Sweeney J D, Blair A J, Cheves T A, Dottori S, Arduini A
Herbert C. Lichtmann Blood Bank and Transfusion Medicine Research Unit, The Miriam Hospital, Providence, Rhode Island 01906, USA.
Transfusion. 2000 Nov;40(11):1313-9. doi: 10.1046/j.1537-2995.2000.40111313.x.
The platelet storage lesion is characterized metabolically by a pH decrease associated with lactic acid generation; a change in platelet morphology from discoid to spherical; a diminished response to in vitro challenge tests, such as the hypotonic shock response (HSR) and extent of shape change (ESC); increased surface P-selectin expression; and decreased in vivo recovery and survival. Altering storage conditions to improve these measures could allow for extension of the duration of in vitro storage.
ABO-identical paired platelet concentrates were pooled and then equally divided into two plastic bags. Either L-carnitine (LC) or an equal volume of saline (control) was added to one container of each pair. Platelets were stored at 20 to 24 degrees C for 5 to 10 days or at 1 to 6 degrees C for 5 days at various concentrations of LC between 0.1 and 15 mM: At the end of storage, pH, glucose consumption, lactate generation, HSR, ESC, and surface P-selectin expression were measured. In different experiments, paired platelet concentrates were spiked with a Staphylococcus epidermidis suspension in the presence and absence of L-carnitine at a concentration of 5 mM:
At 20 to 24 degrees C and concentrations of LC between 0.1 and 5 mM:, there was evidence of better pH preservation, less glucose consumption, and less lactate generation. Only with storage beyond 5 days was a difference present in either surface P-selectin expression or HSR. An L-carnitine concentration of 5 mM: appeared optimal. L-carnitine did not enhance the growth of bacteria after 7 to 8 days of storage.
LC at 5 mM: may improve the quality of platelet concentrates that are stored beyond 5 days. There was no indication that LC at this concentration would promote bacterial growth. It may be a useful additive to platelet preservation.
血小板储存损伤的代谢特征为pH值下降并伴有乳酸生成；血小板形态从盘状变为球状；对体外激发试验（如低渗休克反应（HSR）和形状改变程度（ESC））的反应减弱；表面P-选择素表达增加；以及体内回收率和存活率降低。改变储存条件以改善这些指标可能会延长体外储存时间。
将ABO血型相同的配对血小板浓缩物汇集，然后等分为两个塑料袋。向每对中的一个容器中加入左旋肉碱（LC）或等体积的生理盐水（对照）。血小板在20至24摄氏度下储存5至10天，或在1至6摄氏度下储存5天，LC浓度在0.1至15 mM之间：储存结束时，测量pH值、葡萄糖消耗、乳酸生成、HSR、ESC和表面P-选择素表达。在不同实验中，在有和没有浓度为5 mM的左旋肉碱存在的情况下，用表皮葡萄球菌悬液对配对的血小板浓缩物进行加样：
在20至24摄氏度且LC浓度在0.1至5 mM之间时，有证据表明pH值保存更好、葡萄糖消耗更少且乳酸生成更少。仅在储存超过5天后，表面P-选择素表达或HSR才出现差异。5 mM的左旋肉碱浓度似乎是最佳的。储存7至8天后，左旋肉碱不会促进细菌生长。
5 mM的LC可能会改善储存超过5天的血小板浓缩物的质量。没有迹象表明该浓度的LC会促进细菌生长。它可能是血小板保存的一种有用添加剂。
