Comparative in vitro evaluation of apheresis platelets stored with 100% plasma versus bicarbonated Ringer's solution with less than 5% plasma

Abstract

BACKGROUND: The major strategy for reducing the frequency of adverse reactions to platelet (PLT) transfusions is PLT washing with PLT additive solutions (PASs). In Japan, a mixture of medical infusion solutions such as acetate Ringer's solution, sodium bicarbonate, magnesium sulfate, and ACD‐A is currently used as a PAS because none of the common types of PASs are officially permitted for clinical use. Recently, a bicarbonated Ringer's solution (BRS) was developed using bicarbonate as an alkaline agent. The aim of this study was to evaluate whether a BRS can effectively be utilized as a PAS for clinical use. STUDY DESIGN AND METHODS: The washing and storage solution was prepared by adding 25 mL ACD‐A to 500 mL of BRS (BRS‐A), consisting of 95.2 mmol/L NaCl, 3.8 mmol/L KCl, 0.9 mmol/L MgCl2,1.4 mmol/L CaCl2, 26.6 mmol/L NaHCO3, 5.8 mmol/L glucose, 4.2 mmol/L trisodium citrate, and 1.8 mmol/L citric acid. The in vitro properties of apheresis PLTs suspended in BRS‐A with low concentration of plasma (<5%) were compared with those suspended in 100% plasma during 7‐day storage. RESULTS: The in vitro properties of pH, hypotonic shock response, glucose consumption rate, lactate production rate, swirling, CD62P, and CD42b expression in PLTs suspended in BRS‐A were comparable or superior to those suspended in 100% plasma during 7‐day storage. CONCLUSION: BRS‐A, prepared by mixing the only two solutions permitted for clinical use in Japan, has a positive capability to maintain PLT function. These results indicate that PLT washing and storage with BRS‐A is feasible.

Platelet storage media

“…The composition is described in Table . In a paired in vitro storage study, PLTs were stored in either BRS‐A with only 2·1 ± 0·7% plasma inclusion or in plasma, 100% plasma . The results suggested that in vitro properties (pH, HSR, rate of glycolysis, swirling, CD62P, and CD42b) were similar or even better as compared to the reference, 100% plasma.…”

Storage of apheresis platelet concentrates after manual replacement of >95% of plasma with PAS 5

“…More recently, Oikawa et al . studied a newly developed bicarbonated Ringer's solution as a PAS and found that standard in vitro PLT characteristics were comparable or superior to those suspended in 100% plasma during 7‐day storage. PAS 5, another recently developed PAS which is based on PAS III with added salts, bicarbonate and glucose, is prepared by combining three solutions at the time of use .…”

In vitro analysis of volume‐reduced washed platelet concentrates stored in bicarbonated Ringer's solution containing less than 5% residual plasma

“…The resulting BRS‐A additive solution contained 95 mmol/l NaCl, 3·8 mmol/l KCl, 0·9 mmol/l MgCl 2 , 1·4 mmol/l CaCl 2 , 26·6 NaHCO 3 , 5·8 mmol/l glucose, 4·2 mmol/l trisodium citrate and 2·4 mmol/l citric acid. The mixture was filter sterilized as previously described . The pH (37°C) range of BRS‐A immediately after preparation was approximately from 6·6 to 6·7.…”

“…Recently, a bicarbonated Ringer's solution (BRS) was developed using bicarbonate as an alkaline agent, which is commercially available in Japan. For preparing a PLT additive solution (PAS), BRS was supplemented with acid–citrate–dextrose formula A (ACD‐A) (BRS‐A), which has been reported to maintain the in vitro properties of PLTs with <5% residual plasma for 7‐day storage . BRS‐A can be prepared by mixing the only two solutions permitted for clinical use in Japan and was used as a washing and preservative solution in the present investigation.…”