Use of prostaglandin E₁ during preparation of platelet concentrates

Abstract

A paired study in 10 autologous volunteer donors was undertaken to investigate the efficacy of adding prostaglandin E1 (PGE1) in vitro during routine platelet concentrate (PC) production. After 5 days storage, PCs prepared with PGE1 were compared with control PCs. In vivo platelet recovery, survival and biodistribution were determined following autologous infusion of indium-111 labelled platelets into volunteers, together with the in vitro evaluation of platelet function and biochemistry. PGE1 facilitated easier and faster platelet resuspension following centrifugation. After storage there were few significant in vitro differences between PCs prepared with PGE1 and control PCs. The artifactual leucocyte concentration was significantly lower in the presence of PGE1, suggesting less platelet aggregates had been formed during storage and beta-thromboglobulin release was significantly reduced by PGE1, 14.0 +/- 6.0 micrograms per 10(9) platelets compared with 22.3 +/- 9.8 micrograms per 10(9) platelets in control PCs, (P < 0.01), indicating PGE1 reduced both platelet aggregation and activation probably at the initial preparation stage, known to produce the greatest trauma. Initial in vivo platelet recovery for PCs prepared with PGE1 was similar to that of control PCs, 41.1 +/- 12.5% vs. 44.4 +/- 8.0%, respectively, and there were no differences in organ distribution at 24 h. However, in vivo multiple hit survival was reduced in the presence of PGE1, 5.8 +/- 1.6 days compared with 6.9 +/- 1.4 days in control PCs (P < 0.05). Despite the ability of PGE1 to facilitate platelet resuspension and inhibit platelet aggregation and activation during preparation of the PCs, the reduced in vivo survival time may preclude the use of PGE1 during routine PC preparation.

Residual aggregates in platelet products: what do we know?

“…The results suggested less PLT aggregate formation during storage as well as easier and faster PLT resuspension after centrifugation. However, due to the measured reduction in in vivo survival in this study, this concept was not further pursued in routine production . If visible aggregates are present after the collection, it could be beneficial to rest the PLTs at least for 1 h without agitation, with the bag label‐side down followed by subsequent agitation for at least another hour (likewise with the bag label‐side down).…”

Effects of Prostaglandin E1on the Preparation of Platelet Concentrates in Dogs

“…To treat hemostatic abnormalities caused by thrombocytopenia, thrombocytopathy, or both, platelets in PGE 1 ‐treated PC should act normally after transfusion. The inhibitory effect of PGE 1 on platelets is considered to be reversible, but it was necessary to confirm the reversibility in vitro before a PGE 1 ‐treated PC transfusion is performed. In this study, the collagen‐ or ADP‐induced platelet aggregation was clearly inhibited by PGE 1 treatment.…”

“…However, it is difficult to resuspend platelet pellets following the high‐speed centrifugation caused by platelet activation. Platelet activation during PC preparation contributes to the development of platelet storage lesions and decreased platelet viability . It is therefore important to develop a method to minimize platelet activation during the preparation of PC.…”

“…Prostaglandin E 1 (PGE 1 ) is a reversible inhibitor of platelet activation because of its ability to increase cyclic AMP levels within the platelets . Although early studies showed that the addition of PGE 1 to human PRP facilitated the separation, concentration, and resuspension of platelets, there have been no studies of the effects of PGE 1 on the preparation of PC in dogs. The aim of this study was to investigate the efficacy of adding PGE 1 during PC preparation.…”

Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage

“…Prostaglandin E1 (PGE1) inhibits platelet aggregation during storage that is reversed when the platelets are resuspended in a PGE1 free media . However, earlier studies found reduced in vivo survival of PGE1 treated platelets after 5 days of storage, and note that the inhibitory effects of PGE1 are lost after 5 days of storage . Other reversible inhibitors of platelet activation have been investigated, including GPIIb‐IIIa blockade, a polyphenol derived from green tea, nitric oxide, and the phosphodiesterase inhibitor theophylline …”