Comparison of haemostatic function of <scp>PAS</scp>‐C–platelets vs. plasma–platelets in reconstituted whole blood using impedance aggregometry and thromboelastography

Hout, Fabienne M.A. van; Bontekoe, Ido J.; Laleijne, L. A. E. de; Kerkhoffs, J.L.; Korte, Dirk de; Eikenboom, Jeroen; Bom, Johanna G. van der; Meer, Pieter F. van der

doi:10.1111/vox.12534

Cited by 11 publications

(8 citation statements)

References 29 publications

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“…The observation that most articles reporting CSPs suspended in plasma alone showed higher hemostatic activity than RTP controls whereas CSPs stored in plasma plus PAS were usually no different than RTP controls is similar to that reported by Van Hout et al 53 in vitro. In this article, whole blood was reconstituted using components: RBCs, plasma, and either RTPs in plasma alone or RTPs suspended in plasma and PAS (30:70).…”

Section: Discussionsupporting

confidence: 82%

“…47 Conversely, the addition of PAS to plasma not only may result in reduced hemostatic function of CSPs but also increases the crystalloid volume transfused during the resuscitation, potentially resulting in inferior clinical outcomes. 53 The observation of no consistent trend between time to cold storage and CSP hemostatic activity versus RTPs is consistent with the outcome of a recent study that was published after the searches for this review were performed. This study reported that refrigeration of platelets after 4 days' storage at room temperature can restore hemostatic function to a comparable level as CSP cooled the day after collection.…”

Section: Discussionsupporting

confidence: 80%

“…Response to agonists was reduced in whole blood reconstituted using RTPs in plasma plus PAS compared to RTPs in plasma alone. 53 It has also been shown in CSPs that the addition of PAS to plasma reduces aggregate formation in the storage bag as well as fibrin crosslinking within the clot in vitro. 40,41 This result may be due to reduced binding of factor XIIIa and fibrinogen in CSPs suspended in plasma plus PAS compared to plasma alone.…”

Section: Discussionmentioning

confidence: 99%

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Manufacturing variables and hemostatic function of cold‐stored platelets: a systematic review of the literature

et al. 2019

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ABBREVIATIONS: APs = apheresis-derived platelets; BT = bleeding time; CSPs = cold-stored platelets; PAS = platelet additive solution; PRP = platelet-rich plasma; RTPs = room temperature platelets; TCPs = temperature-cycled platelets; WBD = whole bloodderived. From theOf the 33 short-listed articles that met the eligibility criteria, CSPs were compared to RTPs in 28 (85%) and to temperaturecycled platelets (TCPs) in two (6%). 37,48 No CSP comparisons were performed in three (9%) of the articles. 17,22,47 A total of EndNote CSPs Full-text Fig. 1. Results from the literature searches, screening, and fulltext review.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Manufacturing variables and hemostatic function of cold‐stored platelets: a systematic review of the literature

et al. 2019

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“…Storage lesions of PLT concentrates were assessed [13-15,21,55-,57] during 7-13 days of storage ( Table 2). In most cases, tests were performed by dilution with a plasma T, R Pooled, plasma, 22 or 30°C, 8 days Table 2 Johansson 2008 [55] T Pooled, PAS-B, RT, 7 days Table 2 Middelburg 2013 [56] T Pooled, plasma, riboflavin, RT, 7 days Riboflavin: MA↓ Table 2 Van Hout 2017 [57] T Pooled, plasma/ PAS-C, RT, 13 days pool to a fixed PLT concentration. Experiments showed, in general, increasing clotting rates and clot strength when PLT concentration was raised and the opposite when samples were diluted.…”

Section: Platelet Concentrates: Storage Lesion Of Fresh Plateletsmentioning

confidence: 99%

Thromboelastography as a tool to evaluate blood of healthy volunteers and blood component quality: a review

2019

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Thromboelastography is a technique to evaluate the overall coagulation behaviour of blood and blood components. First, we evaluated the literature concerning the use of thromboelastography for characterizing coagulation behaviour of healthy volunteers, such as blood donors. Overall coagulation is sensitive to gender, most likely caused by the difference in haematocrit and plasma content of male versus female blood. Smaller and less pronounced effects in thromboelastographic response are caused by differences in fibrinogen level or by use of oral contraceptives. Short‐term hypercoagulable effects are observed after smoking or blood donation, while small effects of non‐steroidal anti‐inflammatory drugs on platelets are also present. Second, in whole blood donations, the thromboelastographic variables are also sensitive to storage time and temperature, but are less sensitive to levels of clotting factors. Platelet count and quality have little influence on thromboelastographic variables, and differences are mainly observed at counts <100x109/l, after extended storage time of platelet concentrates or storage under specific conditions, including freezing. Thromboelastographic profiles of plasma samples are mainly affected by residual cell counts, microparticles and fibrinogen levels, and less by levels of clotting factors. Taken together, publications have shown that as an overall clotting test, thromboelastography may support optimization of blood component preparation and storage with regard to temperature, time and secondary and tertiary treatments. Minimal deviations of in vitro quality are most reliable demonstrated when an appropriate assay is chosen.

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“…While the above example is purely mathematical and needs further clinical confirmation, in vitro studies showed that the dilution effect of platelets in PAS may be true, or at least warrants further investigation. Van Hout et al [32] reconstituted whole blood and used either platelets stored in plasma or in PAS-C. Their in vitro study showed that platelet aggregation responses as measured with the Multiplate aggregation assay with ADP and TRAP as stimulus declined during 7 days of storage and were always lower in PASstored platelets; collagen and ristocetin responses also declined over time, but no difference was seen between plasma-or PASstored platelets. Thromboelastographic parameters (measured with the TEG device), showing the overall ability of this reconstituted whole blood to clot, were not affected.…”

Section: Clinical Outcomes In Surgical Patientsmentioning

confidence: 99%

Platelet Additive Solutions: A Review of the Latest Developments and Their Clinical Implications

Meer

Korte²

2018

Transfus Med Hemother

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Platelet additive solutions (PASs) have undergone many reformulations in order to further improve platelet storage. Studies of platelets stored in PAS-F (containing acetate, magnesium and potassium as key constituents) showed that platelets may be stored for 13 days with recovery and survival outcomes that are equal or even superior to 7-day stored platelets in plasma. Clinically, patients transfused with platelets in PAS have fewer allergic reactions, while for febrile reactions data are conflicting. Transfusion-related acute lung injury (TRALI) occurs less frequently if PAS is used for buffy coat-derived platelets, but for apheresis platelets there is no difference. For PAS-B and PAS-C, corrected count increments (CCIs) are lower than for platelets stored in plasma, but for PAS-E (like PAS-F also with acetate, magnesium and potassium but with additional phosphate), though limited data is available in the literature, the CCIs seem to be comparable to those observed for platelets in plasma. With platelets in PAS, there is an accumulated dilution effect of anticoagulant and PAS as well as a loss of number and function (due to storage and/or pathogen inactivation treatment) of platelets, of which it is not clear how this impacts clinical outcomes of patients undergoing massive transfusion. Worst-case in vitro studies, where the entire plasma fraction is replaced by supernatant of platelets in PAS, do show an effect on the ability of reconstituted whole blood to clot, but in a more realistic scenario, functional clotting parameters are not different. In this review, recent laboratory and clinical data are discussed, focusing on studies published after 2010.

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Comparison of haemostatic function of PAS‐C–platelets vs. plasma–platelets in reconstituted whole blood using impedance aggregometry and thromboelastography

Abstract: Our findings demonstrate that the function - aggregation and CD62P responsiveness - of PAS-C-platelets in reconstituted whole blood is inferior to that of plasma-platelets, which may have implications in the setting of massive transfusions.

Cited by 11 publications

References 29 publications

Manufacturing variables and hemostatic function of cold‐stored platelets: a systematic review of the literature

Manufacturing variables and hemostatic function of cold‐stored platelets: a systematic review of the literature

Thromboelastography as a tool to evaluate blood of healthy volunteers and blood component quality: a review

Platelet Additive Solutions: A Review of the Latest Developments and Their Clinical Implications

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