Influence of platelet preparation techniques on in vitro storage quality after psoralen‐based photochemical treatment using new processing sets for triple‐dose units

Abstract

BACKGROUND: The INTERCEPT Blood System (IBS)for platelets (PLTs) uses a combination of psoralen and ultraviolet-A light to inactivate pathogens that may contaminate PLT concentrates (PCs). However, no data are available on the quality of IBS-treated PLTs from different apheresis and buffy-coat PC preparation platforms using the new triple storage (TS) set. STUDY DESIGN AND METHODS:The objective of this study was to evaluate the TS set on three different preparation platforms compared with the large-volume (LV) set, as control. PLT in vitro metabolic and activation parameters were studied over 7 days.RESULTS: Several statistical differences are observed between the two sets, particularly for pH, oxygen pressure (pO 2 ), carbonic gaz pressure (pCO 2 ), and bicarbonate. The three different preparation techniques influence PLT parameters, and the difference is statistically significant for all the studied parameters, except for pCO 2 . The TS set has the advantage of shorter compound adsorption device time, higher PLT recoveries, and less PLT activation. ABBREVIATIONS: APC = apheresis platelet concentrate; ATP = adenosine triphosphate; BC = buffy-coat; BCPC = buffy-coat platelet concentrate; CAD = compound adsorption device; ELISA = enzymelinked immunosorbent assay; HCO 3 = bicarbonate; IBS = INTERCEPT Blood System; LDH = lactate dehydrogenase; LV = large volume; PAS = platelet additive solution; PC(s) = platelet concentrate(s); PI = pathogen inactivation; PLT = platelet; TACSI PL = Terumo automated centrifuge and separator integration platelet; TS = triple storage; UV = ultraviolet.From the

Impact of different pathogen reduction technologies on the biochemistry, function, and clinical effectiveness of platelet concentrates: An updated view during a pandemic

“…These changes were followed by alterations in platelet morphology, slight reductions in swirling, and altered resistance to hyperosmotic shock (HSR). Moderate reductions in GPIb with the activation of GPIIb‐IIIa, 37,38,42,43 with enhanced expression of P‐selectin, have been confirmed by numerous investigators 27,28,30–33,35,36,38,39,42–45 . The increased expression of P‐selectin parallels enhanced signs of apoptosis with the exposure of anionic phospholipids, binding of annexin‐V, and release of microparticles 32,33,35,39,41,42,45 .…”

“…INTERCEPT enhances anaerobic metabolism in treated PCs. Increased glucose consumption, lactate accumulation, and acidification are consistently reported in buffy‐coat 28–30,32,35,36,38,39 or apheresis PCs 27,37–39,41–43 after exposure to INTERCEPT. These changes were followed by alterations in platelet morphology, slight reductions in swirling, and altered resistance to hyperosmotic shock (HSR).…”

“…For the purpose of this review, we have identified a total of 53 relevant publications, 20 evaluating the in vitro quality of PCs subjected to INTERCEPT, 26–45 23 using MIRASOL, 46–68 5 using THERAFLEX, 19,69–72 and 5 studies that have compared INTERCEPT versus MIRASOL 73–77 . Details of these studies are summarized in the Supplemental Table 1.…”

“…The increased expression of P‐selectin parallels enhanced signs of apoptosis with the exposure of anionic phospholipids, binding of annexin‐V, and release of microparticles 32,33,35,39,41,42,45 . Introduction of classic or newer formulations of platelet additive solutions (PASs) does not prevent the deterioration observed after INTERCEPT 28,35,37,39,42–45 . A reduction of citrate concentration in PAS may slightly reduce platelet activation.…”

“…For the purpose of this review, we have identified a total of 53 relevant publications, 20 evaluating the in vitro quality of PCs subjected to INTERCEPT, 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 23 using MIRASOL, 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 5 using THERAFLEX, 19 , 69 , 70 , 71 , 72 and 5 studies that have compared INTERCEPT versus MIRASOL. 73 , 74 , 75 , 76 , 77 Details of these studies are summarized in the…”