In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion

Pérez-Ferrer, Antonio; Suay, R. Navarro; Viejo-Llorente, Aurora; Alcaide-Martin, M. J.; Vicente-Sánchez, J. de; Butta, Nora; Lobón, Jose M. de Prádena y; Povo-Castilla, Javier

doi:10.1016/j.thromres.2015.05.031

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…Very apparent differences in haemostatic potential between fresh and frozen PLT were observed by Pérez‐Ferrer et al . They mimicked a transfusion using WB samples from patients with very low PLT count (13 x 10 9 /l).…”

Section: Whole Blood Donations and Blood Componentsmentioning

confidence: 92%

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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Section: Whole Blood Donations and Blood Componentsmentioning

confidence: 92%

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

2019

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“…(Fig. 2), was calculated to accommodate Hook's law [9,10]. MCE platelets, which reflects actual platelet contribution to clot strength, was calculated as FIBTEM-MCE subtracted from EXTEM-MCE [9,10].…”

Section: Rotem Measurementsmentioning

confidence: 99%

“…2), was calculated to accommodate Hook's law [9,10]. MCE platelets, which reflects actual platelet contribution to clot strength, was calculated as FIBTEM-MCE subtracted from EXTEM-MCE [9,10]. Clot elasticity is considered to reflect actual force with which the clot resists the rotation in the ROTEM device, whereas clot amplitude is contributed not only by clot elasticity but also by clot viscosity.…”

Section: Rotem Measurementsmentioning

confidence: 99%

Hypothermic circulatory arrest induced coagulopathy: rotational thromboelastometry analysis

Ise

Kuwabara

Oyama

et al. 2020

Gen Thorac Cardiovasc Surg

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Objectives Hypothermic circulatory arrest (HCA) has been considered to cause coagulopathy during cardiac surgery. However, coagulopathy associated with HCA has not been understood clearly in details. The objective of this study is to analyze the details of coagulopathy related to HCA in cardiac surgery by using rotational thromboelastometry (ROTEM). Methods We retrospectively analyzed 38 patients who underwent elective cardiac surgery (HCA group = 12, non-HCA group = 26) in our hospital. Blood samples were collected before and after cardiopulmonary bypass (CPB). Standard laboratory tests (SLTs) and ROTEM were performed. We performed four ROTEM assays (EXTEM, INTEM, HEPTEM and FIBTEM) and analyzed the following ROTEM parameters: clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF) and maximum clot elasticity (MCE). The amount of perioperative bleeding, intraoperative transfusion and perioperative data were compared between the HCA and non-HCA group. Results Operation time and hemostatic time were significantly longer in the HCA group, whereas CPB time had no difference between the groups. The amount of perioperative bleeding and intraoperative transfusion were much higher in the HCA group. SLTs showed no difference between the groups both after anesthesia induction and after protamine reversal. In ROTEM analysis, MCE contributed by platelet was reduced in the HCA group, whereas MCE contributed by fibrinogen had no difference. Conclusion Our study confirmed that the amount of perioperative bleeding and intraoperative transfusion were significantly higher in the HCA group. ROTEM analysis would indicate that clot firmness contributed by platelet component is reduced by HCA in cardiac surgery.

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“…It has also recently been reported that frozen and thawed platelets showed reduced surface expression of GPIIb and GPIbα and diminished aggregation response to agonists [25]. In a more recent study designed to evaluate the in vitro hemostatic efficacy of frozen versus fresh platelet transfusions by rotational thromboelastometry, a dual effect in frozen platelet transfusion was found: a hypercoagulable state (shortening of clotting time) and a more predominant impairment of frozen platelet functions when compared to fresh platelets (shorter maximum clot firmness/maximum clot elasticity and longer clot formation time) [26]. …”

Section: Discussionmentioning

confidence: 99%

Generation of Platelet Microparticles after Cryopreservation of Apheresis Platelet Concentrates Contributes to Hemostatic Activity

Eker¹,

Çeti̇nkaya²,

Pekel³

et al. 2017

Tjh

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Objective:In the last decade, substantial evidence has accumulated about the use of cryopreserved platelet concentrates, especially in trauma. However, little reference has been made in these studies to the morphological and functional changes of platelets. Recently platelets have been shown to be activated by cryopreservation processes and to undergo procoagulant membrane changes resulting in the generation of platelet-derived microparticles (PMPs), platelet degranulation, and release of platelet-derived growth factors (PDGFs). We assessed the viabilities and the PMP and PDGF levels of cryopreserved platelets, and their relation with thrombin generation.Materials and Methods:Apheresis platelet concentrates (APCs) from 20 donors were stored for 1 day and cryopreserved with 6% dimethyl sulfoxide. Cryopreserved APCs were kept at -80 °C for 1 day. Thawed APCs (100 mL) were diluted with 20 mL of autologous plasma and specimens were analyzed for viabilities and PMPs by flow cytometry, for thrombin generation by calibrated automated thrombogram, and for PDGFs by enzyme-linked immunosorbent assay testing.Results:The mean PMP and PDGF levels in freeze-thawed APCs were significantly higher (2763±399.4/µL vs. 319.9±80.5/µL, p<0.001 and 550.9±73.6 pg/mL vs. 96.5±49 pg/mL, p<0.001, respectively), but the viability rates were significantly lower (68.2±13.7% vs. 94±7.5%, p<0.001) than those of fresh APCs. The mean endogenous thrombin potential (ETP) of freeze-thawed APCs was significantly higher than that of the fresh APCs (3406.1±430.4 nM.min vs. 2757.6±485.7 nM.min, p<0.001). Moreover, there was a significant positive poor correlation between ETP levels and PMP levels (r=0.192, p=0.014).Conclusion:Our results showed that, after cryopreservation, while levels of PMPs were increasing, significantly higher and earlier thrombin formation was occurring in the samples analyzed despite the significant decrease in viability. Considering the damage caused by the freezing process and the scarcity of evidence for their in vivo superiority, frozen platelets should be considered for use in austere environments, reserving fresh platelets for prophylactic use in blood banks.

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In vitro thromboelastometric evaluation of the efficacy of frozen platelet transfusion

Cited by 9 publications

References 34 publications

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

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

Hypothermic circulatory arrest induced coagulopathy: rotational thromboelastometry analysis

Generation of Platelet Microparticles after Cryopreservation of Apheresis Platelet Concentrates Contributes to Hemostatic Activity

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