Paired comparison of platelet concentrates prepared from platelet‐rich plasma and buffy coats using a new technique with¹¹¹In and⁵¹Cr

Abstract

Two techniques for the preparation of platelet concentrate (PC), the standard platelet-rich plasma (PRP) and buffy coat (BC) methods, were compared in nine paired studies with regard to platelet harvest, white cell (WBC) contamination, and PC quality after 5 days of 22 degrees C storage. Platelet harvest using the BC method averaged approximately 56 percent of the whole blood level (6.2 x 10(10)/concentrate), which was less than the 76 percent achieved with the PRP-PC method (8.7 x 10(10)/concentrate). An additional 5 units collected into an experimental siphon bag for BC-PC processing showed improved platelet harvest (6.7 x 10(10)/concentrate, or approx. 70% of whole blood). WBCs remaining in the BC-PC averaged 0.19 x 10(8) per unit compared to 3.6 x 10(8) per unit for PRP-PC. Buffy coat processing produced red cell (RBC) units with 50 percent of the WBC contamination of conventionally prepared units (9.8 +/- 6.2 x 10(8)/unit vs. 18.9 +/- 7.1 x 10(8)/unit). The siphon bag further reduced WBC levels in the AS-3 RBC units (6.4 +/- 3.7 x 10(8)/unit). In vitro studies performed on Days 1 and 5 after collection showed no significant differences in platelet metabolic and biologic function or cell integrity. Beta-thromboglobulin and surface glycoprotein levels, indicators of platelet activation and membrane alteration, respectively, did not differ significantly in the PRP-PC and BC-PC; nor was lactate production higher in PRP-PC, despite the substantially higher WBC counts. Autologous in vivo platelet viability determinations were performed by using concurrent transfusion of 111In-labeled freshly drawn platelets and 51Cr-labeled stored platelets.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro Properties of Platelet Concentrates

“…However, during the storage time of PC these differences diminished [12]. Thus, it is not surprising that no relevant differences could be found in clinical studies comparing in vivo recovery and survival of transfused PRP-PC and BC-PC after storage for 5 days [17]. Investigations with fresh PC probably might show differences.…”

Evidence-Based Platelet Transfusion Guidelines

“…Comparative studies have shown no difference in the quality of these plt concentrates when they are stored for up to 7 days. 3,4 However, there is emerging evidence that, when plts are stored for extended time periods, the method of plt collection and the storage media influence post-transfusion plt viability. [5][6][7] The hard-spinning of the plts against a red cell layer in the BC method versus against the bottom of the bag in the PRP method, requiring resuspension of the plts, may induce a collection injury that could potentially compromise the long-term storage of PRP plts compared with BC plts.…”

“…11 There is a substantial increase in costs for singledonor compared with pooled random donor plts. As the quality of apheresis plts is similar to pooled random-donor plt concentrates, 3,4 these two products can be used interchangeably based on availability and cost considerations. 12 …”

“…Prophylactic plt transfusions Three aspects of prophylactic plt transfusions can be controlled by the physician: (1) whether to provide prophylactic plt transfusions to patients with chronic thrombocytopenia; (2) what plt count should initiate a plt transfusion (i.e., what is the appropriate plt transfusion trigger); and (3) what dose of plts should be used. 19 Are prophylactic plt transfusions necessary?…”

Are All Leucodepleted Platelet Concentrates Equivalent?

“…All the above influence platelet storage stability. While the quality and storage stability of PCs prepared from platelet–rich plasma, BCs and apheresis have been investigated [1, 2, 3, 4], no comparative study on leucodepleted PCs prepared from the above methods has been reported. Moreover, it is difficult to ascertain whether the changes observed during storage are related to the collection, processing, e.g.…”