In-vivo evaluation of random donor platelet concentrates from pooled buffy coats

Abstract

Random-donor platelet concentrates (PC) prepared from pooled buffy coats have recently been described as an alternative method for platelet preparation. We evaluated such PCs in the clinical setting compared with a standard PC from platelet apheresis. PCs were prepared either from pools of buffy coats (BC-PC) or from single donors (SD-PC) with the cell separator CS-3000 plus. PCs were stored for up to 5 days before transfusion. We compared fresh PC (day 1) with stored (day 2-3) and long-stored PC (day 4-5). For analysis, platelet increment in the recipient was determined immediately and 16-22 h (mean 20 h) after transfusion, corrected for total body area and transfused platelets (CCI). A total of 316 PCs were administered to 36 thrombocytopenic patients suffering from various hematological disorders. Patients with detectable HLA or platelet-specific antibodies or splenomegaly were excluded from the study. Mean platelet content of the PC was 262 x 10(9) for BC-PC and 251 x 10(9) for SD-PC. The 20-h CCI after transfusion of fresh PC was slightly higher with BC-PC than with SD-PC (14.5 versus 11.9; p = 0.19), but values did not differ significantly between the two types of PC on any day of storage. For BC-PC, 20-h CCI decreased with further storage by 30% (10.2; p = 0.02). For SD-PC a decrease by 9% was not significant. In conclusion, platelet concentrates prepared from pools of buffy coats showed excellent transfusion results when administered fresh, but storage decreased the CCI by 30%. No significant difference from PCs from plateletpheresis was observed on any day of storage. Both types of platelet concentrates were capable of sufficient platelet increment even when stored for up to 5 days.

Wissenschaftliche Erläuterungen zur Stellungnahme „Bewertung von Apherese- und Pool-Thrombozytenkonzentraten“ des AK Blut vom 31.03.2015

“…Eine Aktualisierung des systematischen Reviews der Cochrane Gesellschaft [94] [57,[104][105][106][107][108][109][110][111][112]. Auch das Intervall bis zur nächsten Transfusion unterschied sich nicht [111].…”

2 Platelet Concentrates

“…When PCs obtained by the buffy coat method are transfused, the recipient receives blood from a higher number of donors as compared to the transfusion of apheresis concentrates. The corrected count increment (CCI) in both preparations is reduced by approximately 20-30% after storage for 5 days [31].…”

“…Both types of PCs are effective in treating the bleeding patient [1,31,70]. In immunized patients for selection of platelet donors, the appropriate HLA and human platelet antigens (HPA) have to be taken into account (see also section 2.8).…”

Konventionelle vs. pathogeninaktivierte Thrombozytenkonzentrate bei perioperativer Koagulopathie

“…Die Transfusion eines TK sollte nach 60 min einen 1-h-CCI von >7500 bewirken -andernfalls wird der Transfusionserfolg als ungenügend bezeichnet[3,15]. Studien über den Effekt von PI-TKTransfusionen auf die MEA-Analysen.…”