Lai M, Rumi C, D'Onofrio G, Puggioni P L, Menichella G, Candido A, Leone G
Immunohematology Laboratory, Chair of Hematology, Transfusion Center, Catholic University of Sacred Heart, Largo Gemelli 8, Roma 00168, Italy.
Transfus Apher Sci. 2002 Dec;27(3):239-45. doi: 10.1016/s1473-0502(02)00071-x.
BACKGROUND AND OBJECTIVES: Platelet alterations occur during the production and storage of platelet concentrates, the so called "storage lesion". We studied the platelet alterations during the storage period in apheresis concentrates, employing flow cytometry for phosphatidylserine (PS) detection on platelets during the five days of storage. MATERIAL AND METHODS: Twenty-seven single donor platelet concentrates harvested with the Cobe Trima, Baxter Amicus, or Haemonetics MCS+ were analyzed for PS exposure by flow cytometry on the day of production (day 1) and on days 3 and 5 of storage. Furthermore PS expression was analyzed in platelet donors' blood samples withdrawn before plateletpheresis. RESULTS: PS expression on platelets gave the following median values: in blood donors before apheresis it was 1.12% (0.13-1.78) in platelets concentrates on the first day (2 h after apheresis) 2.06% (0.66-15.2), the third day 6.57% (1.98-51.13) and the fifth day 23.04% (3.86-80.23). All differences between median values of PS expression in blood samples before apheresis, and platelets concentrates on days 1, 3 and 5 of storage, are statistically significant. The expression of PS in platelet concentrates was analyzed in relation to the blood cell separator used for the collection procedure and showed the following results: on day 1 the median values of PS in platelet concentrates collected with the three different blood cell separators, Trima, Cobe and MCS, did not show statistically significant differences. On day 3, the platelets concentrates collected with the Trima and with the MCS showed differences that were statistically significant. Those were respectively 10.59% (4.56-51.13) and 3.53% (1.98-12.61), p = 0.005. The PS expression in platelet concentrates collected with the Trima and MCS showed differences that are also statistically significant on day 5 at respectively 32.4% (9.61-80.23) and 8.57% (3.86-48.42), p = 0.005. CONCLUSIONS: PS exposure in platelet concentrates on days 3 and 5 rise to levels that could compromise the quality of the platelet units. Improvements in standardized platelet quality controls, and in platelet collection systems are required to reduce the storage lesions in platelets concentrates.
背景与目的：在血小板浓缩物的生产和储存过程中会发生血小板改变，即所谓的“储存损伤”。我们采用流式细胞术检测储存五天期间单采浓缩物中血小板上的磷脂酰丝氨酸（PS），研究了储存期内血小板的改变情况。 材料与方法：对用Cobe Trima、Baxter Amicus或Haemonetics MCS +采集的27份单采血小板浓缩物，在生产当天（第1天）以及储存第3天和第5天通过流式细胞术分析PS暴露情况。此外，还分析了血小板采集前采集的血小板供者血样中的PS表达情况。 结果：血小板上PS表达的中位数如下：在单采前的献血者血液中为1.12%（0.13 - 1.78），在血小板浓缩物中第1天（单采后2小时）为2.06%（0.66 - 15.2），第3天为6.57%（1.98 - 51.13），第5天为23.04%（3.86 - 80.23）。单采前血样与储存第1天、第3天和第5天血小板浓缩物中PS表达中位数之间的所有差异均具有统计学意义。分析了血小板浓缩物中PS表达与用于采集过程的血细胞分离机的关系，结果如下：第1天，用三种不同血细胞分离机（Trima、Cobe和MCS）采集的血小板浓缩物中PS的中位数未显示出统计学显著差异。第3天，用Trima和MCS采集的血小板浓缩物显示出统计学显著差异，分别为10.59%（4.56 - 51.13）和3.53%（1.98 - 12.61），p = 0.005。第5天，用Trima和MCS采集的血小板浓缩物中PS表达也显示出统计学显著差异，分别为32.4%（9.61 - 80.23）和8.57%（3.86 - 48.42），p = 0.005。 结论：血小板浓缩物在第3天和第5天的PS暴露增加到可能损害血小板单位质量的水平。需要改进标准化的血小板质量控制以及血小板采集系统，以减少血小板浓缩物中的储存损伤。
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