1
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Ichikawa J, Kouta M, Oogushi M, Komori M. Effects of room temperature and cold storage on the metabolic and haemostatic properties of whole blood for acute normovolaemic haemodilution. PLoS One 2022; 17:e0267980. [PMID: 35560137 PMCID: PMC9106157 DOI: 10.1371/journal.pone.0267980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background Acute normovolaemic haemodilution (ANH), as a blood-conservation technique, avoids the need for allogeneic blood transfusions. The historic practice of cold-storing type-O whole blood (WB) in military fields popularised the transfusion of refrigerated WB to treat acute bleeding. In this study, we compared the effects of room temperature (RT) and refrigeration up to 24 hours on the coagulation properties of WB for ANH. Materials and methods Each WB sample, collected from 12 male volunteers, was divided into two parts, one stored at RT and the other refrigerated for 24 hours. Complete blood counts (CBC), blood gas levels, and coagulation profiles were measured, and rotational thromboelastometry (ROTEM) measurements were performed at the initial collection time point (baseline) and at 6, 12, and 24 hours after initial collection. Results The preservation of platelet aggregation response induced by arachidonic acid and adenosine diphosphate was better in cold-stored WB compared to that in RT-stored WB. The platelet aggregation response induced by thrombin receptor-activating peptide 6 was significantly decreased in all samples after 24 hours of storage when compared with that at baseline. The lactate levels in WB stored at RT increased significantly after 6 hours of storage compared to that of cold-stored samples. There were no significant differences in CBC, coagulation parameters, and ROTEM variables between the cold-stored and RT-stored WB samples. Conclusion WB for ANH stored in the refrigerator showed better metabolic characteristics after 6 hours of storage and better aggregation response after 12 hours of storage than WB stored at RT.
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Affiliation(s)
- Junko Ichikawa
- Department of Anaesthesiology, Tokyo Women’s Medical University Medical Centre East, Tokyo, Japan
- * E-mail:
| | - Masaki Kouta
- Department of Anaesthesiology, Tokyo Women’s Medical University Medical Centre East, Tokyo, Japan
| | - Masako Oogushi
- Department of Anaesthesiology, Tokyo Women’s Medical University Medical Centre East, Tokyo, Japan
| | - Makiko Komori
- Department of Anaesthesiology, Tokyo Women’s Medical University Medical Centre East, Tokyo, Japan
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2
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Johnson L, Vekariya S, Tan S, Padula MP, Marks DC. Extended storage of thawed platelets: Refrigeration supports postthaw quality for 10 days. Transfusion 2020; 60:2969-2981. [DOI: 10.1111/trf.16127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/10/2020] [Accepted: 09/14/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Lacey Johnson
- Research and Development Australian Red Cross Lifeblood (formerly the Australian Red Cross Blood Service) Alexandria New South Wales Australia
| | - Shuchna Vekariya
- Research and Development Australian Red Cross Lifeblood (formerly the Australian Red Cross Blood Service) Alexandria New South Wales Australia
- Faculty of Science School of Life Sciences and Proteomics Core Facility, University of Technology Sydney Sydney New South Wales Australia
| | - Shereen Tan
- Research and Development Australian Red Cross Lifeblood (formerly the Australian Red Cross Blood Service) Alexandria New South Wales Australia
| | - Matthew P. Padula
- Faculty of Science School of Life Sciences and Proteomics Core Facility, University of Technology Sydney Sydney New South Wales Australia
| | - Denese C. Marks
- Research and Development Australian Red Cross Lifeblood (formerly the Australian Red Cross Blood Service) Alexandria New South Wales Australia
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia
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3
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Abstract
Abstract
Platelet transfusion is a topic of common interest for many specialists involved in patient care, from laboratory staff to clinical physicians. Various aspects make this type of transfusion different from those of other blood components. In this review, the challenges in platelet transfusion practice that are relevant for laboratory colleagues will be discussed, highlighting how the biochemical and structural characteristics of these blood elements directly affect their function and consequently the clinical outcome. More than 1,300 platelet concentrates are transfused in Germany every day, and several types are offered by their respective manufacturers. We describe the technological advances in platelet concentrate production, with a focus on how the storage conditions of platelets can be improved. Laboratory quality assessment procedures for a safe transfusion are discussed in detail. For this purpose, we will refer to the Hemotherapy Directives (Richtlinie Hämotherapie) of the German Medical Association.
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Affiliation(s)
- Gianmatteo Vit
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
- The Novo Nordisk Foundation Center for Protein Research, Protein Signaling Program , Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University , German Red Cross Blood Service Baden-Württemberg - Hessen , Mannheim , Germany
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4
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D’Alessandro A, Thomas KA, Stefanoni D, Gamboni F, Shea SM, Reisz JA, Spinella PC. Metabolic phenotypes of standard and cold-stored platelets. Transfusion 2020; 60 Suppl 3:S96-S106. [PMID: 31880330 PMCID: PMC7971209 DOI: 10.1111/trf.15651] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Conventional platelet (PLT) storage at room temperature under continuous agitation results in a limited shelf life (5 days) and an increased risk of bacterial contamination. However, both of these aspects can be ameliorated by cold storage. Preliminary work has suggested that PLTs can be cold stored for up to 3 weeks, while preserving their metabolic activity longer than in PLTs stored at room temperature. As such, in the present study, we hypothesized that the metabolic phenotypes of PLTs stored at 4°C for 3 weeks could be comparable to that of room temperature-stored PLTs at 22°C for 5 days. STUDY DESIGN AND METHODS Metabolomics analyses were performed on nine apheresis PLT concentrates stored either at room temperature (22°C) for 5 days or refrigerated conditions (4°C) for up to 3 weeks. RESULTS Refrigeration did not impact the rate of decline in glutamine or the intracellular levels of Krebs cycle metabolites upstream to fumarate and malate. It did, however, decrease oxidant stress (to glutathione and purines) and slowed down the activation of the pentose phosphate pathway, glycolysis, and fatty acid metabolism (acyl-carnitines). CONCLUSION The overall metabolic phenotypes of 4°C PLTs at Storage Day 10 are comparable to PLTs stored at 22°C at the end of their 5-day shelf life, while additional changes in glycolysis, purine, and fatty acid metabolism are noted by Day 21.
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Affiliation(s)
- Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado
| | - Kimberly A. Thomas
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St. Louis, Missouri
| | - Davide Stefanoni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado
| | - Fabia Gamboni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado
| | - Susan M. Shea
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St. Louis, Missouri
| | - Julie A. Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver – Anschutz Medical Campus, Aurora, Colorado
| | - Philip C. Spinella
- Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St. Louis, Missouri
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5
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Javed R, Ahmadi F, Jawed A. Precious platelets: The utility of cold-stored and cryopreserved platelets. GLOBAL JOURNAL OF TRANSFUSION MEDICINE 2020. [DOI: 10.4103/gjtm.gjtm_19_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Scorer T, Williams A, Reddoch-Cardenas K, Mumford A. Manufacturing variables and hemostatic function of cold-stored platelets: a systematic review of the literature. Transfusion 2019; 59:2722-2732. [PMID: 31184775 DOI: 10.1111/trf.15396] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/09/2019] [Accepted: 05/11/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Thomas Scorer
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom.,Centre of Defence Pathology, RCDM, Birmingham, United Kingdom.,Coagulation and Blood Research, U.S. Army Institute of Surgical Research, JBSA Ft Sam Houston, San Antonio, Texas
| | - Ashleigh Williams
- Department of Anaesthesia, Derriford Hospital, Plymouth, United Kingdom
| | - Kristin Reddoch-Cardenas
- Coagulation and Blood Research, U.S. Army Institute of Surgical Research, JBSA Ft Sam Houston, San Antonio, Texas
| | - Andrew Mumford
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
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7
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Siddon AJ, Tormey CA, Snyder EL. Platelet Transfusion Medicine. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Yang J, Yin W, Zhang Y, Sun Y, Ma T, Gu S, Gao Y, Zhang X, Yuan J, Wang W. Evaluation of the advantages of platelet concentrates stored at 4°C versus 22°C. Transfusion 2017; 58:736-747. [PMID: 29266276 DOI: 10.1111/trf.14462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/30/2017] [Accepted: 11/12/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Jiangcun Yang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital; Xi'an China
| | - Wen Yin
- Department of Transfusion Medicine; Xijing Hospital, the Fourth Military Medical University; Xi'an China
| | - Yali Zhang
- Department of Blood Components Preparation; Shaanxi Provincial Blood Center; Xi'an China
| | - Yang Sun
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital; Xi'an China
| | - Ting Ma
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital; Xi'an China
| | - Shunli Gu
- Department of Transfusion Medicine; Xijing Hospital, the Fourth Military Medical University; Xi'an China
| | - Ying Gao
- Department of Hematology, Shaanxi Provincial People's Hospital; Xi'an China
| | - Xiaole Zhang
- Department of Transfusion Medicine; Xijing Hospital, the Fourth Military Medical University; Xi'an China
| | - Jun Yuan
- Department of Laboratory; Shaanxi Provincial People's Hospital; Xi'an China
| | - Wenhua Wang
- Department of Transfusion Medicine, Shaanxi Provincial People's Hospital; Xi'an China
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9
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Milford EM, Reade MC. Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage. Transfusion 2017; 56 Suppl 2:S140-8. [PMID: 27100750 DOI: 10.1111/trf.13504] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 12/14/2022]
Abstract
This review considers the various methods currently in use, or under investigation, for the storage of platelets intended for use in the treatment of active hemorrhage. The current standard practice of storing platelets at room temperature (RT) (20°C-24°C) optimizes circulating time, but at the expense of hemostatic function and logistical considerations. A number of alternatives are under investigation. Novel storage media additives appear to attenuate the deleterious changes that affect RT stored platelets. Cold storage was originally abandoned due to the poor circulating time of platelets stored at 4°C, but such platelets may actually be more hemostatically effective, with a number of other advantages, compared to RT stored platelets. Periodically re-warming cold stored platelets (temperature cycling, TC) may combine the hemostatic efficacy of cold stored platelets with the longer circulating times of RT storage. Alternatives to liquid storage include cryopreservation (freezing) or lyophilization (freeze-drying). The former has had some limited clinical use and larger clinical trials are underway, while the latter is still in the preclinical stage with promising in vitro and in vivo results. The importance of platelet transfusion in the management of active hemorrhage is now well accepted, so it is timely that platelet storage methods are reviewed with consideration of not only their circulating time, but also their hemostatic efficacy.
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Affiliation(s)
- Elissa M Milford
- Australian Defence Force, Australia.,University of Queensland, Australia
| | - Michael C Reade
- Australian Defence Force, Australia.,University of Queensland, Australia
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10
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Baimukanova G, Miyazawa B, Potter DR, Gibb SL, Keating S, Danesh A, Beyer A, Dayter Y, Bruhn R, Muench MO, Cap AP, Norris PJ, Spinella P, Cohen M, Pati S. The effects of 22°C and 4°C storage of platelets on vascular endothelial integrity and function. Transfusion 2016; 56 Suppl 1:S52-64. [PMID: 27001362 DOI: 10.1111/trf.13455] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although a majority of the studies conducted to date on platelet (PLT) storage have been focused on PLT hemostatic function, the effects of 4°C PLTs on regulation of endothelial barrier permeability are still not known. In this study, we compared the effects of room temperature (22°C) stored and (4°C) stored PLTs on the regulation of vascular endothelial cell (EC) permeability in vitro and in vivo. STUDY DESIGN AND METHODS Day 1, Day 5, and Day 7 leukoreduced apheresis PLTs stored at 4 or 22°C were studied in vitro and in vivo. In vitro, PLT effects on EC permeability and barrier function, adhesion, and impedance aggregometry were investigated. In vivo, using a mouse model of vascular leak, attenuation of vascular leak and circulating PLT numbers were measured. RESULTS Treatment of EC monolayers with Day 5 or Day 7 PLTs, stored at both 22°C and 4°C, resulted in similar decreases in EC permeability on average. However, analysis of individual samples revealed significant variation that was donor dependent. Additional in vitro measurements revealed a decrease in inflammatory mediators, nonspecific PLT-endothelial aggregation and attenuated loss of aggregation over time to TRAP, ASPI, ADP, and collagen with 4°C storage. In mice, while 22°C and 4°C PLTs both demonstrated significant protection against vascular endothelial growth factor A (VEGF-A)-induced vascular leak 22°C PLTs exhibited increased protection compared to 4°C PLTs. Systemic circulating levels of 4°C PLTs were decreased compared to 22°C PLTs. CONCLUSIONS In vitro, 4°C-stored PLTs exhibit a greater capacity to inhibit EC permeability than 22°C-stored PLTs. In vivo, 22°C PLTs provide superior control of vascular leak induced by VEGF-A. This discrepancy may be due to increased clearance of 4°C PLTs from the systemic circulation.
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Affiliation(s)
- Gyulnar Baimukanova
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Byron Miyazawa
- Department of Surgery, University of California, San Francisco, California
| | - Daniel R Potter
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Stuart L Gibb
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Sheila Keating
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Ali Danesh
- Blood Systems Research Institute, University of California, San Francisco, California.,Department of Laboratory Medicine, University of California, San Francisco, California
| | - Ashley Beyer
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Yelena Dayter
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Roberta Bruhn
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Marcus O Muench
- Blood Systems Research Institute, University of California, San Francisco, California
| | - Andrew P Cap
- Coagulation and Blood Research Program, US Army Institute of Surgical Research, JBSA-FT Sam Houston, Texas
| | - Philip J Norris
- Blood Systems Research Institute, University of California, San Francisco, California.,Department of Laboratory Medicine, University of California, San Francisco, California
| | - Philip Spinella
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Mitchell Cohen
- Department of Surgery, University of California, San Francisco, California
| | - Shibani Pati
- Blood Systems Research Institute, University of California, San Francisco, California.,Department of Laboratory Medicine, University of California, San Francisco, California
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11
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Johnson L, Tan S, Wood B, Davis A, Marks DC. Refrigeration and cryopreservation of platelets differentially affect platelet metabolism and function: a comparison with conventional platelet storage conditions. Transfusion 2016; 56:1807-18. [DOI: 10.1111/trf.13630] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 01/02/2023]
Affiliation(s)
- Lacey Johnson
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Shereen Tan
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
| | - Ben Wood
- Research and Development; Australian Red Cross Blood Service; Sydney NSW Australia
- Proteomics Core Facility; University of Technology Sydney; Sydney NSW Australia
| | - April Davis
- 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
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12
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Di Michele M, Van Geet C, Freson K. Recent advances in platelet proteomics. Expert Rev Proteomics 2014; 9:451-66. [DOI: 10.1586/epr.12.31] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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13
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Platelet Transfusion Medicine. Platelets 2013. [DOI: 10.1016/b978-0-12-387837-3.00062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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14
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Response to H. Ohto and K.E. Nollet article entitled 'Overview on platelet preservation: better controls over storage lesion', Transfusion and Apheresis Science 44(2011) 321-325. Transfus Apher Sci 2011; 46:105-6; author reply 107. [PMID: 22015251 DOI: 10.1016/j.transci.2011.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 08/09/2011] [Indexed: 11/21/2022]
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15
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Gau CH, Shen EC, Tu HP, Chiu HC, Fu E, Wang WN, Chiang CY. Freezing procedure without thrombin activation to retain and store growth factors from platelet concentrates. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Chandra T, Gupta A, Kumar A, Afreen S. Morphological and functional changes in random donor platelets stored for seven days in platelet additive solution. ACTA ACUST UNITED AC 2011. [DOI: 10.5348/ijbti-2011-5-oa-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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18
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Troubleshooting in platelet storage temperature and new perspectives through proteomics. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2010; 8 Suppl 3:s73-81. [PMID: 20606754 DOI: 10.2450/2010.012s] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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19
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Evaluation of biochemical parameters in platelet concentrates stored in glucose solution. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2010; 5:24-32. [PMID: 19204748 DOI: 10.2450/2007.0019-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/20/2006] [Accepted: 09/20/2006] [Indexed: 11/21/2022]
Abstract
BACKGROUND Therapeutic storage of platelet concentrate is a challenging problem for Transfusion Medicine, so that many studies have been carried out with the aim of improving the duration of storage of platelet concentrates. Little attention, however, has been given to the most appropriate biochemical methods for evaluating the quality of the stored platelet concentrates. MATERIAL AND METHODS [corrected] Platelet concentrates (n=10) were saved under gentle stirring at 22 masculineC for a total period of 8 days. Glucose 0.5% (w/v) was added either at the beginning of storage (time 0) or on the fifth day of storage. One millilitre of each concentrate was withdrawn at time 0 and after 5, 6, 7 and 8 days of storage for microbiological culture, evaluation of pH, lactate dehydrogenase (LDH), mean platelet volume, platelet haematocrit and analysis of metabolites of energy pathways (high energy phosphate derivatives, nucleosides, oxypurines and antioxidants) by high performance liquid chromatography. RESULTS The addition of glucose 0.5% on day 5 did not produce significant differences in metabolites of energy pathways with respect to control platelet concentrates, whereas when the glucose was added at the beginning of storage (time 0) there was a recovery of ATP, GTP and a decrease of energetic catabolism, demonstrating a beneficial effect on energy metabolism. The changes in LDH values did not parallel those of the metabolites: indeed, only on day 7 of storage did the platelet concentrates treated with glucose on day 5 have significantly lower levels of this enzyme than those found in the other concentrates. The improvements produced by addition of glucose at time 0 were confirmed by morphological analyses (mean platelet volume, platelet haematocrit), and the pH. CONCLUSIONS The metabolic profile of glucose-enriched plasma concentrates on the fifth day of storage, and the different time course of increased LDH concentration, could represent valid parameters to interpret platelet vitality in the successive days of storage. These preliminary data also indicate that glucose might be a good additive for a new storage formulation.
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21
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Svendsen MS, Rojkjaer R, Kristensen AT, Salado-Jimena JA, Kjalke M, Johansson PI. Impairment of the hemostatic potential of platelets during storage as evaluated by flow cytometry, thrombin generation, and thrombelastography under conditions promoting formation of coated platelets. Transfusion 2008; 47:2057-65. [PMID: 17958535 DOI: 10.1111/j.1537-2995.2007.01430.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The increasing demand for platelet (PLT) transfusions has focused attention on appropriate use. Coated PLTs are a subpopulation of highly procoagulant PLTs formed by simultaneous stimulation by the agonist's collagen and thrombin hypothesized to drive clot formation at the site of vascular injury. Prolonged storage of PLTs may reduce their ability to support optimal hemostasis upon transfusion. STUDY DESIGN AND METHODS PLT concentrates (PCs) stored for 1, 4, 6, and 8 days were costimulated with thrombin and the collagen glycoprotein VI (GPVI) receptor agonist convulxin, and their ability to form coated PLTs was determined by flow cytometry. Further, a plasma-based thrombin generation assay and thrombelastography were used to evaluate the aged PCs' capacity to support thrombin generation and clot formation, respectively. The stored PCs were additionally tested by standard quality control methods. RESULTS PLT quality as measured by standard analyses was acceptable according to current practice. The hemostatic potential, however, was impaired with increasing storage time. The formation of coated PLTs decreased significantly from approximately 85 to 55 percent with increasing storage time (p<0.05). The velocity of clot formation was significantly increased from Day 4 (p<0.05). The velocity of thrombin generation and resistance against fibrinolysis were significantly reduced on Day 8 compared to Day 1 of storage (p<0.05). CONCLUSION Data in the present study suggest that storage significantly reduced the stored PLTs' ability to respond to conditions expected to exist at the site of vascular injury and that storage-induced reduction in PLT activation sensitivity correlated with a loss of hemostatic potential.
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22
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Galactosylation does not prevent the rapid clearance of long-term, 4 degrees C-stored platelets. Blood 2007; 111:3249-56. [PMID: 18096766 DOI: 10.1182/blood-2007-06-097295] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cold storage of platelets for transfusion is desirable to extend platelet storage times and to prevent bacterial growth. However, the rapid clearance of cold-stored platelets prevents their use. A novel method for preventing the rapid clearance of cold-stored platelets has previously been developed in a murine model. Cold storage induces the clustering and recognition of exposed beta-N-acetylglucosamine (betaGlcNAc) on platelet surfaces. Glycosylation of betaGlcNAc residues with uridine 5'-diphosphogalactose (UDP-galactose) results in the normal survival of short-term (2 h) 0 degrees C-stored murine platelets. Based on this finding, we developed a similar glycosylation process by adding UDP-galactose to human apheresis platelets. A phase 1 clinical trial was conducted transfusing radiolabeled autologous apheresis platelets stored for 48 hours at 4 degrees C with or without pretreatment with UDP-galactose. In contrast to the murine study, galactosylation of human platelets did not prevent the accelerated platelet clearance routinely observed after 4 degrees C storage. We next developed a murine model of platelet storage for 48 hours at 4 degrees C and showed that UDP-galactose treatment of murine platelets also did not prevent their rapid clearance, in agreement with the human platelet study. We conclude that different mechanisms of clearance may exist for short- and long-term cold-stored platelets.
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23
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Cauwenberghs S, van Pampus E, Curvers J, Akkerman JWN, Heemskerk JWM. Hemostatic and signaling functions of transfused platelets. Transfus Med Rev 2007; 21:287-94. [PMID: 17900490 DOI: 10.1016/j.tmrv.2007.05.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Metabolic studies have revealed a gradual impairment in platelet integrity during storage, a process termed the platelet storage lesion. Recent evidence shows that stored platelets also lose signaling responses to physiological agonists with impaired integrin activation, secretion, and aggregation of the cells. On the other hand, storage leads to a gain in platelet activation properties, such as release of microparticles and appearance of surface epitopes for their clearance by macrophages. New techniques for measuring flow-induced thrombus formation and platelet-dependent coagulation provide evidence that the hemostatic activity of platelets decreases during storage. Besides pharmacological inhibition, novel storage strategies, like metabolic suppression, should be considered to better preserve platelet functionality while limiting the expression of clearance markers. Understanding the changes that occur in association with the platelet storage lesion and the use of updated storage methods will help to generate platelets for transfusion with optimal hemostatic function and a long circulation time after transfusion.
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Affiliation(s)
- Sandra Cauwenberghs
- Department of Biochemistry (CARIM), Maastricht University and University Hospital, The Netherlands
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24
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Morrison A, Hornsey VS, Prowse CV, Macgregor IR. Use of the DiaMed Impact R to test platelet function in stored platelet concentrates. Vox Sang 2007; 93:166-72. [PMID: 17683361 DOI: 10.1111/j.1423-0410.2007.00938.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The DiaMed Impact R tests platelet function under close to physiological flow conditions using cone and plate technology. An image analyser quantifies the adhered platelets and results are expressed as percentage of well surface covered by aggregates (SC %) as an index of adhesion and average size of the aggregates (AS microm(2)) as an index of aggregation. The machine is designed to use whole blood and the aim of this study was to determine if it could be used to assess platelet function in platelet concentrates (PC). MATERIAL AND METHODS Platelet concentrates were mixed with various ratios of platelet-poor plasma (PPP) or ABO-compatible routine leucoreduced red cells in saline-adenine-glucose-mannitol. The effects of platelet counts, haematocrit, shear rate and time of activation upon SC and AS were evaluated to identify optimized assay conditions. Routine PCs were then tested on Days 2, 5 and 7. Samples were also stored at 4 or 37 degrees C for 1 to 2 h before assay to see if function was altered. RESULTS Platelet concentrate in PPP resulted in no detectable platelet adhesion. However, addition of red cells to PC resulted in measurable platelet adhesion and aggregation. Optimal conditions were identified as shear rate of 1800 per second, 4-min activation, platelet count between 250 and 400 x 10(6) per ml, haematocrit between 30 and 40%. When stored PCs were tested under these conditions we observed median values of 8.2% for SC and 32.7 microm(2) for AS at 2 days, which reduced to 6.9% and 25.0 microm(2), respectively, after 5-day storage and 6.8% and 21.0 microm(2) after 7 days. CONCLUSION We were able to reconstitute PCs by adding red cells and identified conditions to allow platelet adhesion and aggregation functions of PCs to be measurable in the DiaMed Impact R. Platelet functions of adhesion and aggregation were shown to decrease during storage but improved after a 1-h treatment at 37 degrees C.
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Affiliation(s)
- A Morrison
- Products and Components R&D group, National Science Laboratory, Scottish National Blood Transfusion Service, 21 Ellen's Glen Road, Edinburgh, UK.
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Badlou BA, Spierenburg G, Ulrichts H, Deckmyn H, Smid WM, Akkerman JWN. Role of glycoprotein Ibalpha in phagocytosis of platelets by macrophages. Transfusion 2007; 46:2090-9. [PMID: 17176320 DOI: 10.1111/j.1537-2995.2006.01034.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Platelet (PLT) storage at 0 to 4 degrees C suppresses bacterial multiplication, but induces clusters of glycoprotein (GP) Ibalpha that trigger their phagocytosis by macrophages and reduce their survival after transfusion. A method was sought that detects cold-induced changes in GPIbalpha involved in phagocytosis. STUDY DESIGN AND METHODS Human PLTs were isolated and stored for up to 48 hours at 0 degrees C. Binding of a phycoerythrin (PE)-labeled antibody directed against amino acids (AA) 1-35 on GPIbalpha (AN51-PE) was compared with phagocytosis of PLTs by matured monocytic THP-1 cells, analyzed by fluorescence-activated cell sorting. RESULTS Freshly isolated PLTs were detected as a single population of AN51-PE-positive particles and showed less than 5 percent phagocytosis. Cold storage led to a decrease in AN51-PE binding and an increase in phagocytosis. N-Acetylglucosamine, known to interfere with macrophage recognition of GPIbalpha clusters, restored normal AN51-PE binding to cold-stored PLTs and suppressed phagocytosis. CONCLUSIONS It is concluded that binding of an antibody against AA 1-35 on GPIbalpha reflects changes in GPIbalpha that make PLTs targets for phagocytosis by macrophages.
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Affiliation(s)
- Bahram A Badlou
- Thrombosis and Haemostasis Laboratory, DCCH, the Department of Immunology, UMC-Utrecht, the Institute for Biomembranes Utrecht University, and the Sanquin Blood Bank Region North-West, Utrecht, the Netherlands
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Badlou BA, van der Meer PF, Akkerman JWN, Smid WM, Pietersz RNI. Metabolic energy reduction by glucose deprivation and low gas exchange preserves platelet function after 48 h storage at 4 °C. Vox Sang 2007; 92:311-8. [PMID: 17456155 DOI: 10.1111/j.1423-0410.2007.00891.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We showed earlier that metabolically suppressed platelets (MSP) prepared by incubation in glucose-free, antimycin A medium at 37 degrees C better sustained storage at 4 degrees C than untreated controls at 22 degrees C. However, the use of the mitochondrial inhibitor antimycin A is incompatible with platelet transfusion. OBJECTIVES The aim of this study was to investigate how energy-reduced (ER) platelets could be prepared in the absence of antimycin A. STUDY DESIGN AND METHODS Platelets in gas-impermeable bags in glucose-free medium were kept at 22 degrees C for 4 h to reduce energy stores and thereafter stored at 4 degrees C (ER22-4). Controls were energy-reduced platelets without prior incubation at 22 degrees C (ER4), and MSPs in test tubes and untreated platelets in gas-permeable bags with glucose and stored at 22 degrees C (C22) and 4 degrees C (C4). RESULTS After 48 h storage, ER22-4 were superior to C22 with respect to pH preservation (6 x 4 +/- 0 x 4 vs. 5 x 0 +/- 0 x 4, n= 4), platelet count (800 +/- 225 vs. 650 +/- 150 x 10(9)), thrombin receptor-activating peptide-induced aggregation (50 +/- 15 vs. 10 +/- 5%) and glycoprotein (GP)Ib alpha expression (60 +/- 15% vs. 28 +/- 15). GPIb alpha expression was higher in ER22-4 than in ER4, indicating that energy suppression preserved GPIb alpha during cold storage. CONCLUSION Metabolic suppression without the use of antimycin A could be mimicked by storage of platelets in glucose-free medium in gas-impermeable bags. Energy suppression preserved GPIb alpha expression during storage at 4 degrees C.
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Affiliation(s)
- B A Badlou
- Sanquin Blood Bank North-West Region, Amsterdam, The Netherlands.
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Platelet Storage and Transfusion. Platelets 2007. [DOI: 10.1016/b978-012369367-9/50831-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Abstract
BACKGROUND Earlier it was reported that metabolic arrest followed by incubation at 4 degrees C reduces the platelet (PLT) storage defect. Here it is reported that this treatment also reduces binding and phagocytosis by macrophages. STUDY DESIGN AND METHODS Phagocytosis of mepacrine-labeled PLTs by macrophages changes the latter into bright fluorescent particles easily detected by fluorescence-activated cell sorting. RESULTS In combination with conventional binding analysis it was found that binding to phorbol 12-myristate 13-acetate-matured THP-1 cells is primarily regulated by PLT P-selectin expression and phagocytosis by combined phosphatidylserine (PS) exposure and glycoprotein (GP) Ibalpha clustering. It was found that trapping of PLT Ca2+ and raising cAMP reduces phagocytosis by lowering PS exposure. Chilling of PLTs leads to an increase in binding and PS- and GPIbalpha-mediated phagocytosis. Prior depletion of PLT energy stores prevents this increase by preserving low Ca2+ concentration, PS exposure, and PS-mediated phagocytosis. CONCLUSION These data characterize the individual factors that control PLT binding and phagocytosis and might help to define conditions that improve the survival of stored PLTs after transfusion.
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Affiliation(s)
- Bahram A Badlou
- Thrombosis and Hemostasis Laboratory, Department of Hematology, University Medical Center Utrecht, the Netherlands
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