AuBuchon James P, Taylor Harry, Holme Stein, Nelson Edward
Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Transfusion. 2005 Aug;45(8):1356-61. doi: 10.1111/j.1537-2995.2005.00217.x.
Extension of platelet (PLT) storage and concomitant use of a bacterial detection system would provide logistical advantages by reducing outdating and improving patient care through promotion of the use of sensitive detection systems. This study evaluated the in vitro characteristics and in vivo viability of leukoreduced PLT units derived from PLT-rich plasma stored for 5 days (control) versus 7 days (test) in CLX plastic containers.
Two whole-blood units were collected from each subject into a leuko-reduction filtration system (Leukotrap RC-PL system, Pall Medical) in a paired design, the second 2 days after the first. These were leukoreduced (Leukotrap PL) and stored for 7 and 5 days. Poststorage samples from test and control units were randomly labeled with (51)Cr or (111)In and simultaneously infused autologously to determine recovery and survival.
Small but significant (p < 0.05, paired t test) differences between 5 and 7 days of storage were seen in in vitro variables such as extent of shape change, hypotonic shock response, morphology, and P-selectin expression. In vivo recovery declined on average 11 percent with the two additional days of storage from 54.4 +/- 13.6 to 48.7 +/- 15.0 percent (p < 0.002); survival decreased on average 19 percent from 6.7 +/- 1.0 to 5.4 +/- 1.7 days (p < 0.002).
Storage for 7 days was associated with reduced recovery and survival and in vitro variables, suggestive of extension of the storage lesion. These differences, however, were small in magnitude and unlikely to have significant clinical effects. Current collection and storage systems provide PLTs that are as functional at 7 days as those licensed for 7-day storage two decades ago.
延长血小板（PLT）储存时间并同时使用细菌检测系统，通过减少过期情况以及通过推广使用敏感检测系统来改善患者护理，将具有后勤方面的优势。本研究评估了在CLX塑料容器中，源自富血小板血浆的白细胞滤除血小板单位储存5天（对照）与7天（试验）后的体外特性和体内活力。
采用配对设计，从每位受试者采集两单位全血，通过白细胞滤除过滤系统（白细胞滤除RC-PL系统，颇尔医疗），第二次采集在第一次采集后2天进行。将这些血液进行白细胞滤除（白细胞滤除PL）并分别储存7天和5天。试验组和对照组储存后的样本随机用（51）铬或（111）铟标记，并同时进行自体输注以测定回收率和存活率。
在5天和7天储存期之间，在体外变量如形状变化程度、低渗休克反应、形态和P-选择素表达方面观察到小但显著（p < 0.05，配对t检验）的差异。随着储存时间额外增加两天，体内回收率平均下降11%，从54.4±13.6%降至48.7±15.0%（p < 0.002）；存活率平均下降19%，从6.7±1.0天降至5.4±1.7天（p < 0.002）。
储存7天与回收率、存活率降低以及体外变量变化有关，提示储存损伤有所延长。然而，这些差异幅度较小，不太可能产生显著的临床影响。当前的采集和储存系统所提供的血小板在7天时的功能与二十年前获批7天储存的血小板相当。
