Procházková Renata, Andrýs Ctirad, Hubácková Lenka, Krejsek Jan
Department of Transfusion Medicine, District Hospital Liberec, Czech Republic.
Transfus Apher Sci. 2007 Oct;37(2):115-23. doi: 10.1016/j.transci.2007.03.015. Epub 2007 Oct 22.
A product with well-preserved haemostatic function of platelets is the ultimate goal of platelet concentrate production. However, platelet activation and apoptosis are induced by both collection and storage of platelet concentrates.
Platelet concentrates obtained either by two blood separators with different technology of apheresis (Haemonetics MCS+, Haemonetics Corp. Braintree, USA and Trima Accel, Gambro BCT Inc., Lakewood, USA, respectively) or derived from buffy-coat were compared using evaluation of pH, LDH, lactate, glucose, annexin V, and sP-selectin levels immediately after collecting and at the end of expiration to estimate the differences in the activation and apoptosis of platelets in these products.
The lowest degree of platelet activation was found in products obtained by Haemonetics MCS+ apparatus at the time of collection. Platelet concentrates obtained by apheresis revealed higher rise of LDH, annexin V and sP-selectin compared to buffy-coat derived platelets. Products from Haemonetics MCS+ showed higher rise of annexin V in comparison with products from Trima separator. Increase of LDH and sP-selectin in both apheresis products was comparable.
On the basis of changes of sP-selectin and annexin V levels it could be concluded that initial platelet activation, which is induced by apheresis, is very likely without any further impact on quality of platelets during storage. Development of platelet storage lesions is influenced especially by storage conditions and platelet concentration in products.
血小板止血功能良好保存的产品是血小板浓缩物生产的最终目标。然而,血小板浓缩物的采集和储存均会诱导血小板活化和凋亡。
比较分别通过两种采用不同单采技术的血液分离机(美国布伦特里市海莫奈蒂克斯公司的海莫奈蒂克斯MCS +和美国莱克伍德市甘布罗BCT公司的特里玛Accel)获得的血小板浓缩物,或源自 Buffy 层的血小板浓缩物,通过评估采集后即刻及有效期结束时的pH、乳酸脱氢酶(LDH)、乳酸、葡萄糖、膜联蛋白V和可溶性P选择素水平,以估计这些产品中血小板活化和凋亡的差异。
在采集时,通过海莫奈蒂克斯MCS +仪器获得的产品中血小板活化程度最低。与源自Buffy层的血小板相比,单采获得的血小板浓缩物中LDH、膜联蛋白V和可溶性P选择素升高幅度更高。与特里玛分离器的产品相比,海莫奈蒂克斯MCS +的产品中膜联蛋白V升高幅度更高。两种单采产品中LDH和可溶性P选择素的升高幅度相当。
根据可溶性P选择素和膜联蛋白V水平变化可以得出结论,单采诱导的初始血小板活化很可能在储存期间对血小板质量没有任何进一步影响。血小板储存损伤的发展尤其受产品储存条件和血小板浓度的影响。