We used paramagnetic analogs of endogenous phospholipids to study modification of phospholipid distribution in platelet plasma membranes during aging. Asymmetrical distributions and translocation kinetics were very different for spin-labeled phosphatidylserine and spin-labeled phosphatidylcholine in fresh platelet plasma membranes. In freshly prepared platelets and up to day 7, spin-labeled phosphatidylserine very rapidly penetrated to the inner leaflet of the platelet plasma membrane. However, spin-labeled phosphatidylcholine was mainly retained on the external leaflet. From day 7 to day 9, the two translocation kinetics became identical with symmetrical distribution of both spin-labeled phospholipids at equilibrium. Inhibition of translocase activity and modification of membrane stability accounted for these transformations. The rapid re-exposition of spin-labeled phosphatidylserine after stimulation by the calcium ionophore A231 87, measured in fresh platelet concentrates, persisted up to day 9 but disappeared between day 10 and day 12. From day 7 to day 9, a strong cytoskeleton proteolysis and marked decrease in intracellular ATP were observed. Moreover, complete suppression of P-N-acetyl glucosaminidase secretion and vesicle formation after A23187 stimulation of aged platelets indicated that platelets could no longer be activated beyond day 9. Taken together, these results showed that during in vitro aging there are metabolic and membrane modifications in platelet similar to those described for platelet activation. In addition, all of the observed events occurred simultaneously between day 7 and day 9. These results highlight the importance of maintaining plasma membrane asymmetry to increase the hemostatic effectiveness of transfused platelet concentrates.The coagulation cascade begins after vascular injury to maintain hemostasis in the circulatory blood system. Briefly, the coagulation process starts when blood platelets interact with the tissue factor released by subendothelium cells, inducing platelet activation close to the lesion [l]. These activated platelets undergo several transformations such as skeleton proteolysis, granule secretion, vesicle shedding, shape change and lose their transmembrane phospholipid asymmetry to acquire a surface rich in phosphatidylserine (PtdSer) and phosphatidylethanolamine (PtdEtn) [2-41. All coagulation events then occur and result in formation of the hemostatic plug.Storage lesion, a phenomenon very similar to platelet activation transformation, was observed during in vitro aging of blood bank platelet concentrates. In fact, skeleton proteolysis, degranulation, shape change and vesicle formation have been described during in vitro platelet aging, whereas phos- The aim of this study was to investigate modifications in PL distribution in the plasma membrane during in vitro platelet aging. The study was carried out using paramagnetic phospholipids that were previously described to be good reporters for endogenous PL movements [7, 81. Cytoskeleton proteolysis and intrace...