Evaluation of a new citrate‐acetate‐NaCl platelet additive solution for the storage of white cell‐reduced platelet concentrates obtained from half‐strength CPD pooled buffy coats

111

121

Randomized studies testing the clinical efficacy of platelet additive solutions (PASs) for storage of platelets are scarce and often biased by patient selection. We conducted a multicenter, randomized study to investigate clinical efficacy of platelets stored in PAS II versus plasma, also including patients with clinical complications associated with increased platelet consumption. A total of 168 evaluable patients received pooled buffy coatderived platelet concentrates (PCs) suspended in either plasma (n ‫؍‬ 354) or PAS II (n ‫؍‬ 411) stored up to 5 days. Both univariate as well as multivariate analysis showed a significant effect of used storage medium in regard to 1-and 24-hour count increments and corrected count increments, in favor of plasma PCs. However, there were no significant differences between the groups regarding bleeding complications and transfusion interval. Adverse transfusion reactions occurred significantly less after transfusions with PAS II PCs (P ‫؍‬ .04). Multivariate analysis showed no significant effect of the used storage medium on the incidence of 1-and 24-hour transfusion failure. We showed safety and efficacy of PAS II PCs in intensively treated patients; however, plasma PCs show superior increments. (Blood. 2006;108:3210-3215)

Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 69%

A multicenter randomized study of the efficacy of transfusions with platelets stored in platelet additive solution II versus plasma

Kerkhoffs

Eikenboom

Schipperus

et al. 2006

111

121

“…No differences were observed, consistent with previously reported experience using T-Sol-plasma mixtures. 18 There was no statistically significant difference between test and reference populations with respect to duration of the first period of platelet support or total duration of platelet support ( Table 4). The average interval between platelet transfusions was computed for the first period of platelet transfusion, because all patients (n ϭ 103) underwent the first period of platelet support, and it was not significantly different for test and reference patients (Table 4).…”

Section: Platelet Count Increments 24 Hours Following Transfusion Andmentioning

confidence: 90%

“…18 PRP platelets are stored in 100% donor plasma as individual concentrates rather than as pools in a mixture of plasma with platelet additive solution. Therefore, PRP platelets prepared with photochemical treatment for pathogen inactivation may potentially demonstrate differences in clinical efficacy.…”

Section: Discussionmentioning

confidence: 99%

Transfusion of pooled buffy coat platelet components prepared with photochemical pathogen inactivation treatment: the euroSPRITE trial

Rhenen

Gulliksson

Cazenave

et al. 2002

290

444

A nucleic acid-targeted photochemical treatment (PCT) using amotosalen HCl (S-59) and ultraviolet A (UVA) light was developed to inactivate viruses, bacteria, protozoa, and leukocytes in platelet components. We conducted a controlled, randomized, double-blinded trial in thrombocytopenic patients requiring repeated platelet transfusions for up to 56 days of support to evaluate the therapeutic efficacy and safety of platelet components prepared with the buffy coat method using this pathogen inactivation process. A total of 103 patients received one or more transfusions of either PCT test (311 transfusions) or conventional reference (256 transfusions) pooled, leukoreduced platelet components stored for up to 5 days before transfusion. More than 50% of the PCT platelet components were stored for 4 to 5 days prior to transfusion. The mean 1-hour corrected count increment for up to the first 8 test and reference transfusions was not statistically significantly different between treatment groups (13 100 ؎ 5400 vs 14 900 ؎ 6200, P ‫؍‬ .11). By longitudinal regression analysis for all transfusions, equal doses of test and reference components did not differ significantly with respect to the 1-hour (95% confidence interval [CI], ؊3.1 to 6.1 ؋ 10 9 / L, P ‫؍‬ .53) and 24-hour (95% CI, ؊1.3 to 6.5 ؋ 10 9 /L, P ‫؍‬ .19) posttransfusion platelet count. Platelet transfusion dose, pretransfusion storage duration, and patient size were significant covariates (P < .001) for posttransfusion platelet counts. Clinical hemostasis, hemorrhagic adverse events, and overall adverse events were not different between the treatment groups. Platelet components prepared with PCT offer the potential to further improve the safety of platelet transfusion using technology compatible with current methods to prepare buffy coat platelet components. (Blood. 2003;101: 2426-2433)

“…Plasmalyte was selected as it was FDA licensed for intravenous use, it had previously been used for platelet storage, and no FDA-licensed PAS solutions were currently available. [21][22][23][24][25][26] Unfortunately, many of our studies were completed before the FDA's post-torage viability criteria were formulated, and therefore a variety of control platelets were used. Because there was little, if any, difference between 1-day stored and fresh platelet viabilities (Table 1), if either of these platelets were used as controls, FDA poststorage viability criteria were evaluated for the test PAS platelets.…”

Section: Discussionmentioning

confidence: 99%

Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS)

Slichter

Corson

Jones

et al. 2014

• Extended apheresis platelet storage is dependent on the collection method, storage in a storage solution, and storage bag composition.• The lifespan of the platelet is not intrinsic to the cell, and platelet viability is better maintained in vitro than in vivo.To evaluate the poststorage viability of apheresis platelets stored for up to 18 days in 80% platelet additive solution (PAS)/20% plasma, 117 healthy subjects donated platelets using the Haemonetics MCS1, COBE Spectra (Spectra), or Trima Accel (Trima) systems. Control platelets from the same subjects were compared with their stored test PAS platelets by radiolabeling their stored and control platelets with either 51 chromium or 111 indium. Trima platelets met Food and Drug Administration poststorage platelet viability criteria for only 7 days vs almost 13 days for Haemonetics platelets; ie, platelet recoveries after these storage times averaged 44 6 3% vs 49 6 3% and survivals were 5.4 6 0.3 vs 4.6 6 0.3 days, respectively. The differences in storage duration are likely related to both the collection system and the storage bag. The Spectra and Trima platelets were hyperconcentrated during collection, and PAS was added, whereas the Haemonetics platelets were elutriated with PAS, which may have resulted in less collection injury. When Spectra and Trima platelets were stored in Haemonetics' bags, poststorage viability was significantly improved. Platelet viability is better maintained in vitro than in vivo, allowing substantial increases in platelet storage times. However, implementation will require resolution of potential bacterial overgrowth during storage. (Blood. 2014;123(2):271-280)