A rest period before agitation may improve some in vitro apheresis platelet parameters during storage

Skripchenko, Andrey; Myrup, Andrew; Awatefe, Helen; Thompson-Montgomery, Dedeene; Wagner, Stephen J.

doi:10.1111/j.1537-2995.2011.03493.x

Cited by 19 publications

(20 citation statements)

References 28 publications

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“…As such, in order to obtain platelet units for research only, apheresis requires special administrative permission and is excessively costly (~$1,000 per unit), Nonetheless, it has been demonstrated that centrifugation has a similar effect in terms of platelet activation and aggregation when compared to apheresis suggesting these two methods of collection are comparable. (38,39) Moreover, in terms of mitochondrial oxygen consumption, our preliminary results showed that by day 5 of storage, platelets donated by apheresis demonstrated were similar to the units processed by centrifugation. Secondly, the volume of the platelet concentrates were approximately 80 mL per unit, which is greatly different from the standard platelet transfusion unit.…”

Section: Discussionmentioning

confidence: 60%

Increased platelet storage time is associated with mitochondrial dysfunction and impaired platelet function

Villarroel

Figueredo

Guan

et al. 2013

Journal of Surgical Research

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Background Hemorrhagic shock is a leading cause of death following severe trauma and platelet transfusions are frequently necessary to achieve hemostasis. Platelets, however, require special storage conditions and storage time has been associated with loss of platelet quality. We hypothesized that standard storage conditions have a deleterious effect on platelet mitochondrial function and platelet activation. Materials and methods Platelet donations were collected from healthy donors (n=5), and stored in gas permeable collection bags according to American Association of Blood Bank recommendations. Platelet units were sampled from day of collection (day 0) until day 7. High resolution respirometry was used to assess baseline mitochondrial respiration, maximal oxygen utilization, and individual mitochondrial complex-dependent respiration. FACS was performed to analyze mitochondrial content, mitochondrial reactive oxygen species (ROS), the expression of P-selectin (both before and after challenge with thrombin receptor activating peptide (SFLLRN)), and apoptosis. Data was analyzed using ANOVA and Pearson’s correlation (p<0.05 significant). Results Mitochondrial respiration decreased significantly in platelets stored longer than 2 days (p<0.05). Platelets also demonstrated a persistent decrease in response to stimulation with SFLLRN by the 3rd day of storage (p<0.05) as well as an increase in mitochondrial ROS and apoptosis (p<0.05). Mitochondrial respiration significantly correlated with platelet capacity to activate (r=0.8, p<0.05). Conclusion Platelet mitochondrial respiratory function and activation response decrease significantly in platelets stored for 3 or more days. Because platelet transfusions almost universally occur between the 3rd and 5th day of storage, our findings may have significant clinical importance and warrant further in vivo analysis.

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Section: Discussionmentioning

confidence: 60%

Increased platelet storage time is associated with mitochondrial dysfunction and impaired platelet function

Villarroel

Figueredo

Guan

et al. 2013

Journal of Surgical Research

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“…Nevertheless, with 30 patients in the prasugrel group, this precision was 11%, quite close to the planned precision. Second, we used freshly prepared PRP and the quality of platelets may differ from that of allogenic platelet concentrates [40]. Finally, the ability of non-inhibited platelet supplementation to overcome ADP-Agg max in patients treated with ticagrelor was one of this study's secondary objectives and it cannot be ruled out that the absence of a significant effect from platelet supplementation in this group might be due to a lack of power.…”

Section: Discussionmentioning

confidence: 98%

Impact of non-inhibited platelet supplementation on platelet reactivity in patients treated with prasugrel or ticagrelor for an acute coronary syndrome: An ex vivo study

et al. 2015

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Managing bleeding in patients receiving P2Y12 inhibitors is challenging. Few data are available regarding the efficacy of platelet transfusion in patients treated with prasugrel or ticagrelor. The aim of this study was to evaluate the minimal amount of platelet supplementation (in terms of ratio of non-inhibited platelets to inhibited platelets) necessary to restore platelet reactivity in platelet-rich plasma (PRP) of patients treated with aspirin and a prasugrel or ticagrelor loading dose for an acute coronary syndrome. PRP samples from patients were mixed ex vivo with increasing proportions of pooled PRP from healthy volunteers. Platelet reactivity was challenged with adenosine diphosphate (ADP), arachidonic acid, collagen or thrombin receptor activating peptide using light transmission aggregometry. The primary endpoint was the proportion of patient samples recovering an ADP-induced maximal aggregation (ADP-Aggmax) value above 40%. In patients treated with prasugrel (n = 32), ADP-Aggmax increased progressively with supplements of pooled PRP, with an average increase of 7.9% (95% CI [7.1; 8.8], p < 0.001) per each 20% increase in the ratio of non-inhibited platelets to inhibited platelets. A ratio of 60% was associated with 90% of patients reaching the primary endpoint. In patients treated with ticagrelor (n = 15), ADP-Aggmax did not significantly increase with any level of supplements. In conclusions, ex vivo addition of non-inhibited platelets significantly improved ADP-Aggmax in patients treated with prasugrel with a dose-dependent effect. There was no evidence of such a reversal in patients treated with ticagrelor. These results suggest that platelet transfusion may be more effective in blunting bleeding in patients treated with prasugrel, than those treated with ticagrelor.

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“…A previous study of aliquots of Amicus PLTs held with and without rest by Skripchenko and colleagues 6 found that rest periods improve PLT morphology (% disc), ESC, and mean levels of CD42b. Whether a rest period enables full resuspension of Amicus units with aggregates could not be determined from the limited number of units utilized in that evaluation.…”

Section: Discussionmentioning

confidence: 94%

“…The extent of improvement of these three variables increased with extending the rest period from 1 hour to 6 hours. Interestingly, these in vitro benefits of an initial rest period before storage were still evident after 5 days of storage 6 . The AABB technical manual and apheresis operating manuals are silent about rest periods; practices at blood centers and hospitals vary.…”

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confidence: 99%

A rest period does not affect in vitro storage properties in apheresis platelets collected from the buffy coat layer

2012

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BACKGROUND: A previous study demonstrated that several in vitro storage properties of apheresis platelets (PLTs) that are isolated by sedimentation against the collection container and subsequently resuspended can benefit from a rest period before continuous agitation. This study examines whether the in vitro storage properties of apheresis PLTs isolated by collection from the buffy coat layer benefit from a rest period before agitation. STUDY DESIGN AND METHODS: Freshly collected apheresis PLTs (Trima, GambroBCT) were divided into five 60‐mL aliquots. One aliquot was immediately placed on a flat‐bed agitator; the other aliquots were held on a laboratory bench for 1, 2, 4, and 6 hours before continuous agitation. Samples were obtained on Days 1, 5, and 7 for standard in vitro PLT assays. The experiment was repeated 12 times. RESULTS: For each sampling day, no significant differences were observed in aliquots held with or without a rest period for any of the following PLT properties: PLT content, mean PLT volume, pH, pCO2, bicarbonate, glucose, lactate, hypotonic shock response, extent of shape change, aggregation, morphology, CD62P, CD63, and CD42b. Although regression analysis identified several in vitro properties whose mean levels appeared to improve with increasing length of the rest period, maximum differences in mean levels were small (<6%). CONCLUSION: The in vitro storage properties of Trima apheresis PLTs isolated from the buffy coat layer do not benefit from a rest period.

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A rest period before agitation may improve some in vitro apheresis platelet parameters during storage

Abstract: A rest period from 1 to 6 hours may improve some but not all in vitro PLT storage parameters.

Cited by 19 publications

References 28 publications

Increased platelet storage time is associated with mitochondrial dysfunction and impaired platelet function

Increased platelet storage time is associated with mitochondrial dysfunction and impaired platelet function

Impact of non-inhibited platelet supplementation on platelet reactivity in patients treated with prasugrel or ticagrelor for an acute coronary syndrome: An ex vivo study

A rest period does not affect in vitro storage properties in apheresis platelets collected from the buffy coat layer

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