Evaluation of store lesion in platelet obtained by apheresis compared to platelet derived from whole blood and its impact on the in vitro functionality

Oxidative modulations in platelets stored in SSP+, PAS-G and Tyrode's buffer: a comparative analysis

BACKGROUND

Platelet additive solutions (PASs) improve the efficacy of stored platelets. Oxidative stress causes storage lesions and platelet functions deteriorate. Studies assessing the influence of oxidative stress on platelets stored in PASs are limited. This study compares variations in platelets in different storage solutions (SSP+, PAS-G and Tyrode's buffer).

METHODS

Platelets isolated from the blood of Wistar rats were resuspended in SSP+, PAS-G and Tyrode's buffer and stored for seven days at 22 °C. The markers of platelet metabolism, function, oxidative stress, antioxidant status and viability were analyzed on Days 1, 3, 5 and 7 of storage.

MAIN RESULTS

SSP+ is associated with platelet function, viability and antioxidant defenses (SOD, CAT and GSH); it decreased primary lipid peroxidation products and maintained the susceptible protein groups in reduced state. Platelet function, antioxidant defenses such as SOD and GSH improved, and lipids and thiols were protected from oxidation in PAS-G. SOD and GSH increased, and lipids and thiols were preserved in Tyrode's buffer.

CONCLUSION

SSP+ and PAS-G are more effective in maintaining platelet efficacy till Day 7 compared to Tyrode's buffer. Thus, PAS-G and SSP+ are better than Tyrode's buffer in terms of platelet responses to oxidative stress during storage. This is the first comparative account on the influence of PASs (SSP+, PAS-G and Tyrode's buffer) on platelets in altering oxidative stress. It provides a comprehensive view of the differential responses of platelets in PASs.

Platelet function, but not thrombin generation, is impaired in acute normovolemic hemodilution (ANH) blood

STUDY OBJECTIVE

We investigated the coagulation changes that might occur in acute normovolemic hemodilution (ANH) blood over several hours during cardiac surgery requiring cardiopulmonary bypass.

DESIGN

This study was a prospective observational study.

SETTING

This study took place at a university teaching hospital.

PATIENTS

This study included 26 patients, either ASA 3 or 4 and without known coagulation disorders, undergoing cardiac surgery. Patients were included if the use of cardiopulmonary bypass was expected to reach 2.5 h.

INTERVENTIONS

ANH blood was collected into CPDA-1 collection bags before systemic heparinization. Samples were taken directly from the bags at time of collection and reinfusion to assess changes in platelet and thrombin generation parameters.

MEASUREMENTS

Whole blood from citrated tubes was used immediately for rotational thromboelastometry and platelet aggregometry analyses. Thrombin generation was assessed using calibrated automated thrombography with platelet poor plasma.

MAIN RESULTS

Despite no significant change in platelet count over the ANH storage period, there was significant degradation in platelet function as measured by thrombin receptor activating peptide stimulation on Mulltiplate™ analysis and maximum clot formation on ROTEM™ EXTEM. Notably, there was no change in the ability to generate thrombin.

CONCLUSIONS

Little data exists regarding the quality of coagulation factors in autologous blood. Our study confirms ANH collection results in decreased platelet aggregation with TRAP stimulation; however, this is not appreciated with ADP stimulation. Thrombin generation capacity remains preserved.

Influence of platelet preparation techniques on in vitro storage quality after psoralen-based photochemical treatment using new processing sets for triple-dose units

BACKGROUND

The INTERCEPT Blood System (IBS) for platelets (PLTs) uses a combination of psoralen and ultraviolet-A light to inactivate pathogens that may contaminate PLT concentrates (PCs). However, no data are available on the quality of IBS-treated PLTs from different apheresis and buffy-coat PC preparation platforms using the new triple storage (TS) set.

STUDY DESIGN AND METHODS

The objective of this study was to evaluate the TS set on three different preparation platforms compared with the large-volume (LV) set, as control. PLT in vitro metabolic and activation parameters were studied over 7 days.

RESULTS

Several statistical differences are observed between the two sets, particularly for pH, oxygen pressure (pO₂ ), carbonic gaz pressure (pCO₂ ), and bicarbonate. The three different preparation techniques influence PLT parameters, and the difference is statistically significant for all the studied parameters, except for pCO₂ . The TS set has the advantage of shorter compound adsorption device time, higher PLT recoveries, and less PLT activation.

CONCLUSION

Results from the measured metabolic parameters and PLT variables obtained from PCs treated by LV and TS sets indicated good PLT function preservation up to 7 days of storage. The in vitro assessment results demonstrated acceptable PLT function for transfusion.

Flow cytometry analysis of platelet populations: usefulness for monitoringthe storage lesion in pooled buffy-coat platelet concentrates

BACKGROUND

Early detection of the platelet storage lesion is still a challenge in transfusion practice. Using flow cytometry, we evaluated the appearance of the storage lesion, based on the expression of platelet activation markers, in total platelets and platelet populations.

MATERIALS AND METHODS

Buffy-coat-derived platelet concentrates were stored under standard conditions for 5 days. The expression of activation antigens CD42b, CD36, CD62p and phosphatidylserine on total platelets and populations of small, medium-sized and large platelets was analysed by flow cytometry on storage days 1, 3 and 5.

RESULTS

The activation/lesion on total platelets and each platelet population was detected on storage day 3, by the increased expression of CD36. On the same day, increased expression of CD42b and CD62p was detected, but only on large platelets. Small and medium-sized platelets had increased CD62p expression only on day 5. Externalisation of phosphatidylserine was not detected.

DISCUSSION

Evaluation of the level of expression of various activation markers on different platelet populations could be an additional valid analysis in cell quality control of platelet concentrates, and in the assessment of novel approaches to platelet concentrate manipulation.