1
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Brouard N, Pissenem-Rudwill F, Mouriaux C, Haas D, Galvanin A, Kientz D, Mangin PH, Isola H, Hechler B. Biochemical and functional characteristics of stored (double-dose) buffy-coat platelet concentrates treated with amotosalen and a prototype UVA light-emitting diode illuminator. Transfusion 2023; 63:1937-1950. [PMID: 37615493 DOI: 10.1111/trf.17519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/08/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Pathogen reduction of platelet concentrates (PCs) using amotosalen and broad-spectrum UVA illumination contributes to the safety of platelet transfusion by reducing the risk of transfusion-transmitted infections. We evaluated the in vitro quality of stored buffy-coat (BC) PCs treated with amotosalen and a prototype light-emitting diode (LED) illuminator. METHODS Double-dose BC-PCs collected into PAS-III/plasma or SSP+ /plasma (55/45%) were treated with amotosalen in combination with either conventional UVA lamps (INT100 Illuminator 320-400 nm) or LED illuminators at 350 nm. Platelet quality and function were evaluated over 7 days. RESULTS Platelet counts were conserved during storage in all groups, as was platelet swirling without appearance of macroscopic aggregates. Integrin αIIbβ3 and glycoprotein (GP) VI expression remained stable, whereas GPIbα and GPV declined similarly in all groups. UV lamp- and LED-treated PCs displayed similar glucose consumption, lactate generation, and pH variation. Comparable spontaneous and residual P-selectin and phosphatidylserine exposure, activated αIIbβ3 exposure, mitochondrial membrane potential, lactate dehydrogenase release, and adhesive properties under flow conditions were observed during storage. The use of SSP+ /plasma compared with PAS-III/plasma better preserved most of these parameters, especially during late storage, irrespective of the type of illuminator. CONCLUSION Replacing the UVA lamp for photochemical treatment by LED illuminators had no impact on platelet metabolism, spontaneous activation, apoptosis or viability, or on the in vitro function of BC-PCs stored for 7 days in SSP+ or PAS-III/plasma. These findings support improved procedures for the pathogen reduction and storage of PCs, to ensure transfusion safety and retention of platelet functional properties.
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Affiliation(s)
- Nathalie Brouard
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | | | - Clarisse Mouriaux
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Delphine Haas
- Etablissement Français du Sang (EFS) Grand Est, Strasbourg, France
| | - Adeline Galvanin
- Etablissement Français du Sang (EFS) Grand Est, Strasbourg, France
| | - Daniel Kientz
- Etablissement Français du Sang (EFS) Grand Est, Strasbourg, France
| | - Pierre H Mangin
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Hervé Isola
- Etablissement Français du Sang (EFS) Grand Est, Strasbourg, France
| | - Béatrice Hechler
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS) Grand Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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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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Infanti L, Pehlic V, Mitrovic S, Holbro A, Andresen S, Payrat JM, Lin JS, Buser A. Pathogen inactivation treatment of triple-dose apheresis platelets with amotosalen and ultraviolet a light. Transfus Med 2022; 32:505-511. [PMID: 36124649 PMCID: PMC10087429 DOI: 10.1111/tme.12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 07/07/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND A triple storage (TS) set allows for pathogen inactivation (PI) treatment of triple-dose apheresis platelet products with amotosalen + UVA. We evaluated the quality and metabolic parameters of platelet concentrates (PCs) pathogen inactivated and stored for 7 days. MATERIALS AND METHODS Twelve triple-dose products collected with two different apheresis platforms were treated with amotosalen+UVA. Products were split into three single-dose units. Testing was made pretreatment, after splitting, at days 5 and 7 of storage. RESULTS Single-dose PI PCs had a mean platelet content of 2.89 ± 0.35 x 1011 . From baseline to day 7, pH remained stable (7.1 ± 0.1 vs. 7.0 ± 0.1), pO2 increased (11.3 ± 2.4 vs. 18.3 ± 3.5 kPa) as did LDH (201 ± 119 vs. 324 ± 203 U/L) and lactate (3.6 ± 1.7 vs. 12.1 ± 1.5 mmol/L) (all p < 0.01); pCO2 decreased (4.1 ± 0.8 vs. 1.5 ± 0.7 mmHg; p < 0.01) and so did bicarbonate (6.6 ± 1.1 vs. 2.5 ± 1.4 mmol/L), glucose (5.6 ± 1.2 vs. 0.4 ± 0.4 mmol/L) and ATP (3.4 ± 0.9 vs. 2.5 ± 1.4 nmol/108 platelets) (all p < 0.05). CONCLUSION Triple-dose PCs processed with the TS sets fulfilled the quality requirements and displayed metabolic changes of expected extent during 7-day storage.
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Affiliation(s)
- Laura Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Division of Hematology, University Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Vildana Pehlic
- Regional Blood Transfusion Service, Swiss Red Cross, Division of Hematology, University Hospital, Basel, Switzerland
| | - Sandra Mitrovic
- Clinical Chemistry, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Andreas Holbro
- Regional Blood Transfusion Service, Swiss Red Cross, Division of Hematology, University Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | | | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Division of Hematology, University Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
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4
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González MB, Cuerva RC, Muñoz BF, Rosell-Valle C, López MM, Arribas BA, Montiel MÁ, Sánchez GC, González MS. Optimization of human platelet lysate production and pathogen reduction in a public blood transfusion center. Transfusion 2022; 62:1839-1849. [PMID: 35924726 DOI: 10.1111/trf.17045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Human platelet lysate (HPL) has been proposed as a safe and efficient xeno-free alternative to fetal bovine serum (FBS) for large-scale culturing of cell-based medicinal products. However, the use of blood derivatives poses a potential risk of pathogen transmission. To mitigate this risk, different pathogen reduction treatment (PRT) practices can be applied on starting materials or on final products, but these methods might modify the final composition and the quality of the products. STUDY DESIGN AND METHODS We evaluated the impact of applying a PRT based on riboflavin and ultraviolet irradiation on the raw materials used to manufacture an improved Good Manufacturing Practices (GMP)-grade HPL product in a public blood center. Growth promotion and the levels of growth factors and proteins were compared between an inactivated product (HPL4-i) and a non-inactivated product (HPL4). Stability studies were performed at 4°C, -20°C, and -80°C. RESULTS The application of a PRT on the starting materials significantly altered the protein composition of HPL4-i as compared with HPL4. Despite this, the growth promoting rates were unaffected when compared with FBS used as a control. While all products were stable at -20°C and -80°C for 24 months, a significant decrease in the activity of HPL4-i was observed when stored at 4°C. CONCLUSION Our results show that the application of a PRT based on riboflavin and ultraviolet light on starting materials used in the manufacture of HPL modifies the final composition of the product, yet its cell growth promoting activity is maintained at levels similar to those of non-inactivated products.
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Affiliation(s)
- María Bermejo González
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,PhD Program in Biología Molecular, Biomedicina e Investigación Clínica, University of Seville, Seville, Spain
| | - Rafael Campos Cuerva
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
| | - Beatriz Fernández Muñoz
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
| | - Cristina Rosell-Valle
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
| | - María Martín López
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain
| | - Blanca Arribas Arribas
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,PhD Program in Pharmaceutical Technology and Medicine Sciences (Pharmacy), University of Seville, Seville, Spain
| | - Migue Ángel Montiel
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,PhD Program in Pharmaceutical Technology and Medicine Sciences (Pharmacy), University of Seville, Seville, Spain
| | - Gloria Carmona Sánchez
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,PhD Program in Biomedicine, University of Granada, Granada, Spain
| | - Mónica Santos González
- Unidad de Producción y Reprogramación Celular de Sevilla (UPRC) Red Andaluza de Diseño y, Traslación de Terapias Avanzadas (RADyTTA), Seville, Spain.,Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Fundación Pública Andaluza para la Gestión de la Investigación en Salud en Sevilla (FISEVI), Seville, Spain
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5
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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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6
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Larsson L, Sandgren P, Ohlsson S, Derving J, Friis-Christensen T, Daggert F, Frizi N, Reichenberg S, Chatellier S, Diedrich B, Antovic J, Larsson S, Uhlin M. Non-phthalate plasticizer DEHT preserves adequate blood component quality during storage in PVC blood bags. Vox Sang 2020; 116:60-70. [PMID: 32918773 DOI: 10.1111/vox.12982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/02/2020] [Accepted: 07/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Commercial blood bags are predominantly made of polyvinyl chloride (PVC) plasticized with di(2-ethylhexyl) phthalate (DEHP). DEHP is favourable for storage of red blood cells (RBC). Historically, removal of DEHP from blood bags has been linked to unacceptable haemolysis levels. Oncoming regulatory restrictions for DEHP due to toxicity concerns increase the urgency to replace DEHP without compromising RBC quality. Di(2-ethylhexyl) terephthalate (DEHT) is one suggested substitute. The aim of this study was to compare PVC-DEHT to PVC-DEHP blood bags using additive solutions saline-adenine-glucose-mannitol (SAGM) and phosphate-adenine-glucose-guanosine-saline-mannitol (PAGGSM), to determine whether DEHT can maintain acceptable component quality. MATERIALS AND METHODS RBC concentrates (N = 64), platelet concentrates (N = 16) and fresh frozen plasma (N = 32) were produced from whole blood collected into either DEHT or DEHP plasticized systems. Using a pool-and-split study design, pairs of identical RBC content were created within each plasticizer arm and assigned either SAGM or PAGGSM. Storage effects were assessed weekly for 49 days (RBC), 7 days (platelets) and before/after freezing (plasma). RESULTS Though haemolysis was slightly higher in DEHT, all study arms remained below half of the European limit 0·8%. K+ was lower in DEHT than in DEHP independent of additive solution. The metabolic parameters were not influenced by choice of plasticizer. Platelet activation/metabolism and plasma content were similarly preserved. CONCLUSION Our study demonstrates that the plasticizer DEHT provides adequate blood component quality. We propose DEHT as a strong future candidate for replacement of DEHP in blood bags.
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Affiliation(s)
- Linda Larsson
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Per Sandgren
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sara Ohlsson
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Julia Derving
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | | | | | - Beatrice Diedrich
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jovan Antovic
- Department of Coagulation Research, Institute for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Stella Larsson
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Uhlin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
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7
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Millar D, Hayes C, Jones J, Klapper E, Kniep JN, Luu HS, Noland DK, Petitti L, Poisson JL, Spaepen E, Ye Z, Maurer-Spurej E. Comparison of the platelet activation status of single-donor platelets obtained with two different cell separator technologies. Transfusion 2020; 60:2067-2078. [PMID: 32729161 DOI: 10.1111/trf.15934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/06/2020] [Accepted: 05/24/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The microparticle content (MP%) of apheresis platelets-a marker of platelet activation-is influenced by donor factors and by external stressors during collection and storage. This study assessed the impact of apheresis technology and other factors on the activation status (MP%) of single-donor apheresis platelets. STUDY DESIGN AND METHODS Data from six US hospitals that screened platelets by measuring MP% through dynamic light scattering (ThromboLUX) were retrospectively analyzed. Relative risks (RRs) were derived from univariate and multivariable regression models, with activation rate (MP% ≥15% for plasma-stored platelets; ≥10% for platelet additive solution [PAS]-stored platelets) and MP% as outcomes. Apheresis platform (Trima Accel vs Amicus), storage medium (plasma vs PAS), pathogen reduction, storage time, and testing location were used as predictors. RESULTS Data were obtained from 7511 platelet units collected using Trima (from 16 suppliers, all stored in plasma, 20.0% were pathogen-reduced) and 2456 collected using Amicus (from four different collection facilities of one supplier, 65.0% plasma-stored, 35.0% PAS-stored, none pathogen-reduced). Overall, 30.0% of Trima platelets were activated compared to 45.6% of Amicus platelets (P < .0001). Multivariable analysis identified apheresis platform as significantly associated with platelet activation, with a lower activation rate for Trima than Amicus (RR: 0.641, 95% confidence interval [CI]: 0.578; 0.711, P < .0001) and a 6.901% (95% CI: 5.926; 7.876, P < .0001) absolute reduction in MP%, when adjusting for the other variables. CONCLUSION Trima-collected platelets were significantly less likely to be activated than Amicus-collected platelets, irrespective of the storage medium, the use of pathogen reduction, storage time, and testing site.
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Affiliation(s)
- Daniel Millar
- Department of Integrated Engineering, University of British Columbia and MistyWest Research and Engineering Lab, Vancouver, British Columbia, Canada
| | - Chelsea Hayes
- Department of Pathology, Division of Transfusion Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jessica Jones
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Ellen Klapper
- Department of Pathology, Division of Transfusion Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joel N Kniep
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Hung S Luu
- Department of Pathology, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA
| | - Daniel K Noland
- Department of Pathology, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA
| | | | | | | | - Zhan Ye
- Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Elisabeth Maurer-Spurej
- Department of Pathology and Laboratory Medicine and Centre for Blood Research and Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada
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8
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Rosskopf K, Helmberg W, Schlenke P. Pathogen reduction of double-dose platelet concentrates from pools of eight buffy coats: Product quality, safety, and economic aspects. Transfusion 2020; 60:2058-2066. [PMID: 32619068 PMCID: PMC7540585 DOI: 10.1111/trf.15926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/27/2020] [Accepted: 05/15/2020] [Indexed: 12/29/2022]
Abstract
Background Pathogen reduction (PR) of platelet concentrates (PCs) contributes to the safety of platelet (PLT) transfusion by reducing the risk of transfusion‐transmitted infections and transfusion‐associated graft‐versus‐host disease. In vitro quality of pathogen‐reduced double‐dose PC (PR‐PC) made of eight whole blood (WB)‐derived buffy coats (BCs) were evaluated. Methods Eight small‐volume WB BCs from donors with at least 200 × 109 PLT/L were pooled with an additive solution to produce double‐dose PCs (DD‐PCs), which were treated with amotosalen/ultraviolet A light in a dual storage processing set, yielding 2 units of PR‐PC. Quality controls were undertaken as per European Directive for the Quality of Medicines (EDQM) guidelines. PLT recovery rates were measured. Production costs and savings were compared over the 3 years before and after PR implementation. Results In the pre‐PR period, 19 666 PCs were produced, compared to 17 307 PCs in the PR period. Single BC in the PR period had 41 ± 2 mL, hematocrit 0.39 ± 0.04 and 1.06 ± 0.18 × 1011 PLTs, and showed a recovery of 91% ± 8%. After pooling, separation, PR treatment of DD‐PC, and splitting, each single PC had 189 ± 6 mL with 2.52 ± 0.34 × 1011 PLTs, compared to 2.48 ± 0.40 in the pre‐PR period. The PLT recovery rate after PR was 87% ± 14%. EDQM requirements were met. An increase of about €12 (+7.5%) per PC from the pre‐PR to the PR period was identified. Conclusion A new production method resulting in two PR‐PCs made from pools of 8 BCs with use of one PR set was successfully introduced, and our experience of nearly 3 years demonstrated the high efficacy and in vitro quality of the PR‐PCs obtained.
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Affiliation(s)
- Konrad Rosskopf
- Department of Blood Group Serology and Transfusion Medicine, Medical University Graz and LKH-Univ.Klinikum Graz, Graz, Austria
| | - Wolfgang Helmberg
- Department of Blood Group Serology and Transfusion Medicine, Medical University Graz and LKH-Univ.Klinikum Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University Graz and LKH-Univ.Klinikum Graz, Graz, Austria
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9
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Jóhannsson F, Árnason NÁ, Landrö R, Guðmundsson S, Sigurjonsson ÓE, Rolfsson Ó. Metabolomics study of platelet concentrates photochemically treated with amotosalen and UVA light for pathogen inactivation. Transfusion 2019; 60:367-377. [PMID: 31802514 DOI: 10.1111/trf.15610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The risk of bacterial contamination and the deterioration of platelet (PLT) quality limit the shelf-life of platelet concentrates (PCs). The INTERCEPT pathogen inactivation system reduces the risk of pathogen transmission by inhibiting nucleic acid replication using a combination of a photo-reactive compound and UVA illumination. The goal of this study was to investigate the effects the INTERCEPT system has on the PLT metabolome and metabolic activity. STUDY DESIGN AND METHODS Paired units of buffy coat-derived PCs were generated using a pool and split strategy (n = 8). The paired PCs were either treated with the INTERCEPT system or left untreated. Samples were collected on Days 1, 2, 4, and 7 of storage. Ultra-performance chromatography coupled with time-of-flight mass spectrometry was used to analyze the extra- and intracellular metabolomes. Constraint-based metabolic modeling was then used to predict the metabolic activity of the stored PLTs. RESULTS A relatively large number of metabolites in the extracellular environment were depleted during the processing steps of the INTERCEPT system, in particular, metabolites with hydrophobic functional groups, including acylcarnitines and lysophosphatidylcholines. In the intracellular environment, alterations in glucose and glycerophospholipid metabolism and decreased levels of 2-hydroxyglutarate were observed following the INTERCEPT treatment. Untargeted metabolomics analysis revealed residual amotosalen dimers present in the treated PCs. Systems-level analysis of PLT metabolism indicated that the INTERCEPT system does not have a significant impact on the PLT energy metabolism and nutrient utilization. CONCLUSIONS The INTERCEPT system significantly alters the metabolome of the stored PCs without significantly influencing PLT energy metabolism.
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Affiliation(s)
- Freyr Jóhannsson
- Center for Systems Biology, University of Iceland, Sturlugata 8, Reykjavik, Iceland.,Medical Department, University of Iceland, Sturlugata 8, Reykjavik, Iceland
| | - Níels Á Árnason
- The Blood Bank, Landspitali-University Hospital, Snorrabraut 60, Reykjavik, Iceland
| | - Ragna Landrö
- The Blood Bank, Landspitali-University Hospital, Snorrabraut 60, Reykjavik, Iceland
| | - Sveinn Guðmundsson
- The Blood Bank, Landspitali-University Hospital, Snorrabraut 60, Reykjavik, Iceland
| | - Ólafur E Sigurjonsson
- The Blood Bank, Landspitali-University Hospital, Snorrabraut 60, Reykjavik, Iceland.,School of Science and Engineering, Reykjavik University, Menntavegur 1, Reykjavik, Iceland
| | - Óttar Rolfsson
- Center for Systems Biology, University of Iceland, Sturlugata 8, Reykjavik, Iceland.,Medical Department, University of Iceland, Sturlugata 8, Reykjavik, Iceland
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10
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Arnason NA, Johannson F, Landrö R, Hardarsson B, Irsch J, Gudmundsson S, Rolfsson O, Sigurjonsson OE. Pathogen inactivation with amotosalen plus UVA illumination minimally impacts microRNA expression in platelets during storage under standard blood banking conditions. Transfusion 2019; 59:3727-3735. [PMID: 31674051 DOI: 10.1111/trf.15575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/15/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND To reduce the risk of transfusion transmission infection, nucleic acid targeted methods have been developed to inactivate pathogens in PCs. miRNAs have been shown to play an important role in platelet function, and changes in the abundance of specific miRNAs during storage have been observed, as have perturbation effects related to pathogen inactivation (PI) methods. The aim of this work was to investigate the effects of PI on selected miRNAs during storage. STUDY DESIGN AND METHODS Using a pool and split strategy, 3 identical buffy coat PC units were generated from a pool of 24 whole blood donors. Each unit received a different treatment: 1) Untreated platelet control in platelet additive solution (C-PAS); 2) Amotosalen-UVA-treated platelets in PAS (PI-PAS); and 3) untreated platelets in donor plasma (U-PL). PCs were stored for 7 days under standard blood banking conditions. Standard platelet quality control (QC) parameters and 25 selected miRNAs were analyzed. RESULTS During the 7-day storage period, differences were found in several QC parameters relating to PI treatment and storage in plasma, but overall the three treatments were comparable. Out of 25 miRNA tested changes in regulation of 5 miRNA in PI-PAS and 3 miRNA U-PL where detected compared to C-PAS. A statistically significant difference was observed in down regulations miR-96-5p on Days 2 and 4, 61.9% and 61.8%, respectively, in the PI-PAS treatment. CONCLUSION Amotosalen-UVA treatment does not significantly alter the miRNA profile of platelet concentrates generated and stored using standard blood banking conditions.
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Affiliation(s)
- Niels Arni Arnason
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Freyr Johannson
- Department of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ragna Landrö
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Björn Hardarsson
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Sveinn Gudmundsson
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ottar Rolfsson
- Department of Medicine, University of Iceland, Reykjavik, Iceland
| | - Olafur E Sigurjonsson
- The Blood Bank, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
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11
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Escolar G, McCullough J. Platelet in vitro assays: their correspondence with their in vivo hemostatic potential. Transfusion 2019; 59:3783-3793. [PMID: 31642072 DOI: 10.1111/trf.15559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/26/2019] [Accepted: 08/28/2019] [Indexed: 01/01/2023]
Abstract
Developments during the past few years have resulted in multiple kinds of platelet products for transfusion. This involves different collection methods, containers, preservative solutions, modifications of storage temperatures and durations, and additional treatments such as pathogen reduction. Much experience has been obtained testing these processes in vitro to seek indications of in vivo effectiveness. Availability of an in vitro method that correlated with in vivo effectiveness would be extremely valuable for these different kinds of platelet products and as more innovation in platelet preparation occurs in the future. This report reviews the methods for in vitro platelet testing with a view to their in vivo implications and whether such testing could be helpful in projecting the clinical effectiveness of different platelet products.
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Affiliation(s)
- Gines Escolar
- Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Jeffrey McCullough
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
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12
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Hosseini E, Ghasemzadeh M, Azizvakili E, Beshkar P. Platelet spreading on fibrinogen matrix, a reliable and sensitive marker of platelet functional activity during storage. J Thromb Thrombolysis 2019; 48:430-438. [DOI: 10.1007/s11239-019-01916-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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13
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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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14
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Lotens A, de Valensart N, Najdovski T, Acquart S, Cognasse F, Rapaille A. Influence of platelet preparation techniques on in vitro storage quality after psoralen-based photochemical treatment using new processing sets for triple-dose units. Transfusion 2018; 58:2942-2951. [PMID: 30362131 DOI: 10.1111/trf.14909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The INTERCEPT Blood System (IBS) for platelets (PLTs) uses a combination of psoralen and ultraviolet-A light to inactivate pathogens that may contaminate PLT concentrates (PCs). However, no data are available on the quality of IBS-treated PLTs from different apheresis and buffy-coat PC preparation platforms using the new triple storage (TS) set. STUDY DESIGN AND METHODS The objective of this study was to evaluate the TS set on three different preparation platforms compared with the large-volume (LV) set, as control. PLT in vitro metabolic and activation parameters were studied over 7 days. RESULTS Several statistical differences are observed between the two sets, particularly for pH, oxygen pressure (pO2 ), carbonic gaz pressure (pCO2 ), and bicarbonate. The three different preparation techniques influence PLT parameters, and the difference is statistically significant for all the studied parameters, except for pCO2 . The TS set has the advantage of shorter compound adsorption device time, higher PLT recoveries, and less PLT activation. CONCLUSION Results from the measured metabolic parameters and PLT variables obtained from PCs treated by LV and TS sets indicated good PLT function preservation up to 7 days of storage. The in vitro assessment results demonstrated acceptable PLT function for transfusion.
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Affiliation(s)
- Anaïs Lotens
- Service du Sang, Belgian Red Cross, Namur, Belgium
| | | | | | | | - Fabrice Cognasse
- Etablissement Français du Sang, Saint-Etienne, France.,Université de Lyon, GIMAP-EA3064, Saint-Etienne, France
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15
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Meinke S, Wikman A, Gryfelt G, Hultenby K, Uhlin M, Höglund P, Sandgren P. Cryopreservation of buffy coat-derived platelet concentrates photochemically treated with amotosalen and UVA light. Transfusion 2018; 58:2657-2668. [PMID: 30281156 DOI: 10.1111/trf.14905] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/06/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cryopreserved platelets (CPPs) are considered a promising approach for extended platelet storage, bridging inventory shortages of conventionally stored platelets. It is unknown if platelet concentrates exposed to photochemical treatment (PCT) with amotosalen and ultraviolet A (UVA) light, to inactivate pathogens, are suitable for freezing. The objective of this study was to analyze potential effects of PCT on CPPs as compared with untreated CPPs. STUDY DESIGN AND METHODS A total of 12 PCT-treated and 12 untreated platelet units from buffy coats were cryopreserved at -80°C in 5% dimethyl sulfoxide. CPPs of both types were rapidly thawed at 37°C and resuspended in 200 mL fresh plasma. In vitro properties were analyzed prefreezing, postfreezing and thawing, and on Day 1 after thawing. RESULTS Directly after thawing, no major differences in platelet content, lactase hydrogenase, adenosine triphosphate, mitochondrial membrane potential, CD62P, CD42b, and platelet endothelial cell adhesion molecule were seen between PCT-CPPs and conventional CPPs. Agonist-induced PAC-1 expression and contribution of CPPs to blood coagulation in an experimental rotational thromboelastometry setup were also similar between the groups. On Day 1 after thawing, the CPPs of both types performed less well. The PCT-CPPs tended to be more affected by the freezing process than the conventional CPPs. CONCLUSIONS PCT-CPPs appeared slightly more susceptible to lesion effects by freezing than conventional CPPs, in particular in assays on Day 1 after thawing, but these differences were small relative to the dramatic effects of the freezing process itself.
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Affiliation(s)
- Stephan Meinke
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet
| | - Agneta Wikman
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital.,Department of Laboratory Medicine, Karolinska Institutet
| | - Gunilla Gryfelt
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital
| | - Kjell Hultenby
- Division of Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michael Uhlin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Petter Höglund
- Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet
| | - Per Sandgren
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital.,Department of Laboratory Medicine, Karolinska Institutet
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16
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Ohlsson S, Diedrich B, Uhlin M, Sandgren P. Optimized processing for pathogen inactivation of double-dose buffy-coat platelet concentrates: maintained in vitro quality over 7-day storage. Vox Sang 2018; 113:611-621. [PMID: 30156292 DOI: 10.1111/vox.12696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/12/2018] [Accepted: 06/28/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Efficient pathogen inactivation (PI) offers the possibility of increasing the number of buffy coats per pool without the concurrent increased risk of pathogen transmission. Here, we describe the findings of in vitro analyses of platelets from pools of eight buffy coats treated with amotosalen and UVA light (INTERCEPT Blood System for Platelets) using INTERCEPT disposable processing sets with plastic materials sourced from alternate suppliers and split afterwards to obtain two therapeutic transfusion doses. METHODS Double-dose platelet concentrates were prepared from pools of eight buffy coats in additive solution (SSP+) using either previous 6-lead or new 8-lead pooling sets and PI processing sets in previous or alternate supplier sourced plastics (AS). Platelets were treated with the INTERCEPT Blood System then stored for up to 7 days and tested for in vitro quality. RESULTS All tested units (n = 30) were in conformity with European guidelines. Using AS sets more effectively maintained glucose reserves (P < 0·01), reduced lactate production (P < 0·01), reduced CD62P expression (P < 0·01) and downregulated levels of surface CD42b (P < 0·01) overtime. AS set maintained JC-positive cells (NS) between day 2 and day 7 and sustained platelet integrin activation (PAC-1) between day 2 and day 7 (NS). Overall sCD40L and PGDF accumulated in an equivalent way (P < 0·01) within series. SUMMARY/CONCLUSIONS In summary, our data demonstrate that PI treatment using AS sets, in combination with the new pooling set for double-dose platelet preparation, maintained the platelet in vitro quality over 7 days of storage.
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Affiliation(s)
- S Ohlsson
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Sweden
| | - B Diedrich
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Uhlin
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet Stockholm, Stockholm, Sweden
| | - P Sandgren
- Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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17
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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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18
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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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19
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Superior integrin activating capacity and higher adhesion to fibrinogen matrix in buffy coat-derived platelet concentrates (PCs) compared to PRP-PCs. Transfus Apher Sci 2018; 57:76-81. [DOI: 10.1016/j.transci.2017.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 11/19/2022]
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20
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Stivala S, Gobbato S, Infanti L, Reiner MF, Bonetti N, Meyer SC, Camici GG, Lüscher TF, Buser A, Beer JH. Amotosalen/ultraviolet A pathogen inactivation technology reduces platelet activatability, induces apoptosis and accelerates clearance. Haematologica 2017; 102:1650-1660. [PMID: 28729303 PMCID: PMC5622849 DOI: 10.3324/haematol.2017.164137] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 07/13/2017] [Indexed: 01/03/2023] Open
Abstract
Amotosalen and ultraviolet A (UVA) photochemical-based pathogen reduction using the Intercept™ Blood System (IBS) is an effective and established technology for platelet and plasma components, which is adopted in more than 40 countries worldwide. Several reports point towards a reduced platelet function after Amotosalen/UVA exposure. The study herein was undertaken to identify the mechanisms responsible for the early impairment of platelet function by the IBS. Twenty-five platelet apheresis units were collected from healthy volunteers following standard procedures and split into 2 components, 1 untreated and the other treated with Amotosalen/UVA. Platelet impedance aggregation in response to collagen and thrombin was reduced by 80% and 60%, respectively, in IBS-treated units at day 1 of storage. Glycoprotein Ib (GpIb) levels were significantly lower in IBS samples and soluble glycocalicin correspondingly augmented; furthermore, GpIbα was significantly more desialylated as shown by Erythrina Cristagalli Lectin (ECL) binding. The pro-apoptotic Bak protein was significantly increased, as well as the MAPK p38 phosphorylation and caspase-3 cleavage. Stored IBS-treated platelets injected into immune-deficient nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice showed a faster clearance. We conclude that the IBS induces platelet p38 activation, GpIb shedding and platelet apoptosis through a caspase-dependent mechanism, thus reducing platelet function and survival. These mechanisms are of relevance in transfusion medicine, where the IBS increases patient safety at the expense of platelet function and survival.
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Affiliation(s)
- Simona Stivala
- Laboratory for Platelet Research, Center for Molecular Cardiology, University of Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Baden, Switzerland
| | - Sara Gobbato
- Laboratory for Platelet Research, Center for Molecular Cardiology, University of Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Baden, Switzerland
| | - Laura Infanti
- Regional Blood Transfusion Service of the Swiss Red Cross, Basel, Switzerland
| | - Martin F Reiner
- Laboratory for Platelet Research, Center for Molecular Cardiology, University of Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Baden, Switzerland
| | - Nicole Bonetti
- Laboratory for Platelet Research, Center for Molecular Cardiology, University of Zurich, Switzerland.,Department of Internal Medicine, Cantonal Hospital Baden, Switzerland
| | - Sara C Meyer
- Division of Hematology and Department of Biomedicine, University Hospital Basel, Switzerland
| | | | - Thomas F Lüscher
- Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland
| | - Andreas Buser
- Regional Blood Transfusion Service of the Swiss Red Cross, Basel, Switzerland
| | - Jürg H Beer
- Laboratory for Platelet Research, Center for Molecular Cardiology, University of Zurich, Switzerland .,Department of Internal Medicine, Cantonal Hospital Baden, Switzerland
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21
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Black A, Orsó E, Kelsch R, Pereira M, Kamhieh-Milz J, Salama A, Fischer MB, Meyer E, Frey BM, Schmitz G. Analysis of platelet-derived extracellular vesicles in plateletpheresis concentrates: a multicenter study. Transfusion 2017; 57:1459-1469. [DOI: 10.1111/trf.14109] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Anne Black
- Institute for Clinical Chemistry and Laboratory Medicine; University Hospital of Regensburg; Regensburg Germany
| | - Evelyn Orsó
- Institute for Clinical Chemistry and Laboratory Medicine; University Hospital of Regensburg; Regensburg Germany
| | - Reinhard Kelsch
- Institute of Transfusion Medicine and Transplantation Immunology, University Hospital Muenster; Muenster Germany
| | - Melanie Pereira
- Institute of Transfusion Medicine, Charité University Medical Centre; Berlin Germany
| | - Julian Kamhieh-Milz
- Institute of Transfusion Medicine, Charité University Medical Centre; Berlin Germany
| | - Abdulgabar Salama
- Institute of Transfusion Medicine, Charité University Medical Centre; Berlin Germany
| | - Michael B. Fischer
- Department for Health Sciences and Biomedicine; Danube University Krems; Krems Austria
| | - Eduardo Meyer
- Regional Blood Transfusion Service Zurich SRK; Zurich Switzerland
| | - Beat M. Frey
- Regional Blood Transfusion Service Zurich SRK; Zurich Switzerland
| | - Gerd Schmitz
- Institute for Clinical Chemistry and Laboratory Medicine; University Hospital of Regensburg; Regensburg Germany
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22
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Preserved in vitro metabolic and functional characteristics of double-dose apheresis platelet concentrates photochemically treated with amotosalen and ultraviolet A light. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 16:118-120. [PMID: 27723448 DOI: 10.2450/2016.0117-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/06/2016] [Indexed: 11/21/2022]
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23
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Abe H, Shiba M, Niibe Y, Tadokoro K, Satake M. Reduction of bacteria and human immunodeficiency virus Type 1 infectivity of platelet suspension in plasma using xenon flash-pulse light in a bench-scale trial. Transfusion 2016; 56:2256-66. [PMID: 27282889 DOI: 10.1111/trf.13685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/09/2016] [Accepted: 05/02/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Current pathogen reduction systems for platelet concentrates (PCs) require addition of chemical compounds and/or reduction of plasma content in PCs. We have investigated a new method using xenon (Xe) flash-pulse light without additional compounds or plasma replacement. STUDY DESIGN AND METHODS An aliquot of apheresis platelets (PLTs) in plasma inoculated with bacteria or human immunodeficiency virus Type 1 (HIV-1) was irradiated with Xe flash-pulse light (Xe flash phototreatment). Bacterial growth was monitored up to 6 days of storage, whereas HIV-1 infectivity was assayed just after treatment. Pairs of Xe flash-phototreated and untreated PCs were examined for PLT lesion during the storage period. RESULTS Under the current conditions, a low titer (1.8 colony-forming units [CFUs]/mL) of Staphylococcus aureus did not proliferate during the 6-day storage period, but grew in some cases at high-titer (24.0 CFUs/mL) inoculation. HIV-1 infectivity was reduced by 1.8 log. PLT recovery of the treated PCs was lower than untreated ones. An increase of mean PLT volume and glucose consumption, together with a decrease of hypotonic shock response and pH, were enhanced by the treatment. CD62P- and PAC-1-positive PLTs increased after the treatment, indicating the induction of PLT activation. Among biologic response modifiers, soluble CD40 ligand was significantly increased in the treated PCs on Day 6. CONCLUSIONS Xe flash phototreatment could prevent bacterial proliferation and reduce HIV-1 infectivity in 100% plasma PCs without any additional compounds, but enhanced PLT storage lesions. Further improvement is required to increase the potency of pathogen inactivation with reducing PLT damage.
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Affiliation(s)
- Hideki Abe
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan.
| | - Masayuki Shiba
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | | | - Kenji Tadokoro
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
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24
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Abstract
A goal of platelet storage is to maintain the quality of platelets from the point of donation to the point of transfusion - to suspend the aging process. This effort is judged by clinical and laboratory measures with varying degrees of success. Recent work gives encouragement that platelets can be maintained ex vivo beyond the current 5 -7 day shelf life whilst maintaining their quality, as measured by posttransfusion recovery and survival. However, additional measures are needed to validate the development of technologies that may further reduce the aging of stored platelets, or enhance their hemostatic properties.
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Affiliation(s)
- Peter A Smethurst
- a Components Development Laboratory, NHS Blood and Transplant, Cambridge, UK, and Department of Haematology , University of Cambridge , Cambridge , UK
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25
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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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