Donor variation in stored platelets: Higher metabolic rates of platelets are associated with mean platelet volume, activation and donor health

Abstract

Background Platelets (PLTs) differ in glycolytic activity, resulting in rapid acidification of ‘poor’ storing PLT concentrates (PCs) in plasma, or depletion of glucose when stored in PLT additive solution (PAS). We aimed to understand why PLT glycolysis rates vary between donors and how this affects storage performance. Study Design and Methods Buffy coats from donors <45, 45–70 and >70 years were selected and single‐donor PCs in plasma or PAS‐E were prepared. PCs were stored for 8 days at 22 ± 2°C and sampled regularly for analysis. Mitochondrial activity was analyzed with an Oroboros oxygraph. Age groups, or subgroups divided into quartiles based on glucose consumption, were analyzed with ANOVA. Results In each comparison, PCs of the different groups were not different in volume and cellular composition. PLTs with the highest glucose consumption had a higher initial mean platelet volume (MPV) and developed higher CD62P expression and Annexin A5 binding during storage. Higher glycolytic activity in these PLTs was not a compensation for lower mitochondrial ATP production, because mitochondrial ATP‐linked respiration of fresh PLTs correlated positively with MPV (R2 = 0.71). Donors of high glucose‐consuming PLTs had more health‐related issues. Storage properties of PCs from donors over 70 were not significantly different compared to PCs from donors younger than 45 years. Conclusions High glucose‐consuming PCs developing higher activation levels, not only displayed enhanced mitochondrial activity but were also found to contain larger PLTs, as determined by MPV. Storage performance of PLTs was found to be associated with donor health, but not with donor age.

The role of sodium citrate during extended cold storage of platelets in platelet additive solutions

“…However, to address this particular question, a greater number of donations would need to be investigated, which could be categorized as good (pH >6.4) or poor (pH <6.4) storers. Interestingly, ‘poor’ storage has recently been associated with glycolytic metabolism, 55 which is dampened during cold storage, so it remains to be seen which donor factors may be important in determining platelet quality during cold storage.…”

The impact of donor biological variation on the quality and function of cold‐stored platelets

“…There are already reported known links between donor's sex, age and body weight, and post-transfusion patient outcome [22]. Storage performance of platelet has previously been associated with donor health and lifestyle, and higher glucose consuming platelets are impacted by donor BMI [31]. Specifically, increased BMI may lead to changes in platelet characteristics [38,39].…”

“…Platelets from older males have a reportedly different metabolome compared with those obtained from females and younger males, implying increased energy metabolism [29]. Lastly, collection time may also be a factor impacting platelet activation state among apheresis donors [30], and it is widely accepted that donor characteristics influence room temperature storage [25, 31, 32].…”