Haemostatic profile of riboflavin-treated apheresis platelet concentrates.
Eleni PetrouGeorgios K. NikolopoulosAnastasios G. KriebardisKaterina PantavouElectra LoukopoulouAndreas G. TsantesHara Τ. GeorgatzakouEirini MaratouEvdoxia RaptiS. MellouStyliani KokorisArgyri GialerakiArgirios Ε. Tsantes
5
Citation
45
Reference
10
Related Paper
Citation Trend
Abstract:
The haemostatic activity of platelet concentrates (PCs) treated with pathogen reduction technology (PRT) remains a subject of debate. Our aim was to investigate the effect of Mirasol PRT on the haemostatic properties of PCs stored in plasma.Untreated and Mirasol-treated platelets stored in plasma and derived from ten split double-dose apheresis PCs were evaluated in vitro on days 1, 3 and 5 post collection for functionality, microparticle procoagulation activity (MPA), endogenous thrombin potential (ETP), and haemostatic profile using rotational thromboelastometry (ROTEM).P-selectin expression was significantly higher in Mirasol-treated platelets compared with untreated counterparts on days 3 and 5 (p=0.003 and p=0.002, respectively). Clot strength, as shown by EXTEM maximum clot firmness (MCF), was significantly lower in the Mirasol-treated platelets at all time points (days 1, 3, 5) than in untreated platelets (p=0.009, p<0.001, p<0.001, respectively). There was a considerable increase in MPA over time (p<0.001) and this was significantly higher in the Mirasol-treated platelets on day 5 (p=0.015). A notable acceleration of decrease in ETP values was observed for Mirasol-treated PCs over time (p<0.001), with significant differences between PRT-treated and untreated PCs on days 3 and 5 (p=0.038 and p=0.019, respectively). Clot strength attenuation was significantly associated with pH reduction (p<0.001, Spearman's rho: 0.84), increased microparticle procoagulant activity (p<0.001, Spearman's rho: -0.75), and with decreased ETP (p<0.032, Spearman's rho: 0.41).Increased platelet activation induced by PRT treatment leads to a decrease in in vitro haemostatic capacity as seen by reduced clot strength and thrombin generation capacity over time. The clinical relevance of this needs to be investigated.Keywords:
Thromboelastometry
Pathogen inactivation methods for platelet concentrates are increasingly being used in blood banks worldwide. In vitro studies have demonstrated its effects on storage lesion, but little routine quality control data on blood banking outcomes have been reported.Swirling of distributed products was monitored before and after implementation of Intercept pathogen inactivation. Metabolic parameters pH, glucose and lactic acid were determined in a random cohort of expired pathogen-inactivated products. Storage lesion indicators in apheresis concentrates with premature low swirling were compared to concentrates with normal swirling.During validation for implementing Intercept pathogen inactivation, pH and glucose levels decreased faster in apheresis platelet concentrates with high platelet content than with low platelet content or than in pathogen-inactivated pooled buffy coat-derived products. In routine products, glucose exhaustion was more often found in apheresis compared to buffy coat-derived platelet concentrates despite 3-7% more plasma carryover in the former. Annual incidence of premature low swirling increased significantly by 50% following implementation of pathogen inactivation implementation for apheresis but not for pooled buffy coat platelet concentrates. In addition, apheresis concentrates with premature low swirling had a significantly higher median platelet count (5·0 × 1011 ) than unaffected products (3·5 × 1011 ).The risk of increased storage lesion rates following Intercept pathogen inactivation is higher for apheresis than for buffy coat-derived platelet concentrates, especially when platelet contents are higher than 5·0 × 1011 .
Buffy coat
Plateletpheresis
Platelet concentrate
Cite
Citations (14)
Thromboelastometry
Fresh frozen plasma
Clotting time
Platelet Transfusion
Coagulation testing
Thromboelastography
Cite
Citations (10)
Plateletpheresis
Platelet Transfusion
Platelet concentrate
Cite
Citations (8)
Background: Platelet transfusion leaves many problems and controversies such as short storage times, high risk of contamination, poor therapeutic response and often results in transfusion reactions. Transfusion reactions are associated with platelet storage lesion. Increased storage lesions will increase the biological response modifiers such as soluble cluster of differentiation 40 ligand (sCD40L). Soluble CD40L is associated with febrile, allergic and TRALI transfusion reactions. Given the negative impact of sCD40L, it is essential to analyze the level of sCD40L in platelets. Methods: This type of research was an analytical observational study. Samples were 10 thrombocytes of whole blood and apheresis on the first, second and third days of storage. Two milliliters of the product was centrifuged and plasma sCD40L was examined using the BioVendor ELISA method. Data were analyzed using the SPSS version 25 software. Results: The mean sCD40L level in thrombocyte apheresis based on storage times were 4.36±1.34 ng/mL (Day-1), 6.87±1.75ng/mL (Day-2), and 7.27±2.21 ng/mL (Day-3), while the mean sCD40L level in whole blood thrombocyte were 8.36±3.77 ng/mL (Day-1), 9.42±2.58 ng/mL (Day-2) and 11.10±4.02 ng/mL (Day-3). There were no significant differences in storage times in both groups (P>0.05). However, the mean sCD40L level in thrombocyte whole blood tended to be higher than the mean sCD40L level in thrombocyte apheresis. There was a significant positive correlation between storage times and sCD40L levels in the thrombocyte apheresis group (r = 0.549; P <0.05). ANOVA test suggested a statistically significant difference between storage times in TC Apheresis (P < 0.05). Conclusion: The mean sCD40L level in whole blood thrombocyte was higher than thrombocyte apheresis. There was a significant positive correlation and a statistically significant difference between storage times and sCD40L levels in thrombocyte apheresis.
Blood product
Blood bank
Cite
Citations (5)
Abstract Background Recent studies characterizing in vitro hemostatic properties of whole blood (WB) leukoreduced (LR) with a platelet‐sparing filter have described subtle, if any, changes to viscoelastic clotting; however, reductions in platelet (PLT) content and impedance aggregometry (IA) responses have been noted. The effects of filtration of WB (i.e., filter‐contact effects, reduction in platelet and leukocyte count) have not been rigorously investigated as to their individual impacts on platelet IA responses. Study Design and Methods WB units from healthy donors were collected and characterized to assess the effects of platelet‐sparing leukoreduction (LR) upon the in vitro hemostatic measures of platelet IA and thromboelastometry. Further characterization of platelet IA responses was carried out in WB samples to delineate the effects of platelet count and leukocyte presence/absence upon the response. Results WB filtration reduced the platelet count and IA responses but had no impact on viscoelastic clotting measures in fresh WB. Experiments revealed that IA responses have a linear correlation with platelet count in both apheresis platelets and WB and that passage of platelets through the WB‐LR filter has no impact upon the strength of this response. Further experiments in LR WB showed that addition of autologous leukocytes back to the platelets fully restored the platelet aggregation response to pre‐filtration levels. Conclusion WB filtration results in platelet count reduction and leukocyte removal; however, platelet IA is not degraded by passage through the filter. Apparent declines in platelet IA responses can be fully attributed to the reduction in platelet count and the removal of leukocytes.
Leukoreduction
Thromboelastometry
Clotting time
Filtration (mathematics)
Cite
Citations (1)
Objective To explore the influence of routine storage or cryopreservation on platelet function. Methods Ten units of platelets were collected by single donator apheresis. Each one was divided into 2 equal parts which were preserved with routine storage and cryopreservation respectively. The samples of platelet were respectively collected on each day during the 5 days' routine storage and before and after 5 days of cryopreservation. The platelet aggregative rate, platelet count and pH value were detected with routine methods. The expression of P selectin on the platelet samples was measured by flow cytometry. Results In routine storage group, the platelet aggregative rate, platelet count and pH value had no change in the 5 days, and the expression of P selectin increased significantly from 3.77±1.86 to 10.87±4.75 ( P 0.01) on the first day of storage and remained higher levels thereafter. In the cryopreservation group, no change was found in the parameters mentioned above, and the expression of P selectin was found to increase significantly from 4.37±1.82 to 16.88±7.23 ( P 0.01) after cryopreservation. Conclusion The expression of P selectin on platelets is found to increase after collection under either the routine storage or cryopreservation, and thus it can be regarded as a sensitive marker for platelet activation.
P-selectin
Cite
Citations (0)
Purpose of review Platelet concentrates may be prepared from whole blood or by plateletpheresis. Currently, the non-evidence-based preponderance of apheresis units in the United States and the 50: 50 ratio in Europe may not optimize the gifts of whole-blood donors or minimize healthcare costs. Post-storage pooled, whole-blood-derived platelets, on the other hand, do not provide the convenience of or an equivalent level of safety as apheresis platelets. Recent findings Some data suggest that different methods of manufacture of whole-blood-derived platelets (platelet-rich plasma or buffy coat intermediate steps) result in differing degrees of platelet activation, which may impact on the quality of stored concentrates. Recent studies have observed superior radiolabel recovery and post-transfusion increments for platelets derived from apheresis compared with platelet-rich plasma whole-blood-derived platelets. A pre-storage pooling system for whole-blood-derived platelets has just been licensed in the USA, and may eventually combine the benefits of apheresis-derived and whole-blood-derived platelets. The advantages of the European method of manufacture of buffy coat whole-blood-derived platelet concentrate have convinced the Canadian Blood Services to abandon platelet-rich-plasma-derived concentrates. Summary We present a literature-based review of the relative merits of apheresis-derived and whole-blood-derived platelets. Additional studies are needed in order to define the optimal proportion of the platelet supply from apheresis collections and the choice of whole-blood-derived production method for US blood providers.
Buffy coat
Plateletpheresis
Transfusion medicine
Platelet Transfusion
Cite
Citations (109)
Objective To compare the clinical effectiveness of whole blood derived platelets and apheresis platelets in children with hematological diseases.Methods Children were divided into two groups: apheresis platelet group(463 children) and whole-blood-derived platelet group(155 children).The platelet corrected count increment(CCI),percentage platelet recovery(PPR),the incidence rate of post-transfusion refractoriness to platelets(PTR) and adverse reaction were observed and assayed at 24,48 and 72hours after transfusion.Results In the apheresis platelet group,CCI and PPR at 24,48,and 72 hours after transfusion were significantly higher(P0.01),which were 18.9% and 15.4%,14.1% and 33.4%,27.8% and 25.0%,respectively.The incidence rate of PTR and adverse reaction in apheresis group were 10.58% and 3.02%,respectively,which were lower than those of whole-blood-derived platelet group.Both groups could achieve hemostasis quickly.Conclusion Apheresis platelets have higher CCI,and low incidence rate of PTR and less adverse transfusion reaction,compared to whole blood derived platelet concentrates.
Platelet Transfusion
Cite
Citations (0)
Buffy coat
Platelet Transfusion
Cite
Citations (17)
Methods of platelet preparation may alter the recovery and survival characteristics of platelets following transfusion. As suggested by a recent clinical trial, platelet recovery may be better preserved with apheresis platelet preparations than with platelets prepared from whole blood by the platelet-rich plasma (PRP) method.In vivo platelet recovery and survival of autologous leukoreduced (LR) apheresis platelets and autologous filter-LR PRP platelets were compared in 22 healthy volunteers using a paired crossover design. On the same day, each participant gave one apheresis platelet donation and one whole blood donation from which platelets were recovered from the PRP. The sequence of donations was randomly assigned for each participant. Following 5 days of storage and bacterial screening, a sample from each platelet product was labeled with either (51)chromium or (111)indium (randomly assigned) and both samples were simultaneously re-infused into the original donor. Recovery and gamma-function platelet survival were calculated for each platelet product using the multiple hit mathematical model.Five day stored LR-apheresis platelets had 18.8 percent better recovery, and 32.9 percent longer gamma-survival than filter-LR PRP platelets. Stored apheresis platelets had lower p-selectin expression and higher morphology scores than stored PRP platelets.Filter-LR PRP platelet preparation appears to adversely affect platelet recovery and survival characteristics. The reasons for this effect are not clear. These results may not apply to all apheresis and PRP methods of platelet preparation.
Blood product
Plateletpheresis
Platelet Transfusion
Cite
Citations (44)