1
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Valsami S, Grouzi E, Mochandreou D, Pouliakis A, Piroula-Godoy M, Kokori S, Pittaras T, Raikou A, Politou M. Effect of mirasol pathogen reduction technology system on immunomodulatory molecules of apheresis platelets. Transfus Apher Sci 2023; 62:103523. [PMID: 36041977 DOI: 10.1016/j.transci.2022.103523] [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: 05/23/2022] [Revised: 07/28/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
Pathogen inactivation for platelets by riboflavin system (MIRASOL) efficiently reduces transfusion related pathogen transmission. However little is known about its impact on platelets' immunomodulatory biochemical profile. We aimed was to assess the effects of MIRASOL treatment on platelet quality parameters and immunomodulatory molecules CD62P, RANTES, and CD40L in Single Donor Platelets (SDPs) resuspended in plasma (SDP-P) or T-PAS and additive solution (SDP-A). Twenty nine SDPs (15 SDP-P and 14 SDP-A) were included in the study. Samples were collected before, after MIRASOL treatment and just before transfusion. P-selectin (CD62P), RANTES, and CD40L were tested by ELISA. Platelet products quality assays were also performed. Platelet count/unit decreased after Mirasol treatment by 13 %. The pH of all units decreased over the 5-day storage period but remained above expected limits and the swirling test was positive throughout storage. P-selectin levels were not different between the three different time points in both SDPs-P and SDPs-A while RANTES levels were found to differ statistically significantly at the three different time points in all units and in the SPD-A subgroup. CD40L levels in all SDP products increased slightly during storage but this was not statistically significant. CD62P, RANTES, and CD40L in all time points were elevated in SDPs-A compared to SDPs-P but not at a statistically significant level. In conclusion MIRASOL treatment apart from RANTES increase does not seem to substantially affect platelets associated other cytokines and immunomodulatory molecules namely P-selectin and sCD40L which are implicated in immune transfusion reactions.
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Affiliation(s)
- S Valsami
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Grouzi
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - D Mochandreou
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - A Pouliakis
- Department of Cytopathology, University of Athens, "ATTIKON" University Hospital, Athens, Greece
| | - M Piroula-Godoy
- Masters of Science Programme "Thrombosis-Haemorrhage-Transfusion Medicine" of the National and Kapodistrian University of Athens, Greece
| | - S Kokori
- Laboratory of Haematology & Blood Bank Unit, "Attikon" University Hospital, National and Kapodistrian Athens, Athens, Greece
| | - T Pittaras
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Raikou
- Department of Transfusion Service and Clinical Hemostasis, "Agios Savvas" Regional Cancer Hospital, Athens, Greece
| | - M Politou
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece; Masters of Science Programme "Thrombosis-Haemorrhage-Transfusion Medicine" of the National and Kapodistrian University of Athens, Greece.
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2
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Tsalas S, Petrou E, Tsantes AG, Sokou R, Loukopoulou E, Houhoula D, Mantzios PG, Kriebardis AG, Tsantes AE. Pathogen Reduction Technologies and Their Impact on Metabolic and Functional Properties of Treated Platelet Concentrates: A Systematic Review. Semin Thromb Hemost 2022. [PMID: 36252605 DOI: 10.1055/s-0042-1757897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pathogen reduction technologies (PRTs) such as Mirasol and Intercept were developed to eliminate transfusion-transmitted infections. The impact of PRTs on platelet function during the storage period, their effect on platelet storage lesions, and the optimal storage duration following PRTs have not been clearly defined. The aim of this study was to systematically review the existing literature and investigate the impact of PRTs on functional alterations of PRT-treated platelets during the storage period. The authors identified 68 studies suitable to be included in this review. Despite the high heterogeneity in the literature, the results of the published studies indicate that PRTs may increase platelet metabolic activity, accelerate cell apoptosis, and enhance platelet activation, which can subsequently lead to a late exhaustion of activation potential and reduced aggregation response. However, these effects have a minor impact on platelet function during the early storage period and become more prominent beyond the fifth day of the storage period. Large in vivo trials are required to evaluate the effectiveness of PRT-treated platelets during the storage period and investigate whether their storage can be safely extended to more than 5 days, and up to the traditional 7-day storage period.
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Affiliation(s)
- Stavros Tsalas
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Petrou
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas G Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Nikea, Piraeus, Greece
| | - Electra Loukopoulou
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitra Houhoula
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros G Mantzios
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios G Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Athens, Greece
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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3
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Escolar G, Diaz-Ricart M, McCullough J. Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic. Transfusion 2021; 62:227-246. [PMID: 34870335 PMCID: PMC9300014 DOI: 10.1111/trf.16747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/03/2021] [Accepted: 10/06/2021] [Indexed: 12/25/2022]
Abstract
Standard platelet concentrates (PCs) stored at 22°C have a limited shelf life of 5 days. Because of the storage temperature, bacterial contamination of PCs can result in life‐threatening infections in transfused patients. The potential of blood components to cause infections through contaminating pathogens or transmitting blood‐borne diseases has always been a concern. The current safety practice to prevent pathogen transmission through blood transfusion starts with a stringent screening of donors and regulated testing of blood samples to ensure that known infections cannot reach transfusion products. Pathogen reduction technologies (PRTs), initially implemented to ensure the safety of plasma products, have been adapted to treat platelet products. In addition to reducing bacterial contamination, PRT applied to PCs can extend their shelf life up to 7 days, alleviating the impact of their shortage, while providing an additional safety layer against emerging blood‐borne infectious diseases. While a deleterious action of PRTs in quantitative and qualitative aspects of plasma is accepted, the impact of PRTs on the quality, function, and clinical efficacy of PCs has been under constant examination. The potential of PRTs to prevent the possibility of new emerging diseases to reach cellular blood components has been considered more hypothetical than real. In 2019, a coronavirus‐related disease (COVID‐19) became a pandemic. This episode should help when reconsidering the possibility of future blood transmissible threats. The following text intends to evaluate the impact of different PRTs on the quality, function, and clinical effectiveness of platelets within the perspective of a developing pandemic.
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Affiliation(s)
- Gines Escolar
- Department of Hematopathology, Centre Diagnostic Biomedic, Hospital Clinic, Barcelona, Spain
| | - Maribel Diaz-Ricart
- Department of Hematopathology, Centre Diagnostic Biomedic, Hospital Clinic, Barcelona, Spain
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4
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Jimenez-Marco T, Ballester-Servera C, Quetglas-Oliver M, Morell-Garcia D, Torres-Reverte N, Bautista-Gili AM, Serra-Ramon N, Girona-Llobera E. Cryopreservation of platelets treated with riboflavin and UV light and stored at -80°C for 1 year. Transfusion 2021; 61:1235-1246. [PMID: 33694171 DOI: 10.1111/trf.16324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/04/2021] [Accepted: 01/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The combination of pathogen reduction technologies (PRTs) and cryopreservation can contribute to building a safe and durable platelet (PLT) inventory. Information about cryopreserved riboflavin and UV light-treated PLTs is scarce. STUDY DESIGN AND METHODS Twenty-four buffy coat (BC) PLT concentrates were grouped into 12 type-matched pairs, pooled, and divided into 12 non-PRT-treated control units and 12 riboflavin and UV light PRT-treated test units. Both were cryopreserved with 5% DMSO and stored at -80°C for 1 year. The cryopreservation method used was designed to avoid the formation of aggregates. PLT variables (PLT recovery, swirling, pH, MPV, and LDH) and hemostatic function measured by thromboelastography (TEG) were analyzed before cryopreservation (day 1) and post-cryopreservation at day 14 and months 3, 6, and 12 of storage at -80°C. The analyses were carried out within 1-h post-thaw. RESULTS No aggregates were found in either PLT group at any time. Swirling was observed in both groups. MPV increased and mean pH values decreased over time (p < .001), but the mean pH value was never below 6.4 in either group after 12 months of storage at -80°C. PLT recovery was good and clotting time became significantly shorter over the storage period in both groups (p < .001). CONCLUSION Our cryopreservation and thawing method prevented aggregate formation in cryopreserved riboflavin-UV-light-treated PLTs, which exhibited good recovery, swirling, pH > 6.4, and procoagulant potential, as evidenced by a reduced clotting time after 12 months of storage at -80°C. The clinical relevance of these findings should be further investigated in clinical trials.
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Affiliation(s)
- Teresa Jimenez-Marco
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
| | | | | | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Majorca, Spain
| | | | - Antonia M Bautista-Gili
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
| | - Neus Serra-Ramon
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain
| | - Enrique Girona-Llobera
- Fundació Banc de Sang i Teixits de les Illes Balears, Majorca, Spain.,Institut d'Investigació Sanitària Illes Balears (IdISBa), Majorca, Spain
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5
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Abonnenc M, Crettaz D, Sonego G, Escolar G, Tissot JD, Prudent M. Towards the understanding of the UV light, riboflavin and additive solution contributions to the in vitro lesions observed in Mirasol®-treated platelets. Transfus Clin Biol 2019; 26:209-216. [PMID: 31563447 DOI: 10.1016/j.tracli.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/07/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Pathogen reduction technologies are implemented to increase the safety of blood products. We previously showed that the UVB alone significantly contributes to the storage lesions observed in platelets treated with riboflavin/UVB using a home-made illuminator. The present study aims at confirming these observations using the commercial Mirasol® technology. METHODS A three-arm study (untreated, UV-, Mirasol®-treated platelets) was conducted to investigate the platelet storage lesions throughout storage (n=4). A two-arm study was then designed to compare Intersol and T-PAS+ additive solutions (n=3). Phenotype and functional platelet characteristics were assessed using flow cytometry, aggregometry, antioxidant assays and metabolic parameters. RESULTS Mirasol®-treated platelets exhibit enhanced storage lesions compared to controls (increase of activation markers and glycolysis rate, lower hypotonic shock and double-agonist activation responses, and decrease of total antioxidant capacity). Here, we also confirmed that the UV radiation alone is causing platelet lesions. Riboflavin tends to have an intracellular protective role while it decreases the extracellular antioxidant defenses. Furthermore, benefits of platelet additive solutions containing potassium and magnesium were confirmed as it reduces the extent of storage lesions. CONCLUSIONS The photosensitizer, UV illumination and composition of the platelet additive solutions are key parameters influencing the platelet storage lesion. The clinical relevance of these findings is not fully understood and recent published clinical studies could not show increase in bleeding in patients receiving Mirasol-treated platelets. New developments in storage solutions might help to improve storage conditions of PRT-treated platelets and should be prioritised as research subject in the future.
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Affiliation(s)
- M Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - D Crettaz
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - G Sonego
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland
| | - G Escolar
- Department of Hematopathology, Hospital Clinic of Barcelona, Biomedical Diagnosis Centre (CDB), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - J-D Tissot
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland; Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - M Prudent
- Laboratoire de Recherche sur les Produits Sanguins, Recherche et Développement Produits, Transfusion Interrégionale CRS, Epalinges, Switzerland; Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland.
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6
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Waters L, Padula MP, Marks DC, Johnson L. Cryopreservation of UVC pathogen-inactivated platelets. Transfusion 2019; 59:2093-2102. [PMID: 30790288 DOI: 10.1111/trf.15204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Extending the platelet (PLT) shelf life and enhancing product safety may be achieved by combining cryopreservation and pathogen inactivation (PI). Although studied individually, limited investigations into combining these treatments has been performed. The aim of this study was to investigate the effect of PI treating PLTs before cryopreservation on in vitro PLT quality and function. STUDY DESIGN AND METHODS ABO-matched buffy coat-derived PLTs in PLT additive solution (SSP+; Macopharma) were pooled and split to form matched pairs (n = 8). One unit remained untreated and the other was treated with the THERAFLEX UV-Platelets System (UVC; Macopharma). For cryopreservation, 5% to 6% dimethyl sulfoxide was added to the PLTs, and they were frozen at -80°C. After being thawed, untreated cryopreserved PLTs (CPPs) and UVC-treated CPPs (UVC-CPPs) were resuspended in plasma. In vitro quality was assessed immediately after thawing and after 24 hours of room temperature storage. RESULTS UVC-CPPs had lower in vitro recovery compared to CPPs. By flow cytometry, PLTs demonstrated a similar abundance of GPIX (CD42a), GPIIb (CD41a), and GPIbα (CD42b-HIP1), while the activation of GPIIb/IIIa (PAC-1) was increased in UVC-CPPs compared to CPPs. UVC-CPPs demonstrated greater phosphatidylserine exposure (annexin V) and microparticle shedding but similar P-selectin (CD62P) abundance compared to CPPs. UVC-CPPs displayed similar functionality to CPPs when assessed using aggregometry, thromboelastography, and thrombin generation. CONCLUSIONS This study demonstrates the feasibility of cryopreserving UVC-PI-treated PLT products. UVC-PI treatment may increase the susceptibility of PLTs to damage caused during cryopreservation, but this is more pronounced during postthaw storage at room temperature.
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Affiliation(s)
- Lauren Waters
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,School of Life Sciences and Proteomics Core Facility, Faculty of Science, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Matthew P Padula
- School of Life Sciences and Proteomics Core Facility, Faculty of Science, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
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7
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Johnson L, Cameron M, Waters L, Padula MP, Marks DC. The impact of refrigerated storage of UVC pathogen inactivated platelet concentrates on in vitro
platelet quality parameters. Vox Sang 2018; 114:47-56. [DOI: 10.1111/vox.12730] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/23/2018] [Accepted: 11/03/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Lacey Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Mathew Cameron
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Lauren Waters
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Matthew P. Padula
- School of Life Sciences and Proteomics Core Facility; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Denese C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- Sydney Medical School; University of Sydney; Sydney NSW Australia
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8
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Abonnenc M, Tissot JD, Prudent M. General overview of blood products in vitro quality: Processing and storage lesions. Transfus Clin Biol 2018; 25:269-275. [PMID: 30241785 DOI: 10.1016/j.tracli.2018.08.162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
Blood products are issued from blood collection. Collected blood is immediately mixed with anticoagulant solutions that immediately induce chemical and/or biochemical modifications. Collected blood is then transformed into different blood products according to various steps of fabrication. All these steps induce either reversible or irreversible "preparation-related" lesions that combine with "storage-related" lesions. This short paper aims to provide an overview of the alterations that are induced by the "non-physiological" processes used to prepare blood products that are used in clinical practice.
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Affiliation(s)
- Mélanie Abonnenc
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland
| | - Jean-Daniel Tissot
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland
| | - Michel Prudent
- Transfusion interrégionale CRS, laboratoire de recherche sur les produits sanguins, route de la Corniche 2, 1066 Epalinges, Switzerland; Faculté de biologie et de médecine, université de Lausanne, Lausanne, Switzerland.
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9
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Pathogen-Inaktivierungssysteme für Thrombozytenkonzentrate. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:874-893. [PMID: 29931520 PMCID: PMC7079973 DOI: 10.1007/s00103-018-2766-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10
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Feys HB, Van Aelst B, Compernolle V. Biomolecular Consequences of Platelet Pathogen Inactivation Methods. Transfus Med Rev 2018; 33:29-34. [PMID: 30021699 DOI: 10.1016/j.tmrv.2018.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 12/21/2022]
Abstract
Pathogen inactivation (PI) for platelet concentrates (PC) is a fairly recent development in transfusion medicine that is intended to decrease infectious disease transmission from the donor to the receiving patient. Effective inactivation of viruses, bacteria and eukaryotic parasites adds a layer of safety, protecting the blood supply against customary and emerging pathogens. Three PI methods have been described for platelets. These are based on photochemical damage of nucleic acids which prevents replication of most infectious pathogens and contaminating donor leukocytes. Because platelets do not replicate, the collateral damage to platelet function is considered low to non-existing. This is disputable however because photochemistry is not specific for nucleic acids and significantly affects platelet biomolecules as well. The impact of these biomolecular changes on platelet function and hemostasis is not well understood, but is increasingly being studied. The results of these studies can help explain current and future clinical observations with PI platelets, including the impact on transfusion yield and bleeding. This review summarizes the biomolecular effects of PI treatment on platelets. We conclude that despite a comparable principle of photochemical inactivation, all three methods affect platelets in different ways. This knowledge can help blood banks and transfusion specialists to guide their choice when considering the implementation or clinical use of PI treated platelets.
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Affiliation(s)
- Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Britt Van Aelst
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Veerle Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
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11
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Schubert P, Johnson L, Marks DC, Devine DV. Ultraviolet-Based Pathogen Inactivation Systems: Untangling the Molecular Targets Activated in Platelets. Front Med (Lausanne) 2018; 5:129. [PMID: 29868586 PMCID: PMC5949320 DOI: 10.3389/fmed.2018.00129] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/19/2018] [Indexed: 12/13/2022] Open
Abstract
Transfusions of platelets are an important cornerstone of medicine; however, recipients may be subject to risk of adverse events associated with the potential transmission of pathogens, especially bacteria. Pathogen inactivation (PI) technologies based on ultraviolet illumination have been developed in the last decades to mitigate this risk. This review discusses studies of platelet concentrates treated with the current generation of PI technologies to assess their impact on quality, PI capacity, safety, and clinical efficacy. Improved safety seems to come with the cost of reduced platelet functionality, and hence transfusion efficacy. In order to understand these negative impacts in more detail, several molecular analyses have identified signaling pathways linked to platelet function that are altered by PI. Because some of these biochemical alterations are similar to those seen arising in the context of routine platelet storage lesion development occurring during blood bank storage, we lack a complete picture of the contribution of PI treatment to impaired platelet functionality. A model generated using data from currently available publications places the signaling protein kinase p38 as a central player regulating a variety of mechanisms triggered in platelets by PI systems.
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Affiliation(s)
- Peter Schubert
- Canadian Blood Services, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Dana V Devine
- Canadian Blood Services, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
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12
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Waters L, Cameron M, Padula MP, Marks DC, Johnson L. Refrigeration, cryopreservation and pathogen inactivation: an updated perspective on platelet storage conditions. Vox Sang 2018; 113:317-328. [PMID: 29441601 DOI: 10.1111/vox.12640] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/28/2017] [Accepted: 01/15/2018] [Indexed: 01/08/2023]
Abstract
Conventional storage of platelet concentrates limits their shelf life to between 5 and 7 days due to the risk of bacterial proliferation and the development of the platelet storage lesion. Cold storage and cryopreservation of platelets may facilitate extension of the shelf life to weeks and years, and may also provide the benefit of being more haemostatically effective than conventionally stored platelets. Further, treatment of platelet concentrates with pathogen inactivation systems reduces bacterial contamination and provides a safeguard against the risk of emerging and re-emerging pathogens. While each of these alternative storage techniques is gaining traction individually, little work has been done to examine the effect of combining treatments in an effort to further improve product safety and minimize wastage. This review aims to discuss the benefits of alternative storage techniques and how they may be combined to alleviate the problems associated with conventional platelet storage.
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Affiliation(s)
- L Waters
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M Cameron
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia.,School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - M P Padula
- School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - D C Marks
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
| | - L Johnson
- Research & Development, Australian Red Cross Blood Service, Alexandria, NSW, Australia
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13
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Fryk JJ, Marks DC, Hobson-Peters J, Watterson D, Hall RA, Young PR, Reichenberg S, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Faddy HM. Reduction of Zika virus infectivity in platelet concentrates after treatment with ultraviolet C light and in plasma after treatment with methylene blue and visible light. Transfusion 2017; 57:2677-2682. [PMID: 28718518 DOI: 10.1111/trf.14256] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Zika virus (ZIKV) has emerged as a potential threat to transfusion safety worldwide. Pathogen inactivation is one approach to manage this risk. In this study, the efficacy of the THERAFLEX UV-Platelets system and THERAFLEX MB-Plasma system to inactivate ZIKV in platelet concentrates (PCs) and plasma was investigated. STUDY DESIGN AND METHODS PCs spiked with ZIKV were treated with the THERAFLEX UV-Platelets system at 0.05, 0.10, 0.15, and 0.20 J/cm2 UVC. Plasma spiked with ZIKV was treated with the THERAFLEX MB-Plasma system at 20, 40, 60, and 120 J/cm2 light at 630 nm with at least 0.8 µmol/L methylene blue (MB). Samples were taken before the first and after each illumination dose and tested for residual virus. For each system the level of viral reduction was determined. RESULTS Treatment of PCs with THERAFLEX UV-Platelets system resulted in a mean of 5 log reduction in ZIKV infectivity at the standard UVC dose (0.20 J/cm2 ), with dose dependency observed with increasing UVC dose. For plasma treated with MB and visible light, ZIKV infectivity was reduced by a mean of at least 5.68 log, with residual viral infectivity reaching the detection limit of the assay at 40 J/cm2 (one-third the standard dose). CONCLUSIONS Our study demonstrates that the THERAFLEX UV-Platelets system and THERAFLEX MB-Plasma system can reduce ZIKV infectivity in PCs and pooled plasma to the detection limit of the assays used. These findings suggest both systems have the capacity to be an effective option to manage potential ZIKV transfusion transmission risk.
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Affiliation(s)
- Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service
| | - Jody Hobson-Peters
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul R Young
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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14
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Redox Proteomics and Platelet Activation: Understanding the Redox Proteome to Improve Platelet Quality for Transfusion. Int J Mol Sci 2017; 18:ijms18020387. [PMID: 28208668 PMCID: PMC5343922 DOI: 10.3390/ijms18020387] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/27/2017] [Accepted: 02/07/2017] [Indexed: 12/13/2022] Open
Abstract
Blood banks use pathogen inactivation (PI) technologies to increase the safety of platelet concentrates (PCs). The characteristics of PI-treated PCs slightly differ from those of untreated PCs, but the underlying reasons are not well understood. One possible cause is the generation of oxidative stress during the PI process. This is of great interest since reactive oxygen species (ROS) act as second messengers in platelet functions. Furthermore, there are links between protein oxidation and phosphorylation, another mechanism that is critical for cell regulation. Current research efforts focus on understanding the underlying mechanisms and identifying new target proteins. Proteomics technologies represent powerful tools for investigating signaling pathways involving ROS and post-translational modifications such as phosphorylation, while quantitative techniques enable the comparison of the platelet resting state versus the stimulated state. In particular, redox cysteine is a key player in platelet activation upon stimulation by different agonists. This review highlights the experiments that have provided insights into the roles of ROS in platelet function and the implications for platelet transfusion, and potentially in diseases such as inflammation and platelet hyperactivity. The review also describes the implication of redox mechanism in platelet storage considerations.
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15
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Current Status of Platelet Transfusion in Pediatric Patients. Transfus Med Rev 2016; 30:230-4. [PMID: 27559006 DOI: 10.1016/j.tmrv.2016.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/20/2016] [Accepted: 07/29/2016] [Indexed: 01/19/2023]
Abstract
Outside the neonatal period, most platelets that are transfused to pediatric patients are given to those who are thrombocytopenic secondary to malignancy and associated therapy and/or hematopoietic progenitor cell transplant, or to those with significant bleeding associated with surgery, especially cardiac surgery. Indications for platelet transfusion, doses, and other practices for children largely mimic adult platelet transfusion protocols because there are few pediatric-specific studies in this area. Pediatric platelet transfusion practices would benefit from focused pediatric research. The appropriate indications and doses for platelet transfusions in oncology, hematopoietic progenitor cell transplant, and cardiac surgery patients need to be determined.
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16
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Faddy HM, Fryk JJ, Watterson D, Young PR, Modhiran N, Muller DA, Keil SD, Goodrich RP, Marks DC. Riboflavin and ultraviolet light: impact on dengue virus infectivity. Vox Sang 2016; 111:235-241. [PMID: 27281512 DOI: 10.1111/vox.12414] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dengue viruses (DENV 1-4) are emerging across the world, and these viruses pose a risk to transfusion safety. Pathogen inactivation may be an alternative approach for managing the risk of DENV transfusion transmission. This study aimed to investigate the ability of riboflavin and UV light to inactivate DENV 1-4 in platelet concentrates. MATERIALS AND METHODS DENV 1-4 were spiked into buffy coat-derived platelet concentrates in additive solution (SSP+) before being treated with riboflavin and UV light. Infectious virus was quantified pre- and posttreatment, and the reduction in viral infectivity was calculated. RESULTS All four DENV serotypes were modestly reduced after treatment. The greatest amount of reduction in infectivity was observed for DENV-4 (1·81 log reduction) followed by DENV-3 (1·71 log reduction), DENV-2 (1·45 log reduction) and then DENV-1 (1·28 log reduction). CONCLUSION Our study demonstrates that DENV 1-4 titres are modestly reduced following treatment with riboflavin and UV light. With the increasing number of transfusion-transmitted cases of DENV around the globe, and the increasing incidence and geographical distribution of DENV, additional approaches for maintaining blood safety may be required in the future.
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Affiliation(s)
- H M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Qld, Australia. .,School of Medicine, University of Queensland, Brisbane, Qld, Australia.
| | - J J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Qld, Australia
| | - D Watterson
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - P R Young
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - N Modhiran
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - D A Muller
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Qld, Australia
| | | | | | - D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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17
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Perspectives on the use of biomaterials to store platelets for transfusion. Biointerphases 2016; 11:029701. [DOI: 10.1116/1.4952450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Sandgren P, Berlin G, Tynngård N. Treatment of platelet concentrates with ultraviolet C light for pathogen reduction increases cytokine accumulation. Transfusion 2016; 56:1377-83. [DOI: 10.1111/trf.13601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Per Sandgren
- Department of Clinical Immunology and Transfusion Medicine; Karolinska University Hospital and Karolinska Institutet; Stockholm, Sweden
| | - Gösta Berlin
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Nahreen Tynngård
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Clinical Chemistry; Linköping University; Linköping Sweden
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19
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Kaplan A, Lindgren B, Marschner S, Aznar M, Zalba S, Sánchez P, Ayape ML, Olavarría E, Antelo ML. Evaluation of the post-transfusion platelet increment and safety of riboflavin-based pathogen reduction technology (PRT) treated platelet products stored in platelet additive solution for 5 days or less versus 6–7 days. Transfus Apher Sci 2016; 54:248-52. [DOI: 10.1016/j.transci.2015.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 11/24/2022]
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20
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Faddy HM, Fryk JJ, Prow NA, Watterson D, Young PR, Hall RA, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Marks DC. Inactivation of dengue, chikungunya, and Ross River viruses in platelet concentrates after treatment with ultraviolet C light. Transfusion 2016; 56:1548-55. [PMID: 26926832 DOI: 10.1111/trf.13519] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/04/2015] [Accepted: 01/04/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Arboviruses, including dengue (DENV 1-4), chikungunya (CHIKV), and Ross River (RRV), are emerging viruses that are a risk for transfusion safety globally. An approach for managing this risk is pathogen inactivation, such as the THERAFLEX UV-Platelets system. We investigated the ability of this system to inactivate the above mentioned arboviruses. STUDY DESIGN AND METHODS DENV 1-4, CHIKV, or RRV were spiked into buffy coat (BC)-derived platelet (PLT) concentrates in additive solution and treated with the THERAFLEX UV-Platelets system at the following doses: 0.05, 0.1, 0.15, and 0.2 J/cm(2) (standard dose). Pre- and posttreatment samples were taken for each dose, and the level of viral infectivity was determined. RESULTS At the standard ultraviolet C (UVC) dose (0.2 J/cm(2) ), viral inactivation of at least 4.43, 6.34, and 5.13 log or more, was observed for DENV 1-4, CHIKV, and RRV, respectively. A dose dependency in viral inactivation was observed with increasing UVC doses. CONCLUSIONS Our study has shown that DENV, CHIKV, and RRV, spiked into BC-derived PLT concentrates, were inactivated by the THERAFLEX UV-Platelets system to the limit of detection of our assay, suggesting that this system could contribute to the safety of PLT concentrates with respect to these emerging arboviruses.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | - Paul R Young
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | | | | | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service
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21
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Ignatova AA, Karpova OV, Trakhtman PE, Rumiantsev SA, Panteleev MA. Functional characteristics and clinical effectiveness of platelet concentrates treated with riboflavin and ultraviolet light in plasma and in platelet additive solution. Vox Sang 2015; 110:244-52. [DOI: 10.1111/vox.12364] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 09/30/2015] [Accepted: 10/07/2015] [Indexed: 12/27/2022]
Affiliation(s)
- A. A. Ignatova
- Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev Ministry of Health of Russian; Moscow Russian Federation
| | - O. V. Karpova
- Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev Ministry of Health of Russian; Moscow Russian Federation
| | - P. E. Trakhtman
- Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev Ministry of Health of Russian; Moscow Russian Federation
| | - S. A. Rumiantsev
- Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev Ministry of Health of Russian; Moscow Russian Federation
| | - M. A. Panteleev
- Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev Ministry of Health of Russian; Moscow Russian Federation
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22
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Johnson L, Hyland R, Tan S, Tolksdorf F, Sumian C, Seltsam A, Marks D. In vitro Quality of Platelets with Low Plasma Carryover Treated with Ultraviolet C Light for Pathogen Inactivation. Transfus Med Hemother 2015; 43:190-7. [PMID: 27403091 DOI: 10.1159/000441830] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/15/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The THERAFLEX UV-Platelets system uses shortwave ultraviolet C light (UVC, 254 nm) to inactivate pathogens in platelet components. Plasma carryover influences pathogen inactivation and platelet quality following treatment. The plasma carryover in the standard platelets produced by our institution are below the intended specification (<30%). METHODS A pool and split study was carried out comparing untreated and UVC-treated platelets with <30% plasma carryover (n = 10 pairs). This data was compared to components that met specifications (>30% plasma). The platelets were tested over storage for in vitro quality. RESULTS Platelet metabolism was accelerated following UVC treatment, as demonstrated by increased glucose consumption and lactate production. UVC treatment caused increased externalization of phosphatidylserine on platelets and microparticles, activation of the GPIIb/IIIa receptor (PAC-1 binding), and reduced hypotonic shock response. Platelet function, as measured with thrombelastogram, was not affected by UVC treatment. Components with <30% plasma were similar to those meeting specification with the exception of enhanced glycolytic metabolism. CONCLUSION This in vitro analysis demonstrates that treatment of platelets with <30% plasma carryover with the THERAFLEX UV-Platelets system affects some aspects of platelet metabolism and activation, although in vitro platelet function was not negatively impacted. This study also provides evidence that the treatment specifications of plasma carryover could be extended to below 30%.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Ryan Hyland
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Shereen Tan
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | | | | | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Denese Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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23
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Johnson L, Schubert P, Tan S, Devine DV, Marks DC. Extended storage and glucose exhaustion are associated with apoptotic changes in platelets stored in additive solution. Transfusion 2015; 56:360-8. [DOI: 10.1111/trf.13345] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/13/2015] [Accepted: 08/16/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Lacey Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney Australia
- Centre for Innovation; Canadian Blood Services; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
| | - Peter Schubert
- Centre for Innovation; Canadian Blood Services; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
| | - Shereen Tan
- Research and Development; Australian Red Cross Blood Service; Sydney Australia
| | - Dana V. Devine
- Centre for Innovation; Canadian Blood Services; Vancouver British Columbia Canada
- Centre for Blood Research; University of British Columbia; Vancouver British Columbia Canada
| | - Denese C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney Australia
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24
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Abstract
PURPOSE OF REVIEW Platelets are a frequently requested blood product today and are often in limited supply because of a shelf life of 5-7 days, depending on the country. Room temperature storage is associated with an increased risk of transfusion-transmitted infection. Plasma used for platelet storage is unavailable for other uses, and allogeneic plasma carries with it risks for adverse transfusion reactions. This review looks at recent activities evaluating alternative conditions for the storage of platelets. RECENT FINDINGS New-generation platelet additive solutions are being evaluated and applied as a strategy to reduce the volume of allogeneic plasma transfused and to support storage following pathogen reduction treatments. There is a renewed interest in refrigerator temperature and frozen storage of platelets to improve availability, to reduce septic transfusion risk, and to enhance hemostatic efficacy in the bleeding patient. SUMMARY Use of platelet additive solutions has been shown to reduce the incidence of allergic and nonhemolytic febrile transfusion reactions in two large studies. Results of ongoing research and new clinical trials in cold storage methods will be forthcoming and may present solutions for platelet availability problems and new choices for therapeutic transfusion of the bleeding patient.
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25
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Loh YS, Dean MM, Johnson L, Marks DC. Treatment of platelets with riboflavin and ultraviolet light mediates complement activation and suppresses monocyte interleukin-12 production in whole blood. Vox Sang 2015; 109:327-35. [DOI: 10.1111/vox.12283] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/03/2015] [Accepted: 03/17/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Y. S. Loh
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - M. M. Dean
- Research and Development; Australian Red Cross Blood Service; Brisbane QLD Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
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26
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Johnson L, Marks D. Treatment of Platelet Concentrates with the Mirasol Pathogen Inactivation System Modulates Platelet Oxidative Stress and NF-κB Activation. Transfus Med Hemother 2015. [PMID: 26195930 DOI: 10.1159/000403245] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pathogen inactivation (PI) technologies for platelets aim to improve transfusion safety by preventing the replication of contaminating pathogens. However, as a consequence of treatment, aspects of the platelet storage lesion are amplified. Mirasol treatment also affects platelet signal transduction and apoptotic protein expression. The aim of this study was to examine the effect of Mirasol treatment on the generation of reactive oxygen species (ROS) and subsequent oxidative stress. METHODS Pooled platelet concentrates were prepared in platelet-additive solution (70% SSP+ / 30% plasma). ABO-matched platelets were pooled and split, and treated with the Mirasol system (TerumoBCT) or left untreated as a control. Platelet samples were tested on day 1, 5, and 7 post-collection. RESULTS Mirasol-treated platelets had increased formation of ROS by day 5 of storage. Oxidative damage, in the form of protein carbonylation, was higher in Mirasol-treated platelets, whilst no effect on nitrotyrosine formation or lipid peroxidation was detected. The NF-κB signaling pathway was also activated in Mirasol-treated platelets, with increased expression and phosphorylation of NF-κB p65 and IκBα. CONCLUSION These data demonstrate that Mirasol-treated platelets produce more ROS and display protein alterations consistent with oxidative damage.
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Affiliation(s)
- Lacey Johnson
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - Denese Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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27
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Van Aelst B, Devloo R, Vandekerckhove P, Compernolle V, Feys HB. Ultraviolet C light pathogen inactivation treatment of platelet concentrates preserves integrin activation but affects thrombus formation kinetics on collagen in vitro. Transfusion 2015; 55:2404-14. [DOI: 10.1111/trf.13137] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/03/2015] [Accepted: 03/18/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Britt Van Aelst
- Transfusion Research CenterBelgian Red Cross‐FlandersGhent Belgium
| | - Rosalie Devloo
- Transfusion Research CenterBelgian Red Cross‐FlandersGhent Belgium
| | - Philippe Vandekerckhove
- Blood Service of the Belgian Red Cross‐FlandersMechelen Belgium
- Department of Public Health and Primary CareCatholic University of LeuvenLeuven Belgium
- Faculty of Medicine and Health SciencesUniversity of GhentGhent Belgium
| | - Veerle Compernolle
- Transfusion Research CenterBelgian Red Cross‐FlandersGhent Belgium
- Blood Service of the Belgian Red Cross‐FlandersMechelen Belgium
- Faculty of Medicine and Health SciencesUniversity of GhentGhent Belgium
| | - Hendrik B. Feys
- Transfusion Research CenterBelgian Red Cross‐FlandersGhent Belgium
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28
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Abonnenc M, Sonego G, Crettaz D, Aliotta A, Prudent M, Tissot JD, Lion N. In vitro study of platelet function confirms the contribution of the ultraviolet B (UVB) radiation in the lesions observed in riboflavin/UVB-treated platelet concentrates. Transfusion 2015; 55:2219-30. [DOI: 10.1111/trf.13123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/24/2015] [Accepted: 02/28/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Mélanie Abonnenc
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Giona Sonego
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - David Crettaz
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Alessandro Aliotta
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Michel Prudent
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Jean-Daniel Tissot
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - Niels Lion
- Laboratoire de Recherche sur les Produits Sanguins Epalinges; Transfusion Interrégionale CRS; Epalinges Switzerland
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29
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Van Aelst B, Feys HB, Devloo R, Vanhoorelbeke K, Vandekerckhove P, Compernolle V. Riboflavin and amotosalen photochemical treatments of platelet concentrates reduce thrombus formation kineticsin vitro. Vox Sang 2014; 108:328-39. [DOI: 10.1111/vox.12231] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 01/23/2023]
Affiliation(s)
- B. Van Aelst
- Transfusion Research Center; Belgian Red Cross-Flanders; Ghent Belgium
| | - H. B. Feys
- Transfusion Research Center; Belgian Red Cross-Flanders; Ghent Belgium
| | - R. Devloo
- Transfusion Research Center; Belgian Red Cross-Flanders; Ghent Belgium
| | - K. Vanhoorelbeke
- Laboratory for Thrombosis Research; KU Leuven Kulak; Kortrijk Belgium
| | - P. Vandekerckhove
- Blood Service of the Belgian Red Cross-Flanders; Mechelen Belgium
- Department of Public Health and Primary Care; Catholic University of Leuven; Leuven Belgium
| | - V. Compernolle
- Transfusion Research Center; Belgian Red Cross-Flanders; Ghent Belgium
- Blood Service of the Belgian Red Cross-Flanders; Mechelen Belgium
- Faculty of Medicine and Health Sciences; University of Ghent; Ghent Belgium
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30
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Tynngård N, Trinks M, Berlin G. In vitro function of platelets treated with ultraviolet C light for pathogen inactivation: a comparative study with nonirradiated and gamma-irradiated platelets. Transfusion 2014; 55:1169-77. [DOI: 10.1111/trf.12963] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/28/2014] [Accepted: 11/03/2014] [Indexed: 01/02/2023]
Affiliation(s)
- Nahreen Tynngård
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Clinical Chemistry; Linköping University; Linköping Sweden
| | - Marie Trinks
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Gösta Berlin
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
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31
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Faddy HM, Prow NA, Fryk JJ, Hall RA, Keil SD, Goodrich RP, Marks DC. The effect of riboflavin and ultraviolet light on the infectivity of arboviruses. Transfusion 2014; 55:824-31. [PMID: 25370822 DOI: 10.1111/trf.12899] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/29/2014] [Accepted: 09/01/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Arboviruses are an emerging threat to transfusion safety and rates of infection are likely to increase with the increased rainfall associated with climate change. Arboviral infections are common in Australia, where Ross River virus (RRV), Barmah Forest virus (BFV), and Murray Valley encephalitis virus (MVEV), among others, have the potential to cause disease in humans. The use of pathogen reduction technology (PRT) may be an alternative approach for blood services to manage the risk of arboviral transfusion transmission. In this study, the effectiveness of the Mirasol PRT (Terumo BCT) system at inactivating RRV, BFV, and MVEV in buffy coat (BC)-derived platelets (PLTs) was investigated. STUDY DESIGN AND METHODS BC-derived PLT concentrates in additive solution (SSP+) were spiked with RRV, BFV, or MVEV and then treated with the Mirasol PRT system. The level of infectious virus was determined before and after treatment, and the reduction in viral infectivity was calculated. RESULTS Treatment with PRT (Mirasol) reduced the amount of infectious virus of all three arboviruses. The greatest level of inactivation was observed for RRV (2.33 log; 99.25%), followed by BFV (1.97 log; 98.68%) and then MVEV (1.83 log; 98.42%). CONCLUSION Our study demonstrates that treatment of PLT concentrates with PRT (Mirasol) reduces the infectious levels of RRV, BFV, and MVEV. The relevance of the level of reduction required to prevent disease transmission by transfusion has not been fully defined and requires further investigation. In the face of a changing climate, with its associated threat to blood safety, PRT represents a proactive approach for maintaining blood safety.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
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Affiliation(s)
- D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney New South Wales Australia
| | - H. M. Faddy
- Research and Development; Australian Red Cross Blood Service; Brisbane Queensland Australia
| | - L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney New South Wales Australia
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Zeddies S, De Cuyper IM, van der Meer PF, Daal BB, de Korte D, Gutiérrez L, Thijssen-Timmer DC. Pathogen reduction treatment using riboflavin and ultraviolet light impairs platelet reactivity toward specific agonists in vitro. Transfusion 2014; 54:2292-300. [DOI: 10.1111/trf.12636] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 01/29/2014] [Accepted: 01/29/2014] [Indexed: 01/21/2023]
Affiliation(s)
- Sabrina Zeddies
- Department of Hematopoiesis; University of Amsterdam; Amsterdam the Netherlands
| | - Iris M. De Cuyper
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - Pieter F. van der Meer
- Department of Product and Process Development; Sanquin Blood Bank; Amsterdam the Netherlands
| | - Brunette B. Daal
- Department of Product and Process Development; Sanquin Blood Bank; Amsterdam the Netherlands
| | - Dirk de Korte
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
- Department of Product and Process Development; Sanquin Blood Bank; Amsterdam the Netherlands
| | - Laura Gutiérrez
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
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Winter KM, Johnson L, Kwok M, Vidovic D, Hyland RA, Mufti N, Erickson A, Marks DC. Red blood cell in vitro quality and function is maintained after S-303 pathogen inactivation treatment. Transfusion 2014; 54:1798-807. [PMID: 24617658 DOI: 10.1111/trf.12545] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 11/10/2013] [Accepted: 11/18/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND Over the past decade there has been a growth in the development of pathogen reduction technologies to protect the blood supply from emerging pathogens. This development has proven to be difficult for red blood cells (RBCs). However the S-303 system has been shown to effectively inactivate a broad spectrum of pathogens, while maintaining RBC quality. STUDY DESIGN AND METHODS A paired three-arm study was performed to compare the in vitro quality of S-303-treated RBCs with RBCs stored at room temperature (RT) for the duration of the treatment (18-20 hr) and control RBCs stored at 2 to 6°C. Products were sampled weekly over 42 days of storage (n = 10) and tested using an array of in vitro assays to measure quality, metabolism, and functional variables. RESULTS During S-303 treatment there was a slight loss of RBCs and hemoglobin (Hb < 5 g). Hemolysis, glucose consumption, and potassium release were similar in all groups during the 42 days of storage. S-303-treated RBCs had a significantly lower lactate concentration and pH compared to the paired controls. The S-303-treated RBCs had significantly higher adenosine triphosphate than the RT and control RBCs. There was a significant loss of 2,3-diphosphoglycerate in the S-303-treated products, which was also observed in the RT RBCs. Flow cytometry analysis demonstrated similar RBC size, morphology, expression of CD47, and glycophorin A in all groups. CONCLUSION RBCs treated with S-303 for pathogen reduction had similar in vitro properties to the paired controls and were within transfusion guidelines.
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Affiliation(s)
- Kelly M Winter
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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Mastroianni MA, Llohn AH, Akkök ÇA, Skogheim R, Ødegaard ER, Nybruket MJ, Flesland A, Mousavi SA. Effect of Mirasol pathogen reduction technology system on in vitro quality of MCS+ apheresis platelets. Transfus Apher Sci 2013; 49:285-90. [DOI: 10.1016/j.transci.2013.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 05/24/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
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Loh YS, Johnson L, Kwok M, Marks DC. Pathogen reduction treatment alters the immunomodulatory capacity of buffy coat-derived platelet concentrates. Transfusion 2013; 54:577-84. [PMID: 23829895 DOI: 10.1111/trf.12320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 04/30/2013] [Accepted: 05/19/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND Storage of platelet concentrates (PCs) after Mirasol pathogen reduction technology (PRT) treatment changes platelet (PLT) surface marker expression and secretion of immunomodulatory factors. Given that PLTs are known to participate in immune function, PRT may alter the way PLTs interact with the immune cells of a recipient upon transfusion. As such, the aim of this study was to assess the effects of PRT treatment on the functional ability of PLTs to interact with peripheral blood mononuclear cells (PBMNCs). STUDY DESIGN AND METHODS Buffy coat-derived PCs were pooled and split to obtain matched pairs. One unit was treated using the Mirasol PRT system, while the control PC remained untreated. After 5 days of storage, either the PLTs or the PLT supernatants from the PCs were cocultured with PBMNCs, with or without lipopolysaccharide (LPS). The immunomodulatory factors secreted into culture medium after coculture were examined. RESULTS PRT-treated PLTs and PLT supernatant significantly increased the interleukin (IL)-8 concentration, which was manifested only in the presence of LPS. Conversely, PRT-treated PLTs secreted less soluble P-selectin (sCD62P) upon coculture with PBMNCs. CONCLUSION PRT-treatment induced differential secretion of IL-8 and sCD62P during coculture, which may be attributed to either bioactive substances present in PLT supernatant or as a result of cell-cell interactions.
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Affiliation(s)
- Yen S Loh
- Research and Development, Australian Red Cross Blood Service, Sydney, Australia
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Johnson L, Winter KM, Kwok M, Reid S, Marks DC. Evaluation of the quality of blood components prepared using the Reveos automated blood processing system. Vox Sang 2013; 105:225-35. [DOI: 10.1111/vox.12051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/05/2013] [Accepted: 04/07/2013] [Indexed: 01/03/2023]
Affiliation(s)
- L. Johnson
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - K. M. Winter
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - M. Kwok
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - S. Reid
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - D. C. Marks
- Applied and Developmental Research; Research and Development; Australian Red Cross Blood Service; Sydney; Australia
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Johnson L, Loh YS, Kwok M, Marks DC. In vitroassessment of buffy-coat derived platelet components suspended in SSP+ treated with the INTERCEPT Blood system. Transfus Med 2013; 23:121-9. [DOI: 10.1111/tme.12020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/29/2013] [Accepted: 01/30/2013] [Indexed: 12/01/2022]
Affiliation(s)
- L. Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - Y. S. Loh
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - M. Kwok
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
| | - D. C. Marks
- Research and Development; Australian Red Cross Blood Service; Sydney; Australia
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Johnson L, Reid S, Tan S, Vidovic D, Marks DC. PAS-G supports platelet reconstitution after cryopreservation in the absence of plasma. Transfusion 2013; 53:2268-77. [DOI: 10.1111/trf.12084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/31/2012] [Accepted: 11/16/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Lacey Johnson
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Samantha Reid
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Shereen Tan
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Diana Vidovic
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
| | - Denese C. Marks
- Research and Development; The Australian Red Cross Blood Service; Sydney; Australia
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Reid S, Johnson L, Woodland N, Marks DC. Pathogen reduction treatment of buffy coat platelet concentrates in additive solution induces proapoptotic signaling. Transfusion 2012; 52:2094-103. [PMID: 22320126 DOI: 10.1111/j.1537-2995.2011.03558.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pathogen reduction technology (PRT) can potentially reduce the risk of transfusion-transmitted infections. However, PRT treatment of platelet (PLT) concentrates also results in reduced PLT quality and increased markers of apoptosis during storage. The aim of this study was to investigate changes to the expression and activation of proteins involved in apoptosis signaling. STUDY DESIGN AND METHODS Samples from riboflavin and ultraviolet light PRT-treated and untreated (control) buffy coat-derived PCs in 70% SSP+ and 30% plasma were taken on Days 1, 5, and 7 of storage. Phosphatidylserine (PS) exposure, expression of Bcl-2 family proteins, cytochrome c release, and cleavage of caspase-3 and caspase-3 substrates were analyzed using flow cytometry and Western blotting. RESULTS Compared to untreated controls, markers of apoptosis signaling were increased after PRT and subsequent storage. PS exposure on the PLT outer membrane was significantly higher after PRT on Days 5 and 7 of storage (p < 0.05). Expression of proapoptotic Bak and Bax was higher after PRT and subsequent storage. Cytochrome c release and caspase-3 cleavage were also greater and occurred earlier in the PRT-treated PLTs. The cleavage of caspase-3 substrates gelsolin and ROCK I were also increased after PRT, compared to untreated controls. CONCLUSIONS This study demonstrated an increase in proapoptotic signaling during PLT storage, which was exacerbated by PRT. Many of these differences emerged outside the current 5-day storage period. These changes may not currently influence PLT transfusion quality, but will need to be carefully evaluated when considering extending PLT storage beyond 5 days.
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Affiliation(s)
- Samantha Reid
- Research and Development, Australian Red Cross Blood Service, and the School of Medical and Molecular Biosciences, University of Technology, Sydney, New South Wales, Australia
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Johnson L, Winter KM, Hartkopf-Theis T, Reid S, Kwok M, Marks DC. Evaluation of the automated collection and extended storage of apheresis platelets in additive solution. Transfusion 2011; 52:503-9. [DOI: 10.1111/j.1537-2995.2011.03314.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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