 1072 and point-to-point (P-P) interfaces 1076 and 1078. Similarly, second processor 1080 includes a MCH 1082 and P-P interfaces 1086 and 1088. MCH's 1072 and 1082 couple the processors to respective memories, namely a memory 1032 and a memory 1034, which may be portions of main memory (e.g., a DRAM) locally attached to the respective processors. First processor 1070 and second processor 1080 may be coupled to a chipset 1090 via P-P interconnects 1062 and 1064, respectively. Chipset 1090 includes P-P interfaces 1094 and 1098.
Furthermore, chipset 1090 includes an interface 1092 to couple chipset 1090 with a high performance graphics engine 1038, by a P-P interconnect 1039. In turn, chipset 1090 may be coupled to a first bus 1016 via an interface 1096. Various input/output (I/O) devices 1014 may be coupled to first bus 1016, along with a bus bridge 1018 which couples first bus 1016 to a second bus 1020. Various devices may be coupled to second bus 1020 including, for example, a keyboard/mouse 1022, communication devices 1026 and a data storage unit 1028 such as a non-volatile storage or other mass storage device. As seen, data storage unit 1028 may include code 1030, in one embodiment. As further seen, data storage unit 1028 also includes a trusted storage 1029 to store sensitive information to be protected. Further, an audio I/O 1024 may be coupled to second bus 1020.
Referring now to
Embodiments may be used in many different types of systems. For example, in one embodiment a communication device can be arranged to perform the various methods and techniques described herein. Of course, the scope of the present invention is not limited to a communication device, and instead other embodiments can be directed to other types of apparatus for processing instructions, or one or more machine readable media including instructions that in response to being executed on a computing device, cause the device to carry out one or more of the methods and techniques described herein.
Program instructions may be used to cause a general-purpose or special purpose processing system that is programmed with the instructions to perform the operations described herein. Alternatively, the operations may be performed by specific hardware components that contain hardwired logic for performing the operations, or by any combination of programmed computer components and custom hardware components. The methods described herein may be provided as (a) a computer program product that may include one or more machine readable media having stored thereon instructions that may be used to program a processing system or other electronic device to perform the methods or (b) at least one storage medium having instructions stored thereon for causing a system to perform the methods. The term “machine readable medium” or “storage medium” used herein shall include any medium that is capable of storing or encoding a sequence of instructions (transitory media, including signals, or non-transitory media) for execution by the machine and that cause the machine to perform any one of the methods described herein. The term “machine readable medium” or “storage medium” shall accordingly include, but not be limited to, memories such as solid-state memories, optical and magnetic disks, read-only memory (ROM), programmable ROM (PROM), erasable PROM (EPROM), electrically EPROM (EEPROM), a disk drive, a floppy disk, a compact disk ROM (CD-ROM), a digital versatile disk (DVD), flash memory, a magneto-optical disk, as well as more exotic mediums such as machine-accessible biological state preserving or signal preserving storage. A medium may include any mechanism for storing, transmitting, or receiving information in a form readable by a machine, and the medium may include a medium through which the program code may pass, such as antennas, optical fibers, communications interfaces, and the like. Program code may be transmitted in the form of packets, serial data, parallel data, and the like, and may be used in a compressed or encrypted format. Furthermore, it is common in the art to speak of software, in one form or another (e.g., program, procedure, process, application, module, logic, and so on) as taking an action or causing a result. Such expressions are merely a shorthand way of stating that the execution of the software by a processing system causes the processor to perform an action or produce a result.
A module as used herein refers to any hardware, software, firmware, or a combination thereof. Often module boundaries that are illustrated as separate commonly vary and potentially overlap. For example, a first and a second module may share hardware, software, firmware, or a combination thereof, while potentially retaining some independent hardware, software, or firmware. In one embodiment, use of the term logic includes hardware, such as transistors, registers, or other hardware, such as programmable logic devices. However, in another embodiment, logic also includes software or code integrated with hardware, such as firmware or micro-code.
An embodiment utilizes two pistons to generate flow across a static filter, trapping the cellular content on the intake side of the device. There is no mixing of reagents and no moving pieces between the piston faces.
The following examples pertain to further embodiments.
A filtration system, composed of a filter separating two adjacent rigid chambers, each containing a mechanism to induce flow across the filter medium, the first rigid chamber including an opening (port) connected to a hollow member to allow fluid flow into and out of the first chamber.
The system of Example 1 in which the first rigid chamber contains two openings or ports, both configured to allow fluid flow into and out of the first rigid chamber and whose connected hollow members are coupled to combine the fluid flow outside of the chamber.
The system of Example 2 in which the first opening or port is configured for flow into the first rigid chamber and the second port is configured for flow out of the rigid chamber.
The system of Example 1 in which the first rigid chamber contains multiple (greater than two) openings or ports, all configured to allow fluid flow into and out of the first rigid chamber and whose connected hollow members are coupled to combine the fluid flow outside of the chamber.
The system of Example 4 in which a group one or more ports are configured only for flow into the first rigid chamber and a distinct separate group of one or more ports are configured for flow out of the first rigid chamber; each group having connected hollow members which are coupled to combine the fluid flow outside of the chamber.
The system of Example 1 in which the ports are located on the rigid chamber.
The system of Example 1 in which the ports are located on the flow inducing mechanism.
The system of Example 1 in which the chamber containing ports or openings is located below the chamber that does not contain ports.
EXAMPLE 9
The system of example 1 in which the second chamber also contains one or more openings (ports) to allow fluid flow into and out of said second chamber.
The system of Example 1 in which a mechanism is utilized to control fluid flow into and out of the chambers by opening or closing the ports and/or hollow members.
The system of Example 10 in which the ports for the first chamber are regulated utilizing a passive one-way valve.
The system of Example 10 in which the ports for the first chamber are regulated using a solenoid coupled to a pinch valve.
The system of Example 10 in which the ports for the first chamber are regulated using a ball valve coupled to a rotary motor.
The system of Example 1 in which the filter medium is supported by a rigid member containing a plurality of openings to allow for fluid flow across the filter while preventing the filter from bowing and/or tearing.
The system of Example 14 in which a rigid member is used on each side if the filter media.
The system of Example 14 in which the rigid member is incorporated into the filter media.
The system of Example 1 in which the mechanisms to induce flow across the filter are pistons.
The system of Example 17 in which the face of the piston(s) adjacent to the filter has a plurality of recesses to allow mating with the rigid member of Example 14.
The system of Example 17 in which the piston contains features to maintain contact with the chamber wall to maintain parallelism between the piston face and the filter medium.
The system of Example 17 in which the pistons have a threaded feature coupled to a threaded member driven by a hand crank.
The system of Example 17 in which the pistons have a threaded feature coupled to a threaded member driven by a motor.
The system of Example 21 in which a microcontroller is used to control the drive motors and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 17 in which the pistons are coupled to a hydraulic cylinder to drive the translational motion of the piston.
The system of Example 23 in which a microcontroller is used to control the hydraulic cylinder and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 17 in which the pistons are coupled to a pneumatic cylinder to drive the translational motion of the piston.
The system of Example 25 in which a microcontroller is used to control the pneumatic cylinder and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 1 in which the flow inducing member is a pre-inflated air bladder which can be deflated to create a vacuum and induce flow into a chamber, or inflated to create pressure, inducing flow out of a chamber.
A method for utilizing the system of Example 1 in which: a first solution containing a first concentration of cells is flowed into a first chamber, separated from a second chamber by a filter medium; the fluid component of the first solution is then forced through the filter, resulting in a second solution in the second chamber, opposite of the filter, which has little to no cellular concentration; a smaller volume of the second solution is forced across the filter in the opposite direction, to dislodge cellular content trapped on the filter media into the first solution, resulting in a third solution, which has a higher cellular concentration than the first; the third, concentrated solution is forced out of the system into an output reservoir for end use.
The method of Example 28 in which: a fraction of the first solution containing a first concentration of cells is flowed into a first chamber, separated from a second chamber by a filter medium; the fluid component of the remaining volume of the first solution is then forced through the filter, resulting in a second solution in the second chamber, opposite of the filter, which has little to no cellular concentration; the initial buffer volume of the first solution is forced into the second chamber; a smaller volume of the second solution is forced across the filter in the opposite direction, to dislodge cellular content trapped on the filter media into the first solution, resulting in a third solution, which has a higher cellular concentration than the first; the third, concentrated solution is force out of the system into an output reservoir for end use.
For example, the steps of example 29 may occur before the steps of example 28. However, in other embodiments the steps of example 28 may occur in lieu of the steps of example 29. In other words, in an embodiment the buffer related actions (e.g.,
The method of Example 28 in which a microcontroller is used to regulate the flow of each portion of the method by controlling a motor, hydraulic cylinder, pneumatic cylinder, or other drive method.
The method of Example 30 in which the microcontroller compensates for differences in volumes inside and outside of a filter supporting member to maintain a constant flow rate.
The system of Example 1 in which the chambers are formed from an elastic material which deforms to create the chamber without introducing drag on the mechanisms configured to draw fluid into the chamber.
The system of Example 32, in which the filter is supported by a rigid member on either side of the filter medium, each rigid member containing a plurality of openings to allow fluid flow through the filter medium.
The system of example 32 in which the flexible chamber is expanded and contracted utilizing a mechanical attachment to the flexible member.
The system of example 32 in which the flexible chamber is expanded and contracted utilizing a pump to force material into and out of each chamber.
The system of Example 32 in which the flexible chamber is connected to a piston, resulting in chamber with a rigid surface on the chamber opposite the filter, and an elastic surface on the peripheral walls of the chamber.
The system of Example 36 in which the face of the piston(s) adjacent to the filter has a plurality of recesses to allow mating with the rigid member of Example 33.
The system of Example 36 in which the pistons have a threaded feature coupled to a threaded member driven by a hand crank.
The system of Example 36 in which the pistons have a threaded feature coupled to a threaded member driven by a motor.
The system of Example 39 in which a microcontroller is used to control the drive motors and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 36 in which the pistons are coupled to a hydraulic cylinder to drive the translational motion of the piston.
The system of Example 41 in which a microcontroller is used to control the hydraulic cylinder and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 36 in which the pistons are coupled to a pneumatic cylinder to drive the translational motion of the piston.
The system of Example 43 in which a microcontroller is used to control the pneumatic cylinder and subsequently, fluid flow into, out of, and between the chambers.
The system of Example 32 in which a pump drives fluid into an area outside of the first and second chambers to generate motion of the piston without mechanical contact.
The system of Example 1 in which fluid is driven by a pump.
A method executed by at least one processor comprising: a first solution containing a first concentration of cells is flowed into a first chamber, separated from a second chamber by a filter medium; the fluid component of the first solution is then forced through the filter, resulting in a second solution in the second chamber, opposite of the filter, which has little to no cellular concentration; a smaller volume of the second solution is forced across the filter in the opposite direction, to dislodge cellular content trapped on the filter media into the first solution, resulting in a third solution, which has a higher cellular concentration than the first; the third, concentrated solution is forced out of the system into an output reservoir for end use.
At least one machine readable medium comprising a plurality of instructions that in response to being executed on a computing device, cause the computing device to carry out a method according to examples 28.
An apparatus comprising means for performing example 28.
A blood filtering system comprising: a first piston included in a first chamber; a second piston included in a second chamber; a filter between the first and second pistons; at least one memory and at least one processor, coupled to the at least one memory, to perform operations comprising: move the first piston away from the filter, while the second piston is still, to advance blood into the first chamber from a first container; move the first piston towards the filter while simultaneously moving the second piston away from the filter to advance blood from the first chamber across the filter and into the second chamber and to locate cells of the blood against the filter and within the first chamber; move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance blood from the second chamber across the filter and into the first chamber and to flush the cells of the blood off of the filter; move the first piston toward the filter, while the second piston is still, to advance the cells of the blood out of the first chamber and into a second container.
The system of example 1a comprising: a first grate, included in the first chamber between the filter and the first piston, configured to support the filter; a second grate, included in the second chamber between the filter and the second piston, configured to support the filter; wherein the first grate has first grate protrusions arranged in a first grate pattern; and wherein the second grate has second grate protrusions arranged in a second grate pattern.
The system of example 2a wherein: the first piston has a first piston face having first piston protrusions arranged in a first piston pattern so the first piston protrusions fit between the first grate protrusions when the first piston is immediately adjacent the filter; the second piston has a second piston face having second piston protrusions arranged in a second piston pattern so the second piston protrusions fit between the second grate protrusions when the second piston is immediately adjacent the filter.
The system of example 3a wherein: the first piston face has first voids between the first piston protrusions; the second piston face has second voids between the second piston protrusions; a first void of the first voids includes a first aperture; the first aperture is coupled to a first channel that is to fluidly couple to the second container.
The system of example 4a comprising a second aperture, wherein: the second aperture is coupled to a second channel that is to fluidly couple to the second container; a second void of the first voids includes a second aperture.
The system of example 3a wherein: the filter is substantially located in a plane; one of the first grate protrusions extends away from the filter, in a direction orthogonal to the plane, a first distance; the one of the first grate protrusions and another of the first grate protrusions define a void that extends away from the filter the first distance; the at least on processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter but before the first piston is included in the void; move, at a second rate of speed, the first piston towards the filter while the first piston is included in the void; wherein the second rate of speed is faster than the first rate of speed.
The system of example 3a comprising a first conduit, wherein: the first conduit is to couple the first container to the first chamber; the first conduit includes a first output located on the first piston face.
The system of example 7a comprising a second conduit, wherein: the second conduit is to couple the first container to the first chamber; the second conduit includes a second output located on the first piston face.
The system of example 2a comprising: at least one motor coupled to at least one processor; wherein the at least one motor is to move the first piston within the first chamber in response to first commands from the at least one processor; wherein the at least one motor is to move the second piston within the second chamber in response to second commands from the at least one processor.
The system of example 9a wherein the at least one motor is move the first piston independently of moving the second piston.
The system of example 9a wherein: the at least one motor includes a step motor; the at least one processor is to perform operations comprising: convert a number of steps to be taken by the step motor to at least one of a volume or a flow rate; track a number of steps taken by the step motor to determine a location of the first piston; rotate a portion of the step motor clockwise to move the first piston in a first direction; rotate the portion of the step motor counterclockwise to move the first piston in a second direction which is opposite the first direction.
The system of example 11a wherein: the first piston has a maximum range of motion within the first chamber; a plurality of steps by the step motor is needed to move the first piston across the maximum range of motion.
The system of example 2a wherein: the first piston has a first maximum range of motion within the first chamber; moving the first piston away from the filter, while the second piston is still, to advance blood into the first chamber from the first container includes moving the first piston away from the filter but not across the first maximum range of motion; the at least one processor is to perform operations comprising, after moving the first piston away from the filter, moving the second piston away from the filter, while the first piston is still, to advance blood into the second chamber from the first.
The system of example 13a wherein: the second piston has a second maximum range of motion within the second chamber; the first grate is to simultaneously directly contact both the filter and first piston when the first piston is located at one end of the first maximum range of motion; and the second grate is to simultaneously directly contact both the filter and second piston when the second piston is located at one end of the second maximum range of motion.
The system of example 2a wherein the at least on processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter while simultaneously moving the second piston away from the filter to advance blood from the first chamber across the filter and into the second chamber and to locate the cells of the blood against the filter and within the first chamber; move, at a second rate of speed, the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the blood from the second chamber across the filter and into the first chamber and to flush the cells of the blood off of the filter; wherein the second rate of speed is faster than the first rate of speed.
The system of example 1a wherein: the first piston has a maximum range of motion within the first chamber, the maximum range extending from a first portion directly adjacent the filter to a second portion at an opposite end of the maximum range of motion from the first portion; the at least one processor is to perform operations comprising moving the first piston toward the filter starting from a location not included in the second portion and, as a result, moving the first piston toward the filter across less than the maximum range of motion to advance the cells of the blood out of the first chamber and into the second container.
The system of example 1a, wherein the system does not include a centrifuge.
A blood filtering system comprising: a first piston included in a first chamber; a second piston included in a second chamber; a filter between the first and second pistons; at least one memory and at least one processor, coupled to the at least one memory, to perform operations comprising: move the first piston away from the filter, while the second piston is still, to advance blood into the first chamber from a first container; move the first piston towards the filter while simultaneously moving the second piston away from the filter to advance blood from the first chamber across the filter and into the second chamber and to locate cells of the blood against the filter and within the first chamber; move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance blood from the second chamber across the filter and into the first chamber and to flush the cells of the blood off of the filter; move the first piston toward the filter, while the second piston is still, to advance the cells of the blood out of the first chamber and into a second container.
While the above example provides a system with a hardware filtering system (including pistons and a filter) and a processor and memory, other embodiments may include subsets of the system. For example, an embodiment may include the hardware filtering system without the processor and memory. An embodiment may just include the memory and code with which to drive the filter hardware. The memory may be cloud-based memory.
Another version of Example 1b. A blood filtering system comprising: a first piston included in a first chamber; a second piston included in a second chamber; a filter between the first and second pistons; a machine-readable medium having stored thereon data, which if used by at least one machine, causes the at least one machine to perform a method comprising: move the first piston away from the filter, while the second piston is still, to advance blood into the first chamber from a first container; move the first piston towards the filter while simultaneously moving the second piston away from the filter to advance blood from the first chamber across the filter and into the second chamber and to locate cells of the blood against the filter and within the first chamber; move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance blood from the second chamber across the filter and into the first chamber and to flush the cells of the blood off of the filter; move the first piston toward the filter, while the second piston is still, to advance the cells of the blood out of the first chamber and into a second container.
The system of example 1b comprising: a first grate, between the filter and the first piston, to support the filter; and a second grate, between the filter and the second piston, to support the filter; wherein the first grate has first grate protrusions arranged in a first grate pattern; wherein the second grate has second grate protrusions arranged in a second grate pattern.
For instance, the first and second grates operate to keep the filter, which may be a thin membrane, from excessive warping or pending during fluid flow across the filter and/or during vacuum generation within one or both of the first and second chambers. This stability promotes better filtering of cells.
The system of example 2b wherein: the first piston has a first maximum range of motion within the first chamber; the second piston has a second maximum range of motion within the second chamber; the first piston has a first piston face having first piston protrusions arranged in a first piston pattern so the first piston protrusions fit between the first grate protrusions when the first piston is at one end of the first maximum range of motion; the second piston has a second piston face having second piston protrusions arranged in a second piston pattern so the second piston protrusions fit between the second grate protrusions when the second piston is at one end of the second maximum range of motion.
For instance, the piston protrusions may be keyed to the grate protrusions. An example of a piston protrusion is element 1301 of
The system of example 3b wherein: the first piston face has first voids between the first piston protrusions; a first void of the first voids includes a first aperture; the first aperture is coupled to a first channel that is to fluidly couple to the second container.
The system of example 4b comprising a second aperture, wherein: a second void of the first voids includes a second aperture; the second aperture is coupled to a second channel that is to fluidly couple to the second container.
For instance, see
The system of example 3b wherein: the filter is substantially located in a plane; one of the first grate protrusions extends away from the filter, in a direction orthogonal to the plane, a first distance; the one of the first grate protrusions and another of the first grate protrusions define a void that extends away from the filter the first distance; the at least one processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter but before the first piston is included in the void; move, at a second rate of speed, the first piston towards the filter while the first piston is included in the void; wherein the second rate of speed is faster than the first rate of speed.
For instance, and as mentioned above, at the initiation of the filtration step (e.g.,
The system of example 3b comprising a first conduit, wherein: the first conduit is to couple the first container to the first chamber; the first conduit includes a first output located on the first piston face.
For instance, by drawing the solution in from a location distal (below) to the filter medium, the cell suspension may avoid contact with the filter medium until the chamber is filled (and therefore any trapped air or gas may move to the top of the dead-end chamber 908). A goal of the distal location is to avoid wetting (fluid contact) of the filter as it becomes impermeable to gas once wetted in some embodiments.
The system of example 7b comprising a second conduit, wherein: the second conduit is to couple the first container to the first chamber; the second conduit includes a second output located on the first piston face.
For instance, by increasing the number of inputs the cells may be better distributed across the piston and eventually the filter.
The system of example 2b comprising: at least one motor coupled to the at least one processor; wherein the at least one motor is to move the first piston within the first chamber in response to first commands from the at least one processor; wherein the at least one motor is to move the second piston within the second chamber in response to second commands from the at least one processor.
In some embodiments a single motor may move both the first and second pistons, while in other embodiments a motor may move the first piston and another motor may move the second piston. In other embodiments, multiple systems such as the system of
The system of example 9b wherein the at least one motor is move the first piston independently of moving the second piston.
For instance, one piston may be moving while the other piston is still.
The system of example 9b wherein: the at least one motor includes a step motor; the at least one processor is to perform operations comprising: convert a number of steps to be taken by the step motor to at least one of a volume or a flow rate; track a number of steps taken by the step motor to determine a location of the first piston; rotate a portion of the step motor clockwise to move the first piston in a first direction; rotate the portion of the step motor counterclockwise to move the first piston in a second direction which is opposite the first direction.
The system of example 11b wherein: the first piston has a maximum range of motion within the first chamber; a plurality of steps by the step motor is needed to move the first piston across the maximum range of motion. For instance, a maximum range of motion for the input piston 501 may be from the filter 502 to the lowest point in the input chamber 503 (i.e., towards bottom of
The system of example 2b wherein: the first piston has a first maximum range of motion within the first chamber; moving the first piston away from the filter, while the second piston is still, to advance blood into the first chamber from the first container includes moving the first piston away from the filter but not across the first maximum range of motion; the at least one processor is to perform operations comprising, after moving the first piston away from the filter, moving the second piston away from the filter, while the first piston is still, to advance blood into the second chamber from the first container.
For instance, this may concern buffering as addressed with
The system of example 13b wherein: the second piston has a second maximum range of motion within the second chamber; the first grate is to simultaneously and directly contact both the filter and the first piston when the first piston is located at one end of the first maximum range of motion; and the second grate is to simultaneously and directly contact both the filter and second piston when the second piston is located at one end of the second maximum range of motion.
For instance, if a film is on the piston face or grate the film would not prevent the first grate from simultaneously and directly contacting both the filter and the first piston when the first piston is located at one end of the first maximum range of motion.
The system of example 2b wherein the at least one processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter while simultaneously moving the second piston away from the filter to advance blood from the first chamber across the filter and into the second chamber and to locate the cells of the blood against the filter and within the first chamber; move, at a second rate of speed, the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the blood from the second chamber across the filter and into the first chamber and to flush the cells of the blood off of the filter; wherein the second rate of speed is faster than the first rate of speed.
For instance, this allows a movement closer to a “pulse” to eject cells forcibly from the membrane without having to pass excess fluid from the upper chamber to the lower chamber. See above discussion regarding
The system of example 1b wherein: the first piston has a maximum range of motion within the first chamber, the maximum range extending from a first portion of the maximum range of motion directly adjacent the filter to a second portion of the maximum range of motion at an opposite end of the maximum range of motion from the first portion of the maximum range of motion; the at least one processor is to perform operations comprising moving the first piston toward the filter starting from a location not included in the second portion of the maximum range of motion and, as a result, moving the first piston toward the filter across less than the maximum range of motion to advance the cells of the blood out of the first chamber and into the second container.
As mentioned above,
Thus, the “smaller volume” leads to a highly concentrated cell suspension.
The system of example 1b, wherein the system does not include a centrifuge.
A blood filtering system comprising: a first piston included in a first chamber; a second piston included in a second chamber; a filter between the first and second pistons; at least one memory and at least one processor, coupled to the at least one memory, to perform operations comprising: move the first piston away from the filter, while the second piston is still, to advance bone marrow aspirate (BMA) into the first chamber from a first container; move the first piston towards the filter while simultaneously moving the second piston away from the filter to: (a)(i) advance a fluid fraction of the BMA from the first chamber across the filter and into the second chamber, and (a)(ii) locate a cellular fraction of the BMA adjacent the filter and within the first chamber; move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the fluid fraction from the second chamber across the filter and into the first chamber and to flush the cellular fraction away from the filter; move the first piston toward the filter, while the second piston is still, to advance the cellular fraction out of the first chamber and into a second container.
For instance, “locate a cellular fraction of the BMA adjacent the filter” may mean locating the cellular fraction within a void 1402 of a grate. In other embodiments adjacent may mean within 2mm of the filter. A goal of various embodiments is to deliver more cellular fraction and less fluid fraction to a medical care provider. Consequently, adjacent would mean the cellular fraction is very close to the filter to reduce the fluid fraction but does not necessarily have to contact the filter.
An example of a filter may include the Vivid Plasma Separation membrane (which includes Asymmetric polysulfone) available from Pall Corporation.
The system of example 1c comprising: a first grate, between the filter and the first piston, to support the filter; and a second grate, between the filter and the second piston, to support the filter; wherein the first grate has first grate protrusions arranged in a first grate pattern; wherein the second grate has second grate protrusions arranged in a second grate pattern.
The system of example 2c wherein: the first piston has a first maximum range of motion within the first chamber; the second piston has a second maximum range of motion within the second chamber; the first piston has a first piston face having first piston protrusions arranged in a first piston pattern so the first piston protrusions fit between the first grate protrusions when the first piston is at one end of the first maximum range of motion; the second piston has a second piston face having second piston protrusions arranged in a second piston pattern so the second piston protrusions fit between the second grate protrusions when the second piston is at one end of the second maximum range of motion.
The system of example 3c wherein: the first piston face has first voids between the first piston protrusions; a first void of the first voids includes a first aperture; the first aperture is coupled to a first channel that is to fluidly couple to the second container.
The system of example 4c comprising a second aperture, wherein: a second void of the first voids includes a second aperture; the second aperture is coupled to a second channel that is to fluidly couple to the second container.
The system of example 3c wherein: the filter is substantially located in a plane; one of the first grate protrusions extends away from the filter, in a direction orthogonal to the plane, a first distance; the one of the first grate protrusions and another of the first grate protrusions define a void that extends away from the filter the first distance; the at least one processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter but before the first piston is included in the void; move, at a second rate of speed, the first piston towards the filter while the first piston is included in the void; wherein the second rate of speed is faster than the first rate of speed.
Another version of Example 6c. The system of example 3c wherein: the at least one processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter but before the first piston is between two or more first gate protrusions; move, at a second rate of speed, the first piston towards the filter while the first piston is between two or more gate protrusion; wherein the second rate of speed is faster than the first rate of speed.
The system of example 3c comprising a first conduit, wherein: the first conduit is to couple the first container to the first chamber; the first conduit includes a first output located on the first piston face.
The system of example 7c comprising a second conduit, wherein: the second conduit is to couple the first container to the first chamber; the second conduit includes a second output located on the first piston face.
The system of example 2c comprising: at least one motor coupled to the at least one processor; wherein the at least one motor is to move the first piston within the first chamber in response to first commands from the at least one processor; wherein the at least one motor is to move the second piston within the second chamber in response to second commands from the at least one processor.
The system of example 9c wherein the at least one motor is move the first piston independently of moving the second piston.
The system of example 9c wherein: the at least one motor includes a step motor; the at least one processor is to perform operations comprising: convert a number of steps to be taken by the step motor to at least one of a volume or a flow rate; and track a number of steps taken by the step motor to determine a location of the first piston.
The system of example 11c wherein: the first piston has a maximum range of motion within the first chamber; a plurality of steps by the step motor is needed to move the first piston across the maximum range of motion.
The system of example 2c wherein: the first piston has a first maximum range of motion within the first chamber; moving the first piston away from the filter, while the second piston is still, to advance the BMA into the first chamber from the first container includes moving the first piston away from the filter but not across an entirety of the first maximum range of motion; the at least one processor is to perform operations comprising, after moving the first piston away from the filter while the second piston is still, moving the second piston away from the filter while the first piston is still to advance the fluid fraction into the second chamber from the first container.
The system of example 13c wherein the filter simultaneously and directly contacts both of the first and second grates.
Thus, in an embodiment piston faces do not necessarily directly contact the grates.
The system of example 2c wherein the at least one processor is to perform operations comprising: move, at a first rate of speed, the first piston towards the filter while simultaneously moving the second piston away from the filter to advance the fluid fraction from the first chamber across the filter and into the second chamber and to locate the cellular fraction adjacent the filter and within the first chamber; move, at a second rate of speed, the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the fluid fraction from the second chamber across the filter and into the first chamber and to flush the cellular fraction away from the filter; wherein the second rate of speed is faster than the first rate of speed.
The system of example 1c wherein: the first piston has a maximum range of motion within the first chamber, the maximum range of motion extending from a first area directly adjacent the filter to a second area at an opposite end of the maximum range of motion from the first area; a third area is between the first and second areas; the at least one processor is to perform operations comprising moving the first piston toward the filter starting from the third area and, as a result, moving the first piston toward the filter across less than an entirety of the maximum range of motion to advance the cellular component out of the first chamber and into the second container.
For example, in
The system of example 1c, wherein: the system does not include a centrifuge; the cellular fraction includes at least one of mononucleated cells, red blood cells, or platelets.
A blood filtering system comprising: a lower piston included in a lower chamber and an upper piston included in an upper chamber; a filter between the lower and upper pistons; at least one processor, coupled to at least one memory, to perform operations comprising: move the lower piston away from the filter, while the upper piston is still, to create a pressure differential that draws bone marrow aspirate (BMA) into the lower chamber from an external container; move the lower piston towards the filter while simultaneously moving the upper piston away from the filter to advance BMA fluid of the BMA from the lower chamber across the filter and into the upper chamber and to locate BMA cells of the BMA adjacent the filter and within the lower chamber; move the lower piston toward the filter, while the upper piston is still, to advance the BMA cells out of the lower chamber and into one of the external container and another external container.
Thus, embodiments may include pistons that do not necessarily have protrusions and voids and filter support grates may not be needed. For example, the piston faces may be flat or planar. Further, not all embodiments require a backflush operation. For example, the lower piston may slowly advance towards the filter. Gravity will pull the cellular fraction toward the piston face. The piston face may slowly proceed towards the filter as the upper piston moves away from the filter to allow filtration of the fluid fraction. However, at some point the upper piston may halt while the lower piston continues towards the filter. This may eject the contents remaining in the lower chamber whereby those contents may include a high concentration of the cellular fraction.
The system of example 18c wherein the at least one processor is to perform operations comprising move the lower piston away from the filter while simultaneously moving the upper piston towards the filter to advance the BMA fluid from the upper chamber across the filter and into the lower chamber and to flush the BMA cells away from the filter.
The system of example 18c comprising: a support member coupled to the filter to support the filter when the BMA fluid passes across the filter; and wherein the at least one processor is to perform operations comprising: move, at a first speed, the lower piston towards the filter; after moving the lower piston towards the filter at the first speed, move, at a second speed, the lower piston towards the filter while the upper piston is still to advance the BMA cells out of the lower chamber and into the one of the external container and the another external container; the first speed is faster than the second speed.
Embodiments have largely covered systems with at least one processor and at least one memory. However, other embodiments may include an entirely mechanical analog to such systems. For example, mechanical lever and gear systems may translate the pistons in a manner similar to that of the processor/memory/software/firmware embodiments. For instance, pulling a first lever may perform the intake phase (e.g.,
Embodiments may include kits. For example, a kit may include the system of
A blood filtering system comprising: a first projection means included in a first chamber; a second projection means included in a second chamber; a filter means between the first and second projection means; a means to perform operations comprising: move the first piston away from the filter, while the second piston is still, to advance bone marrow aspirate (BMA) into the first chamber from a first container; move the first piston towards the filter while simultaneously moving the second piston away from the filter to: (a)(i) advance a fluid fraction of the BMA from the first chamber across the filter and into the second chamber, and (a)(ii) locate a cellular fraction of the BMA adjacent the filter and within the first chamber; move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the fluid fraction from the second chamber across the filter and into the first chamber and to flush the cellular fraction away from the filter; move the first piston toward the filter, while the second piston is still, to advance the cellular fraction out of the first chamber and into a second container.
A blood filtering system comprising: a first piston included in a first chamber; a second piston included in a second chamber; a filter between the first and second pistons; a means to move the first piston away from the filter, while the second piston is still, to advance bone marrow aspirate (BMA) into the first chamber from a first container; a means to move the first piston towards the filter while simultaneously moving the second piston away from the filter to: (a)(i) advance a fluid fraction of the BMA from the first chamber across the filter and into the second chamber, and (a)(ii) locate a cellular fraction of the BMA adjacent the filter and within the first chamber; a means to move the first piston away from the filter while simultaneously moving the second piston towards the filter to advance the fluid fraction from the second chamber across the filter and into the first chamber and to flush the cellular fraction away from the filter; a means to move the first piston toward the filter, while the second piston is still, to advance the cellular fraction out of the first chamber and into a second container.
The system of example 22c comprising: a first means to support the filter; and a second means to support the filter.
The system of example 23c comprising: means to move, at a first rate of speed, the first piston towards the filter but before the first piston is within a void of the first means to support the filer; means to move, at a second rate of speed, the first piston towards the filter while the first piston is within the void; wherein the second rate of speed is faster than the first rate of speed.
The system of example 22c comprising means to move the first piston at a first speed and at a second speed wherein the first speed is not equal to the second speed.
The foregoing description of the embodiments of the invention has been presented for the purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise forms disclosed. This description and the claims following include terms, such as left, right, top, bottom, over, under, upper, lower, first, second, etc. that are used for descriptive purposes only and are not to be construed as limiting. The term “on” as used herein (including in the claims) does not indicate that, for example, a first element “on” a second element is directly on and in immediate contact with the second element unless such is specifically stated; there may be a third element or other structure between the first element and the second element on the first element. The embodiments of a device or article described herein can be manufactured, used, or shipped in a number of positions and orientations. Persons skilled in the relevant art can appreciate that many modifications and variations are possible in light of the above teaching. Persons skilled in the art will recognize various equivalent combinations and substitutions for various components shown in the Figures. It is therefore intended that the scope of the invention be limited not by this detailed description, but rather by the claims appended hereto.
This application claims priority to U.S. Provisional Patent Application No. 62/543,484 filed on Aug. 10, 2017 and entitled “Method and Device for Concentration of Cellular Suspensions”, the content of which is hereby incorporated by reference.
Number | Date | Country | |
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62543484 | Aug 2017 | US |