Platelet Transfusion—Insights from Current Practice to Future Development

Pathogen reduction technologies (PRTs) such as Mirasol and Intercept were developed to eliminate transfusion-transmitted infections. The impact of PRTs on platelet function during the storage period, their effect on platelet storage lesions, and the optimal storage duration following PRTs have not been clearly defined. The aim of this study was to systematically review the existing literature and investigate the impact of PRTs on functional alterations of PRT-treated platelets during the storage period. The authors identified 68 studies suitable to be included in this review. Despite the high heterogeneity in the literature, the results of the published studies indicate that PRTs may increase platelet metabolic activity, accelerate cell apoptosis, and enhance platelet activation, which can subsequently lead to a late exhaustion of activation potential and reduced aggregation response. However, these effects have a minor impact on platelet function during the early storage period and become more prominent beyond the fifth day of the storage period. Large in vivo trials are required to evaluate the effectiveness of PRT-treated platelets during the storage period and investigate whether their storage can be safely extended to more than 5 days, and up to the traditional 7-day storage period.

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“…Consequently, comparisons between published results and recommendations are difficult and require caution. 5 74…”

Section: Discussionmentioning

confidence: 99%

Pathogen Reduction Technologies and Their Impact on Metabolic and Functional Properties of Treated Platelet Concentrates: A Systematic Review

Tsalas

Petrou

Tsantes

et al. 2022

Semin Thromb Hemost

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“…PAS‐stored platelets offer a number of advantages, including a lower risk of SARs 10 . As a low plasma content in PCs is a requirement for some pathogen inactivation processes, optimization of PAS has become a focus of interest 9–11,26–28 . Although differences are apparent, both platelets stored in PAS and plasma comply with transfusion standards.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the soluble proteins HMGB1, CD40L and CD62P during various platelet preparation processes and the storage of platelet concentrates: The BEST collaborative study

et al. 2022

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Background Structural and biochemical changes in stored platelets are influenced by collection and processing methods. This international study investigates the effects of platelet (PLT) processing and storage conditions on HMGB1, sCD40L, and sCD62P protein levels in platelet concentrate supernatants (PCs). Study Design/Methods PC supernatants (n = 3748) were collected by each international centre using identical centrifugation methods (n = 9) and tested centrally using the ELISA/Luminex platform. Apheresis versus the buffy coat (BC‐PC) method, plasma storage versus PAS and RT storage versus cold (4°C) were investigated. We focused on PC preparation collecting samples during early (RT: day 1–3; cold: day 1–5) and late (RT: day 4–7; cold: day 7–10) storage time points. Results HMGB1, sCD40L, and sCD62P concentrations were similar during early storage periods, regardless of storage solution (BC‐PC plasma and BC‐PC PAS‐E) or temperature. During storage and without PAS, sCD40L and CD62P in BC‐PC supernatants increased significantly (+33% and +41%, respectively) depending on storage temperature (22 vs. 4°C). However, without PAS‐E, levels decreased significantly (−31% and −20%, respectively), depending on storage temperature (22 vs. 4°C). Contrastingly, the processing method appeared to have greater impact on HMGB1 release versus storage duration. These data highlight increases in these parameters during storage and differences between preparation methods and storage temperatures. Conclusions The HMGB1 release mechanism/intracellular pathways appear to differ from sCD62P and sCD40L. The extent to which these differences affect patient outcomes, particularly post‐transfusion platelet increment and adverse events, warrants further investigation in clinical trials with various therapeutic indications.

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“…We observe that a number of these papers are already viewed at a high rate and even cited, supporting the value of this article series. For this issue, we acquired one original research article [1] and 13 reviews [2][3][4][5][6][7][8][9][10][11][12][13][14] that are shortly introduced below.…”

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confidence: 99%

“…Finally, the major dilemma of managing antithrombotic therapy with anticoagulants and/or antiplatelet agents in thrombocytopenic cancer patients who are often at high risk of both thromboembolic and bleeding complications is discussed. The authors also refer to the need for platelet transfusions in specific situations (see also the review by Capraru et al [14], mentioned below).…”

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confidence: 99%

“…Capraru, Jalowiec, Medri, Daskalakis, Zeerleder, and Taleghani review the current state of platelet transfusion and provide an outlook on ongoing and future developments from the perspective of transfusion medicine [14]. The authors explain the differences between apheresis platelet concentrates from single donors and pooled platelet concentrates from buffy coat or platelet-rich plasma.…”

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confidence: 99%

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