Platelet Activity in Washed Platelet Concentrates

Schoenfeld, Helge; Muhm, Manfred; Doepfmer, Ulrich R.; Exadaktylos, Aristomenis K.; Radtke, H.

doi:10.1213/01.ane.0000116930.28250.15

Cited by 33 publications

(29 citation statements)

References 20 publications

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“…Collagen is a stronger activator that is capable of aggregating partially damaged platelets. ADP, a much weaker agonist, failed to produce the same degree of ␣-degranulation (14).…”

Section: Discussionmentioning

confidence: 87%

“…Spontaneous, as well as ADP-and collageninduced, platelet CD62 (P-selectin; GMP-140) expression were analyzed by flow cytometry (FACscan; Becton Dickinson, Heidelberg, Germany), as described previously (14). The expression of CD62 is a result of activation of platelets and depends on the fusion of ␣-granules with the surface membrane of platelets.…”

Section: Methodsmentioning

confidence: 99%

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The Functional Integrity of Platelets in Volume-Reduced Platelet Concentrates

Schoenfeld¹,

Muhm²,

Doepfmer³

et al. 2005

Anesthesia & Analgesia

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Premature and low-birth-weight infants usually require small-volume platelet transfusions to treat thrombocytopenia. Also, infants undergoing open-heart surgery with extracorporeal circulation and with compromised cardiac function are at risk for excessive intravascular volume. The small-volume platelet substitution can be achieved by dispensing an aliquot from the unit of a standard single-donor platelet concentrate (PC). Alternatively, there is an indication for volume reduction of PCs to maximize the number of platelets transfused in the smallest possible volume. We determined the spontaneous and induced activation of platelets before and after volume reduction in 20 consecutive single-donor-apheresis PCs. After a mean storage time of 2 days, the PCs were plasma-depleted by centrifugation. Spontaneous, adenosine diphosphate (ADP)-induced, and collagen-induced activation were determined by flow cytometry. Furthermore, ADP- and collagen-induced aggregation were measured. A total of 33.8% of platelets in standard PCs were activated spontaneously. Volume reduction of PCs led to a mild but significant increase of spontaneous activation of platelets (43.2%). Additionally, volume reduction resulted in an impaired ADP-induced aggregability of platelets, whereas collagen induction was unaffected. Transfusion of volume-reduced PCs is an effective alternative to use of standard PCs in patients at frequent risk for excessive intravascular volume, because equal volumes increase the platelet count twice as effectively.

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“…Collagen is a stronger activator that is capable of aggregating partially damaged platelets. ADP, a much weaker agonist, failed to produce the same degree of ␣-degranulation (14).…”

Section: Discussionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

The Functional Integrity of Platelets in Volume-Reduced Platelet Concentrates

Schoenfeld¹,

Muhm²,

Doepfmer³

et al. 2005

Anesthesia & Analgesia

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“…Some hospitals elect to wash or volume reduce the incompatible plasma from the platelet PLT unit. Washing the PLT unit is effective in removing plasma proteins; however, it can potentially lead to decreased PLT function manifested by increased CD62 surface expression, a marker of PLT activation, and decreased PLT aggregatio n in vitro [17,18,19]. On the other hand, volume reduction of PLTs results in less PLT activation than washing but is not as effective in removing plasma proteins [19].…”

Section: Part 1: Plt Transfusion and Abo Compatibilitymentioning

confidence: 99%

Platelet Transfusion - the Art and Science of Compromise

Cid

Harm

Yazer

2013

Transfus Med Hemother

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Many modern therapies depend on platelet (PLT) transfusion support. PLTs have a 4- to 7-day shelf life and are frequently in short supply. In order to optimize the inventory PLTs are often transfused to adults without regard for ABO compatibility. Hemolytic reactions are infrequent despite the presence of ‘high titer' anti-A and anti-B antibodies in some of the units. Despite the low risk for hemolysis, some centers provide only ABO identical PLTs to their recipients; this practice might have other beneficial outcomes that remain to be proven. Strategies to mitigate the risk of hemolysis and the clinical and laboratory outcomes following ABO-matched and mismatched transfusions will be discussed. Although the PLTs themselves do not carry the D antigen, a small number of RBCs are also transfused with every PLT dose. The quantity of RBCs varies by the type of PLT preparation, and even a small quantity of D+ RBCs can alloimmunize a susceptible D- host. Thus PLT units are labeled as D+/-, and most transfusion services try to prevent the transfusion of D+ PLTs to D- females of childbearing age. A similar policy for patients with hematological diseases is controversial, and the elements and mechanisms of anti-D alloimmunization will be discussed.

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“…1,2 Also, PLTs are partially activated by the washing process, 3 losing some of their granule contents. 1 Inspection of the immediate product of PLT washing reveals solid masses of PLTs aggregated on the inner surface of the bag or broken fragments of those aggregates floating in the wash solution.…”

mentioning

confidence: 99%