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Gordy D, Swayne T, Berry GJ, Thomas TA, Hudson KE, Stone EF. Characterization of a novel mouse platelet transfusion model. Vox Sang 2024. [PMID: 38643983 DOI: 10.1111/vox.13642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND OBJECTIVES Platelet transfusions are increasing with medical advances. Based on FDA criteria, platelet units are assessed by in vitro measures; however, it is not known how platelet processing and storage duration affect function in vivo. Our study's aim was to develop a novel platelet transfusion model stored in mouse plasma that meets FDA criteria adapted to mice, and transfused fresh and stored platelets are detectable in clots in vivo. STUDY DESIGN AND METHODS Platelet units stored in mouse plasma were prepared using a modified platelet-rich plasma (PRP) collection protocol. Characteristics of fresh and stored units, including pH, cell count, in vitro measures of activity, including activation and aggregation, and post-transfusion recovery (PTR), were determined. Lastly, a tail transection assay was conducted using mice transfused with fresh or stored units, and transfused platelets were identified by confocal imaging. RESULTS Platelet units had acceptable platelet and white cell counts and were negative for bacterial contamination. Fresh and 1-day stored units had acceptable pH; the platelets were activatable by thrombin and adenosine diphosphate, agreeable with thrombin, had acceptable PTR, and were present in vivo in clots of recipients after tail transection. In contrast, 2-day stored units had clinically unacceptable quality. CONCLUSION We developed mouse platelets for transfusion analogous to human platelet units using a modified PRP collection protocol with maximum storage of 1 day for an 'old' unit. This provides a powerful tool to test how process modifications and storage conditions affect transfused platelet function in vivo.
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Affiliation(s)
- Dominique Gordy
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Theresa Swayne
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Gregory J Berry
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Tiffany A Thomas
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Krystalyn E Hudson
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Elizabeth F Stone
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
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2
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Gordy D, Swayne T, Berry GJ, Thomas TA, Hudson KE, Stone EF. Characterization of a Novel Mouse Platelet Transfusion Model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.10.566577. [PMID: 38014145 PMCID: PMC10680660 DOI: 10.1101/2023.11.10.566577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Platelet transfusions are increasing with advances in medical care. Based on FDA criteria, platelet units are assessed by in vitro measures; however, it is not known how platelet processing and storage duration affect function in vivo. To address this, we developed a novel platelet transfusion model that meets FDA criteria adapted to mice, and transfused fresh and stored platelets are detected in clots in vivo. STUDY DESIGN AND METHODS Platelet units stored in mouse plasma were prepared using a modified platelet rich plasma collection protocol. Characteristics of fresh and stored units, including pH, cell count, in vitro measures of activity, including activation and aggregation, and post-transfusion recovery (PTR), were determined. Lastly, a tail transection assay was conducted using mice transfused with fresh or stored units, and transfused platelets were identified by confocal imaging. RESULTS Platelet units had acceptable platelet and white cell counts and were negative for bacterial contamination. Fresh and 1-day stored units had acceptable pH; the platelets were activatable by thrombin and ADP, aggregable with thrombin, had acceptable PTR, and were present in vivo in clots of recipients after tail transection. In contrast, 2-day stored units had clinically unacceptable quality. DISCUSSION We developed mouse platelets for transfusion analogous to human platelet units using a modified platelet rich plasma collection protocol with maximum storage of 1 day for an "old" unit. This provides a powerful tool to test how process modifications and storage conditions affect transfused platelet function in vivo.
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Affiliation(s)
- Dominique Gordy
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Theresa Swayne
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Gregory J. Berry
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Tiffany A. Thomas
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Krystalyn E. Hudson
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
| | - Elizabeth F. Stone
- Columbia University Irving Medical Center, Department of Pathology & Cell Biology, New York, New York
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3
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Agarwal P, Jain A, Elhence P, Verma A. Are Buffy-coat Pooled Platelet Concentrates an Effective Alternative to Apheresis Platelet Concentrates? An In vitro Analysis at a Tertiary Care Center in Northern India. Int J Appl Basic Med Res 2023; 13:175-179. [PMID: 38023597 PMCID: PMC10666831 DOI: 10.4103/ijabmr.ijabmr_73_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background There is a need for platelet products to have the best quality. Apheresis platelet concentrates (PCs) obtained from single-donors PCs (SD-PCs) are considered best but have issues such as feasibility and cost. Buffy-coat pooled PCs (BCP-PCs) are considered an alternative to SD-PCs. This study compares BCP-PCs and SD-PCs for in vitro quality parameters and their changes during storage. Materials and Methods Fifteen units of BCP-PCs and 15 units of SD-PCs were prepared. In this study, a pool of five buffy coats was prepared. Fifteen units of BCP-PCs were analyzed on day 1 and day 5 of storage, while 15 SD-PCs were analyzed on day 1 while ten units on day 5. The parameters analyzed were volume, hematological parameters, pH, swirling, and sterility. Results The mean platelets count of SD-PCs was found to be significantly higher as compared to BCP-PCs. White blood cells (WBCs) contamination was significantly lower in BCP-PCs as compared to SD-PCs. The mean pH and mean platelet volume of SD-PCs were significantly lower than BCP-PCs. During storage, the mean platelets count of BCP-PCs was decreased significantly while that of SD-PCs nonsignificantly. The mean WBCs count and pH decreased in both BCP-PCs and SD-PCs significantly. All units in both types of PCs were sterile. Conclusion Platelet yield was significantly better in SD-PCs, while mean WBCs contamination was significantly lower in BCP-PCs. BCP-PCs may be preferred in place of SD-PCs in case of nonavailability of apheresis, difficulty in finding a willing donor, or when the cost is of consideration.
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Affiliation(s)
- Prashant Agarwal
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ashish Jain
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
- Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Priti Elhence
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anupam Verma
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Gao J, Jia J, Gao X, Ji H. Efficacy of autologous plateletpheresis in adult aortic surgery: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e073341. [PMID: 37286322 DOI: 10.1136/bmjopen-2023-073341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Perioperative coagulopathy is common in patients undergoing aortic surgery, increasing the risk of excessive blood loss and subsequent allogeneic transfusion. Blood conservation has become a vital part of cardiovascular surgery, but measures to protect platelets from destruction by cardiopulmonary bypass (CPB) are still lacking. Autologous platelet concentrate (APC) may have potential benefits for intraoperative blood preservation, but its efficacy has not been studied extensively. This study aims to evaluate the efficacy of APC as a blood conservation technique to reduce blood transfusion in adult aortic surgery. METHODS AND ANALYSIS This is a prospective, single-centre, single-blind randomised controlled trial. A total of 344 adult patients undergoing aortic surgery with CPB will be enrolled and randomised to either the APC group or the control group with a 1:1 randomisation ratio. Patients in the APC group will receive autologous plateletpheresis before heparinisation, while those in the control group will not. The primary outcome is the perioperative packed red blood cell (pRBC) transfusion rate. Secondary endpoints include the volume of perioperative pRBC transfusion; drainage volume within 72 hours post-surgery; postoperative coagulation and platelet function; and the incidence of adverse events. Data will be analysed according to the intention-to-treat principle. ETHICS AND DISSEMINATION This study was approved by the institutional review board of Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (no. 2022-1806). All procedures included in this study will be performed in adherence to the Helsinki Declaration. The results of the trial will be published in an international peer-reviewed journal. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Register (ChiCTR2200065834).
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Affiliation(s)
- Jie Gao
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jinna Jia
- Department of Transfusion Medicine, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xurong Gao
- Department of Transfusion Medicine, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Hongwen Ji
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Transfusion Medicine, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Garraud O, Hamzeh-Cognasse H, Chalayer E, Duchez AC, Tardy B, Oriol P, Haddad A, Guyotat D, Cognasse F. Platelet transfusion in adults: An update. Transfus Clin Biol 2023; 30:147-165. [PMID: 36031180 DOI: 10.1016/j.tracli.2022.08.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many patients worldwide receive platelet components (PCs) through the transfusion of diverse types of blood components. PC transfusions are essential for the treatment of central thrombocytopenia of diverse causes, and such treatment is beneficial in patients at risk of severe bleeding. PC transfusions account for almost 10% of all the blood components supplied by blood services, but they are associated with about 3.25 times as many severe reactions (attributable to transfusion) than red blood cell transfusions after stringent in-process leukoreduction to less than 106 residual cells per blood component. PCs are not homogeneous, due to the considerable differences between donors. Furthermore, the modes of PC collection and preparation, the safety precautions taken to limit either the most common (allergic-type reactions and febrile non-hemolytic reactions) or the most severe (bacterial contamination, pulmonary lesions) adverse reactions, and storage and conservation methods can all result in so-called PC "storage lesions". Some storage lesions affect PC quality, with implications for patient outcome. Good transfusion practices should result in higher levels of platelet recovery and efficacy, and lower complication rates. These practices include a matching of tissue ABH antigens whenever possible, and of platelet HLA (and, to a lesser extent, HPA) antigens in immunization situations. This review provides an overview of all the available information relating to platelet transfusion, from donor and donation to bedside transfusion, and considers the impact of the measures applied to increase transfusion efficacy while improving safety and preventing transfusion inefficacy and refractoriness. It also considers alternatives to platelet component (PC) transfusion.
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Affiliation(s)
- O Garraud
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France.
| | | | - E Chalayer
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - A C Duchez
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - B Tardy
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - P Oriol
- CHU de Saint-Etienne, INSERM and CIC EC 1408, Clinical Epidemiology, Saint-Étienne, France
| | - A Haddad
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Sacré-Cœur Hospital, Beirut, Lebanon; Lebanese American University, Beirut, Lebanon
| | - D Guyotat
- Saint-Etienne University Hospital, Department of Hematology and Cellular Therapy, Saint-Étienne, France
| | - F Cognasse
- SAINBIOSE, INSERM, U1059, University of Lyon, Saint-Étienne, France; Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
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6
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Cognasse F, Hamzeh Cognasse H, Eyraud MA, Prier A, Arthaud CA, Tiberghien P, Begue S, de Korte D, Gouwerok E, Greinacher A, Aurich K, Noorman F, Dumont L, Kelly K, Cloutier M, Bazin R, Cardigan R, Huish S, Smethurst P, Devine D, Schubert P, Johnson L, Marks DC. Assessment of the soluble proteins HMGB1, CD40L and CD62P during various platelet preparation processes and the storage of platelet concentrates: The BEST collaborative study. Transfusion 2023; 63:217-228. [PMID: 36453841 DOI: 10.1111/trf.17200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/22/2022] [Accepted: 10/24/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Structural and biochemical changes in stored platelets are influenced by collection and processing methods. This international study investigates the effects of platelet (PLT) processing and storage conditions on HMGB1, sCD40L, and sCD62P protein levels in platelet concentrate supernatants (PCs). STUDY DESIGN/METHODS PC supernatants (n = 3748) were collected by each international centre using identical centrifugation methods (n = 9) and tested centrally using the ELISA/Luminex platform. Apheresis versus the buffy coat (BC-PC) method, plasma storage versus PAS and RT storage versus cold (4°C) were investigated. We focused on PC preparation collecting samples during early (RT: day 1-3; cold: day 1-5) and late (RT: day 4-7; cold: day 7-10) storage time points. RESULTS HMGB1, sCD40L, and sCD62P concentrations were similar during early storage periods, regardless of storage solution (BC-PC plasma and BC-PC PAS-E) or temperature. During storage and without PAS, sCD40L and CD62P in BC-PC supernatants increased significantly (+33% and +41%, respectively) depending on storage temperature (22 vs. 4°C). However, without PAS-E, levels decreased significantly (-31% and -20%, respectively), depending on storage temperature (22 vs. 4°C). Contrastingly, the processing method appeared to have greater impact on HMGB1 release versus storage duration. These data highlight increases in these parameters during storage and differences between preparation methods and storage temperatures. CONCLUSIONS The HMGB1 release mechanism/intracellular pathways appear to differ from sCD62P and sCD40L. The extent to which these differences affect patient outcomes, particularly post-transfusion platelet increment and adverse events, warrants further investigation in clinical trials with various therapeutic indications.
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Affiliation(s)
- Fabrice Cognasse
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Hind Hamzeh Cognasse
- University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Marie Ange Eyraud
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Amélie Prier
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Charles Antoine Arthaud
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Pierre Tiberghien
- Etablissement Français du Sang (headquarters Dpt), La Plaine, St Denis, France.,UMR RIGHT 1098, Inserm, Etablissement Français du Sang, Université de Franche-Comté, Besançon, France
| | - Stephane Begue
- Etablissement Français du Sang (headquarters Dpt), La Plaine, St Denis, France
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Eric Gouwerok
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands.,Blood Cell Research, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Andreas Greinacher
- Institut für Immunologie und Transfusionsmedizin (Institute for Immunology and Transfusion Medicine), Universitätsmedizin Greifswald (Greifswald School of Medicine), Greifswald, Germany
| | - Konstanze Aurich
- Institut für Immunologie und Transfusionsmedizin (Institute for Immunology and Transfusion Medicine), Universitätsmedizin Greifswald (Greifswald School of Medicine), Greifswald, Germany
| | - Femke Noorman
- Military Blood Bank, Ministry of Defence, Utrecht, The Netherlands
| | - Larry Dumont
- Vitalant Research Institute, Denver, Colorado, USA.,School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Kathleen Kelly
- Vitalant Research Institute, Denver, Colorado, USA.,School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Marc Cloutier
- Héma-Québec, Affaires Médicales et Innovation (Medical Affairs and Innovation), Quebec, Quebec, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation (Medical Affairs and Innovation), Quebec, Quebec, Canada
| | - Rebecca Cardigan
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Sian Huish
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Peter Smethurst
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Dana Devine
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Schubert
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lacey Johnson
- Research & Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Denese C Marks
- Research & Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
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Mastrolia I, Giorgini A, Murgia A, Loschi P, Petrachi T, Rasini V, Pinelli M, Pinto V, Lolli F, Chiavelli C, Grisendi G, Baschieri MC, Santis GD, Catani F, Dominici M, Veronesi E. Autologous Marrow Mesenchymal Stem Cell Driving Bone Regeneration in a Rabbit Model of Femoral Head Osteonecrosis. Pharmaceutics 2022; 14:pharmaceutics14102127. [PMID: 36297562 PMCID: PMC9610232 DOI: 10.3390/pharmaceutics14102127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Osteonecrosis of the femoral head (ONFH) is a progressive degenerative disease that ultimately requires a total hip replacement. Mesenchymal stromal/stem cells (MSCs), particularly the ones isolated from bone marrow (BM), could be promising tools to restore bone tissue in ONFH. Here, we established a rabbit model to mimic the pathogenic features of human ONFH and to challenge an autologous MSC-based treatment. ON has been originally induced by the synergic combination of surgery and steroid administration. Autologous BM-MSCs were then implanted in the FH, aiming to restore the damaged tissue. Histological analyses confirmed bone formation in the BM-MSC treated rabbit femurs but not in the controls. In addition, the model also allowed investigations on BM-MSCs isolated before (ON-BM-MSCs) and after (ON+BM-MSCs) ON induction to dissect the impact of ON damage on MSC behavior in an affected microenvironment, accounting for those clinical approaches foreseeing MSCs generally isolated from affected patients. BM-MSCs, isolated before and after ON induction, revealed similar growth rates, immunophenotypic profiles, and differentiation abilities regardless of the ON. Our data support the use of ON+BM-MSCs as a promising autologous therapeutic tool to treat ON, paving the way for a more consolidated use into the clinical settings.
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Affiliation(s)
- Ilenia Mastrolia
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Correspondence:
| | - Andrea Giorgini
- Division of Orthopedics, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Alba Murgia
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
| | | | | | - Valeria Rasini
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Massimo Pinelli
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Valentina Pinto
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Francesca Lolli
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Chiara Chiavelli
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Giulia Grisendi
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Maria Cristina Baschieri
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Giorgio De Santis
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Fabio Catani
- Division of Orthopedics, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Massimo Dominici
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
| | - Elena Veronesi
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
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8
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Raster J, Jacob M, Greinacher A, Aurich K. Plasma Isoagglutinin Depletion for Blood Group Independent Plasma Transfusion. Transfus Med Hemother 2022; 49:280-287. [PMID: 37969862 PMCID: PMC10642531 DOI: 10.1159/000521217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2023] Open
Abstract
Background Plasma transfusion is one of the basic treatments in patients with major blood loss. The anti-A and anti-B antibodies contained in the plasma demand ABO blood group compatibility. This is limiting the use of plasma in emergency situations and can cause a shortage in the supply of plasma of certain blood groups. We developed a method for anti-A and anti-B depletion by adsorbing plasma isoagglutinins using red blood cells. Materials and Methods Three units of fresh frozen plasma were thawed after quarantine storage, pooled, and an aliquot of red cell concentrate was added. After 2 h of incubation at room temperature antibody-red-cell complexes were removed by centrifugation, the isoagglutinin-depleted plasma was split into three units and deep frozen. Isoagglutinin titers, free hemoglobin, residual red cells, clotting factor activity, and sterility of plasma units were determined after isoagglutinin depletion and a double freeze-thawing procedure. Results Anti-B titers in group A plasma were reduced from values of 1:64 to 1:1 or lower, anti-A titers in group B plasma decreased from values of 1:128 to at least 1:16. Postprocedure clotting factor activities were preserved with 88.0 ± 7.3% (factor V), 106.9 ± 11.4% (factor VIII), and 84.0 ± 7.5% (factor XI) fulfilling the quality control requirements. No residual red cells were found, but free hemoglobin slightly increased to 53.7 ± 5.2 μmol/L. All units were sterile. Discussion We described a method for the production of anti-A- and anti-B-depleted plasma in a closed system that uses standard equipment. The resulting isoagglutinin-depleted plasma may allow for blood group independent plasma transfusion.
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Affiliation(s)
| | | | | | - Konstanze Aurich
- Institut für Immunologie und Transfusionsmedizin, Abteilung Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
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9
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Willer H, Spohn G, Morgenroth K, Thielemann C, Elvers-Hornung S, Bugert P, Delorme B, Giesen M, Schmitz-Rixen T, Seifried E, Pfarrer C, Schäfer R, Bieback K. Pooled human bone marrow-derived mesenchymal stromal cells with defined trophic factors cargo promote dermal wound healing in diabetic rats by improved vascularization and dynamic recruitment of M2-like macrophages. Front Immunol 2022; 13:976511. [PMID: 36059533 PMCID: PMC9437960 DOI: 10.3389/fimmu.2022.976511] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Human Mesenchymal Stromal Cells (hMSCs) are a promising source for cell-based therapies. Yet, transition to phase III and IV clinical trials is remarkably slow. To mitigate donor variabilities and to obtain robust and valid clinical data, we aimed first to develop a manufacturing concept balancing large-scale production of pooled hMSCs in a minimal expansion period, and second to test them for key manufacture and efficacy indicators in the clinically highly relevant indication wound healing. Our novel clinical-scale manufacturing concept is comprised of six single donor hMSCs master cell banks that are pooled to a working cell bank from which an extrapolated number of 70,000 clinical doses of 1x106 hMSCs/cm2 wound size can be manufactured within only three passages. The pooled hMSC batches showed high stability of key manufacture indicators such as morphology, immune phenotype, proliferation, scratch wound healing, chemotactic migration and angiogenic support. Repeated topical hMSCs administration significantly accelerated the wound healing in a diabetic rat model by delivering a defined growth factor cargo (specifically BDNF, EGF, G-CSF, HGF, IL-1α, IL-6, LIF, osteopontin, VEGF-A, FGF-2, TGF-β, PGE-2 and IDO after priming) at the specific stages of wound repair, namely inflammation, proliferation and remodeling. Specifically, the hMSCs mediated epidermal and dermal maturation and collagen formation, improved vascularization, and promoted cell infiltration. Kinetic analyses revealed transient presence of hMSCs until day (d)4, and the dynamic recruitment of macrophages infiltrating from the wound edges (d3) and basis (d9), eventually progressing to the apical wound on d11. In the wounds, the hMSCs mediated M2-like macrophage polarization starting at d4, peaking at d9 and then decreasing to d11. Our study establishes a standardized, scalable and pooled hMSC therapeutic, delivering a defined cargo of trophic factors, which is efficacious in diabetic wound healing by improving vascularization and dynamic recruitment of M2-like macrophages. This decision-making study now enables the validation of pooled hMSCs as treatment for impaired wound healing in large randomized clinical trials.
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Affiliation(s)
- Hélène Willer
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg - Hessen, Mannheim, Germany
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Gabriele Spohn
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt am Main, Germany
| | - Kimberly Morgenroth
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt am Main, Germany
| | - Corinna Thielemann
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Susanne Elvers-Hornung
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg - Hessen, Mannheim, Germany
| | | | | | | | - Erhard Seifried
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt am Main, Germany
| | - Christiane Pfarrer
- Institute for Anatomy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt am Main, Germany
- Institute for Transfusion Medicine and Gene Therapy, Medical Center - University of Freiburg, Freiburg, Germany
- Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Freiburg, Germany
| | - Karen Bieback
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg - Hessen, Mannheim, Germany
- Mannheim Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- FlowCore, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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10
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Pérez Aliaga AI, Labata G, Aranda A, Cardoso M, Puente F, Domingo JM, Garcés C. Improvement of Blood Processing and Safety by Automation and Pathogen Reduction Technology. Transfus Med Hemother 2021; 48:290-297. [PMID: 34803572 DOI: 10.1159/000516696] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/02/2021] [Indexed: 01/18/2023] Open
Abstract
Introduction The objective of the present study was to describe the experience of the Blood and Tissues Bank of Aragon with the Reveos® Automated Blood Processing System and Mirasol® Pathogen Reduction Technology (PRT) System, comparing retrospectively routine quality data obtained in two different observation periods. Methods Comparing quality data encompassing 6,525 blood components from the period 2007-2012, when the semi-automated buffy coat method was used in routine, with 6,553 quality data from the period 2014-2019, when the Reveos system and subsequently the Mirasol system were implemented in routine. Results Moving from buffy coat to Reveos led to decreased discard rates of whole blood units (1.2 to 0.1%), increased hemoglobin content (48.1 ± 7.6 to 55.4 ± 6.6 g/unit), and hematocrit (58.9 ± 6.5% to 60.0 ± 4.9%) in red blood cell concentrates. Platelet concentrates (PCs) in both periods had similar yields (3.5 ×1011). Whereas in the earlier period, PCs resulted from pooling 5 buffy coats, in the second period 25% of PCs were prepared from 4 interim platelet units. The mean level of factor VIII in plasma was significantly higher with Reveos (92.8 vs. 97.3 IU). Mirasol PRT treatment of PCs reduced expiry rates to 1.2% in 2019. One septic transmission was reported with a non-PRT treated PCs, but none with PRT-treated PCs. Conclusion Automation contributed to standardization, efficiency, and improvement of blood processing. Released resources enabled the effortless implementation of PRT. The combination of both technologies guaranteed the self-sufficiency and improvement of blood safety.
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Affiliation(s)
| | - Gorka Labata
- Technological Institute of Aragón, Zaragoza, Spain
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11
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Oeller M, Laner-Plamberger S, Krisch L, Rohde E, Strunk D, Schallmoser K. Human Platelet Lysate for Good Manufacturing Practice-Compliant Cell Production. Int J Mol Sci 2021; 22:ijms22105178. [PMID: 34068404 PMCID: PMC8153614 DOI: 10.3390/ijms22105178] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
Numerous cell-based therapeutics are currently being tested in clinical trials. Human platelet lysate (HPL) is a valuable alternative to fetal bovine serum as a cell culture medium supplement for a variety of different cell types. HPL as a raw material permits animal serum-free cell propagation with highly efficient stimulation of cell proliferation, enabling humanized manufacturing of cell therapeutics within a reasonable timeframe. Providers of HPL have to consider dedicated quality issues regarding identity, purity, potency, traceability and safety. Release criteria have to be defined, characterizing the suitability of HPL batches for the support of a specific cell culture. Fresh or expired platelet concentrates from healthy blood donors are the starting material for HPL preparation, according to regulatory requirements. Pooling of individual platelet lysate units into one HPL batch can balance donor variation with regard to essential platelet-derived growth factors and cytokines. The increasingly applied pathogen reduction technologies will further increase HPL safety. In this review article, aspects and regulatory requirements of whole blood donation and details of human platelet lysate manufacturing are presented. International guidelines for raw materials are discussed, and defined quality controls, as well as release criteria for safe and GMP-compliant HPL production, are summarized.
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Affiliation(s)
- Michaela Oeller
- Department of Transfusion Medicine, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; (M.O.); (S.L.-P.); (L.K.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
| | - Sandra Laner-Plamberger
- Department of Transfusion Medicine, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; (M.O.); (S.L.-P.); (L.K.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
| | - Linda Krisch
- Department of Transfusion Medicine, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; (M.O.); (S.L.-P.); (L.K.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
- Cell Therapy Institute, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria
| | - Eva Rohde
- Department of Transfusion Medicine, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; (M.O.); (S.L.-P.); (L.K.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
- GMP Laboratory, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria
| | - Dirk Strunk
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
- Cell Therapy Institute, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria
| | - Katharina Schallmoser
- Department of Transfusion Medicine, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria; (M.O.); (S.L.-P.); (L.K.); (E.R.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria;
- GMP Laboratory, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria
- Correspondence:
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12
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Thrombocytopenia and Hemostatic Changes in Acute and Chronic Liver Disease: Pathophysiology, Clinical and Laboratory Features, and Management. J Clin Med 2021; 10:jcm10071530. [PMID: 33917431 PMCID: PMC8038677 DOI: 10.3390/jcm10071530] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Thrombocytopenia, defined as a platelet count <150,000/μL, is the most common complication of advanced liver disease or cirrhosis with an incidence of up to 75%. A decrease in platelet count can be the first presenting sign and tends to be proportionally related to the severity of hepatic failure. The pathophysiology of thrombocytopenia in liver disease is multifactorial, including (i) splenomegaly and subsequently increased splenic sequestration of circulating platelets, (ii) reduced hepatic synthesis of thrombopoietin with missing stimulation both of megakaryocytopoiesis and thrombocytopoiesis, resulting in diminished platelet production and release from the bone marrow, and (iii) increased platelet destruction or consumption. Among these pathologies, the decrease in thrombopoietin synthesis has been identified as a central mechanism. Two newly licensed oral thrombopoietin mimetics/receptor agonists, avatrombopag and lusutrombopag, are now available for targeted treatment of thrombocytopenia in patients with advanced liver disease, who are undergoing invasive procedures. This review summarizes recent advances in the understanding of defective but at low level rebalanced hemostasis in stable cirrhosis, discusses clinical consequences and persistent controversial issues related to the inherent bleeding risk, and is focused on a risk-adapted management of thrombocytopenia in patients with chronic liver disease, including a restrictive transfusion regimen.
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13
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Lejdarova H, Pacasova R, Tesarova L, Koutna I, Polokova N, Michlickova S, Dolecek M. Cryopreserved buffy-coat-derived platelets reconstituted in platelet additive solution: A safe and available product with sufficient haemostatic effectiveness. Transfus Apher Sci 2021; 60:103110. [PMID: 33736955 DOI: 10.1016/j.transci.2021.103110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 02/16/2021] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Platelets (PLTs) stored at 20-24 °C have a short shelf life of only 5 days, which can result in their restricted availability. PLT cryopreservation extends the shelf life to 2 years. METHODS We implemented a method of PLT freezing at -80 °C in 5-6% dimethyl sulfoxide. Buffy-coat-derived leucodepleted fresh PLTs blood group O (FP) were used for cryopreservation. Cryopreserved pooled leucodepleted PLTs (CPP) were thawed at 37 °C, reconstituted in PLT additive solution SSP + and compared to FP regarding PLT content, PLT concentration, pH, volume, PLT loss, anti-A/B antibody titre, total protein, plasma content, and PLT swirling. Clot properties were evaluated via rotational thromboelastometry. PLT microparticle number and surface receptor phenotype were assessed via flow cytometry. RESULTS CPP met the required quality parameters. The mean freeze-thaw PLT loss was 22.24 %. Anti-A/B antibody titre and plasma content were significantly lower in CPP. CPP were characterised by faster clot initiation and form stable PLT clots. The number of PLT microparticles increased 25 times in CPP and there were more particles positive for the activation marker CD62 P compared to FP. CONCLUSION Thawing and reconstitution are easy and fast processes if platelet additive solution is used. Low anti-A/B antibody titre and plasma content make possible the use of CPP of blood group O reconstituted in SSP + as universal ABO products, including clinical situations where washed PLTs are required. Clot properties evaluated via rotational thromboelastometry demonstrated that CPP retain a significant part of their activity compare to FP and are haemostatically effective.
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Affiliation(s)
- Hana Lejdarova
- Department of Transfusion and Tissue Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Rita Pacasova
- Department of Transfusion and Tissue Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic.
| | - Lenka Tesarova
- International Clinical Research Centre, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic.
| | - Irena Koutna
- International Clinical Research Centre, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic.
| | - Nadezda Polokova
- Department of Transfusion and Tissue Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic.
| | - Simona Michlickova
- Department of Transfusion and Tissue Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic.
| | - Martin Dolecek
- Clinic of Anaesthesiology, Resuscitation and Intensive Medicine, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic.
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14
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Kaplan A. Preparation, Storage, and Characteristics of Whole Blood, Blood Components, and Plasma Derivatives. Transfus Med 2021. [DOI: 10.1002/9781119599586.ch5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Wang J, Zhou P, Han Y, Zhang H. Platelet transfusion for cancer secondary thrombocytopenia: Platelet and cancer cell interaction. Transl Oncol 2021; 14:101022. [PMID: 33545547 PMCID: PMC7868729 DOI: 10.1016/j.tranon.2021.101022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/14/2023] Open
Abstract
Chemoradiotherapy and autoimmune disorder often lead to secondary thrombocytopenia in cancer patients, and thus, platelet transfusion is needed to stop or prevent bleeding. However, the effect of platelet transfusion remains controversial for the lack of agreement on transfusion strategies. Before being transfused, platelets are stored in blood banks, and their activation is usually stimulated. Increasing evidence shows activated platelets may promote metastasis and the proliferation of cancer cells, while cancer cells also induce platelet activation. Such a vicious cycle of interaction between activated platelets and cancer cells is harmful for the prognosis of cancer patients, which results in an increased tumor recurrence rate and decreased five-year survival rate. Therefore, it is important to explore platelet transfusion strategies, summarize mechanisms of interaction between platelets and tumor cells, and carefully evaluate the pros and cons of platelet transfusion for better treatment and prognosis for patients with cancer with secondary thrombocytopenia.
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Affiliation(s)
- Juan Wang
- Class 2016 Clinical Medicine, Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Pan Zhou
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Yunwei Han
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
| | - Hongwei Zhang
- Department of Blood Transfusion, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
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16
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Gammon RR, Devine D, Katz LM, Quinley E, Wu Y, Rowe K, Razatos A, Min K, Reichenberg S, Smith R. Buffy coat platelets coming to America: Are we ready? Transfusion 2020; 61:627-633. [PMID: 33174258 DOI: 10.1111/trf.16184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Buffy coat (BC) platelets (PLTs) have been used globally for many years. In 2004 Canadian Blood Services (CBS) made the decision to transition from PLT-rich plasma (PRP) to BC PLTs. We reviewed the benefits and manufacture process of BC and the implementation challenges involved. STUDY DESIGN AND METHODS A literature review was performed in the following areas: BC efficacy, donor population shifts, production and good stewardship of PLTs, logistic considerations with overnight holds, advantages of the overnight hold, the CBS experience, licensure and standards, and changes needed to produce BC PLTs in the United States. The aim was to analyze current practice and identify possible actions for blood centers and hospitals. RESULTS Implementation of BC would offer an additional source of PLTs to address the growing elderly population and the declining apheresis donor base. Substantial logistic, operational, and financial benefits were seen when CBS transitioned to BC with overnight hold. CONCLUSIONS Buffy coat blood products are widely used throughout the world. Recent conversion from PRP to BC by CBS showed that conversion can be accomplished with planning, communication, and partnership from all stakeholders. In conclusion, BC PLTs are worth serious consideration in the United States, but regulatory barriers in the United States will need to be addressed.
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Affiliation(s)
| | - Dana Devine
- Canadian Blood Services and University of British Columbia, Vancouver, British Columbia, Canada
| | - Louis M Katz
- Mississippi Valley Regional Blood Center, Davenport Iowa and University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Eva Quinley
- Independent Contractor, Knoxville, Tennessee
| | - YanYun Wu
- University of Miami, Coral Gables, Florida
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17
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Cienfuegos-Pecina E, Leal-Nava ER, Avilés-Rodríguez LE, Llaca-Díaz JM, Pérez-Chávez F, Cázares-Tamez R, Díaz-Chuc EA. Donor platelet and leukocyte count as predictive factors of the quality of platelet concentrates obtained from whole blood by semiautomated fractionation. Transfus Apher Sci 2020; 60:102972. [PMID: 33127311 DOI: 10.1016/j.transci.2020.102972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 10/10/2020] [Accepted: 10/11/2020] [Indexed: 11/26/2022]
Abstract
Platelet concentrates (PCs) obtained from whole blood are produced by fractionation of the buffy coat (BC) or the platelet-rich plasma. Despite the improvements in the technologies used for the hemocomponent fractionation, the proportion of PCs that do not accomplish the quality requirements is high. This study aimed to determine whether the basal platelet and leukocyte counts are predictive factors of the quality of the PCs obtained from BC by semiautomated fractionation. Quality control registers of 196 PCs were analyzed. Gender- and age-dependence of the blood cell count and the characteristics of PCs were evaluated. Platelet yield and residual leukocytes in the PCs were correlated with the platelet and leukocyte counts and the age of the donors. Predictive efficacy was assessed, and an optimal cut-off was established. The proportions of PCs accepted and rejected by using or not the optimal cut-off were compared. 50.0% of the PCs accomplished all the quality control requirements. Female donors had a higher basal platelet count than males. A correlation was observed between basal platelets and platelet yield, but not between basal leukocytes and residual leukocytes. The basal platelet count predicted the quality of the PCs. A cut-off of 231,000 platelets/mm3 was established, but it did not improve the proportion of accepted PCs. In conclusion, we found that the basal platelet count is correlated with the platelet yield. The basal leukocyte count is not correlated with the residual leukocytes. The established cut-off for the basal platelet count did not improve the proportion of accepted PCs.
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Affiliation(s)
- Eduardo Cienfuegos-Pecina
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León; Liver Unit, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Erika Rubí Leal-Nava
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Luz Elena Avilés-Rodríguez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Jorge Martín Llaca-Díaz
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Fernando Pérez-Chávez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Rogelio Cázares-Tamez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León
| | - Erik Alejandro Díaz-Chuc
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León.
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18
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Cienfuegos-Pecina E, Ayala-De la Cruz S, Leal-Nava ER, Pérez-Olvera JA, Llaca-Díaz JM, Avilés-Rodríguez LE, Pérez-Chávez F, Díaz-Chuc EA. Assessment of software-derived predictive algorithms for platelet yield and blood cell count after apheresis. J Clin Apher 2020; 36:94-100. [PMID: 33016510 DOI: 10.1002/jca.21846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/22/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Algorithms have been developed to predict the platelet yield after apheresis from the donor's data, as well as the effect on the blood cell count, to extract an acceptable platelet number without affecting the donor. However, the evaluation of these algorithms has not been widely reported. This study aimed to assess the accuracy of the predictive algorithms of the Trima Accel v. 6 blood collection system. METHODS Platelet concentrates (PCs) obtained by apheresis were analyzed. Platelet count and hematocrit were compared pre- and post-apheresis. Calculated post-apheresis platelet count (CPAPC), hematocrit (CPAH), and platelet yield (CPY), and their actual values were correlated. The bias of the algorithms was assessed with Bland-Altman plots, and the prediction of the extraction of single or double platelet products was evaluated. RESULTS Two hundred and seventy-nine PCs were analyzed. Post-apheresis platelet count (PAPC) and hematocrit were decreased. A moderate correlation was observed between CPY and the actual yield, with a negative bias, and a trend to increase alongside the magnitude of the measurements. CPAPC and CPAH were strongly correlated with their actual values without bias. Prediction of single or double platelet product extraction showed a significant agreement with the actual outcomes. CONCLUSIONS The predictive algorithm for the platelet yield showed bias, and a trend to underestimate the actual platelet yields when they are higher. The algorithms for the prediction of the PAPC and hematocrit did not show bias, proving their accuracy. Prediction of a single or double platelet product extraction has a strong agreement with the APY.
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Affiliation(s)
- Eduardo Cienfuegos-Pecina
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico.,Liver Unit, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Sergio Ayala-De la Cruz
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Erika R Leal-Nava
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Jorge A Pérez-Olvera
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Jorge M Llaca-Díaz
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Luz E Avilés-Rodríguez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Fernando Pérez-Chávez
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Erik A Díaz-Chuc
- Blood Bank, Department of Clinical Pathology, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Nuevo León, Mexico
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Fiedler SA, Boller K, Junker AC, Kamp C, Hilger A, Schwarz W, Seitz R, Salge-Bartels U. Evaluation of the in vitro Function of Platelet Concentrates from Pooled Buffy Coats or Apheresis. Transfus Med Hemother 2020; 47:314-324. [PMID: 32884504 DOI: 10.1159/000504917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022] Open
Abstract
Background Platelet concentrates play an important role in transfusion medicine. Their short lifespan and lack of robustness require efforts to ensure adequate product quality. In this study, we compared the in vitro quality of the main concentrate types, pooled platelet concentrate (PPC) from whole blood donations, and platelet concentrate from single-donor apheresis (APC). Methods Twenty PPCs and 20 APCs prepared in plasma were analyzed on days 2, 4, and 7 of storage. Variables related to metabolism, degranulation, platelet aggregation, P-selectin expression, and annexin V binding were analyzed. Morphology was assessed by transmission electron microscopy of ultrathin sections. A microfluidic device was applied to test the effects of shear stress on platelet function. Results The metabolic parameters indicated stable storage conditions throughout the 7-day period. The resting discoid form was the prevailing morphology on days 2 and 4 in the PPCs and APCs. Chemokine release and receptor shedding of soluble P-selectin and soluble CD40L equally increased in PPCs and APCs. Aggregation responses to ADP and collagen were heterogeneous, with marked losses in collagen responsiveness on day 4 in individual concentrates. Baseline expression of P-selectin in PPCs and APCs was low, and inducibility of P-selectin was well preserved until day 4. Under shear stress, equal adhesiveness and stability were found with platelets from PPCs and APCs. Conclusions Platelets from PPCs and APCs showed similar in vitro function and stability parameters. However, platelet concentrates presented a high variability and individual concentrates an impaired functional capability. Identifying the factors contributing to this would help increase product reliability.
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Affiliation(s)
- Sarah Anna Fiedler
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - Klaus Boller
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | - Ann-Christine Junker
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - Christel Kamp
- Division of Microbiology, Paul-Ehrlich-Institut, Langen, Germany
| | - Anneliese Hilger
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - Wolfgang Schwarz
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - Rainer Seitz
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
| | - Ursula Salge-Bartels
- Division of Hematology/Transfusion Medicine, Paul-Ehrlich-Institut, Langen, Germany
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20
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Haddad A, Elgemmezi T, Chaїb M, Bou Assi T, Abu Helu R, Hmida S, Benajiba M, Ba K, Alqudah M, Abi Hanna P, Najjar O, Garraud O. Quality and safety measures in transfusion practice: The experience of eight southern/eastern Mediterranean countries. Vox Sang 2020; 115:405-423. [PMID: 32124457 DOI: 10.1111/vox.12903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Blood transfusion is inherently associated with risks, and little is known regarding the available quality and safety measures in developing countries. No studies or census has been carried out, and therefore, no data on this compelling issue are available. MATERIALS AND METHODS Data emanating from eight Arabic eastern/southern Mediterranean countries who responded to five surveys were collected and tabulated. RESULTS Asepsis during phlebotomy, screening for serological and immuno-haematological parameters and appropriate storage conditions are maintained across all countries. Variations in blood component processing exist. Universal leucoreduction is systematically applied in Lebanon. Nucleic acid testing is only performed in Egypt. Aphaeresis procedure, leucoreduction and quality control for blood components are virtually inexistent in Mauritania. Written donor questionnaire is absent in Algeria and Tunisia. Most donor deferral periods for infectious agents are inconsistent with international standards. CONCLUSION Gaps in the processing and in the quality/safety measures applied to the manufacture of blood components are quite evident in most eastern/southern Mediterranean countries. The decision of establishing an effective collaboration network and an independent body - aside from WHO - composed of specialists that oversees all transfusion activities in these countries is certainly a crucial step towards ensuring an optimum level of blood safety.
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Affiliation(s)
- Antoine Haddad
- Department of Clinical Pathology and Blood Bank, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon.,EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | | | - Mohamed Chaїb
- Centre de Wilaya de Transfusion Sanguine de Blida, Blida, Algeria
| | - Tarek Bou Assi
- Department of Laboratory Medicine, Psychiatric Hospital of the Cross, Jaledib, Lebanon.,Department of Laboratory Medicine and Blood Bank, Saint Joseph Hospital, Dora, Lebanon
| | - Rasmi Abu Helu
- Department of Medical Laboratory Sciences, Al-Quds University, Abu-Deis, Palestine
| | - Slama Hmida
- Centre National de transfusion Sanguine, Tunis, Tunisia
| | - Mohamed Benajiba
- Centre National de Transfusion Sanguine et d'Hématologie, Rabat, Morocco
| | - Khadijetou Ba
- Faculté de Médicine, Centre National de Transfusion Sanguine, Nouakchott, Mauritanie
| | - Mohammad Alqudah
- Departments of Pathology and Microbiology. School of Medicine, Jordan University of Sciences and Technology, Jordan
| | - Pierre Abi Hanna
- Infectious diseases Department, Sacré-Coeur Hospital, Lebanese University, Beirut, Lebanon
| | | | - Olivier Garraud
- EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France.,Institut National de la Transfusion Sanguine, Paris, France.,Palliative Care Unit, The Ruffec Hospital, Ruffec, France
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21
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The effect of platelet storage temperature on haemostatic, immune, and endothelial function: potential for personalised medicine. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 17:321-330. [PMID: 31385802 DOI: 10.2450/2019.0095-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/30/2019] [Indexed: 02/06/2023]
Abstract
Reports from both adult and paediatric populations indicate that approximately two-thirds of platelet transfusions are used prophylactically to prevent bleeding, while the remaining one-third are used therapeutically to manage active bleeding. These two indications, prophylactic and therapeutic, serve two very distinct purposes and therefore will have two different functional requirements. In addition, disease aetiology in a given patient may require platelets with different functional characteristics. These characteristics can be derived from the various manufacturing methods used in platelet product production, including collection methods, processing methods, and storage options. The iterative combinations of manufacturing methods can result in a number of unique platelet products with different efficacy and safety profiles, which could potentially be used to benefit patient populations by meeting diverse clinical needs. In particular, cold storage of platelet products causes many biochemical and functional changes, of which the most notable characterised to date include increased haemostatic activity and altered expression of molecules inherent to platelet:leucocyte interactions. The in vivo consequences, both short- and long-term, of these molecular and cellular cold-storage-induced changes have yet to be clearly defined. Elucidation of these mechanisms would potentially reveal unique biologies that could be harnessed to provide more targeted therapies. To this end, in this new era of personalised medicine, perhaps there is an opportunity to provide individual patients with platelet products that are tailored to their clinical condition and the specific indication for transfusion.
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22
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Ng MSY, Hay K, Choy J, Middelburg RA, Tung JP, Fraser JF. Fresh frozen plasma and platelet concentrate storage duration not associated with in hospital mortality risk. Vox Sang 2019; 114:835-841. [PMID: 31452207 DOI: 10.1111/vox.12838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/03/2019] [Accepted: 07/26/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES To date, the effects of FFP and PC storage duration on mortality have only been studied in a few studies in limited patient subpopulations. The aim of the current study was to determine whether FFP and PC storage duration is associated with increased in hospital mortality risk across cardiac surgery, acute medicine, ICU and orthopaedic surgery patients. MATERIALS AND METHODS Two-stage individual patient data meta-analyses were performed to determine the effects of FFP and PC storage duration on in hospital mortality. Preset random effects models were used to determine pooled unadjusted and adjusted (adjusted for age, gender and units of product transfused) effect estimates. RESULTS The FFP storage duration analysis included 3625 patients across four studies. No significant association was observed between duration of storage and in hospital mortality in unadjusted analysis, but after adjusting for patient age, gender and units of product a small increased risk of in hospital mortality was observed for each additional month of storage (OR: 1·05, 95% CI: 1·01-1·08). This effect was no longer statistically significant when donor ABO blood group was incorporated into the random effects model on post hoc analyses. A total of 547 patients across five studies were incorporated in the PC storage duration analysis. No association was observed between PC storage duration and odds of in hospital morality (adjusted OR: 0·94, 95% CI: 0·79-1·11). CONCLUSIONS There is insufficient evidence to support shortening FFP or PC shelf life based on in hospital mortality.
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Affiliation(s)
- Monica Suet Ying Ng
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia.,Faculty of Medicine, Oral Health Centre, University of Queensland, Herston, QLD, Australia.,Research and Development, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia
| | - Karen Hay
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Joleen Choy
- Faculty of Medicine, Oral Health Centre, University of Queensland, Herston, QLD, Australia.,Royal Brisbane & Women's Hospital, Herston, QLD, Australia
| | - Rutger A Middelburg
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - John-Paul Tung
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia.,Faculty of Medicine, Oral Health Centre, University of Queensland, Herston, QLD, Australia.,Research and Development, Australian Red Cross Blood Service, Kelvin Grove, QLD, Australia
| | - John Francis Fraser
- Critical Care Research Group, The Prince Charles Hospital, Chermside, QLD, Australia.,Faculty of Medicine, Oral Health Centre, University of Queensland, Herston, QLD, Australia
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23
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Spano C, Grisendi G, Golinelli G, Rossignoli F, Prapa M, Bestagno M, Candini O, Petrachi T, Recchia A, Miselli F, Rovesti G, Orsi G, Maiorana A, Manni P, Veronesi E, Piccinno MS, Murgia A, Pinelli M, Horwitz EM, Cascinu S, Conte P, Dominici M. Soluble TRAIL Armed Human MSC As Gene Therapy For Pancreatic Cancer. Sci Rep 2019; 9:1788. [PMID: 30742129 PMCID: PMC6370785 DOI: 10.1038/s41598-018-37433-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/06/2018] [Indexed: 12/22/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is still one of the most aggressive adult cancers with an unacceptable prognosis. For this reason novel therapies accounting for PDAC peculiarities, such as the relevant stromal reaction, are urgently needed. Here adipose mesenchymal stromal/stem cells (AD-MSC) have been armed to constantly release a soluble trimeric and multimeric variant of the known anti-cancer TNF-related apoptosis-inducing ligand (sTRAIL). This cancer gene therapy strategy was in vitro challenged demonstrating that sTRAIL was thermally stable and able to induce apoptosis in the PDAC lines BxPC-3, MIA PaCa-2 and against primary PDAC cells. sTRAIL released by AD-MSC relocated into the tumor stroma was able to significantly counteract tumor growth in vivo with a significant reduction in tumor size, in cytokeratin-7+ cells and by an anti-angiogenic effect. In parallel, histology on PDAC specimens form patients (n = 19) was performed to investigate the levels of TRAIL DR4, DR5 and OPG receptors generating promising insights on the possible clinical translation of our approach. These results indicate that adipose MSC can very efficiently vehicle a novel TRAIL variant opening unexplored opportunities for PDAC treatment.
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Affiliation(s)
- Carlotta Spano
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Rigenerand srl, Medolla, Modena, Italy
| | - Giulia Grisendi
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Rigenerand srl, Medolla, Modena, Italy
| | - Giulia Golinelli
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Rossignoli
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Malvina Prapa
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Marco Bestagno
- International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Olivia Candini
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Rigenerand srl, Medolla, Modena, Italy
| | | | - Alessandra Recchia
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Miselli
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Rovesti
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Orsi
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Antonino Maiorana
- Department of Diagnostic and Clinical Medicine and of Public Health, Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Manni
- Department of Diagnostic and Clinical Medicine and of Public Health, Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Veronesi
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.,Technopole of Mirandola TPM, Mirandola, Modena, Italy
| | | | - Alba Murgia
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Pinelli
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Edwin M Horwitz
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta, GA, USA
| | - Stefano Cascinu
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Pierfranco Conte
- Department of Surgery, Oncology and Gastroenerology University of Padova, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Massimo Dominici
- Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy. .,Rigenerand srl, Medolla, Modena, Italy. .,Technopole of Mirandola TPM, Mirandola, Modena, Italy.
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24
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Viana JD, Ferreira SC, Matana SR, Rossi F, Patel P, Garson JA, Rocha V, Tedder R, Mendrone-Júnior A, Levi JE. Detection of bacterial contamination in platelet concentrates from Brazilian donors by molecular amplification of the ribosomal 16S gene. Transfus Med 2018; 28:420-426. [PMID: 30304760 DOI: 10.1111/tme.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 08/09/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our work was to establish a semi-automated high-throughput DNA amplification method for the universal screening of bacteria in platelet concentrates (PCs). BACKGROUND Among cases of transfusion transmission of infectious agents, bacterial contamination ranks first in the number of events, morbidity and mortality. Transmission occurs mainly by transfused PCs. Automated culture is adopted by some blood banks for screening of bacterial contamination, but this procedure is expensive and has a relatively long turnaround time. METHODS PCs were spiked with suspensions of five different bacterial species in a final concentration of 1 and 10 colony-forming units (CFU) per millilitre. After incubation, the presence of bacteria was investigated by real-time polymerase chain reaction (PCR) and by the Enhanced Bacterial Detection System (eBDS, Pall) assay as a reference method. Real-time PCR amplification was performed with a set of universal primers and probes targeting the 16S rRNA gene. Co-amplification of human mitochondrial DNA served as an internal control. RESULTS Using the real-time PCR method, it was possible to detect the presence of all bacterial species tested with an initial concentration of 10 CFU mL-1 24 h after contamination, except for Staphylococcus hominis. The PCR assay also detected, at 24 h, the presence of Serratia marcescens and Enterobacter cloacae with an initial concentration of 1 CFU mL-1 . CONCLUSIONS The real-time PCR assay may be a reliable alternative to conventional culture methods in the screening of bacterial contamination of PCs, enabling bacterial detection even with a low initial concentration of microorganisms.
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Affiliation(s)
- J D Viana
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - S C Ferreira
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - S R Matana
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - F Rossi
- Departamento de Microbiologia do Laboratório Central, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - P Patel
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - J A Garson
- Microbiology Services, NHS Blood and Transplant, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | - V Rocha
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - R Tedder
- Microbiology Services, NHS Blood and Transplant, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | | | - J E Levi
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
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25
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Sut C, Tariket S, Aloui C, Arthaud C, Eyraud M, Fagan J, Chavarin P, Hamzeh‐Cognasse H, Laradi S, Garraud O, Cognasse F. Soluble CD40L and CD62P levels differ in single‐donor apheresis platelet concentrates and buffy coat–derived pooled platelet concentrates. Transfusion 2018; 59:16-20. [DOI: 10.1111/trf.14974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Caroline Sut
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Sofiane Tariket
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Chaker Aloui
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | | | - Marie‐Ange Eyraud
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | - Jocelyne Fagan
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | - Patricia Chavarin
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | | | - Sandrine Laradi
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Olivier Garraud
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
- Institut National de la Transfusion Sanguine (INTS) Paris France
| | - Fabrice Cognasse
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
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26
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Asmis L, Moldenhauer A, Hitzler W, Hellstern P. Comparison of platelet function tests for the in vitro quality assessment of platelet concentrates produced under real-life conditions. Platelets 2018; 30:720-727. [PMID: 30204045 DOI: 10.1080/09537104.2018.1513471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Platelet quality in different platelet concentrates (PCs) has been the subject of several studies. Nonetheless, there is a lack of robust data on the correlation and agreement among platelet function tests as a prerequisite for the association of PC functionality in vitro with platelet function in vivo post PC transfusion. The purpose of our study was to correlate a larger panel of platelet function assays in PCs and to assess whether the methods agree sufficiently and can be used interchangeably. Twelve apheresis platelet concentrates in plasma (APC), 16 pooled platelet concentrates in plasma (PPC), and 12 PPC in T-sol (PPCA) were examined on days 1 and 4 after production. PCs were tested for platelet count, light transmission aggregation (LTA) induced by ADP, collagen, or TRAP; platelet ATP release induced by collagen; and spontaneous and ADP and TRAP-induced increase in CD62P and PAC1 expression measured by flow cytometry. All tests were performed in undiluted platelet-rich plasma, recalcified and mixed with an inhibitor of factor Xa and thrombin. Most platelet function parameters correlated significantly with each other, but agreement among methods was insufficient. A proper inverse correlation was observed between ADP-induced LTA and spontaneous platelet activation assessed by CD62P expression (r = -0.61, p < 0.0001). Spontaneous CD62P correlated also significantly with spontaneous PAC1 (r = 0.69, p < 0.0001) and inversely with TRAP-induced CD62P expression (r = -0.86, p < 0.0001). We found significant correlations among all flow cytometric assays measuring platelet CD62P and PAC1 expression induced by ADP or TRAP. Subsequent Bland Altman analysis revealed insufficient agreement between methods. With one exception (collagen-induced LTA compared with TRAP-induced LTA, percentage error = 16%) the limits of agreement expressed as percentage error exceeded the chosen acceptable difference of 30%. In APC, platelet count was 41% and 44% higher, respectively, than in PPC and PPCA (p < 0.0001). Spontaneous CD62P and PAC1 expression were significantly greater, and ADP-induced aggregation and agonist-induced increase in CD62P and PAC1 were significantly lower in PPCA compared to APC and PPC on day 4 of storage. ADP and TRAP-induced CD62P and PAC1 activatability fell significantly during storage between day 1 and day 4 in APC and PPCA, but not in PPC. In conclusion, different platelet function tests capture different aspects of platelet function and do not correlate and agree sufficiently to be used interchangeably.
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Affiliation(s)
- Lars Asmis
- a Center of Perioperative Thrombosis and Hemostasis , Zurich , Switzerland
| | - Anja Moldenhauer
- b Institute of Laboratory Diagnostics, Hygiene and Transfusion Medicine , Academic City Hospital , Ludwigshafen , Germany
| | - Walter Hitzler
- c Transfusion Center , University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - Peter Hellstern
- d Center of Hemostasis and Thrombosis Zurich , Zurich , Switzerland
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27
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Humbrecht C, Somme S, Renaudier P, Gross S, Gachet C, Schlanger S. [Comparative study on platelet transfusion in Lorraine-Champagne and Alsace in 2015]. Transfus Clin Biol 2018; 25:179-186. [PMID: 30076013 DOI: 10.1016/j.tracli.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To find explanations for the observed differences of platelets concentrates (PC) deliveries between 2 French regions, Lorraine-Champagne (LOCH) and Alsace (ALSA). METHODS This is a non-interventional prospective study, performed during 30 days in 2015 in intensive care, cardiovascular surgery and onco-hematological wards of 8 LOCH and ALSA hospitals. Questionnaires listing clinical and biological parameters were attached to the prescription forms and filled in at each PC prescription. RESULTS In all, 290 patients, 1093 prescriptions and 1093 deliveries of PC were analyzed. The pre-transfusional context (patient weight, prophylactic or curative situation, pre-transfusional platelet count) were homogenous. The phasing of the prescription forms wording had a direct impact on the doses' formulation : 100 % of the LOCH forms were expressed in platelet quantity (PQ), vs 22 % in ALSA. The mean interval between 2 transfusions was 2.9 days in ALSA vs 4.9 days in LOCH. The mean PQ/delivery was higher in ALSA (5.6.1011 vs 4.0.1011 in LOCH). The delivered PQs were compared to the 2003 French recommendations that were in force in 2015. Twenty-seven percent of the LOCH delivered PQs were in the recommended interval, vs Forty-nine percent in ALSA. Due to the systematic delivery of a single PC unit, including weights>80Kg, LOCH presented 63 % insufficient PQ deliveries. Twenty-two percent of the deliveries in ALSA were over the recommended interval, mostly linked with the simultaneous delivery of a second PC. CONCLUSION This study identifies disparities in terms of prescription and delivery between LOCH and ALSA, which may explain their respective PC consumption levels.
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Affiliation(s)
- C Humbrecht
- Établissement français du sang Grand Est, 85-87, boulevard Lobau, 54064 Nancy, France.
| | - S Somme
- Établissement français du sang Grand Est, 85-87, boulevard Lobau, 54064 Nancy, France; Établissement français du sang Alsace, 10, rue Spielmann, 67000 Strasbourg, France
| | - P Renaudier
- Agence régionale de santé Lorraine-Champagne, 3, boulevard Joffre, 54000 Nancy, France; Centre de transfusion sanguine, Croix-Rouge luxembourgeoise, 42, boulevard Joseph II, L-1840 Luxembourg, France
| | - S Gross
- Établissement français du sang Lorraine-Champagne, 85-87, boulevard Lobau, 54064 Nancy, France; Établissement français du sang, 20, avenue du stade de France, 93218 Saint-Denis, France
| | - C Gachet
- Établissement français du sang Grand Est, 85-87, boulevard Lobau, 54064 Nancy, France; Établissement français du sang Alsace, 10, rue Spielmann, 67000 Strasbourg, France
| | - S Schlanger
- Agence régionale de santé Alsace, 14, rue du maréchal Juin, 67000 Strasbourg, France; Agence régionale de santé Grand Est, 3, Boulevard Joffre, Nancy, France
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28
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Humbrecht C, Kientz D, Gachet C. Platelet transfusion: Current challenges. Transfus Clin Biol 2018; 25:151-164. [PMID: 30037501 DOI: 10.1016/j.tracli.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/29/2022]
Abstract
Since the late sixties, platelet concentrates are transfused to patients presenting with severe thrombocytopenia, platelet function defects, injuries, or undergoing surgery, to prevent the risk of bleeding or to treat actual hemorrhage. Current practices differ according to the country or even in different hospitals and teams. Although crucial advances have been made during the last decades, questions and debates still arise about the right doses to transfuse, the use of prophylactic or therapeutic strategies, the nature and quality of PC, the storage conditions, the monitoring of transfusion efficacy and the microbiological and immunological safety of platelet transfusion. Finally, new challenges are emerging with potential new platelet products, including cold stored or in vitro produced platelets. The most debated of these points are reviewed.
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Affiliation(s)
- C Humbrecht
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France.
| | - D Kientz
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France
| | - C Gachet
- Établissement français du sang grand est, 85-87, boulevard Lobau, 54064 Nancy cedex, France.
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Garraud O, Sut C, Haddad A, Tariket S, Aloui C, Laradi S, Hamzeh-Cognasse H, Bourlet T, Zeni F, Aubron C, Ozier Y, Laperche S, Peyrard T, Buffet P, Guyotat D, Tavernier E, Cognasse F, Pozzetto B, Andreu G. Transfusion-associated hazards: A revisit of their presentation. Transfus Clin Biol 2018; 25:118-135. [PMID: 29625790 DOI: 10.1016/j.tracli.2018.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As a therapy or a support to other therapies, despite being largely beneficial to patients in general, transfusion it is not devoid of some risks. In a moderate number of cases, patients may manifest adverse reactions, otherwise referred to as transfusion-associated hazards (TAHs). The latest French 2016 haemovigilance report indicates that 93% of TAHs are minor (grade 1), 5.5% are moderate (grade 2) and 1.6% are severe (grade 3), with only five deaths (grade 4) being attributed to transfusion with relative certainty (imputability of level [or grade] 1 to 3). Health-care providers need to be well aware of the benefits and potential risks (to best evaluate and discuss the benefit-risk ratio), how to prevent TAHs, the overall costs and the availability of alternative therapeutic options. In high-income countries, most blood establishments (BEs) and hospital blood banks (HBBs) have developed tools for reporting and analysing at least severe transfusion reactions. With nearly two decades of haemovigilance, transfusion reaction databases should be quite informative, though there are four main caveats that prevent it from being fully efficient: (ai) reporting is mainly declarative and is thus barely exhaustive even in countries where it is mandatory by law; (aii) it is often difficult to differentiate between the different complications related to transfusion, diseases, comorbidities and other types of therapies in patients suffering from debilitating conditions; (aiii) there is a lack of consistency in the definitions used to describe and report some transfusion reactions, their severity and their likelihood of being related to transfusion; and (aiv) it is difficult to assess the imputability of a particular BC given to a patient who has previously received many BCs over a relatively short period of time. When compiling all available information published so far, it appears that TAHs can be analysed using different approaches: (bi) their pathophysiological nature; (bii) their severity; (biii) the onset scheme; (biv) a quality assessment (preventable or non-preventable); (bv) their impact on ongoing therapy. Moreover, TAHs can be reported either in a non-integrative or in an integrative way; in the latter case, presentation may also differ when issued by a blood establishment or a treating ward. At some point, a recapitulative document would be useful to gain a better understanding of TAHs in order to decrease their occurrence and severity and allow decision makers to determine action plans: this is what this review attempts to make. This review attempts to merge the different aspects, with a focus on the hospital side, i.e., how the most frequent TAHs can be avoided or mitigated.
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Affiliation(s)
- O Garraud
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Institut National de la Transfusion Sanguine, 75017 Paris, France.
| | - C Sut
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - A Haddad
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | - S Tariket
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - C Aloui
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - S Laradi
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | | | - T Bourlet
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Microbiology, University Hospital, 42023 Saint-Etienne, France
| | - F Zeni
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Critical Care, University Hospital, 29200 Saint-Etienne, France
| | - C Aubron
- Université de Bretagne Occidentale, 29200 Brest, France; Department of Critical Care, University Hospital, 75005 Brest, France
| | - Y Ozier
- Université de Bretagne Occidentale, 29200 Brest, France; Department of Critical Care, University Hospital, 75005 Brest, France
| | - S Laperche
- Institut National de la Transfusion Sanguine, 75017 Paris, France
| | - T Peyrard
- Institut National de la Transfusion Sanguine, 75017 Paris, France; Inserm S_1134, 75015 Paris, France
| | - P Buffet
- Institut National de la Transfusion Sanguine, 75017 Paris, France; Inserm S_1134, 75015 Paris, France; University Paris-Descartes, Paris, France
| | - D Guyotat
- UMR_5229, University of Lyon, 69675 Lyon, France; Institut du Cancer Lucien Neuwirth, 42023 Saint-Etienne, France
| | - E Tavernier
- UMR_5229, University of Lyon, 69675 Lyon, France; Institut du Cancer Lucien Neuwirth, 42023 Saint-Etienne, France
| | - F Cognasse
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | - B Pozzetto
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Microbiology, University Hospital, 42023 Saint-Etienne, France
| | - G Andreu
- Institut National de la Transfusion Sanguine, 75017 Paris, France
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Current status of blood 'pharming': megakaryoctye transfusions as a source of platelets. Curr Opin Hematol 2018; 24:565-571. [PMID: 28985194 DOI: 10.1097/moh.0000000000000378] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Donor-derived platelets have proven to be of hemostatic value in many clinical settings. There is a fear that the need for platelets may outgrow the donor pool in first-world countries. Moreover, there are other challenges with donor platelets that add to the impetus to find an alternative platelet source, especially after the megakaryocyte cytokine thrombopoietin was identified. Megakaryocytes have since been differentiated from numerous cell sources and the observed released platelet-like particles (PLPs) have led to calls to develop such products for clinical use. The development of megakaryocytes from embryonic stem cell also supported the concept of developing nondonor-based platelets. RECENT FINDINGS Several groups have claimed that nondonor-based platelets derived from in-vitro grown megakaryocytes may soon become available to supplement or replace donor-derived products, but their number and quality has been wanting. A possible alternative of directly infusing megakaryocytes that release platelets in the lungs - similar to that recently shown for endogenous megakaryocytes - has been proposed. SUMMARY This present review will describe the present state-of-the-art in generating and delivering nondonor-derived platelets. Progress has been slow, but advances in our ability to generate human megakaryocytes in culture, generate PLPs from these cells, and test the functionality of the resultant platelets in vitro and in vivo have identified important remaining challenges and raised alternative potential solutions.
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Williams B, Wehman B, Mazzeffi MA, Odonkor P, Harris RL, Kon Z, Tanaka KA. Acute Intracardiac Thrombosis and Pulmonary Thromboembolism After Cardiopulmonary Bypass. Anesth Analg 2018; 126:425-434. [DOI: 10.1213/ane.0000000000002259] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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A portable system for processing donated whole blood into high quality components without centrifugation. PLoS One 2018; 13:e0190827. [PMID: 29346441 PMCID: PMC5773086 DOI: 10.1371/journal.pone.0190827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/20/2017] [Indexed: 02/04/2023] Open
Abstract
Background The use of centrifugation-based approaches for processing donated blood into components is routine in the industrialized world, as disparate storage conditions require the rapid separation of ‘whole blood’ into distinct red blood cell (RBC), platelet, and plasma products. However, the logistical complications and potential cellular damage associated with centrifugation/apheresis manufacturing of blood products are well documented. The objective of this study was to evaluate a proof-of-concept system for whole blood processing, which does not employ electromechanical parts, is easily portable, and can be operated immediately after donation with minimal human labor. Methods and findings In a split-unit study (n = 6), full (~500mL) units of freshly-donated whole blood were divided, with one half processed by conventional centrifugation techniques and the other with the new blood separation system. Each of these processes took 2–3 hours to complete and were performed in parallel. Blood products generated by the two approaches were compared using an extensive panel of cellular and plasma quality metrics. Comparison of nearly all RBC parameters showed no significant differences between the two approaches, although the portable system generated RBC units with a slight but statistically significant improvement in 2,3-diphosphoglyceric acid concentration (p < 0.05). More notably, several markers of platelet damage were significantly and meaningfully higher in products generated with conventional centrifugation: the increase in platelet activation (assessed via P-selectin expression in platelets before and after blood processing) was nearly 4-fold higher for platelet units produced via centrifugation, and the release of pro-inflammatory mediators (soluble CD40-ligand, thromboxane B2) was significantly higher for centrifuged platelets as well (p < 0.01). Conclusion This study demonstrated that a simple, passive system for separating donated blood into components may be a viable alternative to centrifugation—particularly for applications in remote or resource-limited settings, or for patients requiring highly functional platelet product.
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Hao B, Wang Y, Zhou J, Shao S, Dong X. Comparison between the clinical efficacy of platelet concentrates, derived from buffy coat and apheresis in tumor patients. Oncol Lett 2017; 14:1445-1448. [PMID: 28789362 PMCID: PMC5529920 DOI: 10.3892/ol.2017.6270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/12/2017] [Indexed: 12/02/2022] Open
Abstract
The aim of the present study was to evaluate the clinical efficacy between manual buffy coat-derived platelet concentrates (PCs) and automated apheresis platelet concentrates (APCs) in terms of their therapeutic effects. The corrected count increment (CCI) was calculated according to detected differences in platelet concentration in patients who underwent transfusion of APCs, prepared by an automated system (group I, 72 cases) or PCs derived from buffy coat by manual method (group II, 83 cases). The clinical efficacy was assessed in terms of the CCI and clinical symptoms. The platelet contents of all the PCs were detected before transfusion. The mean 1 h CCI was 13.56±4.45 and 24 h CCI was 8.67±4.21 in group I, while the mean 1 h CCI was 15.83±4.65 and 24 h CCI was 9.57±3.36 in group II. The effective rates judged by CCI for groups I and II were 53 and 64%, respectively, and those judged by clinical symptoms were 67 and 60%, respectively. In conclusion, the clinical effectiveness of manual PCs was similar to that for APCs; thus, it could be utilized for clinical use.
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Affiliation(s)
- Baolan Hao
- Department of Blood Transfusion, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Yan Wang
- Department of Blood Transfusion, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Jian Zhou
- Department of Blood Transfusion, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Shujun Shao
- Department of Blood Transfusion, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Xiaofeng Dong
- Department of Blood Transfusion, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
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Thokala RP, Radhakrishnan K, Anandan A, Panicker VK. Recovery of Platelet Count among Apheresis Platelet Donors. J Clin Diagn Res 2016; 10:EC01-EC04. [PMID: 28208861 DOI: 10.7860/jcdr/2016/21070.8997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 08/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Increase in awareness regarding use of single donor platelets and the availability of technology has resulted in increased platelet pheresis procedures. The interval between two succesive plateletpheresis donations is much less compared to whole blood donations. Plateletpheresis procedures are associated with short term and long term adverse events. The effect of plateletpheresis on haematopoietic system remains significant. AIM To study the recovery of platelet count to baseline in plateletpheresis donors. MATERIALS AND METHODS Fifty, first time apheresis donors were followed for platelet count recovery. Platelet count was measured before donation and at 30 minutes, 48 hours, 7th day and 14th day post-donation. Donor platelet count recovery to baseline was observed during the two week period. Results were analysed statistically, p<0.05 was considered statistically significant. RESULTS Platelet count recovered to baseline by 7th day post-donation in 50% of donors in groups I (Pre-donation platelet count 1.5 lacs/μl to 2.2 lacs/μl) and II (Donors with platelet count >2.2 lacs/μl to 2.75 lacs/μl), 30% of donors in group III (Donors with platelet count >2.75 lacs/μl to 3.5 lacs/μl) of the donors. Donor's platelet count recovered to baseline in 85% of donors by day 14 in across the three groups. Recruitment of platelets from spleen was observed in donors with pre-donation platelet count on the lower limit of normal. CONCLUSION By day 7, donor's platelet count recovered to baseline in majority of the donors. Allowing enough recovery periods for donor platelet count, the minimum interval between two apheresis donations can be 7 days till more prospective studies conclude on the frequency and minimum interval between plateletpheresis donations.
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Affiliation(s)
- Ravindra Prasad Thokala
- Assistant Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Krishnamoorthy Radhakrishnan
- Associate Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Ashwin Anandan
- Senior Resident, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
| | - Vinod Kumar Panicker
- Professor, Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute , Chennai, India
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Arora D, Garg K, Kaushik A, Sharma R, Rawat DS, Mandal AK. A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India. J Clin Diagn Res 2016; 10:EC22-EC24. [PMID: 28050376 PMCID: PMC5198329 DOI: 10.7860/jcdr/2016/20707.8925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. AIM To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. MATERIALS AND METHODS Records of single donor apheresis were retrospectively analysed from 1st January 2010 to 31st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included - age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. RESULTS Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. CONCLUSION We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors.
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Affiliation(s)
- Disha Arora
- Ex-Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Ketan Garg
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Ankit Kaushik
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - Richa Sharma
- Senior Resident, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - DS Rawat
- Ex-Associate Professor and Head of Blood Bank, Department of Pathology, Safdarjung Hospital, Delhi, India
| | - AK Mandal
- Professor and Head, Department of Pathology, Safdarjung Hospital, Delhi, India
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Murgia A, Veronesi E, Candini O, Caselli A, D’souza N, Rasini V, Giorgini A, Catani F, Iughetti L, Dominici M, Burns JS. Potency Biomarker Signature Genes from Multiparametric Osteogenesis Assays: Will cGMP Human Bone Marrow Mesenchymal Stromal Cells Make Bone? PLoS One 2016; 11:e0163629. [PMID: 27711115 PMCID: PMC5053614 DOI: 10.1371/journal.pone.0163629] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/12/2016] [Indexed: 01/15/2023] Open
Abstract
In skeletal regeneration approaches using human bone marrow derived mesenchymal stromal cells (hBM-MSC), functional evaluation before implantation has traditionally used biomarkers identified using fetal bovine serum-based osteogenic induction media and time courses of at least two weeks. However, emerging pre-clinical evidence indicates donor-dependent discrepancies between these ex vivo measurements and the ability to form bone, calling for improved tests. Therefore, we adopted a multiparametric approach aiming to generate an osteogenic potency assay with improved correlation. hBM-MSC populations from six donors, each expanded under clinical-grade (cGMP) conditions, showed heterogeneity for ex vivo growth response, mineralization and bone-forming ability in a murine xenograft assay. A subset of literature-based biomarker genes was reproducibly upregulated to a significant extent across all populations as cells responded to two different osteogenic induction media. These 12 biomarkers were also measurable in a one-week assay, befitting clinical cell expansion time frames and cGMP growth conditions. They were selected for further challenge using a combinatorial approach aimed at determining ex vivo and in vivo consistency. We identified five globally relevant osteogenic signature genes, notably TGF-ß1 pathway interactors; ALPL, COL1A2, DCN, ELN and RUNX2. Used in agglomerative cluster analysis, they correctly grouped the bone-forming cell populations as distinct. Although donor #6 cells were correlation slope outliers, they contrastingly formed bone without showing ex vivo mineralization. Mathematical expression level normalization of the most discrepantly upregulated signature gene COL1A2, sufficed to cluster donor #6 with the bone-forming classification. Moreover, attenuating factors causing genuine COL1A2 gene down-regulation, restored ex vivo mineralization. This suggested that the signature gene had an osteogenically influential role; nonetheless no single biomarker was fully deterministic whereas all five signature genes together led to accurate cluster analysis. We show proof of principle for an osteogenic potency assay providing early characterization of primary cGMP-hBM-MSC cultures according to their donor-specific bone-forming potential.
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Affiliation(s)
- Alba Murgia
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Elena Veronesi
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
- TPM, Science & Technology Park for Medicine, Mirandola, Modena, Italia
| | - Olivia Candini
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Anna Caselli
- CVBF - Consorzio per le Valutazioni Biologiche e Farmacologiche, Ospedale Pediatrico Giovanni XXIII, Bari, Italia
| | - Naomi D’souza
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Valeria Rasini
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Andrea Giorgini
- Department of Orthopedic Surgery, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Fabio Catani
- Department of Orthopedic Surgery, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
| | - Massimo Dominici
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
- TPM, Science & Technology Park for Medicine, Mirandola, Modena, Italia
- * E-mail: (MD); (JSB)
| | - Jorge S. Burns
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, Modena, Italia
- TPM, Science & Technology Park for Medicine, Mirandola, Modena, Italia
- * E-mail: (MD); (JSB)
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Preparation, Storage, and Characteristics of Blood Components and Plasma Derivatives. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Berger K, Schopohl D, Wittmann G, Schramm W, Ostermann H, Rieger C. Blood Product Supply in Germany: The Impact of Apheresis and Pooled Platelet Concentrates. Transfus Med Hemother 2016; 43:389-394. [PMID: 27994524 DOI: 10.1159/000445442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Germany, about 60% of all produced platelet concentrates (PCs) are apheresis PCs (APCs). Ongoing discussions on APC reimbursement and costs might lead to a potential shift in pooled PC (PPC)/APC production. Objective of this analysis was to build a comprehensive model from the societal perspective to evaluate consequences associated with shifts in platelet supply and demand. METHODS Literature search, desktop researches on platelet supply and demand. Model calculations, time horizon one year: model input from the Paul-Ehrlich-Institute, data 2013. Base case: 19.2% of annual whole blood donations (WBDs) were used for production of 38.5% PPCs, decay of 46,218 PCs (8.0%). Scenarios calculated: variation in PPC proportion of 10-100%. RESULTS Base case: during PPC production 41,957-83,913 red blood cell concentrates (RBCCs) are estimated to be lost, which corresponds to 1-2% of annual RBCCs in Germany. Scenarios were calculated for a production of 60-100% PPCs: loss is estimated to be 1.5-5.0% of annual RBCCs (65,430-218,099), decay 54,189-69,022 PCs (9.4-12.0%). CONCLUSION Production of different blood components is interlinked and sensitive to unidimensional decisions. Increasing PPC proportion has negative impact on the RBCC production and on the antigen-matched APC donor pool. Completion of the model calculations to predict the optimal PPC/APC proportion would require evidence on the number of refractory patients, donor pool sizes, and incidences of diseases requiring platelet transfusions.
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Affiliation(s)
- Karin Berger
- Department of Hematology/Oncology, University Hospital of Munich, Munich, Germany
| | - Dorothee Schopohl
- Department of Hematology/Oncology, University Hospital of Munich, Munich, Germany
| | - Georg Wittmann
- Department of Transfusion Medicine, Cell Therapeutics and Hemostaseology, University Hospital of Munich, Munich, Germany
| | | | - Helmut Ostermann
- Department of Hematology/Oncology, University Hospital of Munich, Munich, Germany
| | - Christina Rieger
- Department of Hematology/Oncology, University Hospital of Munich, Munich, Germany
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Thiele T, Alt-Mayer T, Greinacher A, Bux J. Implications of a switch to a 100% apheresis platelet supply for patients and for blood donors: a risk benefit analysis. Vox Sang 2016; 111:350-356. [PMID: 27432635 DOI: 10.1111/vox.12433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND A 100% apheresis platelet supply is considered to increase transfusion safety by lowering donor exposures for transfusion recipients. We performed a risk benefit analysis to contrast the reduction of donor exposures and the risk of contaminated blood products in the nation-wide inventory with the donor risks associated with a switch to a 100% apheresis platelet supply in Germany. METHODS Donor exposures and the number of contaminated blood products resulting from HIV-like, HBV-like, HCV-like pathogens and two theoretical agents with infection rates of 10 and 1000 in 100 000, respectively, were calculated for a 100% apheresis platelet supply in Germany based on the 2006-2012 hemovigilance reports. These numbers were compared with the current mixed platelet supply of pooled and apheresis platelets. Moreover, additional donation time and apheresis donor complications resulting from a 100% apheresis platelet supply were estimated. RESULTS Per million total blood products (red cells, platelets, fresh frozen plasma), a 100% apheresis platelet supply would reduce donor exposures by 87 100 and the number of contaminated blood products ranging from 0·8 to 871·1. On the other hand, this requires additional 29 478 apheresis donations, 3·4 years additional donor time, and would be associated with 58 additional donor complications, respectively. CONCLUSIONS A 100% apheresis platelet supply would reduce donor exposures and the number of contaminated blood products in the inventory, but would increase apheresis complications in donors. Potential risks for patients must be carefully weighed against the risks for donors, dependent on the specific pathogen scenario.
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Affiliation(s)
- T Thiele
- Institute for Immunology and Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - T Alt-Mayer
- German Red Cross Blood Service West, Bad Kreuznach, Germany
| | - A Greinacher
- Institute for Immunology and Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - J Bux
- Ruhr University, Bochum, Germany
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Liu HD, Zhang AJ, Xu JJ, Chen Y, Zhu YC. H2S protects against fatal myelosuppression by promoting the generation of megakaryocytes/platelets. J Hematol Oncol 2016; 9:13. [PMID: 26912146 PMCID: PMC4766725 DOI: 10.1186/s13045-016-0244-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/17/2016] [Indexed: 12/13/2022] Open
Abstract
Background Our previous pilot studies aimed to examine the role of hydrogen sulfide (H2S) in the generation of endothelial progenitor cells led to an unexpected result, i.e., H2S promoted the differentiation of certain hematopoietic stem/progenitor cells in the bone marrow. This gave rise to an idea that H2S might promote hematopoiesis. Methods To test this idea, a mice model of myelosuppression and cultured fetal liver cells were used to examine the role of H2S in hematopoiesis. Results H2S promoted the generation of megakaryocytes, increased platelet levels, ameliorate entorrhagia, and improved survival. These H2S effects were blocked in both in vivo and in vitro models with thrombopoietin (TPO) receptor knockout mice (c-mpl−/− mice). In contrast, H2S promoted megakaryocytes/platelets generation in both in vivo and in vitro models with TPO knockout mice (TPO−/− mice). Conclusions H2S is a novel promoter for megakaryopoiesis by acting on the TPO receptors but not TPO to generate megakaryocytes/platelets. Electronic supplementary material The online version of this article (doi:10.1186/s13045-016-0244-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Huan-Di Liu
- Shanghai Key Laboratory of Bioactive Small Molecules and Research Center on Aging and Medicine, Department of Physiology and Pathophysiology, Fudan University Shanghai Medical College, 138 Yi Xue Yuan Road, Shanghai, 200032, China.,Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine in Henan Province, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
| | - Ai-Jie Zhang
- Shanghai Key Laboratory of Bioactive Small Molecules and Research Center on Aging and Medicine, Department of Physiology and Pathophysiology, Fudan University Shanghai Medical College, 138 Yi Xue Yuan Road, Shanghai, 200032, China
| | - Jing-Jing Xu
- Shanghai Key Laboratory of Bioactive Small Molecules and Research Center on Aging and Medicine, Department of Physiology and Pathophysiology, Fudan University Shanghai Medical College, 138 Yi Xue Yuan Road, Shanghai, 200032, China.,Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Chen
- Shanghai Key Laboratory of Bioactive Small Molecules and Research Center on Aging and Medicine, Department of Physiology and Pathophysiology, Fudan University Shanghai Medical College, 138 Yi Xue Yuan Road, Shanghai, 200032, China
| | - Yi-Chun Zhu
- Shanghai Key Laboratory of Bioactive Small Molecules and Research Center on Aging and Medicine, Department of Physiology and Pathophysiology, Fudan University Shanghai Medical College, 138 Yi Xue Yuan Road, Shanghai, 200032, China.
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Daurat A, Roger C, Gris J, Daurat G, Feissel M, Le Manach Y, Lefrant J, Muller L. Apheresis platelets are more frequently associated with adverse reactions than pooled platelets both in recipients and in donors: a study from French hemovigilance data. Transfusion 2016; 56:1295-303. [DOI: 10.1111/trf.13475] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/02/2015] [Accepted: 12/02/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Aurélien Daurat
- Division Anesthésie Réanimation; Urgences Douleur, Centre Hospitalier Universitaire de Nîmes; Nîmes France
| | - Claire Roger
- Division Anesthésie Réanimation; Urgences Douleur, Centre Hospitalier Universitaire de Nîmes; Nîmes France
| | - JeanChristophe Gris
- Laboratory of Hematology; Centre Hospitalier Universitaire de Nîmes; Nîmes France
| | - Gérald Daurat
- Délégation Qualité Gestion des Risques; Centre Hospitalier Universitaire de Nîmes; Nîmes France
| | - Michel Feissel
- Etablissement Français du Sang Pyrénées-Méditerranée; Nîmes France
| | - Yannick Le Manach
- Departments of Anesthesia & Clinical Epidemiology and Biostatistics; Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University; Hamilton Ontario Canada
| | - JeanYves Lefrant
- Division Anesthésie Réanimation; Urgences Douleur, Centre Hospitalier Universitaire de Nîmes; Nîmes France
| | - Laurent Muller
- Division Anesthésie Réanimation; Urgences Douleur, Centre Hospitalier Universitaire de Nîmes; Nîmes France
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Kaur D, Sharma RR, Marwaha N. Defining an appropriate leucoreduction strategy by serial assessment of cytokine levels in platelet concentrates prepared by different methods. Asian J Transfus Sci 2015; 9:31-5. [PMID: 25722570 PMCID: PMC4339928 DOI: 10.4103/0973-6247.150945] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and Objectives: Different methods of platelet concentrate preparations leave behind certain number of residual leukocytes, accounting for most of the febrile nonhemolytic transfusion reactions, especially in multitransfused patients. Various inflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6 are generated during storage and have been implicated for these adverse effects. We have studied the levels of these cytokines and their correlation with leucocyte contents in platelet concentrates prepared by three different methods. Study Design and Methods: Five pools of platelet rich plasma platelet concentrates (PRP-PC) and buffy-coat platelet concentrates (BC-PC) each were prepared and divided into two halves. One half of the pool was leucofiltered (LF), whereas the other half was stored as such. Ten apheresis units were also included in the study. All the platelet concentrates were assessed for leucocyte load and cytokine content (IL-1β, IL-6, and TNF-α) on different days of storage (0, 3, and 5) using Nageotte chamber and commercially available immunoassays respectively. Results: There was a statistically significant rise in cytokine levels (IL-1β, IL-6, and TNF-α) in nonleucofiltered (NLF) random donor platelet concentrates (RDPs) (PRP-PC and BC-PC) during storage (day 3 and 5) whereas LF RDP concentrates (PRP-PC and BC-PC) and apheresis platelet concentrates (AP-PC) did not show any significant rise in cytokine levels (on day 3 and 5) over the baseline values at day 0. Conclusion: This data suggests that although AP-PCs are superior to PRP-PC (NLF) and BC-PC (NLF) in terms of in vitro quality control parameters and cytokine generation during storage, BC-PC mode of platelet preparation followed by leucofiltration is the best method to store platelets and minimise the cytokine accumulation. This strategy is best suited for transfusion in multitransfused hematooncologic patients, who cannot afford single donor apheresis platelets.
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Affiliation(s)
- Daljit Kaur
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ratti Ram Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Marwaha
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Yang BC, Shao CP, Zhang YY, Kong L, Xu YP. Two decades of voluntary nonremunerated blood donation in Shenzhen, China. Transfusion 2014; 55:1108-14. [PMID: 25524632 DOI: 10.1111/trf.12964] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 10/16/2014] [Accepted: 10/16/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND As an emerging metropolis with population expansion from 2 million to 10 million from 1993 to 2012, the clinical demand for blood in Shenzhen has increased 20 times. To deal with this big challenge, Shenzhen utilized voluntary nonremunerated blood donation (VNRBD) in 1993 for the first time in China. After two decades of efforts, Shenzhen has achieved self-sufficiency in its blood supply and guaranteed its blood security by nonpaid blood donation. STUDY DESIGN AND METHODS We summarized the strategies to achieve self-sufficiency and security in the blood supply in Shenzhen during two decades, including the legal construction of VNRBDs and the continuously improving strategies to recruit and retain nonpaid donors. The collection data of whole blood (WB) and apheresis platelet (PLT) donations were retrieved, and donor demographic and donation characteristics were analyzed. RESULTS From 1993 to 1998, paid and nonpaid blood donations coexisted in Shenzhen. From the year 1999, all WB for clinical use came from VNRBDs. From 1999 to 2012, the donors who chose to donate 400 mL each time and repeat and regular donors increased sharply to meet the fast growth of clinical demand. From the year 2005, the clinical demand for PLTs was entirely satisfied by nonpaid donations. CONCLUSIONS After two decades of practice, we believe that the legal regime of VNRBD is fundamental guarantee for long-term self-sufficiency and security in the blood supply. In addition, strengthening the publicity to improve the public's awareness and improving donation services and measures to recruit more nonpaid donors and retain repeat and regular donors are very important.
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Affiliation(s)
- Bao-Cheng Yang
- Shenzhen Blood Center (SZBC), Shenzhen, Guangdong, China
| | - Chao-Peng Shao
- Shenzhen Second People's Hospitial, Shenzhen, Guangdong, China
| | - Yan-Yan Zhang
- Shenzhen Blood Center (SZBC), Shenzhen, Guangdong, China
| | - Lingkui Kong
- Shenzhen Blood Center (SZBC), Shenzhen, Guangdong, China
| | - Yun-Ping Xu
- Shenzhen Blood Center (SZBC), Shenzhen, Guangdong, China
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Wandt H, Schäfer-Eckart K, Greinacher A. Platelet transfusion in hematology, oncology and surgery. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:809-15. [PMID: 25512006 PMCID: PMC4269073 DOI: 10.3238/arztebl.2014.0809] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/15/2014] [Accepted: 09/15/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The standard recommendation to date has been that acute hypoproliferative thrombocytopenia should be treated with a prophylactic platelet transfusion if the morning platelet count is less than 10 000/μL, or less than 20 000/μL if there are additional risk factors. For chronic thrombocytopenia, transfusion has been recommended if the platelet count is less than 5000/μL. In Germany, half a million platelet transfusions are now being given every year, and the number is rising. New studies indicate, however, that a more restrictive transfusion strategy is justified. METHODS A selective literature search was carried out in PubMed, with additional attention to recommendations from Germany and abroad, and to the guidelines of medical specialty societies. RESULTS Prophylactic platelet transfusions should be given when clinically indicated in consideration of the individual hemorrhagic risk. To prevent severe hemorrhage, it is more important to respond to the first signs of bleeding than to pay exclusive attention to morning platelet counts below 10 000/μL. This threshold value remains standard for patients with acute leukemia. According to recent studies, however, clinically stable patients who are at low risk for bleeding-e.g., patients who have undergone autologous hematopoietic stem-cell transplantation-may be well served by a therapeutic, rather than prophylactic, platelet transfusion strategy, in which platelets are transfused only when evidence of bleeding has been observed. For cancer patients, intensive-care patients, and patients with other risk factors, a clinically oriented transfusion strategy is recommended, in addition to close attention to threshold platelet values. CONCLUSION The number of platelet transfusions could be safely lowered by a more restrictive transfusion strategy that takes account of the risk of bleeding, as recommended in the hemotherapy guidelines.
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Affiliation(s)
- Hannes Wandt
- Medical Clinic 5—Nuremberg Hospital: Internal Medicine, Oncology, Hematology
| | | | - Andreas Greinacher
- Institute of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt-University of Greifswald
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an der Heiden M, Ritter S, Hamouda O, Offergeld R. Estimating the residual risk for HIV, HCV and HBV in different types of platelet concentrates in Germany. Vox Sang 2014; 108:123-30. [PMID: 25335096 DOI: 10.1111/vox.12204] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 09/05/2014] [Accepted: 09/08/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES We estimated and compared the residual risks due to window-period donations for pooled and apheresis platelets in Germany using a modification of a previously described statistical model. This model directly utilizes the reported interdonation intervals before a positive donation and reflects in this aspect the look-back procedures used in haemovigilance. MATERIALS AND METHODS Data from the German National Blood Donor Surveillance System for the years 2006-2012, including reports about donations from repeat donors with confirmed positive test results for HIV, HCV and HBV, were used to estimate the risk of undetected infectious units for both pooled and apheresis platelets. RESULTS Demographics of whole-blood and apheresis donors differed in age, gender, catchment area and interdonation interval. These differences impact on the prevalence and incidence of transfusion relevant infections and consequently the residual risk. The estimates for the residual risks for pooled and apheresis platelets were comparable. For HIV, there was no significant difference, for HCV apheresis platelets had a lower residual risk, whereas pooled platelets had a lower risk for undetected HBV infections. CONCLUSION These findings do not support calls for a shift to an apheresis platelets-only policy in Germany.
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Affiliation(s)
- M an der Heiden
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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47
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Gudleviciene Z. Quick and effective method of bone marrow mesenchymal stem cell extraction. Open Med (Wars) 2014; 10:44-49. [PMID: 28352676 PMCID: PMC5152963 DOI: 10.1515/med-2015-0008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/29/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Mesenchymal stem cells (MSCs) are currently exploited in numerous clinical trials to investigate their potential in immune regulation, hematopoesis or tissue regeneration. The most common source of MSCs for clinical use is human bone marrow. To generate sufficient numbers of cells relevant to clinical use in most cases the high volumes (20-50 ml) of bone marrow aspirates are taken. METHODS In this pilot study, 8 healthy bone marrow donors were included. Two different MSC extraction methods were evaluated: MSCs extraction from 60 ml of bone marrow using density gradient and MSCs extraction from 6 ml using red blood cell (RBC) lysis. RESULTS Our results showed that after RBC lysis the efficient amount of human MSCs can be isolated from 10 times less bone marrow volume (6 ml). Moreover, using small volume of bone marrow the adequate therapeutical dose of MSCs could be achieved during similar period of time (3-4 weeks). In conclusion, we have shown that MSCs isolation using RBC lysis is an effective and more advantageous method in comparison to standard MSCs isolation using density-gradient. Using RBC lysis from small volume of bone marrow the same amount of MSCs were obtained as usually using large volume and density-gradient.
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Affiliation(s)
- Zivile Gudleviciene
- National Cancer Institute, Biobank, Santariskiu 1, 08660 Vilnius, Lithuania, tel. +37052190909, fax. +37052720164
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Chatterjee K, Coshic P, Borgohain M, Agarwal N. Experience of buffy coat pooling of platelets as a supportive care in thrombocytopenic dengue patients: A prospective study. Asian J Transfus Sci 2014; 8:89-91. [PMID: 25161345 PMCID: PMC4140070 DOI: 10.4103/0973-6247.137439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Random donor platelet (RDP) is not sufficient to improve the platelet count in most thrombocytopenic patients. Single donor platelet (SDP) or buffy coat pooled platelet (BCPP) are the two choices to provide a full therapeutic dose of platelets. However, there are constraints in the preparation of SDP due to stringent donor selection procedure, time required for procedure, and need of special expensive equipments and kits. BCPP is widely practiced, especially in the European countries, since 1995. In India, we decided to adopt the procedure of buffy coat pooling of platelets, especially for economically backward patients and for emergencies. This study was prospectively conducted from September 2009 to September 2010. A total of 129 units of BCPP [tested prior for viral markers by enzyme-linked immunosorbent assay (ELISA) and individual donor nucleic acid amplification test (ID-NAT)] were issued to 129 patients suffering from dengue and were included in this study. For comparison between efficacy of SDP and BCCP, patients were divided into two groups of 50 each. The post-transfusion platelet counts of the patients were noted after 2 hours of transfusion for each type of component. The platelet yield varied from 2.5 to 4.4 Χ 1011 in BCPP samples. The samples analyzed were sterile without any contamination. The different biochemical parameters were analyzed in detail. The observed post-transfusion platelet recovery and corrected count increment (CCI) at 1 hour and 24 hours after BCPP transfusion were similar to that after SDP transfusion. Hence, we concluded that BCPP can be a low cost alternative to SDP in the times of emergencies like dengue and non-affordability by the patient for SDP.
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Affiliation(s)
- Kabita Chatterjee
- Department of Transfusion Medicine, Blood Bank (Main), All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Poonam Coshic
- Department of Transfusion Medicine, Blood Bank (Main), All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Mayuri Borgohain
- Department of Transfusion Medicine, Blood Bank (Main), All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Nitin Agarwal
- Department of Transfusion Medicine, Blood Bank (Main), All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Paglia G, Sigurjónsson ÓE, Rolfsson Ó, Hansen MB, Brynjólfsson S, Gudmundsson S, Palsson BO. Metabolomic analysis of platelets during storage: a comparison between apheresis- and buffy coat-derived platelet concentrates. Transfusion 2014; 55:301-13. [PMID: 25156572 DOI: 10.1111/trf.12834] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Platelet concentrates (PCs) can be prepared using three methods: platelet (PLT)-rich plasma, apheresis, and buffy coat. The aim of this study was to obtain a comprehensive data set that describes metabolism of buffy coat-derived PLTs during storage and to compare it with a previously published parallel data set obtained for apheresis-derived PLTs. STUDY DESIGN AND METHODS During storage we measured more than 150 variables in 8 PLT units, prepared by the buffy coat method. Samples were collected at seven different time points resulting in a data set containing more than 8000 measurements. This data set was obtained by combining a series of standard quality control assays to monitor the quality of stored PLTs and a deep coverage metabolomics study using liquid chromatography coupled with mass spectrometry. RESULTS Stored PLTs showed a distinct metabolic transition occurring 4 days after their collection. The transition was evident in PLT produced by both production methods. Apheresis-derived PLTs showed a clearer phenotype of PLT activation during early days of storage. The activated phenotype of apheresis PLTs was accompanied by a higher metabolic activity, especially related to glycolysis and the tricarboxylic acid cycle. Moreover, the extent of the activation differed between bags resulting in interbag variability in the storage lesion of apheresis-prepared PLTs. This may be related to donor-related polymorphism. CONCLUSION This study demonstrated two discrete metabolic phenotypes in stored PLTs prepared with both apheresis and buffy coat methods. PLT activation occurs during the first metabolic phenotype and might lead to a low reproducibility of the apheresis PCs.
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Affiliation(s)
- Giuseppe Paglia
- Center for Systems Biology, University of Iceland, Reykjavik, Iceland
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50
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Wuchter P, Bieback K, Schrezenmeier H, Bornhäuser M, Müller LP, Bönig H, Wagner W, Meisel R, Pavel P, Tonn T, Lang P, Müller I, Renner M, Malcherek G, Saffrich R, Buss EC, Horn P, Rojewski M, Schmitt A, Ho AD, Sanzenbacher R, Schmitt M. Standardization of Good Manufacturing Practice-compliant production of bone marrow-derived human mesenchymal stromal cells for immunotherapeutic applications. Cytotherapy 2014; 17:128-39. [PMID: 24856898 DOI: 10.1016/j.jcyt.2014.04.002] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/26/2014] [Accepted: 04/05/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND AIMS Human mesenchymal stem or stromal cells (MSCs) represent a potential resource not only for regenerative medicine but also for immunomodulatory cell therapies. The application of different MSC culture protocols has significantly hampered the comparability of experimental and clinical data from different laboratories and has posed a major obstacle for multicenter clinical trials. Manufacturing of cell products for clinical application in the European Community must be conducted in compliance with Good Manufacturing Practice and requires a manufacturing license. In Germany, the Paul-Ehrlich-Institut as the Federal Authority for Vaccines and Biomedicines is critically involved in the approval process. METHODS This report summarizes a consensus meeting between researchers, clinicians and regulatory experts on standard quality requirements for MSC production. RESULTS The strategy for quality control testing depends on the product's cell composition, the manufacturing process and the indication and target patient population. Important quality criteria in this sense are, among others, the immunophenotype of the cells, composition of the culture medium and the risk for malignant transformation, as well as aging and the immunosuppressive potential of the manufactured MSCs. CONCLUSIONS This position paper intends to provide relevant information to interested parties regarding these criteria to foster the development of scientifically valid and harmonized quality standards and to support approval of MSC-based investigational medicinal products.
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Affiliation(s)
- Patrick Wuchter
- Department of Medicine V, Heidelberg University, Heidelberg, Germany.
| | - Karen Bieback
- Institute of Transfusion Medicine and Immunology Mannheim, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Donor Service Baden-Württemberg-Hessen, Mannheim, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University of Ulm, Ulm, Germany
| | - Martin Bornhäuser
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Lutz P Müller
- Department of Medicine IV, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Halvard Bönig
- Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt/Main and German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt/Main, Germany
| | - Wolfgang Wagner
- Helmholtz Institute for Biomedical Technology, Stem Cell Biology and Cellular Engineering, University of Aachen Medical School, Aachen, Germany
| | - Roland Meisel
- Division of Pediatric Stem Cell Therapy, Clinic for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Petra Pavel
- Stem Cell Laboratory, IKTZ Heidelberg GmbH, Heidelberg, Germany
| | - Torsten Tonn
- Institute of Transfusion Medicine, Red Cross Blood Transfusion Service Dresden, Dresden, Germany
| | - Peter Lang
- Department of Pediatrics, University Clinic Tübingen, Tübingen, Germany
| | - Ingo Müller
- Clinic for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Renner
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Georg Malcherek
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Rainer Saffrich
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Eike C Buss
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Patrick Horn
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Markus Rojewski
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University of Ulm, Ulm, Germany
| | - Anita Schmitt
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Ralf Sanzenbacher
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Michael Schmitt
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
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