Removal of citrate from PAS‐III additive solution improves functional and biochemical characteristics of buffy‐coat platelet concentrates stored for 7 days, with or without INTERCEPT pathogen reduction

Abstract

Background: Deterioration in quality of platelet concentrates (PCs) during storage results from the appearance of storage lesions affecting the hemostatic functions and posttransfusion survival of platelets. These lesions depend on the preparation and pathogen inactivation methods used, duration of storage, and platelet additive solutions (PASs) present in storage bags. Methods: We investigated the effects of citrate contained in third-generation PAS (PAS-III) on storage lesions in buffy-coat PCs with or without photochemical (amotosalen-ultraviolet A) treatment over 7 days. Results: Platelet counts were conserved in all groups during storage, as was platelet swirling without appearance of macroscopic aggregates. Glycoprotein (GP) IIbIIIa and GPVI expression remained stable, whereas GPIbα declined similarly in all groups during storage. Removal of citrate from PAS-III, resulting in global reduction of citrate from 11 to 5 mM, led to a significant decrease in glucose consumption, which largely countered a modest deleterious effect of photochemical treatment. Citrate reduction also resulted in decreased lactate generation and better maintenance of pH during storage, while photochemical treatment had no impact on these parameters. Moreover, citrate-free storage significantly reduced exposure of P-selectin and the apoptosis signal phosphatidylserine, thereby abolishing the activating effect of photochemical treatment on both parameters. Citrate reduction benefited platelet aggregation to various agonists up to Day 7, whereas PCT had no impact on these responses. Conclusion: Removal of citrate from PAS-III has a beneficial impact on platelet metabolism, spontaneous activation, and apoptosis, and improves platelet Abbreviations: ADP, adenosine 5 0 diphosphate; BC-PCs, buffy-coat platelet concentrates; GP, glycoprotein; MPV, mean platelet volume; PAS, platelet additive solution; PAS-III, third-generation platelet additive solution; PC, platelet concentrate; pCO 2 , partial pressure of carbon dioxide; PCT, photochemically treated; pO 2 , partial pressure of oxygen; PS, phosphatidylserine; TRAP-6, thrombin receptor activator peptide 6; UVA, ultraviolet A.

Pathogen Reduction Technologies and Their Impact on Metabolic and Functional Properties of Treated Platelet Concentrates: A Systematic Review

“…In some studies, Intercept-PC treatment had mild or no impact on platelet membrane integrity as reflected by LDH levels. 32 35 37 40 Progressively increasing LDH values during late storage time were also reported. 31 34 55 Furthermore, the duration of CAD treatment influenced LDH levels.…”

“…This was attributed to the wafer, which is included in the CAD bag and which appeared to cause platelet activation. Isola et al 40 reported that after stimulation with TRAP, P-selectin expression was comparable in the examined groups. Enhanced basal P-selectin expression in treated PCs was reported by Carvalho et al, 64 where poststimulation (with thrombin) P-selectin expression progressively decreased.…”

“…Most studies reported no significant differences regarding HSR and swirling values between Intercept-treated and untreated PCs, which were maintained until day 7 of storage. 28 31 32 34 35 36 37 40 Chavarin et al 56 reported well-maintained swirling values in treated PCs during a 5-day period. On the other hand, Apelseth et al 33 observed that swirling declined during storage both in treated and control PCs and significant lower values were reported after Intercept-PRT at the end of storage.…”

Prevention of transfusion‐transmitted syphilis by blood operators: How much is enough when transfusion‐transmission has not been identified for decades?

“…pallidum ‐activated platelets and platelet aggregates would be removed by leukoreduction filters or whether they would fail platelet quality checks during blood product processing. It is also unclear what proportion of treponemes would be reduced by pooling of platelets and use of a single plasma unit or the use of platelet additive solution 44 …”

The platelet proteasome and immunoproteasome are stable in buffy‐coat derived platelet concentrates for up to 7 days

“…24 However, during storage of PCs, the functional capacity of platelets decreases due to the so-called storage lesions. [25][26][27][28][29][30][31][32] These lesions arise from platelet activation, metabolic changes, and aging of platelets in vitro. Microvesicles and major apoptosis-like lesions are key features of storage lesions.…”