Information
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Patent Grant
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6610002
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Patent Number
6,610,002
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Date Filed
Monday, April 9, 200123 years ago
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Date Issued
Tuesday, August 26, 200321 years ago
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Inventors
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Original Assignees
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Examiners
Agents
- Petersen; Steven C.
- O'Rourke; Sarah S.
- Hogan & Hartson, LLP
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CPC
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US Classifications
Field of Search
US
- 210 94
- 210 3601
- 210 5121
- 210 745
- 210 782
- 210 787
- 210 789
- 494 1
- 494 10
- 494 37
- 494 38
- 494 45
- 604 401
- 604 501
- 604 601
- 604 602
- 604 604
- 422 72
- 422 101
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International Classifications
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Disclaimer
Terminal disclaimer
Abstract
A method of harvesting platelet rich plasma from whole blood, comprising adding an aliquot of blood via the inlet tube of a rotating flexible centrifuge bag comprising inlet and outlet tubes sandwiched between doughnut shaped flexible sheets sealed together at the outer and inner perimeters. The whole blood separates radially into fractions. The distal end of the outlet tube is in flow communication with a desired fraction. The desired fraction is removed from the rotating bag via the outlet tube and withdrawal is terminated when an undesired fraction is detected to be near the distal end of the outlet tube. An alternative method comprises adding an aliquot of blood via the inlet channel of a rigid centrifuge container, said container having an interior collection chamber for receiving said whole blood and having a generally off-centered figure eight-shaped side cross-sectional configuration.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to novel methods, devices and apparatuses for the centrifugal separation of a liquid into its components of varying specific gravities, and is more particularly directed toward a blood separation device useful, for example, in the separation of blood components for use in various therapeutic regimens.
2. Description of the State of Art
Centrifugation utilizes the principle that particles suspended in solution will assume a particular radial position within the centrifuge rotor based upon their respective densities and will therefore separate when the centrifuge is rotated at an appropriate angular velocity for an appropriate period of time. Centrifugal liquid processing systems have found applications in a wide variety of fields. For example, centrifugation is widely used in blood separation techniques to separate blood into its component parts, that is, red blood cells, platelets, white blood cells, and plasma.
The liquid portion of the blood, referred to as plasma, is a protein-salt solution in which red and white blood cells and platelets are suspended. Plasma, which is 90 percent water, constitutes about 55 percent of the total blood volume. Plasma contains albumin (the chief protein constituent), fibrinogen (responsible, in part, for the clotting of blood), globulins (including antibodies) and other clotting proteins. Plasma serves a variety of functions, from maintaining a satisfactory blood pressure and providing volume to supplying critical proteins for blood clotting and immunity. Plasma is obtained by separating the liquid portion of blood from the cells suspended therein.
Red blood cells (erythrocytes) are perhaps the most recognizable component of whole blood. Red blood cells contain hemoglobin, a complex iron-containing protein that carries oxygen throughout the body while giving blood its red color. The percentage of blood volume composed of red blood cells is called the “hematocrit.”
White blood cells (leukocytes) are responsible for protecting the body from invasion by foreign substances such as bacteria, fungi and viruses. Several types of white blood cells exist for this purpose, such as granulocytes and macrophages which protect against infection by surrounding and destroying invading bacteria and viruses, and lymphocytes which aid in the immune defense.
Platelets (thrombocytes) are very small cellular components of blood that help the clotting process by sticking to the lining of blood vessels. Platelets are vital to life, because they help prevent both massive blood loss resulting from trauma and blood vessel leakage that would otherwise occur in the course of normal, day-to-day activity.
If whole blood is collected and prevented from clotting by the addition of an appropriate anticoagulant, it can be centrifuged into its component parts. Centrifugation will result in the red blood cells, which weigh the most, packing to the most outer portion of the rotating container, while plasma, being the least dense will settle in the central portion of the rotating container. Separating the plasma and red blood cells is a thin white or grayish layer called the buffy coat. The buffy coat layer consists of the white blood cells and platelets, which together make up about 1 percent of the total blood volume.
These blood components, discussed above, may be isolated and utilized in a wide range of diagnostic and therapeutic regimens. For example, red blood cells are routinely transfused into patients with chronic anemia resulting from disorders such as kidney failure, malignancies, or gastrointestinal bleeding and those with acute blood loss resulting from trauma or surgery. The plasma component is typically frozen by cryoprecipitation and then slowly thawed to produce cryoprecipitated antihemophiliac factor (AHF) which is rich in certain clotting factors, including Factor VIII, fibrinogen, von Willebrand factor and Factor XIII. Cryoprecipitated AHF is used to prevent or control bleeding in individuals with hemophilia and von Willebrand's disease. Platelets and white blood cells, which are found in the buffy layer component, can be used to treat patients with abnormal platelet function (thrombocytopenia) and patients that are unresponsive to antibiotic therapy, respectively.
Various techniques and apparatus have been developed to facilitate the collection of whole blood and the subsequent separation of therapeutic components therefrom. Centrifugal systems, also referred to as blood-processing systems, generally fall into two categories, discontinuous-flow and continuous-flow devices.
In discontinuous-flow systems, whole blood from the donor or patient flows through a conduit into the rotor or bowl where component separation takes place. These systems employ a bowl-type rotor with a relatively large (typically 200 ml or more) volume that must be filled with blood before any of the desired components can be harvested. When the bowl is full, the drawing of fresh blood is stopped, the whole blood is separated into its components by centrifugation, and the unwanted components are returned to the donor or patient through the same conduit intermittently, in batches, rather than on a continuous basis. When the return has been completed, whole blood is again drawn from the donor or patient, and a second cycle begins. This process continues until the required amount of the desired component has been collected.
Discontinuous-flow systems have the advantage that the rotors are relatively small in diameter but have the disadvantage that the extracorporeal volume (i.e., the amount of blood that is out of the donor at any given time during the process) is large. This, in turn, makes it difficult or impossible to use discontinuous systems on people whose size and weight will not permit the drawing of the amount of blood required to fill the rotor. Discontinuous-flow devices are used for the collection of platelets and/or plasma, and for the concentration and washing of red blood cells. They are used to reconstitute previously frozen red blood cells and to salvage red blood cells lost intraoperatively. Because the bowls in these systems are rigid and have a fixed volume, however, it is difficult to control the hematocrit of the final product, particularly if the amount of blood salvaged is insufficient to fill the bowl with red blood cells.
One example of a discontinuous-flow system is disclosed by McMannis, et al., in his U.S. Pat. No. 5,316,540, and is a variable volume centrifuge for separating components of a fluid medium, comprising a centrifuge that is divided into upper and lower chambers by a flexible membrane, and a flexible processing container bag positioned in the upper chamber of the centrifuge. The McMannis, et al., system varies the volume of the upper chamber by pumping a hydraulic fluid into the lower chamber, which in turn raises the membrane and squeezes the desired component out of the centrifuge. The McMannis, et al., system takes up a fairly large amount of space, and its flexible pancake-shaped rotor is awkward to handle. The McMannis, et al., system does not permit the fluid medium to flow into and out of the processing bag at the same time, nor does it permit fluid medium to be pulled out of the processing bag by suction.
In continuous-flow systems, whole blood from the donor or patient also flows through one conduit into the spinning rotor where the components are separated. The component of interest is collected and the unwanted components are returned to the donor through a second conduit on a continuous basis as more whole blood is being drawn. Because the rate of drawing and the rate of return are substantially the same, the extracorporeal volume, or the amount of blood that is out of the donor or patient at any given time in the procedure, is relatively small. These systems typically employ a belt-type rotor, which has a relatively large diameter but a relatively small (typically 100 ml or less) processing volume. Although continuous-flow systems have the advantage that the amount of blood that must be outside the donor or patient can be relatively small, they have the disadvantage that the diameter of the rotor is large. These systems are, as a consequence, large. Furthermore, they are complicated to set up and use. These devices are used almost exclusively for the collection of platelets.
Continuous-flow systems are comprised of rotatable and stationary parts that are in fluid communication. Consequently, continuous-flow systems utilize either rotary seals or a J-loop. A variety of types of rotary centrifuge seals have been developed. Some examples of rotary centrifuge seals which have proven to be successful are described in U.S. Pat. Nos. 3,409,203 and 3,565,330, issued to Latham. In these patents, rotary seals are disclosed which are formed from a stationary rigid low friction member in contact with a moving rigid member to create a dynamic seal, and an elastomeric member which provides a resilient static seal as well as a modest closing force between the surfaces of the dynamic seal.
Another rotary seal suitable for use in blood-processing centrifuges is described in U.S. Pat. No. 3,801,142 issued to Jones, et al. In this rotary seal, a pair of seal elements having confronting annular fluid-tight sealing surfaces of non-corrodible material are provided. These are maintained in a rotatable but fluid-tight relationship by axial compression of a length of elastic tubing forming one of the fluid connections to these seal elements.
Related types of systems which incorporate rotatable, disposable annular separation chambers coupled via rotary seals to stationary tubing members are disclosed in U.S. Pat. Nos. 4,387,848; 4,094,461; 4,007,871; and 4,010,894.
One drawback present in the above-described continuous-flow systems has been their use of a rotating seal or coupling element between that portion of the system carried by the centrifuge rotor and that portion of the system which remains stationary. While such rotating seals have provided generally satisfactory performance, they have been expensive to manufacture and have unnecessarily added to the cost of the flow systems. Furthermore, such rotating seals introduce an additional component into the system which if defective can cause contamination of the blood being processed.
One flow system heretofore contemplated to overcome the problem of the rotating seal utilizes a rotating carriage on which a single housing is rotatably mounted. An umbilical cable extending to the housing from a stationary point imparts planetary motion to the housing and thus prevents the cable from twisting. To promote the desired ends of sterile processing and avoid the disadvantages of a discontinuous-flow system within a single sealed system, a family of dual member centrifuges can be used to effect cell separation. One example of this type of centrifuge is disclosed in U.S. Pat. No. RE 29,738 to Adams entitled “Apparatus for Providing Energy Communication Between a Moving and a Stationary Terminal”. As is now well known, due to the characteristics of such dual member centrifuges, it is possible to rotate a container containing a fluid, such as a unit of donated blood and to withdraw a separated fluid component, such as plasma, into a stationary container, outside of the centrifuge without using rotating seals. Such container systems utilize a J-loop and can be formed as closed, sterile transfer sets.
The Adams patent discloses a centrifuge having an outer rotatable member and an inner rotatable member. The inner member is positioned within and rotatably supported by the outer member. The outer member rotates at one rotational velocity, usually called “one omega,” and the inner rotatable member rotates at twice the rotational velocity of the outer housing or “two omega.” There is thus a one omega difference in rotational speed of the two members. For purposes of this document, the term “dual member centrifuge” shall refer to centrifuges of the Adams type.
The dual member centrifuge of the Adams patent is particularly advantageous in that, as noted above, no seals are needed between the container of fluid being rotated and the non-moving component collection containers. The system of the Adams patent provides a way to process blood into components in a single, sealed, sterile system wherein whole blood from a donor can be infused into the centrifuge while the two members of the centrifuge are being rotated.
An alternate to the apparatus of the Adams patent is illustrated in U.S. Pat. No. 4,056,224 to Lolachi entitled “Flow System for Centrifugal Liquid Processing Apparatus.” The system of the Lolachi patent includes a dual member centrifuge of the Adams type. The outer member of the Lolachi centrifuge is rotated by a single electric motor which is coupled to the internal rotatable housing by belts and shafts.
U.S. Pat. No. 4,108,353 to Brown entitled “Centrifugal Apparatus With Oppositely Positioned Rotational Support Means” discloses a centrifuge structure of the Adams type which includes two separate electrical motors. One electric motor is coupled by a belt to the outer member and rotates the outer member at a desired nominal rotational velocity. The second motor is carried within the rotating exterior member and rotates the inner member at the desired higher velocity, twice that of the exterior member.
U.S. Pat. No. 4,109,855 to Brown, et al., entitled “Drive System For Centrifugal Processing Apparatus” discloses yet another drive system. The system of the Brown, et al., patent has an outer shaft, affixed to the outer member for rotating the outer member at a selected velocity. An inner shaft, coaxial with the outer shaft, is coupled to the inner member. The inner shaft rotates the inner member at twice the rotational velocity as the outer member. A similar system is disclosed in U.S. Pat. No. 4,109,854 to Brown entitled “Centrifugal Apparatus With Outer Enclosure”.
The continuous-flow systems described above are large and expensive units that are not intended to be portable. Further, they are also an order of magnitude more expensive than a standard, multi-container blood collection set. There exists the need, therefore, for a centrifugal system for processing blood and other biological fluids that is compact and easy to use and that does not have the disadvantages of prior-art continuous-flow systems.
Whole blood that is to be separated into its components is commonly collected into a flexible plastic donor bag, and the blood is centrifuged to separate it into its components through a batch process. This is done by spinning the blood bag for a period of about 10 minutes in a large refrigerated centrifuge. The main blood constituents, i.e., red blood cells, platelets and white cells, and plasma, having sedimented and formed distinct layers, are then expressed sequentially by a manual extractor in multiple satellite bags attached to the primary bag.
More recently, automated extractors have been introduced in order to facilitate the manipulation. Nevertheless, the whole process remains laborious and requires the separation to occur within a certain time frame to guarantee the quality of the blood components. This complicates the logistics, especially considering that most blood donations are performed in decentralized locations where no batch processing capabilities exist.
This method has been practiced since the widespread use of the disposable plastic bags for collecting blood in the 1970's and has not evolved significantly since then. Some attempts have been made to apply haemapheresis technology in whole blood donation. This technique consists of drawing and extracting on-line one or more blood components while a donation is performed, and returning the remaining constituents to the donor. However, the complexity and costs of haemapheresis systems preclude their use by transfusion centers for routine whole blood collection.
There have been various proposals for portable, disposable, centrifugal apparatus, usually with collapsible bags, for example as in U.S. Pat. Nos. 3,737,096, or 4,303,193 to Latham, Jr., or with a rigid walled bowl as in U.S. Pat. No. 4,889,524 to Fell, et al. These devices all have a minimum fixed holding volume which requires a minimum volume usually of about 250 ml to be processed before any components can be collected.
U.S. Pat. No. 5,316,540 to McMannis, et al., discloses a centrifugal processing apparatus, wherein the processing chamber is a flexible processing bag which can be deformed to fill it with biological fluid or empty it by means of a membrane which forms part of the drive unit. The bag comprises a single inlet/outlet tubing for the introduction and removal of fluids to the bag, and consequently cannot be used in a continual, on-line process. Moreover, the processing bag has a the disadvantage of having 650 milliliter capacity, which makes the McMannis, et al., device difficult to use as a blood processing device.
As discussed above, centrifuges are often used to separated blood into its components for use in a variety of therapeutic regimens. One such application is the preparation of a bioadhesive sealant. A bioadhesive sealant, also referred to as a fibrin glue, is a relatively new technological advance which attempts to duplicate the biological process of the final stage of blood coagulation. Clinical reports document the utility of fibrin glue in a variety of surgical fields, such as, cardiovascular, thoracic, transplantation, head and neck, oral, gastrointestinal, orthopedic, neurosurgical, and plastic surgery. At the time of surgery, the two primary components comprising the fibrin glue, fibrinogen and thrombin, are mixed together to form a clot. The clot is applied to the appropriate site, where it adheres to the necessary tissues, bone, or nerve within seconds, but is then slowly reabsorbed by the body in approximately 10 days by fibrinolysis. Important features of fibrin glue is its ability to: (1) achieve haemostasis at vascular anastomoses particularly in areas which are difficult to approach with sutures or where suture placement presents excessive risk; (2) control bleeding from needle holes or arterial tears which cannot be controlled by suturing alone; and (3) obtain haemostasis in heparinized patients or those with coagulopathy. See, Borst, H. G., et al.,
J Thorac. Cardiovasc. Surg.,
84:548-553 (1982); Walterbusch, G. J, et al.,
Thorac. Cardiovasc. Surg.,
30:234-235 (1982); and Wolner, F. J, et al,
Thorac. Cardiovasc. Surg.,
30:236-237 (1982).
Despite the effectiveness and successful use of fibrin glue by medical practitioners in Europe, neither fibrin glue nor its essential components fibrinogen and thrombin are widely used in the United States. In large part, this stems from the 1978 U.S. Food and Drug Administration ban on the sale of commercially prepared fibrinogen concentrate made from pooled donors because of the risk of transmission of viral infection, in particular the hepatitis-causing viruses such as HBV and HCV (also known as non-A and non-B hepatitis virus). In addition, the more recent appearance of other lipid-enveloped viruses such as HIV, associated with AIDS, cytomegalovirus (CMV), as well as Epstein-Barr virus and the herpes simplex viruses in fibrinogen preparations makes it unlikely that there will be a change in this policy in the foreseeable future. For similar reasons, human thrombin is also not currently authorized for human use in the United States. Bovine thrombin, which is licensed for human use in the United States is obtained from bovine sources which do not appear to carry significant risks for HIV and hepatitis, although other bovine pathogens, such as bovine spongiform and encephalitis, may be present.
There have been a variety of methods developed for preparing fibrin glue. For example, Rose, et al. in U.S. Pat. No. 4,627,879 discloses a method of preparing a cryoprecipitated suspension containing fibrinogen and Factor XIII useful as a precursor in the preparation of a fibrin glue which involves (a) freezing fresh frozen plasma from a single donor such as a human or other animal, e.g. a cow, sheep or pig, which has been screened for blood transmitted diseases, e.g. one or more of syphilis, hepatitis or acquired immune deficiency syndrome, at about 80° C. for at least about 6 hours, preferably for at least about 12 hours; (b) raising the temperature of the frozen plasma, e.g. to between about 0° C. and room temperature, so as to form a supernatant and a cryoprecipitated suspension containing fibrinogen and Factor XIII; and (c) recovering the cryoprecipitated suspension. The fibrin glue is then prepared by applying a defined volume of the cyroprecipitate suspension described above and applying a composition containing a sufficient amount of thrombin, e.g. human, bovine, ovine or porcine thrombin, to the site so as to cause the fibrinogen in the suspension to be converted to the fibrin glue which then solidifies in the form of a gel.
A second technique for preparing fibrin glue is disclosed by Marx in his U.S. Pat. No. 5,607,694. Essentially, a cryoprecipitate as discussed previously serves as the source of the fibrinogen component and then Marx adds thrombin and liposomes. A third method discussed by Berruyer, (M.) et al., entitled “Immunization by bovine thrombin used with fibrin glue during cardiovascular operations,” (J)
Thorac. Cardiovasc. Surg.,
105(5):892-897 (1992)) discloses a fibrin glue prepared by mixing bovine thrombin not only with human coagulant proteins, such as fibrinogen, fibronectin, Factor XIII, and plasminogen, but also with bovine aprotinin and calcium chloride.
The above patents by Rose, et al., and Marx, and the technical paper by Berruyer, et al. each disclose methods for preparing fibrin sealants; however, each of these methods suffer disadvantages associated with the use of bovine thrombin as the activating agent. A serious and life threatening consequence associated with the use of fibrin glues comprising bovine thrombin is that patients have been reported to have a bleeding diathesis after receiving topical bovine thrombin. This complication occurs when patients develop antibodies to the bovine factor V in the relatively impure bovine thrombin preparations. These antibodies cross-react with human factor V, thereby causing a factor V deficiency that can be sufficiently severe to induce bleeding and even death. See, Rapaport, S. I., et al.,
Am.
(
J.
)
Clin. Pathol.,
97:84-91 (1992); Berruyer, M., et al.,
J. Thorac. Cardiovasc. Surg.,
105:892-897 (1993); Zehnder, J., et al.,
Blood,
76(10):2011-2016 (1990); Muntean, W., et al.,
Acta Paediatr.,
83:84-7 (1994); Christine, R. J., et al.,
Surgery,
127:708-710 (1997).
Further disadvantages associated with the methods disclosed by Marx and Rose, et al. are that the cryoprecipitate preparations require a large time and monetary commitment to prepare. Furthermore, great care must be taken to assure the absence of any viral contaminants.
A further disadvantage associated with the methods previously disclosed is that while human thrombin is contemplated for use as an activator, human thrombin is not available for clinical use and there is no evidence that patients will not have an antigenic response to human thrombin. By analogy, recombinant human factor VIII has been shown to produce antigenic responses in hemophiliacs. See, Biasi, R. de.,
Thrombosis and Haemostasis,
71(5):544-547 (1994). Consequently, until more clinical studies are performed on the effect of human recombinant thrombin one cannot merely assume that the use of recombinant human thrombin would obviate the antigenic problems associated with bovine thrombin. A second difficulty with thrombin is that it is autocatalytic, that is, it tends to self-destruct, making handling and prolonged storage a problem.
Finally, as discussed above, fibrin glue is comprised primarily of fibrinogen and thrombin thus lacking an appreciable quantity of platelets. Platelets contain growth factors and healing factors which are assumed to be more prevalent in a platelet concentrate. Moreover, platelets aid in acceleration of the clotting process.
There is still a need, therefore, for a centrifugal system for processing blood and other biological fluids, that is compact and easy to use and that does not have the disadvantages of prior-art continuous-flow systems and furthermore there exists a need for a convenient and practical method for preparing a platelet gel composition wherein the resulting platelet gel poses a zero risk of disease transmission and a zero risk of causing an adverse physiological reaction.
There is also a widespread need for a system that, during blood collection, will automatically separate the different components of whole blood that are differentiable in density and size, with a simple, low cost, disposable unit.
There is further a need for a centrifugal cell processing system wherein multiple batches of cells can be simultaneously and efficiently processed without the use of rotational coupling elements.
There is yet a further need for a platelet concentrate that aids in increasing the rate of fibrin clot formation, thereby facilitating haemostasis.
Preferably the apparatus will be essentially self-contained. Preferably, the equipment needed to practice the method will be relatively inexpensive and the blood contacting set will be disposable each time the whole blood has been separated.
SUMMARY OF THE INVENTION
Accordingly, one object of this invention is to provide a method and apparatus for the separation of components suspended or dissolved in a fluid medium by centrifugation. More specifically, one object of this invention is to provide a method for the separation and isolation of one or more whole blood components, such as platelet rich plasma, white blood cells and platelet poor plasma, from anticoagulated whole blood by centrifugation, wherein the components are isolated while the centrifuge is rotating.
Another object of this invention is to utilize the isolated cell components in a therapeutic regimen.
Another object of this invention is to provide an apparatus for the separation of whole blood components, wherein the apparatus contains a centrifuge bag that provides for simultaneous addition of whole blood from a source container and the withdrawal of a specific blood component during centrifugation.
Another object of this invention is to provide disposable, single-use centrifuge bags for holding whole blood during the separation of components of the whole blood by centrifugation, wherein the bag is adapted for use in a portable, point-of-use centrifuge.
Another object of this invention is to provide a portable centrifuge containing a disposable centrifuge bag that maximizes the amount of a predetermined blood fraction that can be harvested from an aliquot of blood that is of greater volume than the capacity of the disposable centrifuge bag.
To achieve the foregoing and other objects and in accordance with the purposes of the present invention, as embodied and broadly described therein, one embodiment of this invention comprises a flexible, disposable centrifuge bag adapted to be rotated about an axis, comprising:
a) one or more tubes, and
b) upper and lower flexible sheets, each sheet having a doughnut shaped configuration, an inner perimeter defining a central core and an outer perimeter, wherein the upper and lower sheets are superimposed and completely sealed together at their outer perimeters, and wherein the tubes are sandwiched between the upper and lower sheets and extend from the central core toward the outer perimeter, such that when the upper and lower sheets are sealed at the inner perimeter the tubes are sealed between the upper and lower sheets at the inner perimeter and are in fluid communication with the environment inside and outside the centrifuge bag. The one or more tubes are fluidly connected to an umbilical cable comprising one or more lumen equal to the number of tubes of the centrifuge bag.
To further achieve the foregoing and other objects of this invention, another embodiment of the present invention comprises a rigid molded container adapted to be rotated about an axis, comprising a rigid, annular body having an axial core that is closed at the top end and opened at the bottom end. The rigid molded container further comprises an interior collection chamber for receiving and holding a fluid medium to be centrifuged, the chamber having an outer perimeter, an inner perimeter, and a generally off-centered “figure eight” shaped cross-sectional area. The rigid molded container further comprises a first channel which extends radially from the core and is in fluid communication with a point near the outer perimeter of the chamber, and a second channel which extends radially from the core and is in fluid communication with an area near the narrow portion or “neck” of the figure eight-shaped chamber. The first and second channels thus provide fluid communication with the environment inside and outside the interior collection chamber. The first and second channels are fluidly connected to a dual lumen tubing having an inlet lumen and an outlet lumen.
To further achieve the foregoing and other objects of this invention, another embodiment of the present invention is an apparatus and method for separating components contained in a fluid medium. More particularly, the present invention utilizes the principles of centrifugation to allow for the separation of whole blood into fractions such as platelet rich plasma and platelet poor plasma. In one aspect of the present invention, the above-described separation of the components is provided by utilizing a rotatable centrifuge motor comprising a base having a central column and a disposable centrifuge bag having a central core and which is positionable within the centrifuge motor and rotatable therewith. The disposable centrifuge bag, which holds the whole blood during centrifugation, further comprises an inlet tube for introducing the whole blood to the centrifuge bag, and an outlet tube for removing the desired blood fraction from the centrifuge bag. The inlet and outlet tubes are in fluid communication with a dual lumen tubing. The centrifuge bag is removably fixed within the centrifuge rotor by inserting the raised column through the bag center core and securing with the cover. During the rotation of the centrifuge, components of the whole blood will assume a radial, horizontal position within the centrifuge bag based upon a density of such components, and thus the fluid medium components will be separated from other components having different densities.
Once a desired degree of separation of whole blood has been achieved, the present invention provides for the specific removal of the desired fraction within one or more of the regions from the centrifuge bag through the outlet tube during continued rotation of the centrifuge, thereby allowing for on-line removal of the desired fraction. Additional aliquots may be added to the centrifuge bag via the inlet tube simultaneously or after the desired component has been harvested. In one embodiment, the centrifuge bag is a flexible, transparent, generally flat doughnut-shaped bag. In another embodiment, the centrifuge bag is a rigid, transparent container having an interior chamber for receiving and holding the fluid medium during centrifugation, the interior chamber having a generally off-centered figure eight cross-sectional configuration.
Another aspect of the present invention comprises a disposable centrifuge bag having an inlet tube and an outlet tube, wherein the outlet tube is fluidly connected with a bent fitting.
Another aspect of the present invention comprises a centrifuge rotor for holding a centrifuge bag, the rotor comprising a base and a cover, the base further having a first grooved, raised center column and the cover having a second grooved, raised center column. The centrifuge bag is a flexible, doughnut-shaped bag comprising inlet and outlet tubes in fluid communication with the environment inside and outside the centrifuge bag, wherein the tubes are seated in the base and cover column grooves to hold the centrifuge bag in a fixed position relative to the base and cover, such that the bag does not spin independently of the base and cover but rather spins concurrently and at the same rate of rotation as the base and cover.
Another aspect of the present invention comprises a centrifuge rotor for holding a centrifuge bag, the rotor comprising a base and a cover for securing a centrifuge bag therebetween, the centrifuge cover further comprising one or more concentric indicator circles that are spaced from the center of the cover or the base to aid the operator in visualizing the distal ends of these tubes.
Another aspect of the present invention for the separation of components of a fluid medium (e.g., whole blood) utilizes a centrifuge rotor comprising an interior chamber having a complex configuration, wherein the chamber holds a flexible, doughnut-shaped centrifuge bag for retaining the fluid medium during centrifugation. The centrifuge rotor is defined by a base having a lower chamber, and a cover having an upper chamber. When the cover is superimposed on the base, the upper and lower chambers define the annular interior chamber of the rotor. The interior rotor chamber has a generally off-centered figure eight-shaped cross-sectional configuration specifically designed to maximize the collection of the desired component (e.g., platelet rich plasma) by centrifugation of a fluid medium (e.g., anticoagulated whole blood). The centrifuge bag is formed from a substantially flexible material, such that the profile of the centrifuge bag during centrifugation is thus determined at least in part by the volume of the fluid medium contained therein. When the centrifuge bag is filled to maximum capacity, it assumes the configuration of the interior of the rotor chamber.
Another aspect of this invention comprises a method for on-line harvesting of a predetermined component of a fluid medium. One embodiment of the present invention utilizes a centrifuge and a disposable centrifuge bag for containing the fluid medium during separation and which is positionable within the centrifuge, the centrifuge bag further comprising at least one inlet tube and at least one outlet tube. The centrifuge includes a centrifuge rotor having a base portion, a cover, and an outer rim. The base portion and the cover define the interior of the centrifuge rotor, which is separated into upper and lower chambers. The disposable centrifuge bag is positionable horizontally within the lower chamber and may be appropriately secured to the centrifuge base by the cover. The centrifuge bag is fluidly connected via a dual lumen tubing to a source (e.g., to a container comprising anticoagulated autologous whole blood) and collection container (e.g., for receiving platelet rich plasma or some other component that will then be further processed). The dual lumen tubing comprises an inlet lumen fluidly connected to the inlet tube of the centrifuge bag and an outlet lumen fluidly connected to the outlet tube of the centrifuge bag. The centrifuge bag is substantially annular relative to the rotational axis of the centrifuge. When the centrifuge bag is positioned within the centrifuge rotor and appropriately secured thereto to allow for simultaneous rotation, the fluid medium may be provided to the centrifuge bag via the inlet lumen of the tubing during rotation of the centrifuge. The components of the bag assume radial, horizontal positions base based on their densities. When a desired degree of separation has been achieved, the desired fraction may be removed from the centrifuge bag via the outlet lumen during continued rotation of the centrifuge. The position of the fraction to be harvested may be shifted into the area of the outlet tube as needed, either by withdrawing components that are positioned near the outer perimeter through the inlet tube, or by adding additional aliquots of the fluid medium to the bag. In one embodiment of this method, the bag is a flexible, transparent doughnut-shaped bag. In another embodiment of this method, the bag is a rigid, transparent bag comprising an interior chamber having an off-centered, figure eight cross-sectional configuration.
It is yet another object of the invention to provide a centrifugal liquid processing system that may be automated.
It is yet another object of the present invention to provide a centrifuge having an internal lead drive mechanism allowing for a compact size.
A further object of the present invention is to provide for a method and device for the production and isolation of thrombin for all medical uses.
It is yet another object of this invention to provide a method for preparing a completely autologous platelet gel.
Another object of the present invention is to provide an autologous platelet gel wherein the risks associated with the use of bovine and recombinant human thrombin are eliminated.
A further object of the present invention is to provide an autologous platelet gel for any application.
It is a further object of the present invention to provide cellular components to be used in medical applications.
Additional objects, advantages, and novel features of this invention shall be set forth in part in the description and examples that follow, and in part will become apparent to those skilled in the art upon examination of the following or may be learned by the practice of the invention. The objects and the advantages of the invention may be realized and attained by means of the instrumentalities and in combinations particularly pointed out in the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings, which are incorporated in and form a part of the specifications, illustrate the preferred embodiments of the present invention, and together with the description serve to explain the principles of the invention.
In the Drawings:
FIG. 1
is a perspective view illustrating one embodiment of the continuous-flow centrifugal processing system of the present invention illustrating a centrifuge and side-mounted motor positioned within a protective housing or enclosure of the invention.
FIG. 2
is an exploded side view of the centrifuge and the side-mounted motor of the centrifugal processing system of
FIG. 1
illustrating the individual components of the centrifuge.
FIG. 3
is a partial perspective view of the lower case assembly of the drive shaft assembly of FIG.
2
.
FIG. 4
is an exploded side view of the lower case assembly of FIG.
3
.
FIG. 5
is an exploded perspective view of the components of the lower case assembly of FIG.
3
.
FIG. 6
is a top view of the lower bearing assembly which is positioned within the lower case assembly of FIG.
3
.
FIG. 7
is a perspective view of the lower bearing assembly of FIG.
6
.
FIG. 8
is an exploded side view of the lower bearing assembly of
FIGS. 6 and 7
.
FIG. 9
is a perspective view of the receiving tube guide of the centrifuge of FIG.
2
.
FIG. 10
is an exploded, perspective view of a gear of the mid-shaft gear assembly of FIG.
2
.
FIG. 11
is a perspective view of the gear of
FIG. 10
as it appears assembled.
FIG. 12
is an exploded, perspective view of the top bearing assembly of the centrifuge of FIG.
2
.
FIG. 13
is a perspective view of the top case shell of the top bearing assembly of FIG.
12
.
FIG. 14
is a perspective view of the centrifuge of the present invention shown in
FIG. 1
, having a quarter section cut away along lines
14
—
14
of FIG.
1
.
FIG. 15
is a perspective view of one embodiment of a centrifuge rotor base.
FIG. 16
is a perspective view of one embodiment of a centrifuge rotor cover.
FIG. 17
is a side cross-sectional view of one embodiment of a rotor of this invention taken along view lines
17
of
FIG. 14
for holding a disposable centrifuge bag, showing a dual lumen tubing connected to the bag.
FIG. 18
is a side cross-sectional view of one embodiment of a rotor of this invention taken along view lines
18
of
FIG. 1
for holding a disposable centrifuge bag, showing the grooved columns of the base and cover.
FIG. 19
is an enlarged perspective view similar to
FIG. 1
illustrating an alternate embodiment of a centrifuge driven by a side-mounted motor (with only the external drive belt shown).
FIG. 20
is a cutaway side view of the centrifuge of
FIG. 19
illustrating the internal pulley drive system utilized to achieve a desired drive ratio and illustrating the rotor base configured for receiving a centrifuge bag.
FIG. 21
is a cutaway side view similar to
FIG. 20
with the rotor base removed to better illustrate the top pulley and the location of both idler pulleys relative to the installed internal drive belt.
FIG. 22
is a sectional view of the centrifuge of
FIG. 20
further illustrating the internal pulley drive system an showing the routing of the centrifuge tube (or umbilical cable).
FIG. 23
is a top view of a further alternate centrifuge similar to the centrifuge of
FIG. 19
but including internal, separate bearing members (illustrated as four cam followers) that allows the inclusion of guide shaft to be cut through portions of the centrifuge for positioning of the centrifuge tube (or umbilical cable).
FIG. 24
is a perspective view similar to
FIG. 19
illustrating the centrifuge embodiment of
FIG. 23
further illustrating the guide slot and showing that the centrifuge can be driven by an external drive belt.
FIG. 25
is a top view of a flexible, disposable centrifuge bag of this invention.
FIG. 26
is a perspective view of a flexible, disposable centrifuge bag of this invention.
FIGS. 27
,
28
,
29
, and
30
are illustrations of bent fittings of this invention having “T” shaped, “curved T” shaped, “L” shaped, and “J” shaped configurations, respectively.
FIG. 31
is an illustration of an inlet and/or outlet tube of this invention.
FIG. 32
is a top view of a disposable centrifuge bag of this invention after the centrifugation of whole blood, showing the separated blood components.
FIGS. 33-39
are schematic illustrations of one method of this invention for separating whole blood components using a disposable centrifuge bag of this invention.
FIG. 40
is a top view of an alternate embodiment of a disposable centrifuge bag of the present invention having inner and outer chambers.
FIG. 41
is a top view of the disposable centrifuge bag shown in
FIG. 34
illustrating movement of the red blood cell layer from the outer perimeter toward the inner perimeter.
FIG. 42
is a bottom view of an alternate embodiment of a disposable centrifuge bag of the present invention having inner and outer chambers in fluid communication with outlet and inlet ports.
FIG. 43
is a side cross-sectional view of a rigid disposable centrifuge bag of this invention.
FIG. 44
is a schematic illustration of separated blood components contained in a centrifuge bag having an elliptical cross-sectional view of the centrifuge bag shown in FIG.
43
.
FIG. 45
is a side cross-sectional view of a rigid disposable centrifuge bag of this invention.
FIG. 46
is a schematic illustration of the surface areas and various dimensions of the figure eight configuration as shown in FIG.
45
.
FIG. 47
is a schematic illustration of separated blood components contained in a centrifuge bag having a figure eight side cross-sectional configuration.
FIG. 48
is a side cross-sectional view of an alternative embodiment of an assembled centrifuge rotor of this invention comprising the rotor cover of FIG.
49
and the rotor base of FIG.
50
.
FIG. 49
is a side cross-sectional view of an alternative embodiment of a rotor cover of this invention.
FIG. 50
is a side cross-sectional view of an alternative embodiment of a rotor base of this invention.
FIG. 51
is a perspective view of the rotor base of FIG.
50
.
FIG. 52
is a perspective view of the rotor cover of FIG.
49
.
FIG. 53
is a block diagram illustrating the components of a centrifugal processing system of the present invention.
FIG. 54
is a graph illustrating the timing and relationship of transmission of control signals and receipt of feedback signals during operation of one embodiment of the automated centrifugal processing system of FIG.
53
.
FIG. 55
is a side view of an alternative embodiment of the automated centrifugal processing system of
FIG. 53
showing a centrifuge having a rotor wherein the reservoir extends over the outer diameter of the centrifuge portion that facilitates use of an externally-positioned sensor assembly.
FIG. 56
is a side view of a further alternative embodiment of the external sensor assembly feature of the centrifugal processing system of the invention without an extended rotor and illustrating the positioning of a reflector within the centrifuge.
FIG. 57
is a side view of yet another embodiment of the external sensor assembly feature of the centrifugal processing system of the invention illustrating a single radiant energy source and detector device.
FIG. 58
is a block diagram of a an automated centrifugal processing system, similar to the embodiment of
FIG. 47
, including components forming a temperature control system for controlling temperatures of separated and processed products.
FIG. 59
is a perspective view of components of the temperature control system of FIG.
58
.
FIG. 60
is schematic and sectional view of the dispenser of the present invention.
FIG. 61
is a flow diagram representing the method for isolating platelet rich plasma and platelet poor plasma for use in preparing a platelet gel of the present invention.
FIG. 62
is a flow diagram representing the final portion of the method for preparing a platelet gel of the present invention using platelet rich plasma as a starting material.
FIG. 63
is a flow diagram representing the final portion of the method for preparing a platelet gel of the present invention using platelet poor plasma as a starting material.
FIG. 64
is a graphic representation of the effect that the serum-to-plasma ratio has on clotting times.
FIG. 65
graphically represents the effect of calcium addition on the clotting times of platelet rich plasma and platelet poor plasma.
FIG. 66
is a graphic representation of the relationship between clotting time and actual gel time using blood drawn from a donor.
FIG. 67
is a graphic representation of the relationship between clotting time and actual gel time using blood drawn from a donor.
FIG. 68
graphically represents the effect of calcium addition on clotting times and gel times using blood drawn from a donor.
FIG. 69
graphically represents the effect of calcium addition on clotting times and gel times using blood drawn from a donor.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
The centrifugal processing system
10
of the present invention is best shown in
FIG. 1
having a stationary base
12
, a centrifuge
20
rotatably mounted to the stationary base
12
for rotation about a predetermined axis A, a rotor
202
for receiving a disposable bag (not shown) designed for continuous-flow. As illustrated, the centrifugal processing system
10
includes a protective enclosure
11
comprising the main table plate or stationary base
12
, side walls
13
, and a removable lid
15
made of clear or opaque plastic or other suitable materials to provide structural support for components of the centrifugal processing system
10
, to provide safety by enclosing moving parts, and to provide a portable centrifugal processing system
10
. The centrifugal processing system
10
further includes a clamp
22
mounted over an opening (not shown) in the lid
15
. Clamp
22
secures at a point at or proximately to axis A without pinching off the flow of fluid that travels through umbilical cable
228
. A side mounted motor
24
is provided and connected to the centrifuge
20
by way of a drive belt
26
for rotating the drive shaft assembly
28
(see
FIG. 2
) and the interconnected and driven rotor assembly
200
in the same rotational direction with a speed ratio selected to control binding of umbilical cable
228
during operation of the system, such as a speed ratio of 2:1 (i.e., the rotor assembly
200
rotates twice for each rotation of the drive shaft assembly
28
). The present invention is further directed toward a dispensing device
902
, best shown in
FIG. 60
for the withdrawal and manipulation of specific blood components for various therapeutic regimens, such as but not limited to the production of platelet rich plasma, platelet poor plasma, and white blood cells which may be used for the production of autologous thrombin and autologous platelet gels.
Referring now to
FIG. 2
, the continuous-flow centrifugal processing system
10
comprises a centrifuge
20
to which a rotor
202
is removably or non-removably attached. The design of centrifuge
20
and its self-contained mid-shaft gear assembly
108
(comprised of gears
110
,
110
′,
131
, and
74
) is a key component of the invention thereby allowing for the compact size of the entire centrifugal processing system
10
and providing for a desired speed ratio between the drive shaft assembly
28
and the rotor assembly
200
.
The centrifuge
20
is assembled, as best seen in
FIG. 2
, by inserting the lower bearing assembly
66
into lower case shell
32
thus resulting in lower case assembly
30
. Cable guide
102
and gears
110
and
110
′ are then positioned within lower case assembly
30
, as will be discussed in more detail below, so that gears
110
and
110
′ are moveably of engaged with lower bearing assembly
66
. Upper bearing assembly
130
is then inserted within top case shell
126
thus resulting in bearing assembly
124
which is then mated to lower case assembly
30
, such that gears
110
and
110
′ are also moveably engaged with upper bearing assembly
130
, and held in place by fasteners
29
. Lower bearing assembly
66
is journaled to stationary base or main table plate
12
by screws
14
, thus allowing centrifuge
20
to rotate along an axis A, perpendicular to main table plate
12
(as shown in FIG.
1
).
Referring now to
FIGS. 3
,
4
, and
5
, the lower case assembly
30
is preferably, but not necessarily, machined or molded from a metal material and includes a lower case shell
32
, timing belt ring
46
, timing belt flange
50
, and bearing
62
(e.g., ball bearings and the like). Lower case shell
32
includes an elongated main body
40
with a smaller diameter neck portion
36
extending from one end of the main body
40
for receiving timing belt ring
46
and timing belt flange
50
. The larger diameter main body
40
terminates into the neck portion
36
thereby forming an external shoulder
38
having a bearing surface
42
for timing belt ring
46
. Timing belt ring
46
and timing belt flange
50
, as best seen in
FIG. 5
, have inner diameters that are slightly larger than the outer diameter of neck portion
36
allowing both to fit over neck portion
36
. Shoulder
38
further contains at least one and preferably four internally thread holes
44
that align with hole guides
48
and
52
in timing belt ring
46
and timing belt flange
50
, respectively (shown in FIG.
5
). Consequently, when assembled, screws
54
are received by hole guides
52
and
48
and are threaded into thread holes
44
thus securing timing belt
46
and timing belt flange
50
onto neck portion
36
. Lower case shell
32
also has an axial or sleeve bore
56
extending there through, and an internal shoulder
58
, the upper surface
60
of which is in approximately the same horizontal plane as external shoulder
38
. Bearing
62
(shown in
FIG. 4
) is press fit concentrically into sleeve bore
56
so that it sits flush with upper surface
60
. Internal shoulder
58
also has a lower weight bearing surface
64
which seats on the upper surface
68
of lower bearing assembly
66
, shown in
FIGS. 6-8
.
Lower bearing assembly
66
comprises a lower gear insert
70
, ball bearings
84
, gear
74
and spring pins
76
and
76
′. As will become clear, the gear
74
may be of any suitable gear design for transferring an input rotation rate to a mating or contacting gear, such as the gears
110
,
110
′ of the mid-shaft gear assembly
108
, with a size and tooth number selected to provide a desired gear train or speed ratio when combined with contacting gears. For example, the gear
74
may be configured as a straight or spiral bevel gear, a helical gear, a worm gear, a hypoid gear, and the like out of any suitable material. In a preferred embodiment, the gear
74
is a spiral gear to provide a smooth tooth action at the operational speeds of the centrifugal processing system
10
. The upper surface
68
of lower gear insert
70
comprises an axially positioned sleeve
72
, which receives and holds gear
74
. gear
74
is preferably retained within sleeve
72
by the use of at least one and preferably two spring pins
76
and
76
′ which are positioned within spring pin holes
73
and
73
′ extending horizontally through lower gear insert
70
into sleeve
72
. Thus, when gear
74
having spring pin receptacles
77
and
77
′ is inserted into sleeve
72
the spring pins
76
and
76
′ enter the corresponding receptacles
77
and
77
′ thus holding the gear
74
in place. Of course, other assembly techniques may be used to position and retain gear
74
within the lower gear assembly
66
and such techniques are considered within the breadth of this disclosure. For example, gear
74
may be held in sleeve
72
by a number of other methods, such as, but not limited to being press fit or frictionally fit, or alternatively gear
74
and lower gear insert
70
may be molded from a unitary body.
The base
78
of lower gear insert
70
has a slightly larger diameter than upper body
80
of lower gear insert
70
as a result of a slight flare. This slight flare produces shoulder
82
upon which ball bearing
84
is seated. Once assembled lower bearing assembly
66
is received by sleeve bore
56
extending through neck portion
36
of lower case shell
32
. A retaining ring
86
is then inserted into the annular space produced by the difference of the outer diameter of the lower bearing assembly
66
and the inner diameter of sleeve bore
56
above ball bearings
84
. A second retaining ring
87
(shown in
FIG. 2
) is also inserted into the annular space produced by the difference between the outer diameter of the lower bearing assembly
66
and the inner diameter of sleeve bore
56
below ball bearing
84
, thereby securing lower gear insert
70
within lower case shell
32
. Consequently, ball bearings
62
and
84
are secured by retaining rings
86
and
87
, respectively, resulting in lower case shell
32
being journaled for rotation about lower bearing assembly
66
but fixed against longitudinal and transverse movement thereon. Therefore, when assembled lower bearing assembly
66
is mounted to stationary base
12
, by securing screws
14
into threaded holes
79
located in the base
78
. Lower case shell
32
is thus able to freely rotate about stationary lower bearing assembly
66
when the drive belt
26
is engaged.
Referring now to
FIG. 5
, extending from the opposite end of neck portion
36
on lower case shell
32
are a number of protrusions or fingers
88
,
90
,
92
, and
94
. Positioned between protrusions
88
and
90
, and between protrusions
92
and
94
are recessed slots
96
and
98
, respectively, for receiving tube guide
102
(FIG.
9
). The function of tube guide
102
will be discussed in further detail below, but in short it guides umbilical cable
228
connected to centrifuge bag
226
through the mid-shaft gear assembly
108
and out of the centrifuge
20
.
Positioned between protrusions
90
and
92
, and between protrusions
88
and
94
are recessed slots
104
and
106
, respectively, for receiving gears
110
and
110
′ of mid-shaft gear assembly
108
(FIG.
2
). The gears
110
and
110
′ are preferably configured to provide mating contact with the gear
74
and to produce a desired, overall gear train ratio within the centrifuge
20
. In this regard, the gears
110
and
110
′ are preferably selected to have a similar configuration (e.g., size, tooth number, and the like) as the gear
74
, such as a spiral gear design. As illustrated in
FIGS. 2 and 14
mid-shaft gear assembly
108
comprises a pair of gears
110
and
110
′ engaged with gears
74
and
131
. While the construction of gears and gear combinations is well known to one skilled in the mechanical arts, a brief description is disclosed briefly herein.
FIG. 10
illustrates an exploded view depicting the assembly of gear
110
, and
FIG. 11
is a perspective view of the gear
110
of
FIG. 10
as it appears assembled. Gear
110
′ is constructed in the same manner. Gear
111
is locked onto mid-gear shaft
112
using key stock
114
and external retaining ring
116
. Ball bearing
118
is then attached to mid gear shaft
112
using a flat washer
120
and cap screw
122
. Recessed slots
104
and
106
of lower case shell
32
then receive ball bearing
118
and
118
′ (not shown). In an alternate embodiment ball bearing
118
can be replaced by bushings (not shown). When assembled, gears
110
and
110
′ make contact with the lower gear
74
(see
FIGS. 2 and 14
) to provide contact surfaces for transferring a force from the stationary gear
74
to the gears
110
and
110
′ to cause the gears
110
and
110
′ to rotate at a predetermined rate that creates a desired output rotation rate for the driven rotor assembly
200
. The rotor assembly
200
is driven by the drive shaft assembly
28
which is rotated by the drive motor
24
at an input rotation rate or speed, and in a preferred embodiment, the drive shaft assembly
28
through the use of the gears
110
and
110
′ is configured to rotate the rotor assembly
200
at an output rotation rate that is twice the input rotation rate (i.e., the ratio of the output rotation rate to the input rotation rate is 2:1). This ratio is achieved in the illustrated embodiment by locking the gears
110
and
110
′ located within the drive shaft assembly
28
to rotate about the centrifuge center axis, A, with the lower case shell
32
which is rotated by the drive motor
24
. The gears
110
and
110
′ also contact the stationary gear
74
which forces the gears
110
,
110
′ to rotate about their rotation axes which are traverse to the centrifuge center axis, A, and as illustrated, the rotation axes of the gears
110
,
110
′ coincide. By rotating with the lower case shell
32
and rotating about the gear rotation axes, the gears
110
,
110
′ are able to provide the desired input to output rotation rate of 2:1 to the rotor assembly
200
.
In this regard, gears
110
and
110
′ and tube guide
102
are locked into position by attaching top bearing assembly
124
to lower case assembly
30
. Top bearing assembly
124
(as shown in
FIG. 12
) comprises top case shell
126
, ball bearing
128
, and an upper bearing
130
. Top case shell
126
, as best seen in
FIGS. 12 and 13
, comprises an upper surface
132
, a lower lip
134
and a central or axial bore
136
there through. Upper surface
132
slightly overhangs axial bore
136
resulting in a shoulder
138
having a lower surface
140
(shown in FIG.
13
). Lower lip
134
is a reverse image of upper lip
100
on lower case shell
32
(shown in FIG.
5
).
Upper bearing assembly
130
(
FIG. 12
) comprises an upper surface
133
and a lower surface
135
wherein the upper surface
133
has a means for receiving a rotor
202
. On the lower surface
135
a concentrically positioned column
137
protrudes radially outward perpendicular to lower surface
135
. Upper bearing assembly
130
further comprises an axially positioned bore
139
that traverses column
137
and upper surface
133
and receives upper gear insert
131
. Upper gear insert
131
also contains an axial bore
142
and thus when positioned concentrically within column
137
axial bores
139
and
142
allow for umbilical cable
228
to travel through upper bearing assembly
130
of top case shell
126
down to cable guide
102
(shown in FIG.
14
). As discussed previously with respect to lower bearing assembly
66
, upper gear insert
131
may be any suitable gear design for receiving an input rotation rate from a mating or contacting gear, such as the gears
110
,
110
′ of the mid-shaft gear assembly
108
, with a size and tooth number selected to provide a desired gear train or speed ratio when combined with contacting gears. For example, gear insert
131
may be configured as a straight or spiral bevel gear, a helical gear, a worm gear, a hypoid gear, and the like. In a preferred embodiment, gear
131
is a spiral gear to provide a smooth tooth action at the operational speeds of the centrifugal processing system
10
. Gear insert
131
is preferably retained within column
137
by use of at least one and preferably two spring pins (not shown); however, other assembly techniques may be used to position and retain the gear insert
131
within the column
137
and such techniques are considered within the breadth of this disclosure. For example, gear insert
131
may be held in column
137
by a number of other methods, such as, but not limited to being press fit or frictionally fit or alternatively gear insert
131
and the upper bearing assembly may be molded from a unitary body.
Upper bearing assembly
130
is then inserted into axial bore
136
of top case shell
126
so that the lower surface
135
sits flush with upper surface
132
of top case shell
126
. Ball bearing
128
is then inserted into the annular space created between the outer diameter of column
137
and the inner side wall
141
of top case shell
126
thereby securing upper bearing assembly
130
into place.
Referring now to
FIG. 13
, lower lip
134
is contoured to mate with protrusions
88
,
90
,
92
and
94
extending from lower case shell
32
. Specifically, the outer diameter of lower lip
134
matches the outer diameter of the upper end of main body
40
of lower case shell
32
and recesses
144
and
148
receive and retain protrusions
88
and
92
respectively, while recesses
146
and
150
receive and retain protrusions
94
and
88
, respectively. Holes are placed through each recess and each protrusion so that when assembled, fasteners
152
(shown in
FIG. 12
) can be inserted through the holes thereby fastening the top bearing assembly
124
to the lower case assembly
30
.
Positioned between recesses
144
and
146
and between recesses
148
and
150
are recessed slots
104
′ and
106
′, respectively, for receiving gears
110
and
110
′ of mid-shaft gear assembly
108
(FIGS.
2
and
14
). The gears
110
and
110
′ are preferably configured to provide mating contact with the gear insert
131
and to produce a desired, overall gear train ratio within the centrifuge
20
. In this regard, the gears
110
and
110
′ are preferably selected to have a similar configuration (e.g., size, tooth number, and the like) as the gear
131
, such as a spiral gear design. Furthermore recessed slots
96
′ and
98
′ exist between recesses
144
and
150
and between recesses
146
and
148
, respectively. When gears
110
and
110
′ are assembled as shown in
FIG. 14
, recessed slots
96
and
96
′ from the lower case shell
32
and top case shell
126
, respectively, form port
154
, and recessed slots
98
and
98
′ form port
156
thereby allowing the umbilical cable
228
to exit centrifuge
20
through either port
154
or
156
. Described above is one method of assembling the centrifugal processing system
10
of the present invention; however, those skilled in the art will appreciate that the lower case assembly
30
and upper bearing assembly can be joined in number of ways that allow the four gears to be properly aligned with respect to one another.
In the above manner, the centrifugal processing system
10
provides a compact, portable device useful for separating blood and other fluids in an effective manner without binding or kinking fluid feed lines, cables, and the like entering and exiting the centrifuge
20
. The compactness of the centrifugal processing system
10
is furthered by the use of the entirely contained and interior gear train described above that comprises, at least in part, gear
74
, gears
1110
and
110
′, and gear insert
131
of the upper bearing
130
. The gear insert
131
of the upper bearing
130
is preferably selected to provide a contact surface(s) with the gears
110
and
110
′ that transfers the rotation rate of the gears
110
and
110
′ and consequently from gear
74
and to the gear insert
131
of the upper bearing
130
. In one preferred embodiment, the gear insert
131
of the upper bearing
130
is a spiral gear rigidly mounted within the upper bearing
130
to rotate the rotor assembly
200
and having a design similar to that of the spiral gear
74
, i.e., same or similar face advance, circular pitch, spiral angle, and the like. During operation, the gear
74
remains stationary as the lower case shell
32
is rotated about the centrifuge axis, A, at an input rotation rate, such as a rotation rate chosen from the range of 0 rpm to 5000 rpm. The gears
110
,
110
′ are rotated both about the centrifuge axis, A, with the shell
32
and by contact with the stationary gear
74
. The spiral gears
110
,
110
′ contact the gear insert
131
of the upper bearing
130
causing the gear insert
131
and connected upper bearing
130
to rotate at an output rotation rate that differs, i.e., is higher, than the input rotation rate.
Although a number of gear ratios or train ratios (i.e., input rotation rate/output rotation rate) may be utilized to practice the invention, one embodiment of the invention provides for a gear train ratio of 1:2, where the combination and configuration of the gear
74
, gears
110
,
110
′, and gear
131
of the upper bearing
130
are selected to achieve this gear train ratio. Uniquely, the rotation of the gears
110
,
110
′ positively affects the achieved gear train ratio to allow, in one embodiment, the use of four similarly designed gears which lowers manufacturing costs while achieving the increase from input to output rotation speeds. Similarly, as will be understood by those skilled in the mechanical arts, numerous combinations of gears in differing number, size, and configuration that provides this ratio (or other selected ratios) may be utilized to practice the invention and such combinations are considered part of this disclosure. For example, although two gears
110
,
110
′ are shown in the mid-shaft gear assembly
108
to distribute transmission forces and provide balance within the operating centrifuge, more (or less) gears may be used to transmit the rotation of gear
74
to the gear of the upper bearing
130
. Also, just as the number, size, and configuration of the internal gears may be varied from the exemplary illustration of
FIGS. 1-14
, the material used to fabricate the gear
74
, the gears
110
,
110
′, and the gear insert
131
may be any suitable gear material known in the art.
Another feature of the illustrated centrifugal processing system
10
that advantageously contributes to compactness is the side-mounted drive motor
24
. As illustrated in
FIGS. 1 and 2
, the drive motor
24
is mounted on the stationary base
12
of the enclosure
11
adjacent the centrifuge
20
. The drive motor
24
may be selected from a number of motors, such as a standard electric motor, useful for developing a desired rotation rate in the centrifuge
20
of the centrifugal processing system
10
. The drive motor
24
may be manually operated or, as in a preferred embodiment, a motor controller may be provided that can be automatically operated by a controller of the centrifugal processing system
10
to govern operation of the drive motor
24
(as will be discussed in detail with reference to the automated embodiment of the invention). As illustrated in
FIG. 1
, a drive belt
26
may be used to rotate the drive shaft assembly
28
(and, therefore, the rotor assembly
200
). In this embodiment, the drive belt
26
preferably has internal teeth (although teeth are not required to utilize a drive belt) selected to mate with the external teeth of the timing belt ring
46
of the lower case assembly
30
portion of the drive shaft assembly
28
. The invention is not limited to the use of a drive belt
26
, which may be replaced with a drive chain, an external gear driven by the motor
24
, and any other suitable drive mechanisms. When operated at a particular rotation rate, the drive motor
24
rotates the drive shaft assembly
28
at nearly the same rotation rate (i.e., the input rotation rate). A single speed drive motor
24
may be utilized or in some embodiments, a multi and/or variable speed motor
24
may be provided to provide a range of input rotation rates that may be selected by the operator or by a controller to obtain a desired output rotation rate (i.e., a rotation rate for the rotor assembly
200
and included centrifuge bag
226
.
The present invention generally includes an apparatus and methods for the separation of a predetermined fraction(s) from a fluid medium utilizing the principles of centrifugation. Although the principles of the present invention may be utilized in a plurality of applications, one embodiment of this invention comprises isolating predetermined fraction(s) (e.g., platelet rich plasma or platelet poor plasma) from anticoagulated whole blood. The platelet rich plasma may be used, for example, in the preparation of platelet concentrate or gel, and more particularly may be used to prepare autologous platelet gel during surgery using blood drawn from the patient before or during surgery.
The centrifuge
20
has been discussed above and demonstrates the compact and portable aspects of the present invention. To complete the device of the present invention a fluid collection device, also referred to as a bowl or rotor
202
is attached to the upper surface
133
of the upper bearing assembly
130
as shown in
FIGS. 1 and 2
. Rotor
202
is preferably mounted permanently to upper bearing assembly
130
, however, rotor
202
may also be capable of being removed. Rotor
202
comprises a rotor base
204
(shown in
FIG. 15
) having a lower annular groove
212
, and a rotor cover
206
having an upper annular groove
214
. As shown in
FIGS. 17 and 18
the annular interior chamber
216
of rotor
202
is defined by upper and lower annular grooves
212
and
214
. The lower annular
212
receives a centrifuge bag
226
for containing the fluid medium to be centrifuged. Centrifuge bag
226
is connected to supply and receiving containers
398
,
400
, respectively, via umbilical cable
228
which is preferably, but not limited to a dual lumen. There may be instances where a certain technique requires multiple outlet or inlet ports and consequently umbilical cable
228
of the present invention may comprise multiple lumens. Umbilical cable
228
according to the preferred embodiment comprises inlet lumen
230
and outlet lumen
232
such that a fluid medium may be provided to and removed from the centrifuge bag
226
during rotation of the centrifuge rotor
202
.
One embodiment of centrifuge rotor
202
is more particularly illustrated in
FIGS. 15
,
16
,
17
and
18
.
FIG. 15
is a perspective view of rotor base
204
, and
FIG. 16
is a perspective view of rotor cover
206
.
FIG. 17
is a cross-sectional side view of rotor
202
taken along view lines
17
in
FIG. 1
, and
FIG. 18
is a cross-sectional side view of rotor
202
taken along view lines
18
in FIG.
1
. As illustrated in
FIG. 15
, rotor base
204
comprises raised annular rim
208
and raised column
218
that is axially disposed in base
204
. Raised column
218
further has a groove
222
extending across the diameter of column
218
. Annular groove
212
is defined by raised annular rim
208
and raised column
218
. The height of rim
208
is equal to the height of column
218
. Rotor cover
206
shown in
FIG. 16
comprises raised annular rim
210
and raised column
220
which is axially disposed in rotor cover
206
. Raised column
220
further has a groove
224
extending across the diameter of column
220
. Annular groove
214
is defined by rim
210
and column
220
. The height of rim
210
is equal to the height of column
220
.
Generally, when centrifuge rotor
202
is to be assembled for use, a flexible centrifuge bag such as a doughnut-shaped centrifuge bag
226
(
FIGS. 19 and 20
) having a center core
242
is placed in rotor base
204
such that center column
218
extends through the core
242
of centrifuge bag
226
and the centrifuge bag
226
lies in annular groove
212
. Rotor cover
206
is superimposed on rotor base
204
such that grooves
222
and
224
are aligned, as illustrated in
FIGS. 17 and 18
. When rotor cover
204
is secured to rotor base
206
by appropriate screws, fasteners, or the like (not shown), rims
208
and
210
are in complete contact with each other such that annular groove
212
and annular groove
214
define rotor interior chamber
216
. In one embodiment, columns
218
and
220
are in complete contact with each other. Alternatively, the inner perimeter
240
of centrifuge bag
226
is secured between columns
218
and
220
such that columns
218
and
220
do not completely physically contact each other.
With the above description of one embodiment of the centrifuge in mind, another preferred embodiment of a centrifuge for use in the centrifugal processing system
10
will be described. Referring to
FIGS. 19-22
, a preferred embodiment of a centrifuge
640
is illustrated that utilizes a uniquely arranged internal pulley system to obtain a desired input to output drive ratio (such as 2:1, as discussed above) rather than an internal gear assembly. The centrifuge
640
utilizes the side-mounted motor
24
(shown in
FIG. 1
) through drive belt
26
to obtain the desired rotation rate at the rotor portion of the centrifuge.
Referring first to
FIG. 19
, the centrifuge
640
includes a rotor base
644
(or top plate) with a recessed surface
648
for receiving and supporting a centrifuge bag during the operation of the centrifuge
640
. The rotor base
644
is rigidly mounted with fasteners (e.g., pins, screws, and the like) to a separately rotable portion (i.e., a top pulley
698
discussed with reference to
FIGS. 20 and 21
) of a lower case shell
660
. A cable port
656
is provided centrally in the rotor base
644
to provide a path for a centrifuge tube or umbilical cable that is to be fluidically connected to a centrifuge bag positioned on the recessed surface
648
of the rotor base
644
. It is important during operation of the centrifuge
640
to minimize and control contact and binding of the umbilical cable and moving parts (such as drive belts and pulleys). In this regard, the lower case shell
660
includes a side cable port
662
for the umbilical cable to enter the centrifuge
640
, which, significantly, the side cable port
662
is located between idler pulleys
666
,
668
to provide a spacing between any inserted tube or cable and the moving drive components of the centrifuge
640
.
Idler shaft or pins
664
are mounted and supported within the lower case shell
660
to allow the pins
664
to physically support the pulleys
666
,
668
. The idler pulleys
666
,
668
are mounted on the pins
664
by bearings to freely rotate about the central axis of the pins
664
during operation of the centrifuge
640
. The idler pulleys
666
,
668
are included to facilitate translation of the drive or motive force provided or imparted by the drive belt
26
to the lower case shell
660
to the rotor base
644
, as will be discussed in more detail with reference to
FIGS. 20 and 21
, and to physically support the internal drive belt
670
within the centrifuge
640
. The drive belt
26
is driven by the side-mounted motor
24
(shown in
FIG. 1
) and contacts the lower case shell
660
to force the lower case shell
660
to rotate about its central axis. The lower case shell
660
is in turn mounted on the base
674
in a manner that allows the lower case shell
660
to freely rotate on the base
674
as the drive belt
26
is driven by the side-mounted motor
26
. The base
674
is mounted to a stationary base
12
(shown in
FIG. 1
) such that the base
674
is substantially rigid and does not rotate with the lower case shell
660
.
Referring now to
FIGS. 20-22
, the centrifuge
640
is shown with a cutaway view to more readily facilitate the discussion of the use of the internal pulley assembly to obtain a desired output to input ratio, such as two to one. As shown, the base
674
includes vibration isolators
676
fabricated of a vibration absorbing material such as rubber, plastic, and the like through which the base
674
is mounted relatively rigidly to the stationary base
12
(of FIG.
1
). The drive belt
26
from the side-mounted motor
24
(of
FIG. 1
) contacts (frictionally or with the use of teeth and the like as previously discussed) a drive pulley
680
, which is rigidly mounted to the lower case shell
660
. As the drive belt
26
is driven by the motor
24
, the lower case shell
660
through drive pulley
680
rotates about its center axis (which corresponds to the center axis of the centrifuge
640
). This rotation rate of the lower case shell
660
can be thought of as the input rotation rate or speed.
To obtain a desired, higher rotation rate at the rotor base
644
, the lower case shell
660
is mounted on the base to freely rotate about the centrifuge center axis with bearings
690
that mate with the base
674
. The bearings
690
are held in place between the bottom pulley
692
and the base
674
, and the bottom pulley
692
is rigidly attached (with bolts or the like) to the base
674
to remain stationary while the lower case shell
660
rotates. The illustrated bearings
690
are two piece bearings which allow the lower case shell
660
to rotate on the base
674
. An internal drive belt
670
is provided and inserted through the lower case shell
660
to contact the outer surfaces of the bottom pulley
692
. The belt
670
preferably is installed with an adequate tension to tightly mate with the bottom pulley
692
such that frictional forces cause the belt
670
to rotate around the stationary bottom pulley
692
. This frictional mating can be enhanced using standard rubber belts or belts with teeth (and of course, other drive devices such as chains and the like may be substituted for the belt
670
).
The internal drive belt
670
passes temporarily outside the centrifuge
640
to contact the outer surfaces of the idler pulleys
666
and
668
. These pulleys
666
,
668
do not impart further motion to the belt
670
but rotate freely on pins
664
. The idler pulleys
666
,
668
are included to allow the rotation about the centrifuge center axis by lower case shell
660
to be translated to another pulley (i.e., top pulley
698
) that rotates about the same axis. To this end, the idler pulleys
666
,
668
provide non-rigid (or rotable) support that assists in allowing the belt
670
to be twisted without binding and then fed back into an upper portion of the lower case assembly
660
(as shown clearly in FIGS.
20
and
21
). As the internal drive belt
670
is fed into the lower case assembly
660
, the belt
670
contacts the outer surfaces of a top pulley
698
.
During operation of the centrifuge
640
, the movement of the internal drive belt
670
causes the top pulley
698
to rotate about the centrifuge center axis. The idler pulleys
666
and
668
by the nature of their placement and orientation within the centrifuge
640
relative to the pulleys
692
and
698
cause the rotor base
644
to rotate in the same direction as the lower case shell
660
. Significantly, the top pulley
698
rotated about the centrifuge center axis at twice the input rotation rate because it is mounted to the lower case shell
660
via bearings
694
(preferably, a two piece bearing similar to bearings
690
but other bearing configurations can be used) which are mounted to the center shaft
686
of the lower case shell
660
to frictionally contact an inner surface of the top pulley
698
. Since the internal drive belt
670
is rotating about the bottom pulley
692
and the idler pulleys
666
,
668
are rotating about the centrifuge central axis by drive belt
26
, the top pulley
698
is turned about the centrifuge central axis in the same direction as the lower case shell
660
but at twice the rate.
In other words, the drive force of the drive belt
26
and the internal drive belt
670
are combined by the components of the centrifuge
640
to create the output rotation rate. While a number of output to input drive ratios may be utilized, as discussed previously, a 2:1 ratio is generally preferable, and the centrifuge
640
is preferably configured such that the second, faster rotation rate of the top pulley
698
is substantially twice that of the lower case shell
660
. The use of an internal drive belt
670
in combination with two pulleys rotating about the same axis and the structural support for the pulleys within a rotating housing results in a centrifuge that is very compact and that operates effectively at a 2:1 drive ratio with relatively low noise levels (which is desirable in many medical settings).
The 2:1 drive ratio obtained in the top pulley
698
is in turn passed on to the rotor base
644
by rigidly attaching the rotor base
644
to the top pulley
698
with fasteners
652
. Hence, a centrifuge bag placed on the recessed surface
648
of the rotor base
644
is rotated at a rate twice that of the umbilical cable
228
that is fed into lower case shell
660
, which effectively controls binding as discussed above. The bearing
694
(one or more pieces) wrap around the entire center shaft
686
of the lower case shell
660
. To provide a path for the umbilical cord
228
to pass through the centrifuge
640
to the rotor base
644
(which during operation will be enclosed with a rotor top or cover as shown in FIG.
1
), the rotor base
644
includes the cable port
656
and the center shaft
686
is configured to be hollow to form a center cable guide. This allows an umbilical cable
228
to be fed basically parallel to the centrifuge center axis to the centrifuge bag (not shown). The lower case shell
660
includes the side cable port
662
to provide for initial access to the centrifuge
640
and also includes the side cable guide (or tunnel)
684
to guide the cable
228
through the lower case shell
660
to the hollow portion of the center shaft
686
. The side port
662
and the side cable guide
684
are positioned substantially centrally between the two idler pulleys
666
,
668
to position the cable
228
a distance away from the internal drive belt
670
to minimize potential binding and wear.
The centrifuge
640
illustrated in
FIGS. 19-22
utilizes two piece bearings for both the bottom and top pulleys
692
and
698
, respectively, and to provide a path for the umbilical cable
228
a central “blind” pathway (via side cable guide
684
, the hollow center of the center shaft
686
, and cable ports
656
,
662
) was provided in the centrifuge
640
. While effective, this “blind” pathway can in practice present binding problems as the relatively stiff cable
228
is fed or pushed through the pathway. To address this issue, an alternate centrifuge embodiment
700
is provided and illustrated in
FIGS. 23 and 24
. In this embodiment, the upper portions of the centrifuge
700
include a guide slot between the idler pulleys
666
,
668
that enables an umbilical cable
228
to be fed into the centrifuge
700
from the top with the no components to block the view of the operator inserting the cable
228
.
To allow a guide slot to be provided, the contiguous upper bearing
694
in the centrifuge
640
are replaced with bearing members that have at least one gap or separation that is at least slightly larger than the outer diameter of the cable
228
. A number of bearing members may be utilized to provide this cable entry gap and are included in the breadth of this disclosure. As illustrated, the centrifuge
700
includes a rotor base
702
that is rigidly fastened with fasteners
704
to the top pulley
698
(not shown) to rotate with this pulley at the output rate (e.g., twice the input rate) and to receive and support a centrifuge bag on recessed surface
716
. The rotor base
702
further includes the cable port
718
which is useful for aligning the center of the bag and cable
228
with the center of the centrifuge
700
.
To allow ready insertion of the cable
228
in the centrifuge
700
, the rotor base
702
further includes a cable guide slot
712
which as illustrated is a groove or opening in the rotor base
702
that allows the cable
228
to be inserted downward through the centrifuge
700
toward the side cable guide
724
of the lower case shell
720
. The lower case shell
720
also includes a cable guide slot
722
cut through to the top of the side cable guide
724
. Again, the guide slots
712
and
724
are both located in a portion of the centrifuge
700
that is between the idler pulleys
666
,
668
to position an inserted cable
228
from contacting and binding with the internal drive belt
670
, which basically wraps around 180 degrees of the top pulley or lower case shell
720
.
As shown in
FIG. 23
, the bearing members
706
are spaced apart and preferably, at least one of these spaces or gaps is large enough to pass through the cable
228
to the center shaft of the lower case shell
720
. As illustrated, four cam followers are utilized for the bearing members
706
, although a different number may be employed. The cam followers
706
are connected to the top pulley to enable the top pulley to rotate and are connected, also, to the center shaft of the lower case shell
720
to rotate with the lower case shell
720
. The cam followers
706
ride in a bearing groove
710
cut in the lower case shell
720
. To provide an unobstructed path for the cable
228
, the cable guide slots
712
and
722
are positioned between the two cam followers
706
adjacent the idler pulleys
666
,
668
, and preferably the guide slots
712
,
722
are positioned substantially centrally between the pulleys
666
,
668
. The guide slots
712
,
722
are positioned between these cam followers
706
to position the cable
228
on the opposite side of the centrifuge
700
as the contact surfaces between the internal drive belt
670
and the top pulley
698
(shown in FIGS.
20
-
22
). In this manner, the use of separated bearing members
706
in combination with a pair of cable guide slots
712
,
722
allows an operator to readily install the umbilical cable
228
without having to blindly go through the inside of the drive system and minimizes binding or other insertion difficulties.
A. Flexible, Disposable Centrifuge Bag
One embodiment of disposable, flexible centrifuge bag
226
is more particularly illustrated in
FIGS. 25 and 26
. The bag is an integral two stage self balancing disposable design. The disposable centrifuge bag
226
has a substantially flat, toroidal- or doughnut-shaped configuration having outer and inner perimeters
238
and
240
, respectively, and comprises radially extending upper and lower sheets
234
,
236
formed from a substantially flexible material. The upper and lower sheets
234
,
236
are superimposed and completely sealed together at outer perimeter
238
by a heat weld, rf (radio frequency) weld or other comparable method of adhering two surfaces. Inner perimeter
240
defines core
242
of bag
226
. In one embodiment of the invention, centrifuge bag
226
further comprises an inlet tube
248
sandwiched between upper and lower sheets
234
,
236
and extending from the center of core
242
defined by inner perimeter
240
to the outer perimeter
238
and an outlet tube
250
sandwiched between upper and lower sheets
234
,
236
and extending from the center of the core
242
to the outer perimeter
238
. When upper and lower sheets
234
,
236
are sealed together at inner perimeter
240
, inlet and outlet tubes
248
,
250
are thereby sealed therebetween. Inlet and outlet tubes
248
,
250
are each in fluid communication with the interior of centrifuge bag
226
and the environment outside centrifuge bag
226
. The length of outlet tube
250
is shorter than the length of inlet tube
248
.
In one embodiment of this invention, outlet tube
250
is a straight tube as shown in FIG.
31
. Alternatively, outlet tube
250
includes a bent fitting
252
fluidly connected to the distal end of outlet tube
250
(FIGS.
25
and
26
). The bent fitting
252
may be of any number of configurations, although preferably bent fitting
252
is shaped in the form of a “T”, “curved T”, a “J”, or an “L”, as illustrated in
FIGS. 27
,
28
,
29
and
30
, respectively. Alternatively, outlet tube
250
and bent fitting
252
may be one contiguous molded unit rather than two connected pieces. Preferably, bent fitting
252
is in the shape of a “T” or a “curved T” as illustrated in
FIGS. 27 and 28
, respectively. The “T” or “curved T” design of bent fitting
252
ensures that the desired blood component (fraction) will be removed from the sides of the bent fitting
252
, rather than from a fraction located above or below the bent fitting, as discussed below in detail.
When the centrifuge bag
226
is positioned in the annular groove
212
of the centrifuge rotor
202
as described above, it is critical that inlet and outlet tubes
248
,
250
are seated in groove
222
. Further, when rotor cover
206
is positioned over and removably secured to the centrifuge base
204
, it is important that inlet and outlet tubes
248
,
250
are also seated in groove
224
. Seating inlet and outlet tubes
248
,
250
in grooves
222
,
224
ensures that centrifuge rotor
202
is held in a fixed position between rotor base
204
and rotor cover
206
such that the centrifuge bag
226
and centrifuge rotor
202
rotate together. That is, the fixed position of centrifuge bag
226
ensures that centrifuge bag
226
will not rotate independently of centrifuge bag
226
during centrifugation.
Inlet and outlet tubes
248
,
250
are fluidly connected at their proximal ends to umbilical cable
228
, which in this particular embodiment is a dual lumen tubing connecting centrifuge bag
226
to source and receiving containers
398
,
400
, respectively, for the introduction and removal of components from the centrifuge bag
226
during centrifugation (see FIG.
17
). Dual lumen tubing
228
comprises inlet lumen
230
, which connects inlet tube
248
of centrifuge bag
226
with source container
398
, and outlet lumen
232
, which connects outlet tube
250
centrifuge bag
226
with receiving container
400
. In one embodiment, the inlet and outlet tubes
248
,
250
are adapted at their proximal ends for inserting into the inlet and outlet lumens
230
and
232
, respectively. Alternatively, connecting means
254
are inserted into the proximal ends of inlet and outlet tubes
248
,
250
for connecting the tubes to the inlet and outlet lumens
230
,
232
as illustrated in FIG.
26
.
In operation, one end of umbilical cable
228
must be secured to rotor assembly
200
to prevent itself from becoming twisted during rotation of rotor assembly
200
by the coaxial half-speed rotation of drive shaft assembly
28
, which imparts a like rotation with respect to the rotor
202
axis and consequently to the umbilical cable
228
that is directed through cable guide
102
. That is, if rotor assembly
200
is considered as having completed a first rotation of 360° and drive shaft assembly
28
as having completed a 180° half-rotation in the same direction, the umbilical cable
228
will be subjected to a 180° twist in one direction about its axis. Continued rotation of rotor assembly
200
in the same direction for an additional 360° and drive shaft assembly
28
for an additional 180° in the same direction will result in umbilical cable
228
being twisted 180° in the opposite direction, returning umbilical cable
228
to its original untwisted condition. Thus, umbilical cable
228
is subjected to a continuous flexture or bending during operation of the centrifugal processing system
10
of the present invention but is never completely rotated or twisted about its own axis.
An alternative embodiment of a disposable centrifuge bag of this invention, shown in
FIG. 35
comprises two or more inlet tubes and/or two or more outlet tubes, wherein the tubes are fluidly connected to a multiple lumen tubing.
The disposable centrifuge bag
226
is formed from a transparent, substantially flexible material, including but not limited to, polyvinyl chloride, polyethylene, polyurethane, ethylene vinyl acetate and combinations of the above or other flexible materials. Based upon the flexibility of the centrifuge bag
226
, the profile of the flexible centrifuge bag
226
, shown in
FIGS. 25 and 26
, is determined at least in part by the amount of fluid contained therein. The profile of centrifuge bag
226
is further defined by the interior configuration of the centrifuge rotor, as discussed below in detail. The ability to manipulate the profile of centrifuge bag
226
based on the interior configuration of the centrifuge rotor is utilized at least in part to maximize the volume of fluid medium that can be contained in centrifuge bag
226
during centrifugation, as will be discussed below.
The fluid or medium to be centrifuged may be contained within source container
300
. For example, when the centrifuge
20
of this invention is used to prepare an autologous platelet gel, the fluid (i.e., whole blood), may be withdrawn from the patient during or prior to surgery into source container
398
containing an anticoagulant. The anticoagulated whole blood is introduced to centrifuge bag
226
through inlet tube
248
via inlet lumen
230
after the centrifuge bag
226
has been positioned in the centrifuge rotor
202
and rotation thereof is initiated. As discussed above, securing centrifuge bag
226
in centrifuge base
204
in grooves
222
,
224
holds the centrifuge bag
226
in a fixed position therebetween, such that the centrifuge bag
226
cannot move independently of the centrifuge rotor
202
, and therefore the centrifuge bag
226
and rotor assembly
200
rotate concurrently at the same rate of rotation. Rotation of the centrifuge rotor
202
directs the heavier density constituents of the anticoagulated whole blood within the centrifuge bag
226
toward the outer perimeter
238
of the bag
226
, while the lighter density constituents remain closer to an inner region, as illustrated in FIG.
32
. More specifically, as illustrated in
FIG. 32
, when the fluid medium being separated is whole blood, the whole blood is separated within centrifuge bag
226
into a red blood cell fraction (
256
), a white blood cell fraction (
258
), a platelet rich plasma fraction (
260
), and a platelet poor plasma fraction (
262
). As will be appreciated by those of skill in the art, whole blood fractions, red blood cell's and plasma are differently colored, and consequently the separation of the fractions can be easily detected by the operator. At an appropriate time during centrifuging, suction or other drawing means may be applied to the interior of centrifuge bag
226
via outlet lumen
232
to remove the desired fraction from the centrifuge bag
226
. In a further embodiment, centrifuge cover
206
may further contain concentric index lines to assist the operator in viewing the positions of outlet tube
250
to the RBC plasma interface. Based on the speeds and times the location of the WBC and platelets can be varied with respect to the red blood cell's and plasma interface. For example, if the rpm is held low (approximately 1,000-1,700, preferably 1,500) the plasma and platelets will separate from the RBC layer, as the rpm's are increased (1,400-1,700) the platelets will separate out of the plasma and reside at the plasma to RBC interface in greater concentrations. With increased speeds WBC reside deeper into the RBC pack.
With further regard to bent fittings
252
, in one embodiment a bent fitting is fluidly connected to the distal end of outlet tube
250
. While bent fitting
252
is shown in
FIG. 32
as having a “T” shape (FIG.
27
), this is for illustrative purposes only. Thus, it will be appreciated that bent fitting
252
as shown in
FIG. 32
could have a number of other configurations, such as those shown in
FIGS. 25-31
. The design of bent fitting
252
ensures that the desired component is withdrawn (e.g., the platelet rich plasma fraction
260
) with less risk of contamination from withdrawing a portion of the adjacent fraction
258
. Thus, in one embodiment, the desired fraction is withdrawn when its position overlaps with the position of bent fitting
252
. Alternatively, the inlet tube
248
may be first used to draw off the red blood cell fraction
256
, and when it is desirable to remove the predetermined fraction from the centrifuge bag
226
, the predetermined fraction is drawn through bent fitting
252
and outlet tube
250
and directed to receiving container
400
via outlet lumen
232
.
With continued reference to
FIG. 32
, as the separation of the fluid medium is initiated by centrifugation, substantially annular regions having constituents of a particular density or range of densities begin to form. For purposes of illustration, the separation of whole blood will be discussed, and as shown in
FIG. 32
four regions are represented, each of which contains a particular type of constituent of a given density or range of densities. Moreover, it should be appreciated that there may be a given distribution of densities across each of the regions such that the regions may not be sharply defined. Consequently, in practice the regions may be wider (e.g., a larger radial extent) and encompass a range of densities of constituents.
In the example of
FIG. 32
, the first region
256
is the outermost of the four regions and contains red blood cells. The second region
258
contains white blood cells, which have a lower density than that of the red blood cells. The third region
260
contains the platelet rich plasma fraction, and the innermost region
262
contains the least dense platelet poor plasma fraction. In one embodiment, it may be desired to harvest the platelet rich plasma fraction in region
260
. In order to remove the platelet rich plasma fraction from the centrifuge bag
226
, vacuum or suction is provided via outlet lumen
232
to the centrifuge bag
226
to remove a desired portion of region
260
. A portion of the fraction
260
that is in the area of the bent fitting
252
is drawn through bent fitting
252
and into an appropriate one of the collection containers
400
(FIG.
17
).
More specifically,
FIGS. 33-39
illustrate one method of this invention for the separation of whole blood components, which is a dynamic process.
FIG. 33
shows one portion of the centrifuge bag
226
, illustrating the separation of the whole blood components after infusion of an aliquot of whole blood into centrifuge bag
226
and centrifugation for approximately 60 seconds to 10 minutes at a rate of rotation between 0 and 5,000 rpms. It will be understood by those of skill in the art that faster speeds of rotation will separate the blood in a shorter prior of time.
FIG. 33
shows the four separated whole blood fractions, with the denser fractions closer to outer perimeter
238
, and the less dense fractions closer to inner perimeter
240
. While it is well-known that hematocrits (i.e., the volume of blood, expressed as a percentage, that consists of red blood cells) will vary among individuals, ranging from approximately 29%-68%, such variations are easily adjusted for as a result of the novel design of centrifuge bag
226
and consequently will not affect the isolation of any of the desired fractions as discussed below in detail. Thus, for illustrative purposes, it will be assumed that centrifugation of an initial infusion of an aliquot of anticoagulated whole blood will give the profile shown in FIG.
33
. In one embodiment, it is desired to harvest the platelet rich plasma fraction
260
. This may be achieved by performing a batch separation process or a continuous separation process as described below.
In one embodiment of a batch separation process of this invention for harvesting the platelet rich plasma fraction
260
, centrifuge bag
226
has a design as shown in
FIG. 32
wherein bent fitting
252
positioned approximately in the area where a platelet rich plasma fraction
260
is typically found after centrifugation of an aliquot of whole blood. This approximation is simplified by the placement of concentric indicator lines
205
,
207
, and
209
, (not shown) in the upper surface of rotor cover
206
, wherein the concentric lines
205
,
207
and
209
correspond approximately with the edges of regions
260
,
258
, and
256
, respectively. Alternative, concentric lines similar to
205
,
207
and
209
may be directly imprinted onto the surface of centrifuge bag
226
.
After centrifugation of an aliquot of blood contained in centrifuge bag
226
, a substantial portion of the platelet rich plasma fraction
260
is withdrawn from centrifuge bag
226
through bent fitting
252
while centrifuge rotor
202
is still spinning. As the volume of the platelet rich plasma fraction
260
is reduced upon withdrawal, the innermost fraction
262
naturally moves in the direction of the outer perimeter
238
due to centrifugal force, as shown in FIG.
34
. The withdrawal of platelet rich plasma fraction
260
is terminated at a point where the platelet poor plasma fraction
262
is close to bent fitting
252
and before any significant portion of platelet poor plasma fraction
262
could be withdrawn through bent fitting
252
, as shown in FIG.
34
. This point can be determined either visually by the operator by volume, or by a sensor, as described below in detail. After withdrawal of the desired platelet rich plasma fraction
260
, inlet lumen
230
is disconnected from the whole blood source container
398
and connected to a disposal container, after which the remaining fluid in centrifuge bag
226
is evacuated through inlet tube
248
and directed to the disposal container. The inlet lumen is then reconnected to the whole blood source container, and the above-described batch process is repeated as many times as required until the necessary quantity of the desired fraction is isolated.
Alternatively, the above-described process can be performed as a continuous process wherein the step of disconnecting the inlet lumen
230
from the whole blood source
398
can be avoided. The continuous process separation of whole blood may be achieve by using a disposable centrifuge bag
226
′ as illustrated in
FIGS. 35-39
comprising an inlet tube
248
and three outlet tubes
245
,
247
and
250
, wherein the tubes are connected to an umbilical cable comprising four lumens. More specifically, a disposable centrifuge bag for use in a continuous separation of whole blood comprises inlet tube
248
connected via an inlet lumen to a whole blood source container, a first outlet tube
250
connected to a first outlet lumen that is in turn connected to a platelet rich plasma receiving container, a second outlet tube
245
connected via a second outlet lumen to either a red blood cell receiving container or a waste container and a third outlet tube
247
connected via a third outlet lumen to a platelet poor plasma receiving container. In the continuous separation process, after withdrawal of the portion of platelet rich plasma or other cellular components as described above with reference to
FIGS. 33 and 34
. Centrifuge bag has the capacity to receive an additional volume (aliquot) of whole blood. Consequently, as shown in
FIG. 35
infusion of an aliquot of whole blood is reinitiated through first inlet tube
248
with continued centrifugation until the capacity of the centrifuge bag
226
′ is reached. As a result of the additional volume of blood, the profile of the blood fractions in centrifuge bag
226
′ will approximately assume the profile shown in FIG.
35
. As can be seen in
FIG. 35
, the additional volume of blood results in a shift of the location of the blood fractions, such that the platelet rich plasma fraction
260
has shifted back into the area of the bent fitting
252
, and the platelet poor plasma fraction
262
has shifted back towards the inner perimeter
240
and away from the vicinity of the bent fitting
252
. Additional platelet rich plasma
260
can now be removed from centrifuge bag
226
′ through outlet tube
250
as shown in FIG.
35
.
As described above, removal of an additional volume of the platelet rich plasma fraction
260
results in a shift in the location of the platelet poor plasma fraction
262
closer to the outer perimeter
238
and consequently closer to the vicinity of bent fitting
252
, as shown in
FIG. 36
, at which point removal of platelet rich plasma is again temporarily terminated.
Additional infusions of whole blood aliquots to centrifuge bag
262
′ and removal of platelet rich plasma (by shifting the position of the platelet rich plasma fraction
260
relative to the position of the bent fitting
252
) as described above may be repeated a number of times. Eventually, however, the continued infusion of whole blood followed by removal of only the platelet rich plasma fraction will necessarily result in a gradual increase in the volumes (and consequently the widths) of the remaining blood fractions
256
,
258
and
260
in centrifuge bag
226
′. In particular, the volume, and therefore the width, of the red blood cell fraction
256
will increase to the extent that the other fractions are pushed closer to the inner perimeter
240
(FIG.
37
). As shown in
FIG. 37
, the increased volume of red blood cells now present in centrifuge bag
226
′ shifts the location of the fractions towards the inner perimeter
240
such that the white blood cell fraction
260
is now in the vicinity of the bent fitting
252
as opposed to the desired platelet rich plasma fraction
262
.
The novel design of centrifuge bag
226
′ advantageously provides means for shifting the fractions back to the desired locations when the situation shown in
FIG. 37
arises. That is, second outlet tube
245
serves as an inlet conduit for introduction of whole blood aliquots into centrifuge bag
226
′, also serves the function of withdrawing fractions that are located close to the outer perimeter
238
. This is achieved in part by attaching the second outlet lumen to either a red blood cell receiving container or a waste container having a suction means (e.g., syringe, pump, etc.) As shown in
FIG. 38
, second outlet tube
245
, having its distal end close to outer perimeter
238
, can be operated to withdraw a substantial volume of the red blood cell fraction
256
, which in turn shifts the location of the remaining fractions
258
,
260
,
262
. The withdrawal of the red blood cell fraction
256
may be monitored visually by the operator, or by other means such as a sensor. Alternatively, the positions of the fractions may be shifted by withdrawing the platelet poor plasma fraction
262
through third outlet tube
247
, which is connected via a third outlet lumen to a platelet poor plasma receiving container.
FIG. 37
shows that, after withdrawal of a portion of the red blood cell fraction
256
, the centrifuge bag
226
′ again has the capacity to receive an additional volume of whole blood for centrifugation. An additional infusion of an aliquot of whole blood through inlet tube
248
into the centrifuge bag
226
′ of FIG.
37
and centrifugation will produce the profile illustrated in FIG.
39
. The above-described steps may be repeated as needed until the desired amount of platelet rich plasma has been harvested. All of the above-described steps occur while the centrifuge rotor
202
is spinning.
The above-described continuous separation method was illustrated in terms of performing the whole blood infusion step and the platelet rich plasma harvesting step sequentially. An alternative embodiment involves performing the infusion and harvesting steps substantially simultaneously, that is, the platelet rich plasma fraction is withdrawn at approximately the same time as an additional aliquot of whole blood is being added to the bag. This alternate embodiment requires that the centrifuge rotor spin at a rate that results in almost immediate separation of the blood components upon infusion of an aliquot of whole blood.
As stated previously, all of the above-described steps may be monitored either visually by the operator by volume, or by a sensor. If the steps are to be visually monitored, centrifuge cover
206
may further include one or more concentric indicator circles
205
,
207
,
209
(shown in
FIGS. 17 and 18
) which may be spaced from the center of cover
206
at distances approximately equal to the outer edges of regions
260
,
258
256
, respectively, to aid the operator in visualizing the positions of these regions with respect to
252
.
FIGS. 33-39
illustrate one embodiment of how the design of centrifuge bags
226
and
226
′ permit the general locations of the various blood fractions to be shifted to allow for continuous harvesting of a desired blood fraction without the risk of contaminating the harvested blood fraction, and further allow for continual on-line harvesting of a large volume (10 to 5 L's) of blood using a small, portable centrifuge device comprising a 10 cc to 200 cc capacity disposable centrifuge bags
226
and
226
′.
For example, the design of centrifuge bag
226
having inlet tube
248
and outlet tube
250
means that the desired component or fraction will be withdrawn from centrifuge bag
226
only through outlet tube
250
, while the addition of whole blood aliquots or the removal of other components (e.g., red blood cell fraction
256
) will proceed only through dual functional inlet tube
248
. In this respect, the harvested fraction (e.g., platelet rich plasma fraction
260
) is never withdrawn through inlet tube
248
which was previously exposed to other fluid media (e.g., whole blood or red blood cells). Thus, the design of centrifuge bag
226
offers a significant advantage over conventional centrifuge containers comprising only one tube which serves to both introduce the fluid medium to the container and to withdraw the harvested fraction from the container.
Furthermore, because of its unique design, the use of centrifuge bags
226
and
226
′ are independent of composition of the whole blood to be centrifuged. For example, as stated above, hematocrits (i.e., the percent volume of blood occupied by red blood cells) vary from individual to individual, and consequently the profile illustrated in
FIG. 32
will vary from individual to individual. That is, the width of red blood cell fraction
256
may be wider or narrower, which in turn will result in the platelet rich plasma fraction
260
being positioned further away in either direction from bent fitting
252
. However, as discussed above in detail with particular reference to
FIGS. 33-34
, the design of centrifuge bags
226
and
226
′ allow the location of the desired fraction to be shifted until it is in the region of bent fitting
252
. Such shifting can be brought about, for example using centrifuge bag
226
, by withdrawing the red blood cell fraction through inlet tube
248
, or by adding whole blood aliquots through inlet tube
248
.
An alternative embodiment of a disposable, flexible centrifuge bag
270
is illustrated in FIG.
40
. The disposable centrifuge bag
270
has a substantially flat, toroidal- or doughnut-shaped configuration having outer and inner perimeters
271
and
272
, respectively, and comprises radially extending upper and lower sheets
273
,
274
formed from a substantially flexible material. The upper and lower sheets
273
,
274
are superimposed and completely sealed together at outer perimeter
271
by an rf weld, heat weld or other comparable method of adhering two surfaces. Inner perimeter
272
defines core
275
of centrifuge bag
270
. In one embodiment of the invention, centrifuge bag
270
further comprises inlet tube
276
sandwiched between upper and lower sheets
273
,
274
and radially extending from the center of core
275
to the outer perimeter
271
, and outlet tube
278
sandwiched between upper and lower sheets
273
,
274
and extending across the diameter of core
275
and having first and second distal ends
280
,
281
. When upper and lower sheets
273
,
274
are sealed together at inner perimeter
272
, inlet and outlet tubes
276
,
278
are thereby sealed therebetween. Inlet and outlet tubes
276
,
278
are each in fluid communication with the interior of centrifuge bag
270
and the environment outside centrifuge bag
270
. Inlet tube
276
and outlet tube
278
are fluidly connected to umbilical cable
228
(not shown), which in this particular embodiment is a dual lumen tubing. Inlet tube
276
is fluidly connected at its proximal end to umbilical cable
228
, preferably by an L-shaped connector (not shown), and outlet tube
278
is fluidly connected at its center to umbilical cable
228
via a T-shaped connector (not shown).
The disposable centrifuge bag
270
is formed from a transparent, substantially flexible material, including but not limited to, polyvinyl chloride, polyethylene, polyurethane, ethylene vinyl acetate and combinations of the above or other flexible materials.
Upper and lower sheets
273
,
274
of centrifuge bag
270
are further sealed at two portions between the outer perimeter and the inner perimeter. That is, centrifuge bag
270
further comprises a first C-shaped seal
282
located between the outer and inner perimeters
271
,
272
and having an first concave indentation or well
283
on the concave side of C-shaped seal
282
, and a second C-shaped seal
284
located between the outer and inner perimeters
271
,
272
and having an second concave indentation or well
285
on the concave side of C-shaped seal
284
. First and second C-shaped seals
282
and
284
are formed by sealing portions of upper and lower sheets
273
,
274
together by methods known in the art for sealing two surfaces, including but not limited to rf or heat welding. Ends
288
and
289
of first C-shaped seal
282
are bent inward towards the inner core
275
, and likewise ends
290
and
291
of second C-shaped seal
284
are bent inward towards the inner core
275
. First and second C-shaped seals
282
,
284
have their concave sides facing each other such that the first and second indentations
283
,
285
are diametrically opposed to each other. That is, when centrifuge bag
270
is viewed from the top as in
FIG. 40
, first and second C-shaped seals
282
,
284
are mirror images of each other. First and second C-shaped seals
282
,
284
together define an outer chamber
292
between the outer perimeter
271
and first and second C-shaped seals
282
,
284
, wherein the outer chamber
292
has a toroidal configuration and serves as a first processing compartment. First and second C-shaped seals
282
,
284
together further define an inner chamber
293
between first and second C-shaped seals
282
,
284
and inner perimeter
272
, wherein the inner chamber
293
has a toroidal configuration and serves as a second processing compartment. The first and second C-shaped seals
282
,
284
are positioned such that ends
288
and
290
are directly opposite and spaced apart from each other to define a first channel
286
therebetween, and such that ends
289
and
291
are directly opposite and spaced apart from each other to define a second channel
287
therebetween, wherein the first and second channels
286
,
287
are diametrically opposed and provide fluid communication between the first processing compartment
292
and the second processing compartment
293
. Inlet tube
276
extends through either channel
286
or channel
287
, and the first and second distal ends
280
,
281
of outlet tube
278
extend into first and second indentations
283
,
285
, respectively.
Centrifuge bag
270
is removably secured between rotor base
204
and rotor cover
206
of rotor
202
in a manner as described above so that centrifuge bag
270
is held in a fixed position relative to rotor base
204
and rotor cover
206
during rotation of the centrifuge rotor
202
. As will be appreciated by those of skill in the art, alternative embodiments of rotor base
204
(
FIG. 15
) and rotor cover
206
(
FIG. 16
) will be required to accommodate the design of centrifuge bag
270
. Thus, an alternate embodiment of rotor base
204
comprises raised column
218
comprising first and second grooves which are perpendicular to each other and extend the diameter of the raised base column
218
, such that when rotor
202
is assembled, inlet tube
276
and outlet tube
278
of centrifuge bag
270
are seated in the first and second grooves, respectively, of raised base column
218
. Similarly, an alternate embodiment of cover
206
comprises raised column
220
comprising first and second grooves which are perpendicular to each other and extend the diameter of the raised cover column
220
, such that when rotor
202
is assembled, inlet tube
276
and outlet tube
278
are further seated in the first and second grooves, respectively, of raised cover column
220
.
As stated above, inlet and outlet tubes
276
,
278
are fluidly connected to umbilical cable
228
, which in this particular embodiment is a dual lumen tubing connecting centrifuge bag
270
to source and receiving containers
398
,
400
, respectively, for the introduction of the fluid to be centrifuged in bag
270
and for the removal of one or more of the separated components from the centrifuge bag
270
during rotation of the centrifuge
20
. Dual lumen tubing
228
comprises inlet lumen
230
, which connects inlet tube
276
with source container
398
, and outlet lumen
232
, which connects outlet tube
278
with receiving container
400
.
The fluid or medium to be centrifuged using centrifuge bag
270
may be contained within source container
398
. For example, when the centrifuge
20
of this invention is used to prepare an autologous platelet gel, the fluid (i.e., whole blood), may be withdrawn from the patient during or prior to surgery into source container
398
containing an anticoagulant. The anticoagulated whole blood is introduced to centrifuge bag
270
through inlet tube
276
via inlet lumen
230
after the centrifuge bag
270
has been positioned in the centrifuge rotor
202
and rotation thereof is initiated.
Centrifuge bag
270
may be used for the separation and isolation of one or more components dissolved or suspended in a variety of fluid media, including, but not limited to, the separation of cellular components from biological fluids. For example, centrifuge bag
270
is useful for the concentration and removal of platelets from whole blood. Therefore, the following description of the separation of platelets from whole blood using centrifuge bag
270
is merely for purposes of illustration and is not meant to be limiting of the use of bag
270
. The separation of a fluid medium such as whole blood in centrifuge bag
270
may be considered to be a two-stage separation process. The first stage of the separation of platelets from whole blood involves separation of a platelet suspension from the red blood cells. The platelet suspension is typically plasma rich in platelets, and it is commonly referred to as platelet-rich plasma (PRP). However, as used herein, the term “platelet suspension” is not limited to PRP in the technical sense, but is intended to encompass any suspension in which platelets are present in concentrations greater than that in whole blood, and can include suspensions that carry other blood components in addition to platelets. The second stage of the separation comprises separating platelets from the platelet suspension to produce a platelet concentrate. As used herein, the term “platelet concentrate” is intended to encompass a volume of platelets that results after a “platelet suspension” undergoes a subsequent separation step that reduces the fluid volume of the platelet suspension. The platelet concentrate may be a concentrate that is depleted of white blood cells and red blood cells.
With reference to
FIG. 41
, stage one of a whole blood separation process using centrifuge bag
270
begins with the introduction of an aliquot of whole blood into centrifuge bag
270
via inlet tube
276
during rotation of the centrifuge
20
. As the aliquot of whole blood enters outer chamber
292
of centrifuge bag
270
, it quickly separates radially under the influence of centrifugal force into various fractions within outer chamber
292
based on the densities of the components of the whole blood, including an outermost fraction containing the red blood cells which pack along the outer perimeter
271
of centrifuge bag
270
, and an inner fraction comprising the platelet suspension. The platelet suspension after centrifugation of the first aliquot of whole blood is represented in
FIG. 41
by ring
294
. Continued infusion of whole blood into the first processing compartment
292
adds an additional volume of red blood cells and consequently pushes the platelet suspension inward as represented by ring
295
. Additional infusions of whole blood will continue to push the platelet suspension further inward, as represented by rings
296
and
297
until the first processing compartment
292
is substantially filled with red blood cells (the remainder of the volume being plasma) such that the platelet suspension is pushed through channels
286
and
287
into second processing compartment
293
. As discussed above, the ends
288
,
289
and
290
,
291
of C-shaped seals
282
,
284
, respectively, bend inward, which both helps to funnel the platelet suspension through channels
286
,
287
and to minimize the amount of red blood cells that pass through channels
286
,
287
. The point at which the red blood cells are near the entrance of channels
286
,
287
may be monitored either visually or by a sensor, as described below in detail. At this point the infusion of additional aliquots of whole blood is terminated, and the second stage of the two-stage separation process begins.
During stage two of the separation process, the platelet suspension which was pushed through channels
286
,
287
into the second processing compartment
293
flow under the influence of centrifugal force towards positions within the second processing compartment
293
that have the greatest radial distances, that is, towards concave wells
283
,
285
, where the platelets, being the higher density component of the platelet suspension, begin to collect and pack. The platelets can then be withdrawn from concave wells
283
,
285
through outlet tube
278
. In the above-described two-stage process for the separation of a platelet suspension from whole blood, the first and second C-shaped seals
282
,
284
thus serve as physical barriers between the red blood cells and the platelets to facilitate the separation and collection of platelets from whole blood. First and second concave wells
283
,
285
act as reservoirs for containing the platelets as they are separated from the platelet suspension in the second stage of the separation process.
After withdrawal of the platelets from the wells
283
and
285
, inlet lumen
230
is disconnected from the whole blood source container, after which the remaining components in centrifuge bag
270
are evacuated through inlet tube
276
by applying suction to inlet lumen
230
and are directed to a disposable container. The inlet lumen
230
is then reconnected to the whole blood source container, and the above-described batch process is repeated as many times as required until the desired quantity of platelets has been harvested.
An alternative embodiment of a disposable, flexible centrifuge bag having inner C-shaped seals is illustrated in
FIG. 42
as centrifuge bag
320
. Disposable centrifuge bag
320
has a substantially flat, toroidal- or doughnut-shaped configuration having outer and inner perimeters
322
and
324
, respectively, and comprises radially extending upper and lower sheets
323
,
325
formed from a substantially flexible material. The upper and lower sheets
323
,
325
are superimposed and completely sealed together at outer perimeter
322
by an rf weld, heat weld or other comparable method of adhering two surfaces. Inner perimeter
324
defines core
327
of bag
320
.
Upper and lower sheets
323
,
325
of centrifuge bag
320
are further sealed at two portions between the outer perimeter and the inner perimeter. That is, centrifuge bag
320
further comprises a first C-shaped seal
326
located between the inner and outer perimeters
322
,
324
, and a second C-shaped seal
328
located between the inner and outer perimeters
322
,
324
. The first and second C-shaped seals
326
,
328
have their concave sides facing each other such that when centrifuge bag
320
is viewed from the top as in
FIG. 36
, first and second C-shaped seals
326
and
328
are mirror images of each other. First and second C-shaped seals
326
,
328
together define an outer compartment
348
between the outer perimeter
322
and first and second C-shaped seals
326
and
328
, wherein the outer compartment
348
has a toroidal configuration. First and second C-shaped seals further define an compartment
350
between first and second C-shaped seals
326
,
328
and inner perimeter
324
, wherein the inner compartment
350
has a doughnut shaped configuration. The ends
330
and
332
of first C-shaped seal
326
are slightly curved inward towards the inner core
327
, and likewise ends
334
and
336
of second C-shaped seal
328
are slightly curved inward towards the inner core
327
. The first and second C-shaped seals
326
and
328
are positioned such that ends
330
and
334
of first and second C-shaped seals
326
,
328
, respectively, are directly opposite and spaced apart from each other, thereby defining first channel
335
therebetween, and such that ends
332
and
336
of first and second seals
326
and
328
, respectively, are directly opposite and spaced apart from each other, thereby defining second channel
337
therebetween, wherein the first and second channels
335
and
337
are diametrically opposed. First and second channels
335
and
337
provide fluid communication between the outer and inner compartments.
Centrifuge bag
320
further comprises an inlet port
340
, in the lower sheet
325
for introducing fluid into outer compartment
348
. Preferably the inlet port
340
is spaced 90 degrees from channel
335
however it could also be positioned at an angle greater or less than 90 degrees from channel
335
. Centrifuge bag
320
further comprises first and second outlet ports
344
,
346
in lower sheet
325
and positioned within channels
335
and
337
for withdrawing a fluid compartment from centrifuge bag
320
.
In a preferred embodiment, centrifuge bag
320
comprises inlet tube
338
secured to the outside surface of upper sheet
323
or lower sheet
325
and radially extending from the center of core
327
towards the outer perimeter
322
, wherein inlet tube
338
is fluidly connected at its distal end to inlet port
340
. Inlet port
340
fluidly connects inlet tube
338
with the outer chamber
348
of centrifuge bag
320
. Inlet tube
338
is fluidly connected at its proximal end to umbilical cable
228
, preferably by an L-shaped connector (not shown). Further, in a preferred embodiment centrifuge bag
320
comprises outlet tube
342
secured to the outside surface of upper sheet
323
or lower sheet
325
and extending across the diameter of core
327
, wherein one end of outlet tube
342
is fluidly connected to first outlet port
344
and the other end of outlet tube
342
is fluidly connected to second outlet port
346
. Outlet tube is fluidly connected at its center to umbilical cable
228
via a T-shaped connector (not shown).
In an alternative embodiment of this invention, centrifuge bag
320
comprises inlet tube
338
sandwiched between upper and lower sheets
323
,
325
and extending radially from the center of core
327
towards outer perimeter
322
, wherein inlet tube
328
is fluidly connected at its distal end to inlet port
340
, and outlet tube
342
sandwiched between upper and lower sheets
323
,
325
and extending across the diameter of core
327
, wherein one end of outlet tube
342
is fluidly connected to outlet port
344
and the other end of outlet tube
342
is fluidly connected to outlet port
346
. When upper and lower sheets
323
,
325
are sealed together at inner perimeter
324
, inlet and outlet tubes
338
,
342
are thereby sealed therebetween. Inlet tube
338
and outlet tube
342
are fluidly connected to umbilical cable
228
(not shown), which in this particular embodiment is a dual lumen tubing.
Centrifuge bag
320
is removably secured between rotor base
204
and rotor cover
206
of rotor
202
in a manner as described above so that centrifuge bag
320
is held in a fixed position relative to rotor base
204
and rotor cover
206
during rotation of the centrifuge rotor
202
. As will be appreciated by those of skill in the art, alternative embodiments of rotor base
204
(
FIG. 15
) and rotor cover
206
(
FIG. 16
) as discussed above with respect to centrifuge bag
270
will be required to accommodate the design of centrifuge bag
370
.
Centrifuge bag
370
may be used for the separation and isolation of one or more components dissolved or suspended in a variety of fluid media, including, but not limited to, the separation of cellular components from biological fluids. For example, centrifuge bag
370
is useful for the concentration and removal of platelets from whole blood. Therefore, the following description of the separation of platelets from whole blood using centrifuge bag
320
is merely for purposes of illustration and is not meant to be limiting of the use of bag
320
. The separation of a fluid medium such as whole blood in centrifuge bag
320
may be considered to be a one-stage separation process. With reference to
FIG. 36
, centrifugation of whole blood begins with the introduction of an aliquot of whole blood into centrifuge bag
320
through inlet port
340
via inlet tube
338
during rotation of the centrifuge
20
. Inlet tube
338
is fluidly connected via inlet lumen
230
of umbilical cable
228
to an anticoagulated whole blood source. As the aliquot of whole blood enters the outer chamber
348
of centrifuge bag
320
, it quickly separates radially within outer chamber
348
into various fractions based on the densities of the components of the whole blood, including an outermost fraction containing the red blood cells which pack along the outer perimeter
322
of centrifuge bag
320
, and inner fractions containing the platelets and plasma. Continued infusion of whole blood adds an additional volume of red blood cells and consequently pushes the fraction containing platelets inward. Additional infusions of whole blood will continue to push the platelet-containing fraction further inward until the chamber
348
is substantially filled with red blood cells (the remainder of the volume being plasma), such that the platelet-containing fraction is pushed into channels
335
,
337
and into the vicinity of outlet ports
344
,
346
. As discussed above, the ends of C-shaped seals
326
,
328
curve slightly inward, which both helps to funnel the platelet-containing fraction into channels
335
,
337
, and to minimize the amount of red blood cells that flow into channels
335
,
337
. The point at which the red blood cells are near the entrance of channels
335
,
337
may be monitored either visually or by a sensor, as described below in detail. As the platelet-containing fraction enters the vicinity of outlet ports
344
,
346
, the infusion of whole blood is terminated, and suction or other drawing means is applied to outlet tube
342
to withdraw the platelet-containing fraction through outlet ports
344
,
346
.
After withdrawal of substantial portion of the platelet rich plasma, inlet lumen
230
is disconnected from the whole blood source container and connected to a disposal container, after which the remaining components in centrifuge bag
320
are evacuated through inlet port
34
- by applying suction to inlet tube
276
and are directed to a disposal container. The inlet lumen
230
is then reconnected to the whole blood source container, and the above-described process is repeated as many times as required until the desired quantity of platelets has been harvested.
B. Rigid Centrifuge Container
As can be appreciated, it may be desirable to maximize the surface area of separated fraction to be harvested, since this maximizes the amount of the fraction which may be collected without increasing the potential for introducing impurities into the separation (e.g., adjacent, lighter density components may begin moving into the region of the fraction being harvested), and without increasing the size of the centrifuge to an undesirable degree.
In order to maximize the amount of the desired component (e.g., platelet rich plasma, white blood cells, or platelet poor plasma) which may be harvested, one embodiment of a centrifuge container of this invention for the separation of components in a fluid medium (e.g., whole blood), shown in
FIGS. 45-52
, is designed to position the desired component (e.g., platelet rich plasma) the platelet rich plasma at a region within the fixed centrifuge container or centrifuge bag so that the desired fraction has a maximum horizontal surface area (i.e., width). Thus, another embodiment of this invention comprises a centrifuge container
500
shown in FIG.
45
.
FIG. 45
is a side cross-sectional view of a rigid container
500
comprising a rigid, annular body
510
having an axial core
600
that is closed at the top end
610
and opened at the bottom end
620
. Rigid container
500
further comprises an interior collection chamber
580
for receiving and holding the fluid medium to be centrifuged and having an outer perimeter
585
and an inner perimeter
590
. The side, cross-sectional profile of chamber
580
is generally an off-centered “figure eight” or “dumbbell” shape, as shown in FIG.
46
. As used herein, “figure eight” or “dumbbell” shaped means that the height of section A is approximately equal to the height of section C, and the heights of sections A and C are greater that the height of section B. Furthermore, as used herein, “off-center” means that the width W
1
from the center of section B to outer perimeter
585
is less than the width W
2
from the center of section B to inner perimeter
590
as shown in
FIGS. 45 and 46
.
Rigid container
500
further comprises inlet channel
550
extending radially from core
600
to a point near the outer perimeter
585
and is fluidly connected at its distal end with the outer area of chamber
580
. Rigid container
500
further comprises outlet channel
554
extending radially from core
600
to the more central portion of chamber
580
(i.e., the narrow portion or “neck” of the figure eight cross-section) and is fluidly connected at its distal end with chamber
580
. While the inlet and outlet channels
550
,
554
are shown in
FIG. 45
as being fluidly connected to the top end of chamber
580
, the present invention also includes embodiments wherein both channels
550
,
554
are in fluid communication with the bottom end of chamber
580
, or wherein channel
550
is in fluid communication with the top end of chamber
580
and channel
554
is in fluid communication with the bottom end of chamber
580
, or vice versa. Inlet and outlet channels
550
,
554
are fluidly connected to dual lumen tubing
228
having an inlet lumen
230
and an outlet lumen
232
. Rigid container
500
is removably secured to the upper surface
133
of upper bearing assembly
130
with appropriate screws, fasteners or the like (not shown). Inlet lumen
230
may be connected to a source for fluid medium, and outlet lumen
232
may be connected to a suction means for withdrawing the desired fraction from the chamber
580
.
The configuration of chamber
580
is specifically designed to maximize the collection of platelet rich plasma by centrifugation of anticoagulated whole blood. More particularly, the shape of chamber
580
increases the width of the platelet rich plasma fraction when viewed from the top and decreases the depth of the platelet rich plasma fraction when viewed from the side, thus allowing the withdrawal of a greater amount of platelet rich plasma. This unique design can be better explained by comparing
FIGS. 44 and 47
.
FIG. 44
shows a side profile of a rigid centrifuge container
500
as shown in
FIG. 43
, having a generally oval profile and containing whole blood that has been separated into four fractions by centrifugation. In
FIG. 44
, width W
3
indicates the relative horizontal width of the platelet rich plasma fraction to be harvested, and D
1
indicates the relative depth of the platelet rich plasma fraction.
FIG. 47
shows a side profile of rigid centrifuge container
580
of this invention having the above-described off-centered figure eight shape and containing whole blood that has been separated into four fractions by centrifugation. In
FIG. 47
, width W
4
indicates the relative horizontal width of the platelet rich plasma fraction
260
to be harvested, and D
2
indicates the relative depth of the platelet rich plasma fraction
260
. Width W
4
is necessarily wider than width W
3
in FIG.
44
. Thus it can be easily appreciated that upon withdrawal of the platelet rich plasma fraction
260
from the oval shaped container shown in
FIG. 44
, platelet poor plasma fraction
262
will shift closer to the outlet tube
554
relatively quickly. In contrast the dumbbell shaped profile of chamber
580
shown in
FIG. 47
significantly increases the width W
4
while decreasing the average depth D
2
, and therefore a greater portion of the platelet rich plasma fraction
260
can be withdrawn with greater accuracy before the platelet poor plasma fraction
262
reaches the outlet tube
554
.
In an embodiment where the platelet rich plasma is to be collected one could design chamber
580
as follows. The configuration of chamber
580
, that is, the relative heights A, B, and C as shown in
FIG. 46
, will be determined based on the typical location of the platelet rich plasma fraction
260
after centrifugation of whole blood. For example, in a rigid centrifuge container
500
as illustrated in
FIG. 45
, having chamber
580
with a 30 ml capacity and a radius of approximately 65 mm measured from its rotational axis to the edge
630
, the platelet rich plasma will collect in chamber
580
at a region at a radial position ranging from about 35 to about 60 mm from the axis. In this region of the chamber
580
, as illustrated in
FIG. 46
, the chamber
580
has a height of about 10 mm such that the horizontal surface area “B” of this region, illustrated in
FIG. 46
, is about 4 mm
2
. Consequently, it can be appreciated that because of the unique configuration of chamber
580
, the surface area of the platelet rich plasma fraction
260
as illustrated in
FIG. 47
may be maximized without undesirably increasing the overall size of the rigid centrifuge container
500
. It will be appreciated by those skilled in the art that various geometric designs may be utilized depending on the fluid medium being centrifuged and the cellular fraction to be collected. The process for harvesting platelets from whole blood using rigid container
500
may be achieved in a manner similar to that described for bag
226
Rigid centrifuge container
500
may be made from any number of rigid, transparent materials that are capable of withstanding typical sterilization conditions, including but not limited to acrylic resins, polycarbonate, or any clear thermal plastic. Preferably rigid container
500
is made of a cost-effective material that is relatively inexpensive to dispose of.
C. Centrifuge Rotor Having a Complex Interior Geometry
An alternate embodiment of a centrifuge rotor of this invention for holding flexible centrifuge bag
226
is illustrated in
FIGS. 48-52
. Generally and referring to
FIGS. 48 and 49
, the centrifuge rotor
755
is defined by a rotor base
760
(
FIGS. 48
,
50
and
52
) having a lower channel
780
, and a rotor cover
770
(
FIGS. 49 and 51
) having an upper channel
782
. The annular interior chamber
784
(
FIG. 48
) of rotor
755
is defined by lower and upper channels
780
,
782
, and has a generally off-centered figure eight side cross-sectional configuration specifically designed to maximize the collection of platelet rich plasma by centrifugation of anticoagulated whole blood, as discussed below in detail.
As illustrated in
FIGS. 51 and 52
, rotor base
760
comprises raised annular rim
775
and raised column
786
which is axially disposed in the interior of rotor base
760
. Raised column
786
further has a groove
790
(
FIG. 52
) extending the diameter of column
786
. The height of rim
775
is equal to the height of column
786
. As illustrated in
FIG. 51
, rotor cover
770
comprises raised annular rim
777
and raised column
788
which is axially disposed in the interior of cover
770
. Raised column
788
further has a groove
792
(
FIG. 52
) extending the diameter of column
788
. The height of rim
777
is equal to the height of column
788
. Rotor base
760
and rotor cover
770
are preferably made from any number of rigid transparent materials including, but not limited to acrylic resins, polycarbonate, or any clear thermal plastic.
When centrifuge rotor
755
is to be assembled for use, flexible, doughnut-shaped centrifuge bag
226
having a center core
242
is placed in rotor base
760
such that center column
786
preferably, but not necessarily, extends through the core of centrifuge bag
226
, and inlet and outlet tubes
248
,
250
of bag
226
are seated in groove
790
. Rotor cover
770
is superimposed on rotor base
760
such that grooves
790
and
792
are aligned and further so that inlet and outlet tubes
248
,
250
are seated in groove
792
. In one embodiment, when cover
770
is appropriately secured to base
760
(e.g., with screws, clamps, or the like), rims
775
and
777
are in complete contact with each other, and columns
786
and
788
are preferably in complete contact with each other, thereby creating chamber
784
(FIG.
48
). Alternatively when cover
770
is secured to base
760
as described, the inner perimeter of bag
226
is secured between columns
786
and
788
such that the columns do not physically contact each other.
When the generally flat, flexible centrifuge bag
226
is contained within chamber
784
prior to the infusion of a fluid medium (e.g., whole blood), it will not fill the entire volume of chamber
784
but rather will have a radially extending, flat shape as centrifuge rotor
755
is spinning. However, after a sufficient volume of the fluid medium (e.g., whole blood) has been introduced into flexible bag
226
through inlet tube
248
such that bag
226
is substantially completely filled, it will be appreciated that filled centrifuge bag
226
will conform to the shape of chamber
784
and consequently will have a off-centered figure eight shaped cross-section.
The off-centered figure eight configuration of the chamber
784
is of approximately the same configuration as the rigid bag
500
. Therefore, for the same reasons, the shape of chamber
784
(and consequently the shape of filled bag
226
), will assume an off-centered figure eight shape wherein the width of the platelet rich plasma fraction is greatly increased relative to the width of a filled bag having an elliptical cross-sectional shape (see, for example, FIGS.
46
and
47
).
As discussed above, a number of methods may be utilized to gauge the harvesting of the desired fraction (such as, but not limited to, platelet rich plasma) from the centrifuge bag. For instance, the separation of platelet rich plasma fraction may be indicated by visual observation of a concentric ring containing the platelet rich plasma (which will be a less colored fraction) and an outer red-colored concentric ring containing the red blood cells. In this case, when such fraction(s) have been separated, the platelet rich plasma may be withdrawn from centrifuge bag
226
by bent fitting
160
to direct the platelet rich plasma to the appropriate collector.
As an alternative to the foregoing, sensors may be incorporated as discussed in detail below to detect the presence of the platelet rich plasma fraction.
Based upon the foregoing, it can be appreciated that the centrifugal processing system
10
and the centrifuge rotors and bags of this invention have a plurality of features which are suited to harvesting platelet rich plasma, white blood cells, platelet poor plasma or red blood cells from a patient's whole blood in accordance with each of the aspects of the present invention. For example, as discussed above, hematocrits (the volume of blood occupied by red blood cells, expressed as a percentage) vary from individual to individual. Thus, depending on the amount of red blood cells present in a particular sample, the exact radial location of various blood components within the centrifuge bag after centrifugation will also vary. The centrifuge bags of this invention overcome this issue by having an inlet tube capable of not only introducing whole blood into the centrifuge bag, but also capable of withdrawing some of all of the red blood cell fraction as needed to shift the location of the fraction to be harvested into the area of the outlet tube. Such features are presented in centrifuge bags
226
,
270
,
320
and
500
. Yet another embodiment of the centrifuge bags of this invention which overcomes problems with varying hematocrits is centrifuge bag
226
′ having multiple outlet tubes.
Additionally, the centrifugal processing system
10
effectively provides a closed system which enhances the potential for maintaining a desired degree of sterility associated with the entire procedure since materials can thus be both provided to and removed from the centrifuge bag during rotation of the centrifuge via, for instance, a dual lumen tubing connected to a fluid source (e.g., anticoagulated whole blood withdrawn from a patient before or during surgery) and collection containers (i.e., for the preparation of a platelet gel), without interrupting the process, and thus without significant exposure of the materials to environmental conditions.
Moreover, the portable size of the centrifugal processing system
10
in combination with the above-described features of shifting the separated fractions and maximizing the surface area of the harvested fraction allows for increased processing capabilities autologous platelet gel over larger, conventional centrifuges
The on-line harvesting capabilities of the centrifugal processing system
10
allows for continuous, dynamic separation and collection of platelet rich plasma, white blood cells, red blood cells and platelet poor plasma, by adjusting the input and removal of fluid medium and separated fractions as described above. Further, the orientation of the flexible and rigid centrifuge bags of this invention and of the contents therein (e.g., being generally radially extending) is not significantly modified in the transformation from separation to harvesting of the various constituents. Moreover, vortexing throughout the contents of the centrifuge bags of this invention is reduced or eliminated since the centrifugal processing system
10
does not have to be decelerated or stopped for addition of fluid medium or removal of the various fractions therefrom.
Further, the general orientation of the flexible and rigid centrifuge bags of the invention (e.g., substantially horizontal) is maintained during removal of the desired whole blood fraction similar to the orientation of the centrifuge bags assumed during centrifugation to further assist in maintaining the degree of separation provided by centrifugation. Consequently, the potential is reduced for disturbing the fractions to the degree where the separation achieved is adversely affected.
Although the present invention has been described with regard to the separation of whole blood components, it will be appreciated that the methods and apparatus described herein may be used in the separation components of other fluid media, including, but not limited to whole blood with density gradient media; cellular components, or sub-sets of the four whole blood components previously defined.
While blood separation and materials handling may be manually controlled, as discussed above, a further embodiment of the present invention provides for the automation of at least portions of the separation and material handling processes. Referring to
FIG. 53
, an automated centrifugal processing system
800
is illustrated that is generally configured to provide automated control over the steps of inputting blood, separating desired components, and outputting the separated components. The following discussion of the processing system
800
provides examples of separating platelets in a blood sample, but the processing system
800
provides features that would be useful for separating other components or fractions from blood or other fluids. These other uses for the processing system
800
are considered within the breadth of this disclosure. Similarly, the specific components discussed for use in the processing system
800
are provided for illustration purposes and not as limitations, with alternative devices being readily apparent to those skilled in the medical device arts.
In the embodiment illustrated in
FIG. 53
, the processing system
800
includes a blood source
802
connected with a fluid line
804
to an inlet pump
810
. A valve
806
, such as a solenoid-operated valve or a one-way check valve, is provided in the fluid line
804
to allow control of flow to and from the blood source
802
during operation of the inlet pump
810
. The inlet pump
810
is operable to pump blood from the blood source
802
through the fluid line
818
to a centrifuge
20
. Once all or a select portion of the blood in the blood source
802
have been pumped to a blood reservoir
824
of the centrifuge
820
the inlet pump
810
is turned off and the blood source
802
isolated with valve
806
. The inlet pump
810
may be operated at later times to provide additional blood during the operation of the processing system
800
(such as during or after the removal of a separated component).
The centrifuge
20
preferably includes a flexible centrifuge bag, for example
226
,
226
′,
270
, or
320
, positioned within the rotor
202
for collecting the input blood, or alternatively rotor
202
may be a rigid container having an off centered figure eight shaped chamber, which may collect blood directly as discussed previously. Thus, while the embodiment described below illustrates a centrifuge having bag
226
, it is to be understood that the alternative centrifuge bags disclosed herein may be used in a similar manner. The centrifuge
20
as discussed above has an internal mid-shaft gear assembly
108
that provides the motive force to rotate the rotor assembly
200
, and particularly the rotor
202
, at a rotation rate that is adequate to create centrifugal forces that act to separate the various constituents or components of the blood in the rotor
202
. The drive assembly
822
may comprise a number of devices useful for generating the motive force, such as an electric motor with a drive shaft connected to internal drive components of the centrifuge
20
. In a preferred embodiment, the drive assembly
822
comprises an electric motor that drives a belt attached to an exterior portion of the centrifuge
20
and more particularly to the timing belt ring
44
. To obtain adequate separation, the rotation rate is typically between about 0 RPM and 5000 RPM, and in one embodiment of the invention, is maintained between about 0 RPM and 5000 RPM.
As discussed in detail previously, components of particular densities assume radial positions or belts at differing distances from the central axis A of the rotor
202
. For example, the heavier red blood cells typically separate in an outer region while lower density platelets separate into a region more proximal to the central axis of the rotor
202
. Between each of these component regions, there is an interface at which the fluid density measurably changes from a higher to a lower density (i.e., as density is measured from an outer to an inner region), and this density interface is used in some embodiments of the centrifugal processing system
800
to identify the location of component regions (as will be discussed in more detail below). In a preferred embodiment, the drive assembly
822
continues to operate to rotate the centrifuge
20
to retain the separation of the components throughout the operation of the centrifugal processing system
800
.
Once blood separation has been achieved within the rotor
202
, the outlet pump
830
is operated to pump select components from the rotor
202
through outlet lumen
828
. As discussed previously, in relation to the features of the disposable blood centrifuge bag
226
, the centrifuge bag held within the rotor
202
preferably is configured to allow the selective removal of a separated blood component, such as platelets located in a platelet rich plasma region, by the positioning of an outlet lumen
232
a radial distance from the central axis of the centrifuge bag
226
. Preferably, this radial distance or radial location for the outlet lumen is selected to coincide with the radial location of the desired, separated component or the anticipated location of the separated component. In this manner, the outlet pump
830
only (or substantially only) removes a particular component (such as platelets into container
400
) existing at that radial distance. Once all or a desired quantity of the particular component is removed from the centrifuge bag
226
, operation of the outlet pump
830
is stopped, and a new separation process can be initiated. Alternatively, in a preferred embodiment, additional blood is pumped into the centrifuge by
226
by further operating the inlet pump
810
after or concurrent with operation of the outlet pump
830
.
A concern with fixing the radial distance or location of the outlet port is that each blood sample may have varying levels or quantities of different components. Thus, upon separation, the radial distance or location of a particular component or component region within the centrifuge bag
226
varies, at least slightly, with each different blood sample. Additionally, because of the varying levels of components, the size of the component region also varies and the amount that can be pumped out of the centrifuge bag
226
by the outlet pump
830
without inclusion of other components varies with each blood sample. Further, the position of the component region will vary in embodiments of the separation system
800
in which additional blood is added after or during the removal of blood by the outlet pump
830
.
To address the varying location of a particular separated component, the centrifugal processing system
800
preferably is configured to adjust the location of a separated component to substantially align the radial location of the separated component with the radial location of the outlet port. For example, the centrifugal processing system
800
may be utilized to collect platelets from a blood sample. In this example, the centrifugal processing system
800
preferably includes a red blood cell collector
812
connected to the inlet pump
810
via fluid line
814
having an isolation valve
816
(e.g., a solenoid-operated valve or one-way check valve). Alternatively, the pump or syringe may also act as the valve. The inlet pump
810
is configured to selectively pump fluids in two directions, to and away from the centrifuge
820
through fluid line
818
, and in this regard, may be a reversible-direction peristaltic pump or other two-directional pump. Similarly, although shown schematically with two fluid lines
804
and
814
, a single fluid line may be utilized as an inlet and an outlet line to practice the invention.
Operation of the inlet pump
810
to remove fluid from the centrifuge bag
226
is useful to align the radial location of the desired separated component with the outlet tube
250
and inlet tube
248
of the centrifuge bag
226
. When it is desired to align platelets or platelet rich plasma with the outlet tube
250
, the inlet tube
248
connected to lumen
232
and
230
, respectively, inlet tube
248
is preferably at a greater radial distance than the outlet tube
250
. When suction is applied to the inlet lumen
230
by inlet pump
810
, red blood cells are pumped out of the centrifuge bag
226
and into the red blood cell collector
812
. As red blood cells are removed, the separated platelets (i.e., the desired component region) move radially outward to a new location within the centrifuge bag
226
. The inlet pump
810
is operated until the radial distance of the separated platelets or platelet region from the central axis is increased to coincide with the radial distance or location of the outlet tube
250
of the centrifuge bag
226
. Once substantial alignment of the desired component region and the outlet tube
250
is achieved, the outlet pump
830
is operated to remove all or a select quantity of the components in the aligned component region.
To provide automation features of the invention, the centrifugal processing system
800
includes a controller
850
for monitoring and controlling operation of the inlet pump
810
, the centrifuge
20
, the drive assembly
822
, and the outlet pump
830
. Numerous control devices may be utilized within the centrifugal processing system
800
to effectively monitor and control automated operations. In one embodiment, the controller
850
comprises a computer with a central processing unit (CPU) with a digital signal processor, memory, an input/output (I/O) interface for receiving input and feedback signals and for transmitting control signals, and software or programming applications for processing input signals and generating control signals (with or without signal conditioners and/or amplifiers). The controller
850
is communicatively linked to the devices of the centrifugal processing system
800
with signal lines
860
,
862
,
864
,
866
, and
868
which may include signal conditioning devices and other devices to provide for proper communications between the controller
850
and the components of the centrifugal processing system
800
.
Once blood is supplied to the blood source container
802
, the operator pushes the start button and the controller
850
transmits a control signal over signal line
864
to the drive assembly
822
, which may include a motor controller, to begin rotating the centrifuge
20
to cause the components of the blood in centrifuge bag
226
to separate into radially-positioned regions (such as platelet rich plasma regions). After initiation of the centrifuge spinning or concurrently with operation of the drive assembly
822
, the controller
850
generates a control signal over signal line
860
to the inlet pump
810
to begin pumping blood from the blood source container
802
to the centrifuge bag
226
of the centrifuge
20
. In some embodiments of the processing system
800
, the drive assembly
822
is operable at more than one speed or over a range of speeds. Additionally, even with a single speed drive shaft the rotation rate achieved at the centrifuge
20
may vary. To address this issue, the processing system
800
may include a velocity detector
858
that at least periodically detects movement of the centrifuge bag
226
portion of the centrifuge
20
and transmits a feedback signal over signal line
866
to the controller
850
. The controller
850
processes the received signal to calculate the rotation rate of the centrifuge
20
, and if applicable, transmits a control signal to the drive assembly
822
to increase or decrease its operating speed to obtain a desired rotation rate at the centrifuge bag
226
.
To determine when separation of the components in the centrifuge bag
226
is achieved, the processing system
800
may be calibrated to account for variations in the centrifuge
20
and drive assembly
822
configuration to determine a minimum rotation time to obtain a desired level of component separation. In this embodiment, the controller
850
preferably includes a timer mechanism
856
that operates to measure the period of time that the centrifuge
20
has been rotated by the drive assembly
822
(such as by beginning measuring from the transmission of the control signal by the controller
850
to the drive assembly
822
). When the measured rotation time equals the calibrated rotation time for a particular centrifuge
20
and drive assembly
822
configuration, the timing mechanism
856
informs the controller
850
that separation has been achieved in the centrifuge bag
226
. At this point, the controller
850
operates to transmit control signal over signal line
860
to the input pump
810
to cease operation and to the outlet pump
830
over signal line
868
to initiate operation to pump a separated component in the component region adjacent the outlet port of lumen
232
of centrifuge bag
226
through fluid line
828
. In another embodiment where rotation time is utilized by controller
850
, the velocity feedback signal from the velocity detector
858
is utilized by the controller
850
to adjust the rotation time as necessary to obtain the desired level of component separation. For example, the centrifugal processing system
800
can be calibrated for a number of rotation rates and the corresponding minimum rotation times can be stored in a look up table for retrieval by the controller
850
based on a calculated rotation rate. Rotational rates may be varied either manually or automatically to optimize cellular component position and or concentration.
Because the location of component separation regions varies during separation operations, a preferred embodiment of the centrifugal processing system
800
includes a sensor assembly
840
to monitor the separation of components within the centrifuge bag and to transmit feedback signals over line
862
to the controller
850
. As will be understood by those skilled in the art, numerous sensor devices exist for detecting the presence of certain components in a fluid, and specifically a blood, sample. Many of these devices comprise a source of radiant energy, such as infrared, laser, or incandescent light, and a compatible radiant energy-sensitive detector that reacts to the received energy by generating an electric signal. Briefly, these radiant energy devices are useful because the detected signal varies in a measurable fashion with variances in the density of the material through which beams of the radiant energy are passed. According to the invention, the sensor assembly
840
may comprise any of these well-known types of radiant energy source and detector devices and other sensor devices useful for measuring the existence of constituents of fluids such as blood.
The source and the detector of the sensor assembly
840
are preferably located within the centrifugal processing system
800
to allow monitoring of the centrifuge bag
226
and, particularly, to identify the presence of a particular blood component in a radial position coinciding with the radial position of the outlet port of the centrifuge bag
226
. In one embodiment, the radiation beams from the source are transmitted through a “window” in the centrifuge bag
226
that has a radial location that at least partially overlaps the radial location of the outlet port. During operation of the centrifugal processing system
800
, the feedback signals from the detector of the sensor assembly
840
allow the controller
850
to identify when a density interface has entered the window. This may occur for a number of reasons. The change in density may occur when red blood cells are being removed by operation of the inlet pump
810
to remove fluid from the centrifuge bag
226
via the inlet tube
248
. The change in density may also occur when a denser component is being added to the centrifuge bag
226
causing the particular blood component to be pushed radially inward. In the centrifugation of whole blood, this occurs when additional blood is added by operation of the input pump
810
and red blood cells collect in a region radially outward from the platelet region.
To account for differing movement of the density interface, the window of the radiation source may be alternatively positioned radially inward from the location of the outlet tube
250
of the centrifuge bag
226
. By positioning the window inward from the outlet tube
250
, the controller
850
can identify when the outlet pump
830
has nearly removed all of the particular component of the monitored region and/or when the inlet pump
810
has removed a quantity of denser components causing the monitored region to move radially outward. The controller
850
can then operate to send control signals to turn off the outlet pump
830
or the inlet pump
810
(as appropriate) to minimize the amount of undesired components (lower density components) that enter the outlet tube
250
. Alternatively, the sensor assembly
840
may have two radiation sources and detectors, and the second window of the sensor assembly
840
may be located a distance radially outward from the outlet tube
250
. With two sensing windows, the sensor assembly
840
is operable to provide the controller
850
information about a density interface moving radially inward toward the outlet tube
250
(such as when red blood cells are added). In response, the controller
850
can generate a control signal to the inlet pump
810
to operate to pump the denser components, such as red blood cells, out of the centrifuge bag
226
. Two sensing windows also allow the controller
850
to detect a density interface moving outward, which allows the controller
850
to shut off the outlet pump
830
(and/or the inlet pump
810
to stop evacuating processes) and/or to start the inlet pump
810
to add additional blood.
To further clarify operation of the processing system
800
,
FIG. 54
is provided which illustrates the timing and relationship of control signals generated by the controller
850
and the receipt of feedback signals from the sensor assembly
840
. In this embodiment, the radiation detector of the sensor assembly
840
is positioned adjacent outlet tube (inlet to the outlet pump
830
) in the centrifuge bag
226
to sense density changes in the fluid flowing past the outlet tube
250
. As illustrated, operation of the processing system
800
begins at time to, with the inlet pump
810
, the outlet pump
830
, and the centrifuge drive assembly
822
all being off or not operating. At time t
1
, the controller
850
operates in response to operator input or upon sensing the blood source
802
is adequately filled (sensor not shown) to generate a control signal on line
864
to begin operating the centrifuge drive assembly
822
to rotate the centrifuge bag
226
. In some embodiments, this control signal over line
864
also contains rotation rate information to initially set the operating speed of the drive assembly
822
. Concurrently or at a selected delay time, the controller
850
generates a control signal on line
860
to start the inlet pump
810
in a configuration to pump fluid to the centrifuge bag
226
over fluid line
818
. The sensor assembly
840
provides an initial density feedback signal to the controller
850
on line
862
, which the controller
850
can process to determine an initial or unseparated density adjacent the outlet tube. Alternatively, the controller
850
may be configured to request a feedback signal from the sensor assembly
840
after a set delay period (as measured by the timer mechanism
856
) to allow separation of the components being pumped into the centrifuge bag
226
(such as the calibrated, minimum rotation time discussed above) into regions.
At time t
2
, the controller
850
functions to align the region having the desired density, such as a region comprising a higher density of platelets, adjacent the detector of the sensor assembly
840
(i.e., adjacent the outlet tube). To achieve alignment, the controller
850
transmits a control signal over line
860
to the inlet pump
810
to stop pumping fluid to the centrifuge bag
226
, to reverse pumping directions including shutting valve
806
and opening valve
816
, and to begin pumping components having a higher density then the particular, desired component from the centrifuge bag
226
to the collector
812
. For example, when the centrifugal processing system
10
is operated to separate and collect platelets or platelet rich plasma, the inlet pump
810
at time, t
2
, is operated to pump out the red blood cell fraction by applying suction at the inlet tube
248
to the centrifuge bag
226
. At time t
3
, the density of the fluid adjacent the outlet tube
250
begins to change as denser components are removed by the inlet pump
810
, and the sensor feedback signal being transmitted to the controller
850
changes in magnitude. The sensor feedback signal continues to change in magnitude (either becoming stronger or weaker depending on the particular sensor utilized and the material being collected) until at time t
4
, when the controller
850
processes the feedback signal and determines that the density of the adjacent fluids is within a desired range. This transition can also be thought of as detecting when an interface between two regions of differing densities passes by the location of the detector of the sensor assembly
840
.
With the region of the desired, separated component aligned with the outlet tube
250
, the controller
850
operates at time t
4
, to send a control signal over line
860
to stop operations of the inlet pump
810
. Also, at time t
4
, or at any time thereafter, the controller
850
generates a control signal over line
868
to begin operation the outlet pump
830
to apply suction at the outlet tube
250
of the centrifuge bag
226
to remove the desired component, such as the platelet rich plasma fraction, from the centrifuge bag
226
. At time t
5
, the sensor feedback signal again begins to change in magnitude as the density of the fluid near the outlet tube
250
begins to change, such as when platelet poor plasma begins to enter the sampling window of the sensor assembly
840
. At time t
6
, the density of the fluid adjacent the outlet tube
250
and, hence, in the sampling window is outside of a desired density range (e.g., the fluid has less than a predetermined percentage of platelets or other desired fluid component). In response, the controller
850
transmits a control signal on line
868
to halt operations of the outlet pump
830
. Of course, the controller
850
can be operated to transmit the signal to the outlet pump
830
at any time prior to time t
6
, such as at a time after time t
5
, when the density of the adjacent fluid begins to change but prior to time t
6
or based on volume removed. The controller
850
can then operate any time after time t
6
, to halt operation of the centrifuge drive assembly
822
. Further, as discussed above, operations of the separation centrifugal processing system
800
can be repeated with the inlet pump
810
being operated to add additional fluid, e.g., blood, after time t
6
. Alternatively, the inlet pump
810
and the outlet pump
830
may be operated concurrently to add an additional volume of blood with a corresponding new amount of the component being collected after time t
4
, to extend the period of time between detection of the interface at time t
4
and the detection of an out of range density at time t
6
.
In the above discussion of the automated processing system
800
, a sensor assembly
840
was shown in
FIG. 53
schematically, and it was noted that the location of a radiant energy source and a detector may be any location within the processing system
800
useful for obtaining an accurate measurement of separating blood components within the centrifuge bag
226
. For example, the source and detector can be both positioned within the centrifuge
20
at a location adjacent the centrifuge bag
226
. In this embodiment, problems may arise with providing proper signal and power line connections to the source and sensor and with accounting for the rotation of the centrifuge and portions of the sensor assembly
840
. Hence, one preferred embodiment of the processing system
800
provides for an externally positioned sensor assembly
840
including source and detector to simplify the structure of the centrifuge
20
while still providing effective density determinations of fluids within the blood reservoir.
FIG. 55
illustrates a general side view of the relevant components of this external sensor embodiment of the centrifugal processing system
800
. Generally, the centrifuge
20
comprises a rotor extension portion
880
and a drive portion
881
, which is connected to the drive assembly
822
(connection not shown). Both the centrifuge
20
and the rotor extension portion
880
rotate about a central or rotation axis, c
axis
, of the centrifuge
20
. As discussed in more detail with respect to the internal gearing features of the centrifuge
20
, the drive portion
881
spins in a ratio of 2 to 1 (or other suitable ratio) relative to the reservoir extension portion
880
to control twisting of inlet and outlet fluid lines to the rotor extension portion
880
. The internal gearing features of the centrifuge
20
also enable the centrifuge
20
to effectively obtain rotation rates that force the separation of components with differing densities while limiting the risk that denser components, such as red blood cells, will become too tightly packed during separation forming a solid, dense material that is more difficult to pump or remove from the centrifuge
20
.
Referring again to
FIG. 55
, the rotor extension portion
880
is shown located on the upper end of the centrifuge
20
and includes a centrifuge bag
226
or other receptacle. Preferably, the rotor extension portion
880
is fabricated from a transparent or partially transparent material, such as any of a number of plastics, to allow sensing of fluid densities. The rotor extension portion
880
extends a distance, d
over
, beyond the outer edge of the centrifuge
20
as measured radially outward from the central axis, c
axis
. The distance, d
over
, is preferably selected such that the desired component, such as the platelet rich plasma fraction, to be collected readily separates into a region at a point within the centrifuge bag
226
that also extends outward from the centrifuge
20
. In this regard, the rotor extension portion
880
is also configured so that the centrifuge bag
226
extends within the rotor extension portion
880
to a point near the outer circumference of the rotor extension portion
880
. The distance, d
over
, selected for extending the rotor extension portion
880
is preferably selected to facilitate alignment process (discussed above) and to control the need for operating the input pump
810
to remove denser components. In one embodiment, the distance, d
over
, is selected such that during separation of a typical blood sample center of the platelet rich region is about one half the extension distance, d
over
, from the circumferential edge of the centrifuge
20
.
The sensor assembly
840
is entirely external to the centrifuge
20
as shown in FIG.
55
. The sensor assembly
840
includes a source
882
for emitting beams
884
of radiant energy into and through the rotor extension portion
880
and the included centrifuge bag
226
. Again, as discussed previously, the radiant energy source
882
may be nearly any source of radiant energy (such as incandescent light, a strobe light, an infrared light, laser and the like) useful in a fluid density sensor and the particular type of detector or energy used is not as important as the external location of the source
882
. The sensor assembly
840
further includes a detector
886
that receives or senses beams
888
that have passed through the centrifuge bag
226
and have impinged upon the detector
886
. The detector
886
is selected to be compatible with the source
882
and to transmit a feedback signal in response sensing the energy beams
888
. The detector
886
(in combination with the controller
850
and its processing capacities) is useful for detecting the density of fluids in the centrifuge bag
226
between the source
882
and the detector
886
. Particularly, the sensor assembly
840
is useful for identifying changes in fluid density and interfaces between fluids with differing densities. For example, the interface between a region containing separated red blood cells and a region containing the platelet rich plasma fraction, and the interface between the platelet rich plasma region and a platelet-poor plasma region.
With some source and detector configurations, a sampling window is created rather than a single sampling point (although a single sampling point configuration is useful as part of the invention as creating a window defined by a single radial distance). The sampling window is defined by an outer radial distance, d
OUT
, from the central axis, c
axis
and an inner radial distance, d
IN
. As may be appreciated, for many source and detector configurations the size of the sampling window may be rather small approximating a point and may, of course vary in cross-sectional shape (e.g., circular, square, rectangular, and the like). As discussed previously, it is preferable that the sensor assembly
840
be positioned relative to the reservoir extension portion
880
and the centrifuge bag
226
such that the sampling window created by the source
882
and detector
886
at least partially overlaps the radial position of the region created during separation processes containing a component of particular density, such as platelets. This may be a calibrated position determined through calibration processes of the centrifuge
20
in which a number of blood (or other fluid) samples are fully separated and radial distances to a particular region are measured. The determined or calibrated position can then be utilized as a initial, fixed location for the sensor assembly
840
with the source
882
and detector
886
being positioned relative to the rotor extension portion
880
such that the sampling window overlaps the anticipated position of the selected separation region. Of course, each sample may vary in content of various components which may cause this initial alignment to be inaccurate and operations of the centrifugal processing system
800
may cause misalignment or movement of regions. Hence, alignment processes discussed above preferably are utilized in addition to the initial positioning of the sampling window created by the sensor assembly
840
.
In an alternate embodiment, the sensor assembly
840
is not in a fixed position within the separation system
800
and can be positioned during separation operations. For example, the sensor assembly
840
may be mounted on a base which can be slid radially inward toward the centrifuge
20
and radially outward away from the centrifuge
20
to vary the distances, d
IN
and d
OUT
. This sliding movement is useful for providing access to the centrifuge bag
226
, such as to insert and remove a disposable bag. During operation, the sensor assembly
840
would initially be pushed outward from the centrifuge
20
until a new bag was inserted into the centrifuge bag
226
. The sensor assembly
840
could then be slid inward (or otherwise moved inward) to a calibrated position. Alternatively, the centrifugal processing system
800
could be operated for a period of time to achieve partial or full separation (based on a timed period or simple visual observation) and then the sensor assembly
840
slid inward to a position that the operator of the centrifugal processing system
800
visually approximates as aligning the sampling window with a desired region of separated components (such as the platelet rich plasma region). The effectiveness of such alignment could then readily be verified by operating the sensor assembly
840
to detect the density of the fluids in the centrifuge bag
226
and a calculated density (or other information) could be output or displayed by the controller
850
. This alternate embodiment provides a readily maintainable centrifugal processing system
800
while providing the benefits of a fixed position sensor assembly
840
and added benefits of allowing easy relative positioning to obtain or at least approximate a desired sample window and separation region alignment.
In some situations, it may be preferable to not have a rotor extension portion
880
or to modify the rotor extension portion
880
and the sensor assembly
840
such that the extension is not significant to monitoring the separation within the blood reservoir or centrifuge bag
226
. Two alternative embodiments or arrangements are illustrated in
FIGS. 56 and 57
that provide the advantages of an external sensor assembly
840
(such as an external radiation source and detector). With these further embodiments provided, numerous other expansions of the discussed use of an external sensor will become apparent to those skilled in the arts and are considered within the breadth of this invention.
Referring to
FIG. 56
, a rotor
202
is illustrated that has no extending portion (although some extension may be utilized) and contains the centrifuge bag
226
. Again, the rotor
202
and centrifuge bag
226
are preferably fabricated from plastics or other materials that allow radiation to pass through to detect changes in densities or other properties of fluid samples within the centrifuge bag
226
. In this embodiment of the sensor assembly
840
, the radiation source
882
and the detector
886
are not positioned on opposing sides of the rotor
202
. Instead, a reflector
885
(such as a mirror and the like) is positioned within the drive portion
881
of the centrifuge to receive the radiation beams
884
from the radiation source
882
and direct them through the portion
880
and centrifuge bag
226
. The detector
886
is positioned within the sensor assembly
840
and relative to the centrifuge
20
to receive the deflected or reflected beams
888
that have passed through the fluid sample in the centrifuge bag
226
. In this manner, the sampling window within the centrifuge bag
226
can be selected to align with the anticipated location of the fraction that is to be collected upon separation. In a preferred embodiment, the sampling window at least partially overlaps with the location of the outlet tube of the blood reservoir or centrifuge bag
226
.
In one embodiment, the drive portion is fabricated from a non-transparent material and a path for the beams
884
from the radiation source
884
to the reflector
885
is provided. The path in one preferred embodiment is an opening or hole such as port
154
or
156
(
FIG. 14
) in the side of the drive portion
881
that creates a path or tunnel through which the beams
884
travel unimpeded. Of course, the opening may be replaced with a path of transparent material to allow the beams to travel to the reflector
885
while also providing a protective cover for the internals of the drive portion
881
. A path is also provided downstream of the reflector
885
to allow the beams
884
to travel through the drive portion
881
internals without or with minimal degradation. Again, the path may be an opening or tunnel through the drive portion leading to the portion
202
or be a path created with transparent materials. The beams
884
in these tunnel path embodiments enter the drive portion
881
one time per revolution of the drive portion
881
, which provides an acceptable rate of sampling. Alternatively, a reflector
885
may readily be provided that extends circumferentially about the center axis of the drive portion
881
to provide a sampling rate equivalent to the rate of beam
884
transmission. Of course, the positions of the radiation source
882
and the detector
886
may be reversed and the angle of the reflector
885
and transmission of the beams
884
may be altered from those shown to practice the invention.
A further embodiment of an external sensor assembly
840
is provided in FIG.
57
. In this embodiment, the radiation source
882
also acts as a radiation detector so there is no need for a separate detector. In this more compact external sensor configuration, the radiation source and detector
882
transmits beams
884
into the rotating drive portion
881
through or over the path in the drive portion
881
. The reflector
885
reflects the beams
884
toward the rotor
202
and the centrifuge bag
226
to create a sampling window within the centrifuge bag
226
in which density changes may be monitored. After passing through the centrifuge bag
226
and included fluid sample, the beams
888
strike a second reflector
887
that is positioned within the rotor
202
to reflect the beams
888
back over the same or substantially the same path through the centrifuge bag
226
to again strike the reflector
885
. The reflector
885
directs the beams
888
out of the drive portion
881
and back to the radiation source and detector
882
which, in response to the impinging beams
888
, transmits a feedback signal to the controller
850
for further processing.
In one embodiment, the beams
884
enter the driving portion
881
once during every revolution of the driving portion
881
. The portion
880
is preferably rotating twice for every rotation of the driving portion
881
, as discussed in detail above, and hence, the second reflector
887
is aligned to receive the beams
888
only on every other rotation of the driving portion
881
. Alternatively, a pair of reflectors
887
may be positioned in the rotor
202
such that the beams
888
may be received and reflected back through the centrifuge bag
226
once for every rotation of the driving portion
881
. In yet a further embodiment, the reflector
885
and second reflector
887
may expand partially or fully about the center axis of the centrifuge
20
(with corresponding openings and/or transparent paths in the driving portion
881
) to provide a higher sampling rate.
According to an important feature of the invention, temperature control features are provided in an alternate embodiment of the automated processing system invention
900
, as illustrated in FIG.
58
. Providing temperature controls within the processing system
900
can take many forms such as controlling the temperature of input fluid samples from the blood source
802
, monitoring and controlling the temperature of fluids in the centrifuge bag
226
to facilitate separation processes, and controlling the operating temperature of temperature sensitive components of the processing system
900
. These components include but are not limited to, red blood cells, white blood cells, plasma, platelet rich plasma or any of these components mixed with other drugs, proteins or compounds. In a preferred embodiment of the invention, a temperature control system is included in the processing system
900
to heat components removed from the centrifuge bag
226
by the outlet pump
830
to a desired temperature range. For example, when the processing system
900
is utilized in the creation of autologous platelet gel, a dispenser assembly
902
is included in the processing system
900
and includes chambers or syringes for collecting and processing platelet rich plasma drawn from the centrifuge
20
. As part of the gel creation process, it is typically desirable to activate the platelets in the harvested platelet rich plasma fraction prior to the use of the gel (e.g., delivery to a patient). The temperature control system is useful in this regard for raising, and for then maintaining, the temperature of the platelets in the dispenser assembly to a predetermined activation temperature range. In one embodiment of the gel creation process, the activation temperature range is 25° C. to 50° C. and preferably 37° C. to 40° C., but it will be understood that differing temperature ranges may readily be utilized to practice the invention depending on the desired activation levels and particular products being processed or created with the processing system
900
.
Referring to
FIG. 58
, the temperature control system of the processing system
900
includes a temperature controller
904
that is communicatively linked to the controller
850
with feedback signal line
906
. The controller
850
may be utilized to initially set operating temperature ranges (e.g., an activation temperature range) and communicate these settings over feedback signal line
906
to the temperature controller
904
. Alternatively, the temperature controller
904
may include input/output (I/O) devices for accepting the operating temperature ranges from an operator or these ranges may be preset as part of the initial fabrication and assembly of the processing system
900
. The temperature controller
904
may comprise an electronic control circuit allowing linear, proportional, or other control over temperatures and heater elements and the like. In a preferred embodiment, the temperature controller
904
includes a microprocessor for calculating sensed temperatures, memory for storing temperature and control algorithms and programs, and I/O portions for receiving feedback signals from thermo sensors and for generating and transmitting control signals to various temperature control devices (e.g., resistive heat elements, fan rotors, and other devices well-known to those skilled in the heating and cooling arts).
As illustrated, a temperature sensor
908
comprising one or more temperature sensing elements is provided to sense the temperature of the dispenser assembly
902
and to provide a corresponding temperature feedback signal to the temperature controller
904
over signal line
910
(such as an electric signal proportional to sensed temperature changes). The temperature sensor
908
may be any temperature sensitive device useful for sensing temperature and, in response, generating a feedback signal useful by the temperature controller
904
, such as a thermistor, thermocouple, and the like. In a preferred embodiment, the temperature sensor
908
is positioned within the dispenser assembly
902
to be in heat transferring or heat sensing contact with the syringes or other chambers containing the separated product which is to be activated. In this manner, the temperature controller
904
is able to better monitor whether the temperature of the relevant chambers within the dispenser assembly
902
is within the desired activation temperature range.
To maintain the chambers of the dispenser assembly
902
within a temperature range, a heater element
913
is included in the temperature control system and is selectively operable by the temperature controller
904
such as by operation of a power source based on signals received from the temperature sensor
908
. The heater element
913
may comprise any number of devices useful for heating an object such as the chambers of the dispenser assembly
902
, such as a fluid heat exchanger with tubing in heat exchange contact with the chambers. In a preferred example, but not as a limitation, electrical resistance-type heaters comprising coils, plates, and the like are utilized as part of the heater element
913
. Preferably, in this embodiment, the resistive portions of the heater element
913
would be formed into a shape that conforms to the shape of the exterior portion of the chambers of the dispenser assembly
902
to provide efficient heat transfer but preferably also allow for insertion and removal of the chambers of the dispenser assembly
902
. During operation of the separation system
900
, the temperature controller
904
is configured to receive an operating temperature range, to receive and process temperature feedback signals from the temperature sensor
908
, and in response, to selectively operate the heater element
913
to first raise the temperature of the chambers of the dispenser assembly
902
to a temperature within the operating temperature range and to second maintain the sensed temperature within the operating range.
For example, a desired operating range for activating a gel or manipulating other cellular components and their reactions onto themselves or with agents may be provided as a set point temperature (or desired activation temperature) with a tolerance provided on either side of this set point temperature. The temperature controller
904
, in this example, may operate the heater element
913
to raise the temperature of the chambers of the dispenser assembly
902
to a temperature above the set point temperature but below the upper tolerance temperature at which point the heater element
913
may be shut off by the temperature controller
904
. When the temperature sensed by the temperature sensor
908
drops below the set point temperature but above the lower tolerance temperature, the temperature controller
904
operates the heater element
913
to again raise the sensed temperature to above the set point temperature but below the upper tolerance temperature. In this manner, the temperature controller
904
effectively maintains the temperature of the chambers in the dispenser assembly
902
within a desired activation temperature range (which, of course, may be a very small range that approximates a single set temperature). In one embodiment, the temperature controller is or operates as a proportional integral derivative (PID) temperature controller to provide enhanced temperature control with smaller peaks and abrupt changes in the temperature produced by the heater element
913
. Additionally, the temperature controller
904
may include visual indicators (such as LEDs) to indicate when the sensed temperature is within a set operating range and/or audio alarms to indicate when the sensed temperature is outside the set operating range.
In another embodiment, the heater element
913
is configured to operate at more than one setting such that it may be operated throughout operation of the processing system
900
and is not shut off. For example, the heater element
913
may have a lower setting designed to maintain the chambers of the dispenser assembly
902
at the lower end of the operating range (e.g., acceptable activation temperature range) with higher settings that provide heating that brings the chambers up to higher temperatures within the set operating range. In another embodiment, the heater element
913
is configured to heat up at selectable rates (e.g., change in temperature per unit of time) to enhance the activation or other processing of separated liquids in the dispenser assembly
902
. This feature provides the temperature controller
904
with control over the heating rate provided by the heater element
913
.
As discussed previously, the invention provides features that combine to provide a compact separation system that is particularly adapted for onsite or field use in hospitals and similar environments where space is limited.
FIG. 59
illustrates one preferred arrangement of the centrifugal processing system
900
of
FIG. 58
that provides a compact profile or footprint while facilitating the inclusion of a temperature control system. An enclosure
916
is included as part of the temperature control system to provide structural support and protection for the components of the temperature control system. The enclosure
916
may be fabricated from a number of structural materials, such as plastic. The enclosure
916
supports a heater housing
918
that is configured to allow insertion and removal of the chambers and other elements of the dispenser assembly
902
. The heater housing
918
has a wall that contains the heater element
913
(not shown in
FIG. 59
) which is connected via control line
914
to the temperature controller
904
. The temperature sensor
908
(not shown in
FIG. 59
) is also positioned within the heater housing
918
, and as discussed with reference to
FIG. 58
, is positioned relative to the chambers of the dispenser assembly
902
to sense the temperature of the chambers, and the contained fluid, during operation of the system
900
. A temperature feedback signal is transmitted by the temperature sensor
908
over line
910
to temperature controller
904
, which responds by selectively operating the heater element
913
to maintain the temperature within the heater housing
918
within a selected operating range.
Because the separation system
900
includes temperature sensitive components, such as the controller
850
, the temperature control system preferably is configured to monitor and control the temperature within the enclosure
916
. As illustrated, a temperature sensor
920
is included to sense the ambient temperature within the enclosure
916
and to transmit a feedback signal over line
922
to temperature controller
904
. An air inlet
930
, such as a louver, is provided in the enclosure
916
to allow air, A
IN
, to be drawn into and through the enclosure
916
to remove heated air and maintain the temperature within the enclosure
916
at an acceptable ambient temperature. To circulate the cooling air, a fan
934
is provided to pull the air, A
IN
, into the enclosure
916
and to discharge hotter air, A
OUT
, out of the enclosure
916
. The fan
934
is selectively operable by the temperature controller
904
via control signals over line
938
. The size or rating of the fan
934
may vary in embodiments of the invention and is preferably selected based on the volume of the enclosure
916
, the components positioned within the enclosure
916
(e.g., the quantity of heat generated by the separation system
900
components), the desired ambient temperature for the enclosure
916
, and other cooling design factors.
In an alternate embodiment of the present invention a dispenser
902
, as shown in
FIG. 60
, is provided, for manipulating the cellular fraction which has been isolated and collected via outlet lumen
232
. In general, the present invention relates to a dispenser
902
which allows for a manual or automated manipulation of a two-phase method for forming an autologous platelet gel
970
composition wherein all of the blood components for the platelet gel
970
are derived from a patient to whom the platelet gel
970
will be applied.
The methods of the present invention for preparing an autologous platelet gel
970
composition, discussed in further detail below, are represented in the flow diagrams depicted in
FIGS. 61-63
. As discussed previously, the methods of the present invention begins by forming anticoagulated whole blood
396
which is achieved by collecting a patient's whole blood
394
in a source container
398
having an anticoagulation agent, such as sodium citrate (citrate) or heparin. Preferably, the whole blood
394
is collected and mixed with a 3.8% solution of sodium citrate (referred to herein as “citrate collection medium”) specifically in a 9:1 ratio of blood to citrate collection medium. A 3.8% solution of sodium citrate is prepared by adding 3.8 grams of sodium citrate per 100 ml of water. While a 3.8% sodium citrate collection medium is that which is frequently used to collect and preserve blood, the person skilled in this art will recognize that the ratio of sodium citrate to whole blood could be in the range of about 10.9-12.9% mMOL, final concentration.
First, as discussed in detail previously and depicted in
FIG. 61
, platelet rich plasma
260
and/or platelet poor plasma
262
are formed by centrifuging a quantity of anticoagulated whole blood
396
that was previously drawn from the patient. The platelet rich plasma
260
is first drawn from the centrifuge bag
226
and into collection chamber
400
. Collection chamber
400
is preferably a syringe, but any container that will not contact activate the collected fraction is acceptable. The platelet rich plasma
260
can be pumped via outlet pump
830
(
FIG. 53
) into a collection chamber
400
or the desired fraction can be drawn directly into dispenser
902
.
In the preferred embodiment, depicted in
FIG. 62
according to route
951
, the platelet rich plasma
260
, in centrifuge bag
226
, is divided into two portions and stored in vessels
952
and
960
. The first portion is approximately ¼ to ½ of the total volume of platelet rich plasma
260
and is utilized in phase-one to prepare the thrombin, while the second portion of platelet rich plasma
260
is utilized in phase-two vessel
960
. Once the platelet rich plasma
260
or alternatively the platelet poor plasma
262
(shown in
FIG. 61
) is obtained, the preferred methods to obtain thrombin and then produce the platelet gel compositions in an expedited manner, that is, in less than three minutes, are detailed diagrammatically in routes
951
or
981
, shown in
FIGS. 62 and 63
, respectively and discussed in detail below. If, however, a longer clotting time, that is, in a range of two to eight minutes, is desirous the method to obtain the platelet gel composition of the present invention can proceed along the routes
971
and
987
, which are also detailed diagrammatically in
FIGS. 63 and 63
, respectively and discussed in detail below.
Phase-one according to the preferred embodiment (
FIG. 62
) begins by restoring the clot-forming process. To accomplish this, an agent (restoration agent) capable of reversing the effects of the anticoagulation agent is added back into the first portion of the platelet rich plasma
260
stored in vessel
952
. Preferably, the restoration agent can be vessel
952
itself or the restoration agent is contained within vessel
952
prior to the introduction of platelet rich plasma
260
; however, the restoration agent may also be introduced later. It is furthermore preferable that the contact activator be a material such as but not limited to glass wool
953
or silica, aluminum, diatomaceous earth, kaolin, etc., or non-wettable surfaces such as plastic, siliconized glass, etc. Chemical activators, such as kaolin, can also be used to speed up the clotting time; however, their subsequent removal would also be necessary. In the preferred embodiment, a plastic syringe is the preferred container used to collect the desired fraction. In the presently preferred embodiment of the invention, the reversal of the anticoagulant is accomplished using calcium chloride. However, any substance which is known or found to be functionally equivalent to calcium chloride, such as, calcium gluconate or calcium carbonate, in restoring the coagulation activity of citrated blood may be used in the practice of the present invention. Thus, although calcium chloride is the presently preferred calcium salt for use in the invention, any calcium salt which functions in a similar manner to calcium chloride may be used in the invention. Similarly, although many blood coagulation reactions are currently believed to require calcium ions as cofactors, any substance which is known or subsequently found to be functionally equivalent to calcium in facilitating these coagulation reactions may be used, either individually or in combination with calcium, in the practice of the present invention. If the anticoagulation agent used was heparin, then heparinase or any other suitable anticoagulant reversing compound would be used to reverse the effect of the anticoagulation agent. The concentration of the restoration agent used to reverse the anticoagulation will depend in part, upon the concentration of the anticoagulation agent in the platelet rich plasma
260
and the stoichiometry of the chelating and coagulation reactions. However, the concentration of the restoration agent used to reverse the anticoagulation must be sufficient to achieve clot formation.
Upon restoration of the platelet rich plasma
260
as shown in
FIG. 62
, a clot
954
will naturally form. The resulting clot
954
is then triturated by squeezing the clot
954
through glass wool
953
which serves not only as a contact activator but also as a filter, thus expressing thrombin
955
. Alternatively, or in addition a filter
958
having a large micron pore size thereby allowing the removal of clot debris and any activator or solids that are present. Filter
958
is positioned at the outlet
956
of vessel
952
. In the preferred embodiment, the thrombin
955
is then mixed with the second portion of platelet rich plasma (PRP)
260
contained within vessel
960
to form the platelet gel composition
970
of the present invention in less than three minutes and in quantities sufficient for clinical use.
Other additives can be added to the above-described process to increase the concentration of thrombin formed by the intrinsic pathway or the extrinsic pathway.
As discussed in detail above, restoring the clotting cascade function of citrated plasma by addition of calcium chloride and exposure to an activating agent such as glass wool can generate autologous thrombin. The yield of autologous thrombin by this method however, may be low due to incomplete conversion of prothrombin and the inactivation of generated thrombin by fibrin and antithrombin III. The addition of modifying agents, such as epsilon aminocaproic acid, to the plasma may improve the yield by reducing the amount of thrombin neutralization. The greatest improvement in thrombin yield, however, will be achieved by providing a thromboplastic material upon which the necessary clotting factors will assemble to maximize the rate of prothrombin conversion. The activated platelet membrane provides such a stimulant surface and also enriches the necessary factor V activity by secreting additional factor V during platelet degranulation. The addition of exogenous lipoprotein and/or thromboplastic material to the plasma environment may also serve to maximize the thrombin generation by activation of both intrinsic and extrinsic clotting cascades. Additional amplification of autologous thrombin generation may also be attained by pretreatment of PRP and/or PPP to block or remove both antithrombin-III and fibrinogen prior to conversion of prothrombin to thrombin. Such modification may be attained by use of appropriate adsorptive agents, antibodies or precipitating reagents.
In an alternative embodiment, thrombin
950
is mixed with the platelet poor plasma
262
of phase-two thereby forming the autologous platelet gel composition
972
of the present invention in less than three minutes.
A third embodiment of the present invention, route
971
, shown in
FIG. 62
, contemplates collecting the original quantity of platelet rich plasma (PRP)
260
derived from the anticoagulated whole blood
396
in a container, having a wettable surface, such as glass. The platelet rich plasma
260
is then recalcified and the platelet gel composition
974
forms. The desired platelet gel composition
974
will require approximately two to eight minutes to form as opposed to less than a three minute formation as was described in the preferred embodiment.
In the fourth embodiment depicted diagrammatically by route
981
in
FIG. 63
, the platelet poor plasma
262
, rather then the platelet rich plasma
260
, is divided into two portions, as discussed previously in the preferred embodiment. The first portion, used in phase-one, which is approximately ¼ to ½ the original volume is stored in a vessel
952
having a wettable surface, then the restoration agent, preferably calcium chloride, is added directly to the platelet poor plasma
262
. Surface activation of the restored platelet poor plasma
262
occurs as result of the vessel's surface and/or the glass wool
953
or other surface or chemical activators and a clot
962
thus forms. The resulting clot
962
is triturated, as described previously, and the thrombin
955
is collected. Thrombin
955
is then mixed with the platelet rich plasma
260
of phase-two thereby forming the platelet gel sealant composition
973
.
In the fifth embodiment, thrombin
955
is mixed with the platelet poor plasma
262
of phase-two thereby forming the platelet gel composition
975
in less than three minutes.
The sixth embodiment follows route
987
, shown in
FIG. 63
wherein the original quantity of platelet poor plasma
262
is collected in a container having a wettable surface, such as glass. The platelet poor plasma
262
is then recalcified and the platelet gel composition forms.
The tensile strength of the platelet gel compositions of the present invention can be effected by the addition of calcium ions. Consequently, if a stronger bioadhesive sealant composition is desired using the methods discussed above and disclosed in routes
951
and
981
, in
FIGS. 62 and 62
, respectively, more calcium ions may be added at the time the serum is introduced into the platelet rich plasma
260
or the platelet poor plasma
262
. Alternatively, if the method of preparing the platelet gel compositions follows routes
971
and
987
, depicted in
FIGS. 62 and 63
, respectively, then calcium ions may be introduced directly into the platelet rich plasma
260
or the platelet poor plasma
262
and the platelet gel compositions
974
and
976
, respectively, will form.
As discussed in further detail below, the time period necessary for the formation of the platelet gel composition of the present invention is dependent on the quantity of serum added. A 1:4, 1:2 and 3:4 ratio of serum to platelet rich plasma or platelet poor plasma results in the formation of the platelet gel composition in approximately 90, 55 and 30 seconds, respectively. Furthermore, due to the fact that thrombin is autocatalytic, it is important that the serum be used 0.2 within five hours of preparation, preferably within two hours and ideally immediately. Alternatively, the serum can be chilled or frozen indefinitely.
The platelet gel compositions of this invention may be used for sealing a surgical wound by applying to the wound a suitable amount platelet rich plasma or platelet poor plasma. Moreover, due to the fact that the platelet gel compositions of the present invention have been prepared solely from blood components derived from the patient that is to receive the platelet gel there is a zero probability of introducing a new blood transmitted disease to the patient. The methods of the present invention may be further modified so that the formed platelet gel composition functions not only as a haemostatic agent, but also as an adjunct to wound healing and as a matrix for delivery of drugs and proteins with other biologic activities. For example, it is well known that fibrin glue has a great affinity to bind bone fragments which is useful in bone reconstruction, as in plastic surgery or the repair of major bone breaks. Consequently, in keeping with the autologous nature of the platelet gel composition of the present invention autologous bone from a patient can be ground or made into powder or the like, and mixed into the platelet rich plasma obtained in phase-two of the methods of the present invention. Autologous thrombin is then mixed in with the platelet rich plasma and bone fragments in an amount sufficient to allow the resulting gel to be applied to the desired locale where it congeals. Other materials that may be utilized are, but not limited to, gelatin collagen, degradable polymers, hyaluronic acid, carbohydrates and starches.
In instances where the desired platelet gel composition of the present invention is to further function as a delivery device of drugs and proteins with other biologic activities the method of the present invention may be modified as follows. Prior to adding the thrombin, obtained in phase-one, to the platelet rich plasma of phase-two a wide variety of drugs and proteins with other biologic activities may be added to the platelet rich plasma of phase-two. Examples of the agents to be added to the platelet rich plasma prior to the addition of the serum include, but are not limited to, analgesic compounds, such as Lidocaine, antibacterial compounds, including bactericidal and bacteriostatic compounds, antibiotics (e.g., adriamycin, erythromycin, gentimycin, penicillin, tobramycin), antifungal compounds, anti-inflammatories, antiparasitic compounds, antiviral compounds, anticancer compounds, such as paclitaxol enzymes, enzyme inhibitors, glycoproteins, growth factors (e.g. lymphokines, cytokines), hormones, steroids, glucocorticosteroids, immunomodulators, immunoglobulins, minerals, neuroleptics, proteins, peptides, lipoproteins, tumoricidal compounds, tumorstatic compounds, toxins and vitamins (e.g., Vitamin A, Vitamin E, Vitamin B, Vitamin C, Vitamin D, or derivatives thereof). It is also envisioned that selected fragments, portions, derivatives, or analogues of some or all of the above may be used.
A number of different medical apparatuses and testing methods exist for measuring and determining coagulation and coagulation-related activities of blood. These apparatuses and methods can be used to assist in determining the optimal formulation of activator, that is, thrombin, calcium and plasma necessary to form the platelet gel composition of the present invention. Some of the more successful techniques of evaluating blood clotting and coagulation are the plunger techniques illustrated by U.S. Pat. Nos. 4,599,219 to Cooper et al., 4,752,449 to Jackson et al., and 5,174,961 to Smith, all of which are assigned to the assignee of the present invention, and all of which are incorporated herein by reference.
Automated apparatuses employing the plunger technique for measuring and detecting coagulation and coagulation-related activities generally comprise a plunger sensor cartridge or cartridges and a microprocessor controlled apparatus into which the cartridge is inserted. The apparatus acts upon the cartridge and the blood sample placed therein to induce and detect the coagulation-related event. The cartridge includes a plurality of test cells, each of which is defined by a tube-like member having an upper reaction chamber where a plunger assembly is located and where the analytical test is carried out, and a reagent chamber which contains a reagent or reagents. For an activated clotting time (ACT) test, for example, the reagents include an activation reagent to activate coagulation of the blood. A plug member seals the bottom of a reagent chamber. When the test commences, the contents of the reagent chamber are forced into the reaction chamber to be mixed with the sample of fluid, usually human blood or its components. An actuator, which is a part of the apparatus, lifts the plunger assembly and lowers it, thereby reciprocating the plunger assembly through the pool of fluid in the reaction chamber. The plunger assembly descends by the force of gravity, resisted by a property of the fluid in the reaction chamber, such as its viscosity. When the property of the sample changes in a predetermined manner as a result of the onset or occurrence of a coagulation-related activity, the descent rate of the plunger assembly there through is changed. Upon a sufficient change in the descent rate, the coagulation-related activity is detected and indicated by the apparatus.
Using the methods discussed above, cartridges were assembled with serum obtained from either platelet rich plasma or platelet poor plasma, and CaCl
2
in the reagent chambers. Clotting time tests were performed by the automated process with either platelet rich plasma (PRP) or platelet poor plasma (PPP) dispersed into the reaction chambers of the cartridges. In the first experiment, the results of which are represented in
FIG. 64
, the amount of serum, the type of plasma from which the serum was derived, and the type of plasma the serum was mixed with were tested to determine the shortest clotting times. The ratios of serum to platelet rich plasma or platelet poor plasma that were studied included 1:4, 1:2, and 3:4. In the second set of experiments, the results of which are represented in
FIGS. 66 and 67
, the relationship between actual gel time for the platelet gel of the present was compared to the clotting time in the cartridge, wherein there is a 0, 30, or 60 minute delay of adding the serum from its generation. The third set of experiments, the results of which are represented in
FIGS. 68 and 69
, studied the effect of calcium addition on actual gel time versus clotting time in the cartridge. The final set of experiments, the results of which are represented in
FIG. 65
, studied the effect of adding calcium on clotting times.
Although clotting times varied among donors, comparisons of clotting times for individual donors show significant effects of the serum to plasma ratio and the calcium concentration. For all donors, the shortest clotting times occurred for the 3:4 ratio, with clotting times that were 47% shorter than those for the 1:4 ratio. Although the difference in clotting times for the 3:4 ratio and the 1:2 ratio was not statistically significant, the clotting times were consistently shorter using the 3:4 ratio for all donors. These results demonstrate that clotting times may be shortened by increasing the serum to platelet rich plasma ratio. Similarly, clotting times were significantly affected by the amount of calcium added, with the shortest clotting times obtained when no calcium was added, suggesting that the serum contained levels, of calcium that were sufficient to recalcify the citrated platelet rich plasma. Preliminary results from the scale-up experiments suggest that experimental clotting times in the cartridges correlate with actual gel times.
The invention is further illustrated by the following non-limited examples. All scientific and technical terms have the meanings as understood by one with ordinary skill in the art. The specific examples which follow illustrate the methods in which the bioadhesive sealant compositions of the present invention may be prepared in a clinical setting and are not to be construed as limiting the invention in sphere or scope. The methods may be adapted to variation in order to produce compositions embraced by this invention but not specifically disclosed. Further, variations of the methods to produce the same compositions in somewhat different fashion will be evident to one skilled in the art.
EXAMPLES
The examples herein are meant to exemplify the various aspects of carrying out the invention and are not intended to limit the invention in any way.
Example 1
Preparation of Bioadhesive Sealant Composition Using Platelet Rich Plasma and Serum
6 cc's of platelet rich plasma are drawn into receiving chamber
961
and 3 cc's per PRP or PPP are drawn into receiving chamber
957
which further contains 0.33 cc's of 10% calcium chloride and glass wool. Clotting of the contents will occur in two to eight minutes in receiving chamber
957
. The clot is then squeezed through optional filter
958
and the serum, produced therefrom, is added to the platelet rich plasma contained in receiving chamber
961
by either mixing or spraying the two components. The platelet rich plasma and the serum will gel within approximately three minutes.
The application of the gel using the syringe-type devices
902
as described above maybe less than desirable for may applications. Consequently, in an alternate embodiment the inactive blood component and thrombin can be mixed and/or injected into a mold having a desired geometric shape. The mold may be constructed of a material having a wettable surface, such as, but not limited to plastic. In particular, platelet gel of the present invention may be used to temporarily fill, cavities such as but not limited to holes left in the gum from tooth extraction and/or holes left in tissue or bone as a result of injury or surgical procedures. The present invention provides a simpler way of introducing platelet gel for specific uses, by providing that the platelet gel be pre-shaped or molded into a beneficial shape prior to being inserted into a cavity. In the case of tooth extraction the platelet gel may be shaped so as to achieve a basic conical shape. Other shapes such as, but not limited to rods, and rectangles are contemplated by this invention. The ability to cause the gel to be more, or less, solid and thus malleable may be achieved during the activation sequence of the gel formation.
The foregoing description is considered as illustrative only of the principles of the invention. Furthermore, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and processes shown as described above. Accordingly, all suitable modifications and equivalents may be resorted to falling within the scope of the invention as defined by the claims which follow.
The foregoing description is considered as illustrative only of the principles of the invention. The words “comprise,” “comprising,” “include,” “including,” and “includes” when used in this specification and in the following claims are intended to specify the presence of one or more stated features, integers, components, or steps, but they do not preclude the presence or addition of one or more other features, integers, components, steps, or groups thereof. Furthermore, since a number of modifications and changes will readily will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and process shown described above. Accordingly, all suitable modifications and equivalents may be resorted to falling within the scope of the invention as defined by the claims which follow.
Claims
- 1. A method of harvesting desired cellular components from anticoagulated whole blood, said method comprising:a) providing a flexible centrifuge bag comprising: i) at least one inlet tube; ii) at least one outlet tube; iii) upper and lower flexible sheets, said sheets having doughnut shaped configurations, inner perimeters defining a central core of said centrifuge bag and outer perimeters, wherein said upper and lower sheets are superimposed and completely sealed together at their outer perimeters thereby defining the outer perimeter of said centrifuge bag, and wherein said tubes are sandwiched between said upper and lower sheets and extend from the central core of said centrifuge bag, whereby when said upper and lower sheets are sealed together at their inner perimeters said tubes are sealed between said upper and lower sheets at the inner perimeters; b) providing a centrifuge rotor; c) securing said flexible centrifuge bag horizontally in said centrifuge rotor whereby said centrifuge bag is rotatable therewith; d) rotating said centrifuge rotor; e) providing an aliquot of said whole blood to said rotating centrifuge bag via said inlet tube, whereby said whole blood separates radially into an outermost first fraction containing red blood cells, a second fraction containing white blood cells, a third fraction containing platelet rich plasma, and an innermost fourth fraction containing platelet poor plasma, wherein the distal end of said outlet tube is in flow communication with a fraction containing a desired cellular components fraction; and f) withdrawing said desired cellular components fraction from said rotating centrifuge bag via said outlet tube until a substantial portion of said fraction has been removed from said bag; and g) terminating withdrawal of said desired cellular components fraction when an undesired fraction is detected to be near the distal end of said outlet tube.
- 2. The method of claim 1, wherein said inlet tube has a distal end positioned at a first radial distance from the center axis of said centrifuge bag said outlet tube having a distal end positioned at a second radial distance from the center axis of said centrifuge bag, said first radial distance being greater than said second radial distance.
- 3. The method of claim 1, wherein said desired cellular components fraction is withdrawn from said bag by applying suction to said outlet tube.
- 4. The method of claim 1, further comprising:h) disconnecting said inlet tube from said whole blood source; i) withdrawing the remaining fractions from said bag by applying suction to said inlet tube; and j) repeating steps e) through i) until a desired quantity of said desired cellular components have been collected.
- 5. The method of claim 1, wherein said tubes are fluidly connected to a multiple lumen tubing comprising at one inlet lumen and at least one outlet lumen.
- 6. The method of claim 5, wherein said inlet tube is fluidly connected at its proximal end to said inlet lumen.
- 7. The method of claim 5, wherein said outlet tube is fluidly connected at its proximal end to said outlet lumen.
- 8. The method of claim 5, wherein said multiple lumen tubing is prevented from completely rotating about its axis during rotation of said centrifuge rotor.
- 9. The method of claim 1, wherein said detection is accomplished visually or by a sensor.
- 10. The method of claim 1, wherein said centrifuge rotor comprises a transparent cover comprising one or more spaced apart concentric indicator lines for monitoring the separation of said whole blood components, and wherein the distal end of said outlet tube is positioned relative to a predetermined indicator line.
- 11. The method of claim 1, wherein said cover comprises indicator lines having radial distances that indicate the location of the desired cellular components with respect to the distal end of said outlet port.
- 12. The method of claim 11, wherein the distal end of said outlet tube is positioned relative to said second indicator line.
- 13. A method of collecting cellular components from whole blood, said method comprising:a) providing a flexible centrifuge bag comprising radially extending upper and lower flexible sheets and having at least one inlet tube, a first outlet tube, a second outlet tube, and a third outlet tube; b) providing a centrifuge; c) securing said flexible centrifuge bag in said centrifuge whereby said centrifuge bag is rotatable therewith; d) rotating said centrifuge and said centrifuge bag; e) providing an aliquot of said whole blood to said rotating centrifuge bag via said inlet tube, whereby said whole blood components separate radially into an outermost first fraction containing red blood cells, a second fraction containing white blood cells, a third fraction containing platelet rich plasma, and an innermost fourth fraction containing platelet poor plasma, wherein the distal end of said outlet tube is in flow communication with a desired cellular components fraction; and f) withdrawing said desired cellular fraction from said rotating centrifuge bag via said first outlet tube until a substantial portion of said desired cellular fraction has been removed from said bag and terminating withdrawal of said desired cellular fraction when an undesired cellular fraction is detected to be near the distal end of said first outlet tube.
- 14. The method of claim 13, further comprising:g) repeating steps d) through f) until the volume of the second fraction and/or the first fraction accumulates to the point where the desired cellular fraction within the centrifuge bag is no longer in flow communication with the distal end of said first outlet tube; h) shifting the location of the desired cellular fraction within the centrifuge bag until the desired cellular fraction is in flow communication with the distal end of said first outlet tube; and i) repeating steps d)-h) until the desired quantity of desired cellular fraction is collected.
- 15. The method of claim 14, wherein the distal end of said second outlet tube is near the outer perimeter of said centrifuge bag, and said shifting comprises withdrawing said first fraction from said rotating centrifuge bag through said second outlet tube.
- 16. The method of claim 13, wherein said tubes are connected at their proximal ends to a multiple lumen tubing.
- 17. The method of claim 16, wherein said multiple lumen tubing comprises an inlet lumen connected at one end to said inlet tube and at the other end to a whole blood source.
- 18. The method of claim 16, wherein said multiple lumen tubing comprises a first outlet lumen connected at one end to said first outlet tube and at the other end to a receiving container.
- 19. The method of claim 16, wherein said multiple lumen tubing is prevented from completely rotating about its axis during rotation of said centrifuge.
- 20. The method of claim 13, wherein said detection is accomplished visually or by a sensor.
- 21. A method for harvesting platelets from whole blood, comprising:a) providing a disposable centrifuge bag comprising: i) upper and lower flexible sheets, said sheets having doughnut shaped configurations, inner perimeters defining a central core of said centrifuge bag, and outer perimeters, wherein said upper and lower sheets are superimposed and completely sealed together at their outer and inner perimeters; ii) a first processing compartment for receiving said whole blood and separating said whole blood into a red blood cell fraction and a platelet suspension fraction; iii) a second processing compartment for separating platelets from said platelet suspension fraction; iv) channels for directing said platelet suspension fraction from said first processing compartment into said second processing compartment; v) an inlet tube for introducing said whole blood to said first processing chamber; and vi) an outlet tube for removing platelets from said second processing compartment; b) providing a centrifuge; c) securing said flexible centrifuge bag in said centrifuge, whereby said centrifuge bag is fixably rotatable with said centrifuge; d) rotating said centrifuge; e) providing an aliquot of whole blood to said rotating centrifuge bag via said inlet tube, whereby the whole blood separates radially within said first processing compartment into a red blood cell fraction and a platelet suspension fraction; f) repeating step e) as necessary until said platelet suspension flows through said channels into said second processing compartment and terminating said providing step when said red blood cell fraction is detected to be near said channels, whereby said platelets separate from said platelet suspension in said second processing compartment; and g) removing said platelet concentrate from said second processing compartment via second outlet tube.
- 22. The method of claim 21, wherein said inlet tube extends radially from said central core and is sealed between the upper and lower sheets at the inner perimeter.
- 23. The method of claim 22, wherein first and second ends of said outlet tube are proximal to said first and second indentations, respectively.
- 24. The method of claim 21, wherein said second processing compartment further comprises first and second diametrically opposed wells on the inner surface for collecting said platelets.
- 25. The method of claim 24, wherein said outlet tube extends across the diameter of said core, wherein first and second ends of said outlet tube are proximal to said first and second wells, respectively.
- 26. The method of claim 21, wherein said inlet tube is fluidly connected at its proximal end to an inlet lumen of a multi lumen tubing.
- 27. The method of claim 26, wherein said inlet lumen is further connected to a whole blood source.
- 28. The method of claim 27, further comprising:h) disconnecting said inlet lumen from said whole blood source; i) withdrawing the remaining components from said bag by applying suction to said inlet lumen; j) reconnecting said inlet lumen to said whole blood source; and k) repeating steps e) through j) until a desired amount of said platelets has been harvested.
- 29. The method of claim 21, wherein said outlet tube is fluidly connected at its axis to an outlet lumen of a dual lumen tubing.
- 30. The method of claim 21, wherein said detection is accomplished visually or by a sensor.
- 31. A method for harvesting platelet rich plasma from whole blood, comprising:a) providing a disposable centrifuge bag comprising: i) upper and lower flexible sheets, said sheets having doughnut shaped configurations, inner perimeters defining a central core of said centrifuge bag, and outer perimeters, wherein said upper and lower sheets are superimposed and completely sealed together at their outer and inner perimeters; ii) an outer compartment for receiving said whole blood; iii) an inner compartment between said outer compartment and said core; iv) first and second channels for providing fluid communication between said outer and said compartments; v) an inlet port in said lower sheet in fluid communication with said outer compartment for introducing whole blood into said outer compartment; vi) first and second outlet ports in said lower sheet and positioned in said first and second channels, respectively, for removing platelets from said centrifuge bag; vii) an inlet tube fixed to the outer surface of said lower sheet and extending radially from the central core, wherein the distal end of said inlet tube is in fluid communication with said inlet port; and viii) an outlet tube fixed to the outer surface of said lower sheet and extending across the diameter of said central core, wherein the first and second ends of said outlet tube are in fluid communication with said first and second outlet ports, respectively; b) providing a centrifuge; c) securing said centrifuge bag in said centrifuge, whereby said centrifuge bag is fixably rotatable with said centrifuge; d) rotating said centrifuge; e) providing an aliquot of whole blood to said rotating centrifuge bag via said inlet tube, whereby the whole blood separates radially within said outer compartment into an outer red blood cell fraction and an inner platelet rich plasma fraction; f) repeating step e) until said platelet rich plasma fraction flows into said channels; and g) withdrawing said platelet rich plasma fraction through said outlet ports until said red blood cell fraction is detected to be near said outlet ports.
- 32. The method of claim 31, wherein said inlet tube is fluidly connected at its proximal end with an inlet lumen of a dual lumen tubing.
- 33. The method of claim 32, wherein said inlet lumen is further connected to an anticoagulated whole blood source.
- 34. The method of claim 33, further comprising:h) disconnecting said inlet lumen from said whole blood source; i) withdrawing the remaining components from said bag by applying suction to said inlet lumen; j) reconnecting said inlet lumen to said whole blood source; and k) repeating steps e) through j) until a desired amount of said platelets has been harvested.
- 35. The method of claim 31, wherein said outlet tube is fluidly connected at its axis with an outlet lumen of a dual lumen tubing.
- 36. The method of claim 31, wherein said detection is accomplished visually or by a sensor.
- 37. A method of harvesting platelet rich plasma from anticoagulated whole blood, said method comprising:a) providing a rigid centrifuge container comprising i) a rigid annular body having an axial core; ii) an interior collection chamber for receiving and holding said whole blood during centrifugation, said chamber having an outer perimeter and an inner perimeter and having a generally off-centered figure eight-shaped side cross-sectional configuration wherein the narrowest portion of said chamber is closer to the inner perimeter; iii) an inlet channel extending radially from said core to a distance near the outer perimeter of said chamber, the distal end of said inlet channel being in fluid communication with the interior of said chamber; and iv) an outlet channel extending radially from said core to a distance approximately near the narrowest portion of said chamber, said outlet channel being in fluid communication with the interior of said chamber at the narrowest portion; b) providing a centrifuge; c) securing said rigid centrifuge container to said centrifuge; d) rotating said centrifuge and said centrifuge container; e) providing an aliquot of said whole blood to said rotating centrifuge container via said inlet channel, whereby said whole blood separates radially within said chamber into an outermost first fraction containing red blood cells, a second fraction containing white blood cells, a third fraction containing platelet rich plasma, and an innermost fourth fraction containing platelet poor plasma, and wherein the distal end of said outlet channel is positioned to be in flow communication with said platelet rich plasma fraction; and f) removing said platelet rich plasma from said rotating centrifuge container via said outlet channel.
- 38. The method of claim 37, wherein said inlet channel and said outlet channel are fluidly connected at their proximal ends to a dual lumen tubing having an inlet lumen and an outlet lumen.
- 39. The method of claim 38, wherein said inlet lumen is fluidly connected at one end to said inlet channel and at the other end to a whole blood source.
- 40. The method of claim 39, further comprising:g) disconnecting said inlet lumen from said whole blood source; h) withdrawing the remaining fractions from said chamber by applying suction to said inlet lumen; i) repeating steps e)-h) as needed until the desired amount of said platelet rich plasma has been harvested.
- 41. The method of claim 38, wherein said dual lumen tubing is prevented from completely rotating about its axis during rotation of said centrifuge.
- 42. A method for harvesting platelet rich plasma from anticoagulated whole blood, comprising:a) providing a flexible centrifuge bag comprising an inlet tube and at least one outlet tube; b) providing a rotatable rotor comprising an annular base having a lower annular channel and an annular cover having an upper annular channel for holding said flexible centrifuge bag therebetween; c) positioning said flexible centrifuge bag in said base; d) superimposing said cover over said base, whereby said lower and upper channels define an interior chamber having a generally off-centered figure eight cross-sectional configuration and wherein said centrifuge bag is fixably rotatable with said rotor; e) rotating said rotor; f) introducing an aliquot of said fluid to said rotating centrifuge bag via said inlet tube, whereby whole blood components separate into at least an outer red blood cell fraction and an inner platelet rich plasma fraction based on their densities at varying radial distances from the central axis; and g) removing said platelet rich plasma fraction via said outlet tube.
- 43. The method of claim 42, wherein said base comprises a first outer rim extending from the base top surface and a first column axially centered and extending from the base top surface, wherein said first column has a first groove extending across the diameter of its top surface, wherein said lower annular channel is defined by said first rim and said first column.
- 44. The method of claim 43, wherein said base column extends through said bag central core.
- 45. The method of claim 42, wherein said cover comprises a second outer rim extending from the cover bottom surface and a second column axially centered and extending from the cover bottom surface, wherein said second column has a second groove extending across the diameter of its top surface, wherein said upper annular channel is defined by said second rim and said second column.
- 46. The method of claim 42, wherein said centrifuge bag further comprises superimposed upper and lower flexible sheets having doughnut shaped configurations, inner perimeters defining a central core of said centrifuge bag, and outer perimeters, wherein said upper and lower sheets are completely sealed together at their outer and inner perimeters.
- 47. The method of claim 42, wherein said inlet and outlet tubes are sandwiched between said upper and lower sheets and sealed therebetween and extend from the central core of said centrifuge bag, wherein said inlet and outlet tubes are seated in said first groove said second grooves.
- 48. The method of claim 42, wherein said cover is fabricated from a material that is at least partially transparent.
- 49. The method of claim 42, further comprising one or more radially spaced apart concentric indicator lines on said cover for monitoring the separation of said whole blood components.
- 50. The method of claim 42, wherein said inlet and outlet tubes are connected at their distal ends to a multiple lumen tubing.
- 51. The method of claim 50, wherein said multiple lumen tubing is prevented from completely rotating about a central axis.
- 52. The method of claim 42, wherein at least one of said outlet tubes is fluidly connected at its distal end to a bent fitting.
US Referenced Citations (16)