Impairment of the hemostatic potential of platelets during storage as evaluated by flow cytometry, thrombin generation, and thrombelastography under conditions promoting formation of coated platelets

Svendsen, M.; Røjkjær, Rasmus; Kristensen, Annemarie T.; Salado-Jimena, José A; Kjalke, Marianne; Johansson, Pär I.

doi:10.1111/j.1537-2995.2007.01430.x

Cited by 32 publications

(35 citation statements)

References 37 publications

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“…While RT storage negatively impacts clot strength and enhances fibrinolysis compared to fresh platelets, significant loss of function was not seen in 4°C-stored samples. Specifically, TEG analysis indicates that despite pre-activation, RT-stored platelets result in the formation of weaker clots that are less resistant to fibrinolysis, probably due to low thrombin generation levels (54). The maintenance of hemostatic function in 4°C-stored platelets, as estimated by TEG, is in line with previous reports (20).…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Function of Apheresis Platelets Stored at 4°C and 22°C

Reddoch

Pidcoke

Montgomery

et al. 2014

Shock

231

326

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Introduction Platelet refrigeration decreases the risk of bacterial contamination and may preserve function better than standard-of-care room temperature storage. Benefits could include lower transfusion-related complications, decreased costs, improved hemostasis in acutely bleeding patients, and extended shelf-life. In this study, we compared the effects of 22°C and 4°C storage on the functional and activation status of apheresis platelets (APs). Methods APs (n = 5 per group) were stored for 5 days at 22°C with agitation (RT) versus at 4°C with agitation (4C+AG) and without (4C). Measurements included platelet counts, mean platelet volume, blood gas analytes, aggregation response, thromboelastography, TxB2 and sCD40L release, activation markers and microparticle formation. Results Sample pH levels were within acceptable limits for storage products (pH 6.2-7.4). Platelet glucose metabolism (P < 0.05), aggregation response (ADP: RT 0; 4C+AG 5.0 ± 0.8; 4C 5.6 ± 0.9; P < 0.05), and clot strength (MA: RT 58 ± 2; 4C+AG 63 ± 2; 4C 67 ± 2; P < 0.05) were better preserved at 4°C compared to RT storage. Refrigerated samples were more activated compared to RT (P < 0.05), although TxB2 (P < 0.05) and sCD40L release (P < 0.05) were higher at RT. Agitation did not improve the quality of 4°C-stored samples. Conclusion AP stored at 4°C maintain more viable metabolic characteristics, are hemostatically more effective, and release fewer pro-inflammatory mediators than AP stored at RT over 5 days. Given the superior bacteriologic safety of refrigerated products, these data suggest that cold-stored platelets may improve outcomes for acutely bleeding patients.

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Section: Discussionmentioning

confidence: 99%

Hemostatic Function of Apheresis Platelets Stored at 4°C and 22°C

Reddoch

Pidcoke

Montgomery

et al. 2014

Shock

231

326

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“…The MCF remained unaffected by increasing concentrations of phospholipids, and similar to observations gained from other experimental conditions the amplitude was independent of the type and concentration of activator. [7], the effect of vasoactive agents, platelet agonists, and anticoagulants [22,23], as well as assessment of storage of donor platelets [24]. Some studies have revealed that different types of activators provide different results in various clinical scenarios, such as e.g.…”

Section: Phospholipid Titration Studies (Figure 3 Panel A-c)mentioning

confidence: 99%

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

et al. 2010

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Introduction: Renewed interest has arisen in the use of thromboelastography/thromboelastometry in evaluating coagulation kinetics. The test medium, type of activator and its concentration may influence the interpretation of coagulation kinetics. This study aimed to investigate methodological influences of activator and test medium on thromboelastometric parameters of coagulation kinetics. Methods: Dynamic clot formation was evaluated by thromboelastometry using whole blood (WB), platelet rich plasma or platelet poor plasma employing different concentrations of extrinsic (tissue factor) and contact activator (synthasil) and with variable concentrations of phospholipids. Results: Plasma samples displayed prolonged clot initiation and enhanced clot propagation compared to WB. Clot firmness was markedly reduced in platelet poor plasma as compared to platelet rich plasma and whole blood. Increasing concentration of activator shortened the clot initiation and increased the velocity of clot propagation whereas terminal clot firmness remained unaffected. Platelets accelerated clot propagation and raised clot firmness. Phospholipids shortened the time of clot initiation and increased velocity of propagation, while clot firmness remained unchanged. Conclusion: Our results demonstrate that evaluation of coagulation kinetics using thromboelastometry vary according to the composition of the test medium, type-and concentration of activator, as well as the presence and concentration of phospholipids in the test reagent.Response to Reviewers: Response to reviewers.First and foremost, thank you very much for the positive and constructive review. We have tried our best to answer all questions and revised the manuscript accordingly.Reviewer #1: This is a nice methodological paper about the ROTEM device, which is well written by an experienced group.Minor comments 1) P3 , line 41: physiologically -corrected 2) P4, line 28: significantly -corrected 3) Please indicate molar concentrations of synthasil and Innovin, if possible Unfortunately, it is not possible to use molar concentrations. We are working on a detailed (including molar concentrations and activity) examination of various tissue factor sources, however that reached beyond the scope of the present study. 4) P9: followed -corrected 5) P11, line 38: please add . "in vitro [33] as well as coagulation activation in vivo, when the blood is only re-calcified [PMID: 16420574]" Thank you for this excellent point, we have added accordingly. 6) I am not sure whether I could reproduce the phospholipid preparation, maybe a graphical scheme could be helpfulWe have slightly rephrased 7) As many users of the ROTEM probably will not have the extra software, please consider providing graphical presentations of the CT and /or alpha angle in addition to MaxVel, which is a derived variable CT has been included. We found it too excessive to also show alpha. 8) Refs 21 and 26 appear identical to meWe have corrected the reference list accordingly Reviewer #2: The paper by Sorensen et ...

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“…Various studies have investigated platelet activation, which has been used to evaluate platelet quality during processing and storage of plateletpheresies products. Activated platelet markers that have been used in studies of plateletpheresis include P-selectin (CD62P) [2,27,30], CD63 [20,22,47], gly- [12,13,19,28,62], and coated platelets [1,11,57]. Trima Accel: this suggests that increased P-selectin expression may result from delayed processing times within the apheresis device [27,30].…”

Section: Platelet Activationmentioning

confidence: 99%

“…The plateletpheresis method has also been observed to influence platelet activation; in addition to the storage phase itself, the plateletpheresis process conducted with the Trima Blood Collection System decreases the number of coated platelets [11,57]. Table 2 presents the changes in metabolic activity during apheresis platelet storage [11,55,59].…”

Section: Platelet Activationmentioning

confidence: 99%

Plateletpheresis: the Process, Devices, and Indicators of Product Quality

Jang¹,

Kim²,

Kim³

et al. 2014

Journal of Life Science

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Platelet products are used to treat hemorrhagic or platelet dysfunction diseases. Plateletpheresis involves collecting the platelet components of blood using an apheresis blood-collection system. Various indicators are available for evaluating the qualities of the apheresis platelets. The productivity of platelet collection is evaluated through both the collection efficiency and collection rates. Platelet storage quality can be evaluated in vitro using several indicators, including visual appearance, metabolic activities, volume, platelet count, white blood cell count, microparticles, and various platelet activation markers. Platelet activation markers have been used as indicators of storage quality in various studies. Post-transfusion platelet quality can be evaluated based on the corrected count increment and the percentage of platelet recovery. Although various studies have investigated the aspects of plateletpheresis, no article has systemically presented assessments of the platelet products obtained from different plateletpheresis devices. The present study provides a review of plateletpheresis, including the specifics of the process, the types of devices employed, the platelet quality, the overall efficacy, and the evaluation indicator qualities. Furthermore, the differences in functionality among the different apheresis devices are discussed. Although adverse reactions to the citrate anti-coagulant have been reported, apheresis processing may provide a safer option for donors who are at a high risk for presyncopal or syncopal reactions related to whole blood collection.

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Impairment of the hemostatic potential of platelets during storage as evaluated by flow cytometry, thrombin generation, and thrombelastography under conditions promoting formation of coated platelets

Abstract: Data in the present study suggest that storage significantly reduced the stored PLTs' ability to respond to conditions expected to exist at the site of vascular injury and that storage-induced reduction in PLT activation sensitivity correlated with a loss of hemostatic potential.

Cited by 32 publications

References 37 publications

Hemostatic Function of Apheresis Platelets Stored at 4°C and 22°C

Hemostatic Function of Apheresis Platelets Stored at 4°C and 22°C

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

Plateletpheresis: the Process, Devices, and Indicators of Product Quality

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