1
|
Vinković M, Hećimović A, Jukić I, Vuk T. Aggregates in apheresis-derived platelet concentrates: A 5-year single-centre experience. Vox Sang 2024; 119:686-692. [PMID: 38629266 DOI: 10.1111/vox.13637] [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: 12/05/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND AND OBJECTIVES The phenomenon of aggregates in apheresis-derived platelet concentrates (APCs) has not yet been fully elucidated. Initially, visible aggregates (IVA) usually dissolve within 24 h after collection, but some persist till the end of the shelf life (persistent aggregates, PA). A study conducted at the Croatian Institute of Transfusion Medicine aimed to identify factors that influence the aggregate occurrence in APCs. MATERIALS AND METHODS We conducted a cross-sectional study for the 2018-2022 period and collected data on APCs with IVA. We analysed APCs discarded due to PA separately for two apheresis technologies and compared them to the control group. RESULTS Significantly more donations were discarded in the IVA group compared with the control group and total number of discarded APCs. A total of 205 APCs were discarded due to PA (14.7% of IVA APCs and 1.27% of all APCs collected). Amicus APCs with PA had a significantly lower platelet count and mean platelet volume. They were obtained by procedures with less anticoagulant used. In contrast to Amicus APCs, Haemonetics APCs with PA had a significantly higher platelet count. None of the donor-related factors examined was predictive of PA. CONCLUSION APCs with IVA are more often discarded, not only due to aggregates, but also for impairment of other quality control parameters. Type of apheresis technology, being one of the most common risk factors for IVA, was not confirmed as the main risk factor for PA. There seem to be some donor-related causal factors.
Collapse
Affiliation(s)
- Matea Vinković
- Research and Development Department, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ana Hećimović
- Medical Division, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Irena Jukić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Medical Division, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Tomislav Vuk
- Quality Management Division, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| |
Collapse
|
2
|
Castillo-Aleman YM, Lumame S, Castelo C, Mir R, Ventura-Carmenate Y, Al-Kaabi FM. Recurrent clumping in the extracorporeal photopheresis circuit using acid citrate dextrose solution A. J Clin Apher 2024; 39:e22117. [PMID: 38661254 DOI: 10.1002/jca.22117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/04/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Affiliation(s)
- Yandy Marx Castillo-Aleman
- Department of Immunology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
- Apheresis Unit, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
| | - Shinnette Lumame
- Apheresis Unit, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
| | - Charisma Castelo
- Apheresis Unit, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
| | - Ruqqia Mir
- Department of Neurology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
| | - Yendry Ventura-Carmenate
- Department of Immunology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
- Apheresis Unit, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi, United Arab Emirates
| | | |
Collapse
|
3
|
Kutac D, Bohonek M, Landova L, Staskova E, Blahutova M, Malikova I, Slouf M, Horacek JM, Stansbury LG, Hess JR, Seghatchian J. Cryopreservation of apheresis platelets treated with riboflavin and UV light. Transfus Apher Sci 2022; 62:103580. [PMID: 36167613 DOI: 10.1016/j.transci.2022.103580] [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: 07/05/2022] [Revised: 08/23/2022] [Accepted: 09/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Pathogen reduction technology (PRT) is increasingly used in the preparation of platelets for therapeutic transfusion. As the Czech Republic considers PRT, we asked what effects PRT may have on the recovery and function of platelets after cryopreservation (CP), which we use in both military and civilian blood settings. STUDY DESIGN AND METHODS 16 Group O apheresis platelets units were treated with PRT (Mirasol, Terumo BCT, USA) before freezing; 15 similarly collected units were frozen without PRT as controls. All units were processed with 5-6% DMSO, frozen at - 80 °C, stored > 14 days, and reconstituted in thawed AB plasma. After reconstitution, all units were assessed for: platelet count, mean platelet volume (MPV), platelet recovery, thromboelastography, thrombin generation time, endogenous thrombin potential (ETP), glucose, lactate, pH, pO2, pCO2, HCO3, CD41, CD42b, CD62, Annexin V, CCL5, CD62P, and aggregates > 2 mm and selected units for Kunicki score. RESULTS PRT treated platelet units had lower platelet number (247 vs 278 ×109/U), reduced thromboelastographic MA (38 vs 62 mm) and demonstrated aggregates compared to untreated platelets. Plasma coagulation functions were largely unchanged. CONCLUSIONS Samples from PRT units showed reduced platelet number, reduced function greater than the reduced number would cause, and aggregates. While the platelet numbers are sufficient to meet the European standard, marked platelets activation with weak clot strength suggest reduced effectiveness.
Collapse
Affiliation(s)
- Dominik Kutac
- Department of Hematology and Blood Transfusion, Military University Hospital Prague, Czech Republic; Department of Military Internal Medicine and Military Hygiene, Faculty of Military Health Sciences, University of Defence in Brno, Hradec Kralove, Czech Republic.
| | - Milos Bohonek
- Department of Hematology and Blood Transfusion, Military University Hospital Prague, Czech Republic; Faculty of Biomedical Engineering, Czech Technical University in Prague, Czech Republic
| | - Ludmila Landova
- Department of Hematology and Blood Transfusion, Military University Hospital Prague, Czech Republic
| | - Eva Staskova
- Department of Hematology and Blood Transfusion, Military University Hospital Prague, Czech Republic
| | - Marie Blahutova
- Department of Hematology and Blood Transfusion, Military University Hospital Prague, Czech Republic
| | - Ivana Malikova
- Institute of Medical Biochemistry and Laboratory Diagnostics, Faculty of Medicine, Charles University of Prague and the General University Hospital in Prague, Czech Republic
| | - Miroslav Slouf
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Czech Republic
| | - Jan M Horacek
- Department of Internal Medicine IV - Hematology, University Hospital Hradec Kralove, Czech Republic
| | - Lynn G Stansbury
- Harborview Injury Prevention Research Center, Harborview Medical Center, Seattle, WA, USA; Department of Anesthesia and Pain Medicine, University of Washington, Seattle, WA, USA
| | - John R Hess
- Harborview Injury Prevention Research Center, Harborview Medical Center, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Jerard Seghatchian
- International Consultancy in Blood Components Quality/Safety, Audit/Inspection and DDR Strategy, London, UK
| |
Collapse
|
4
|
Assessment of apheresis platelets during 5 days of storage: A National Cancer Institute, Cairo University experience. Transfus Apher Sci 2021; 61:103327. [PMID: 34876357 DOI: 10.1016/j.transci.2021.103327] [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: 08/24/2021] [Revised: 10/31/2021] [Accepted: 11/22/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Platelet transfusion therapy is widely used to prevent hemorrhage in patients with thrombocytopenia and platelet disorders. The platelet concentrate (PC) quality is affected by increased storage time, as reflected in the decreased number of platelets, morphological changes, and impaired functions. This study aimed to analyze the impact of 5 days storage on platelets count and the expression of CD63, and Annexin V as activation markers during PC storage. METHODS Fifty PCs collected from single donors were tested for platelet count on days 0, 3, and 5 using a Sysmex blood counter. CD61, CD63, and Annexin V expression was analyzed by a multicolor Navios flow cytometer. RESULTS There was a significant decrease in platelet count during 5 days of storage. There was a direct relationship between storage time and degree of platelet activation. CD63 had almost double increased expression on day 5 than day 3. Annexin V showed significantly increased expression on day 3 with minor differences between days 3 and 5. CONCLUSION According to standard blood bank conditions, PC stored for 5 days showed a degree of in vitro activation as evidenced by CD63 and Annexin V expression, may lead to reduced therapeutic efficacy. Flow cytometry monitoring platelet activation in PC offers a better understanding of the changes during PC storage and may help improve platelet products.
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Six KR, Sicot G, Devloo R, Feys HB, Baruch D, Compernolle V. A comparison of haematopoietic stem cells from umbilical cord blood and peripheral blood for platelet production in a microfluidic device. Vox Sang 2019; 114:330-339. [PMID: 30900265 PMCID: PMC6850637 DOI: 10.1111/vox.12776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/31/2019] [Accepted: 03/02/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Several sources of haematopoietic stem cells have been used for static culture of megakaryocytes to produce platelets in vitro. This study compares and characterizes platelets produced in shear flow using precursor cells from either umbilical (UCB) or adult peripheral blood (PB). MATERIALS AND METHODS The efficiency of platelet production of the cultured cells was studied after perfusion in custom-built von Willebrand factor-coated microfluidic flow chambers. Platelet receptor expression and morphology were investigated by flow cytometry and microscopy, respectively. RESULTS Proliferation of stem cells isolated out of UCB was significantly higher (P < 0·0001) compared to PB. Differentiation of these cells towards megakaryocytes was significantly lower from PB compared to UCB where the fraction of CD42b/CD41 double positive events was 44 ± 9% versus 76 ± 11%, respectively (P < 0·0001). However, in vitro platelet production under hydrodynamic conditions was more efficient with 7·4 platelet-like particles per input cell from PB compared to 4·2 from UCB (P = 0·02). The percentage of events positive for CD42b, CD41 and CD61 was comparable between both stem cell sources. The mean number of receptors per platelet from UCB and PB was similar to that on blood bank platelets with on average 28 000 CD42b, 57 000 CD61 and 5500 CD49b receptors. Microscopy revealed platelets appearing similar to blood bank platelets in morphology, size and actin cytoskeleton, alongside smaller fragments and source megakaryocytes. CONCLUSION This characterization study suggests that platelets produced in vitro under flow either from UCB or from PB share receptor expression and morphology with donor platelets stored in the blood bank.
Collapse
Affiliation(s)
- Katrijn R Six
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Rosalie Devloo
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dominique Baruch
- PlatOD, Paris, France.,INSERM, UMR_S1140, University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Veerle Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Blood Services, Belgian Red Cross-Flanders, Mechelen, Belgium
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Collection, storage, inspection and quality control of platelet concentrates obtained by apheresis: The situation in Spain. Transfus Apher Sci 2017; 56:357-361. [DOI: 10.1016/j.transci.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 11/22/2022]
|
9
|
Feys HB, Pottel H, Coene J, Vandewalle G, Vandekerckhove P, Compernolle V. Persistent aggregates in apheresis platelet concentrates are commonly collected from donors with a history of aggregate donation. Vox Sang 2016; 111:431-433. [PMID: 27509321 DOI: 10.1111/vox.12437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/09/2016] [Accepted: 06/30/2016] [Indexed: 11/29/2022]
Abstract
Platelet apheresis sometimes causes persistent aggregates (PA). This study (n = 211) shows that changing the apheresis settings to reach fixed product volumes instead of yields does not influence PA incidence, even though PA products on average contain more platelets than controls. Furthermore, logistic regression was used to model if PA can be predicted on the basis of certain predonation parameters. PA donation history was the only parameter retained, proving a strong determinant of predictability [AUC = 0.735 (SE = 0.022)]. Consequently, donations from a donor with previous PA history are 7.8 times more likely to contain PA than from a donor without preceding history.
Collapse
Affiliation(s)
- H B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - H Pottel
- Department of Public Health and Primary Care, KU Leuven, KULAK, Kortrijk, Belgium
| | - J Coene
- Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
| | - G Vandewalle
- Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
| | - P Vandekerckhove
- Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - V Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
10
|
Feys HB, Van Aelst B, Devloo R, Vandekerckhove P, Compernolle V. The contribution of von Willebrand factor-GPIbα interactions to persistent aggregate formation in apheresis platelet concentrates. Vox Sang 2015; 110:344-51. [PMID: 26646710 DOI: 10.1111/vox.12365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/05/2015] [Accepted: 10/14/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Apheresis platelet concentrates sometimes contain persistent aggregates (PA). Because apheresis involves extracorporeal circulation, we hypothesized that interactions between GPIbα and von Willebrand factor (VWF) underlie their origin. MATERIALS AND METHODS Platelets in donations with PA were compared to aggregate-free (AF) controls. Flow cytometry was used to determine platelet bound VWF. Degranulation was measured using P-selectin expression in flow cytometry and cytokine release using immunosorbent assays. Platelet adhesion to VWF was assessed in hydrodynamic flow and real-time video microscopy. RESULTS Platelets in PA concentrates had significantly more (P = 0·009, n ≥ 8) bound VWF compared to AF platelets, but differences in VWF concentration, VWF collagen binding, activated VWF or GPIbα expression were not found. Degranulation was higher (P = 0·030, n = 7) in PA than AF concentrates on day 1 of storage, but adhesion to immobilized VWF under hydrodynamic flow conditions was normal at that moment. On day 6, however, significantly less VWF adhesion (P = 0·009, n ≥ 6) was found for PA platelets compared to AF, indicating accelerated storage lesion in PA products. In a model that mimicks PA formation by chemically induced binding of VWF to platelets, we found that degranulation, phosphatidylserine expression and metabolism did not differ with paired controls at any time during subsequent storage. CONCLUSION Accelerated storage lesion is found in concentrates with PA, but this cannot be explained solely by increased platelet bound VWF following apheresis. Therefore, additional stressors are probably responsible for the increases observed in platelet degranulation and storage lesion in products with PA.
Collapse
Affiliation(s)
- H B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - B Van Aelst
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - R Devloo
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | - P Vandekerckhove
- Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.,Department of Public Health and Primary Care, Catholic University of Leuven, Leuven, Belgium
| | - V Compernolle
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium.,Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, University of Ghent, Ghent, Belgium
| |
Collapse
|