High platelet content can increase storage lesion rates following Intercept pathogen inactivation primarily in platelet concentrates prepared by apheresis

Abstract

Background Pathogen inactivation methods for platelet concentrates are increasingly being used in blood banks worldwide. In vitro studies have demonstrated its effects on storage lesion, but little routine quality control data on blood banking outcomes have been reported. Materials and MethodsSwirling of distributed products was monitored before and after implementation of Intercept pathogen inactivation. Metabolic parameters pH, glucose and lactic acid were determined in a random cohort of expired pathogen-inactivated products. Storage lesion indicators in apheresis concentrates with premature low swirling were compared to concentrates with normal swirling.Results During validation for implementing Intercept pathogen inactivation, pH and glucose levels decreased faster in apheresis platelet concentrates with high platelet content than with low platelet content or than in pathogen-inactivated pooled buffy coat-derived products. In routine products, glucose exhaustion was more often found in apheresis compared to buffy coat-derived platelet concentrates despite 3-7% more plasma carryover in the former. Annual incidence of premature low swirling increased significantly by 50% following implementation of pathogen inactivation implementation for apheresis but not for pooled buffy coat platelet concentrates. In addition, apheresis concentrates with premature low swirling had a significantly higher median platelet count (5Á0 9 10 11 ) than unaffected products (3Á5 9 10 11 ). ConclusionThe risk of increased storage lesion rates following Intercept pathogen inactivation is higher for apheresis than for buffy coat-derived platelet concentrates, especially when platelet contents are higher than 5Á0 9 10 11 .

Quality control in veterinary blood banks: evaluation of canine platelet concentrates stored for five days

“…Similar findings were reported in human PC, with the report of significant differences in glucose, lactate, pH, pCO 2 , bicarbonate and ATP values in PC with high platelet counts on day 5 of storage [15]. Another study also reported a faster decrease of swirling, pH and glucose values in PC with high platelet counts when compared with those with lower platelet counts [16]. Our data on PDW and MPV indicate that platelets in the PC with lower than average counts may present less swelling and lower fragmentation rates.…”

“…Our data on PDW and MPV indicate that platelets in the PC with lower than average counts may present less swelling and lower fragmentation rates. When PC contains a high number of platelets per volume, oxygen is consumed faster, and the metabolic pathway used by platelets becomes anaerobic with consequent lactate production and decrease in pH [15,16]. Still, a higher plasma volume per bag increases the transfusion volume and the risk of transfusion reactions [7,9].…”

Comparison of three commercially available buffy coat pooling sets for the preparation of platelet concentrates

“…Platelets produced by the TER pooling sets did have an increased lactic acid production rate. This may follow the platelet concentration and/or content because we previously showed that PI treatment can increase storage lesion when the platelet number is high [2,12]. Whether this underlies the difference in lactic acid found in this study is not clear.…”

“…Platelet yield and platelet quality were determined at different time-points during and after PC preparation. The primary criteria for PC prepared by each of these pooling sets were (1) effective leucocyte depletion (<10 6 leucocytes per unit), (2) compatibility with the available equipment including separators, centrifuges and PI sets and (3) fulfil all criteria for transfusable PI-treated platelets as set by the Blood Service.…”

Non-ionizing 405 nm Light as a Potential Bactericidal Technology for Platelet Safety: Evaluation of in vitro Bacterial Inactivation and in vivo Platelet Recovery in Severe Combined Immunodeficient Mice

“…There are two additional systems commonly studied: Mirasol (TerumoBCT, USA), approved for use in other countries, which combines riboflavin and broad-spectrum UV light (265-370 nm); and Theraflex UV Platelets (Macopharma, France), currently under development using 254 nm UV-C light (10,11). However, available PRTs do affect product quality in vitro and function in vivo, following transfusion (12)(13)(14). The ideal PRT would be relatively inexpensive, simple to implement and, with no or minimal effect on the quality or efficacy of the transfusion product (15).…”