Clinical Department of Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria.
Transfusion. 2010 May;50(5):1036-42. doi: 10.1111/j.1537-2995.2009.02543.x. Epub 2009 Dec 29.
Platelet (PLT) transfusion is a mainstream therapy for preventing or treating bleeding episodes in patients with thrombocytopenia. The efficacy is usually estimated from the corrected count increment of PLTs after transfusion, which does not assess PLT function. We therefore evaluated PLT function in blood samples of patients with thrombocytopenia before and after transfusion.
PLT function was assessed in 24 chemotherapy-treated patients and in the PLT concentrates (PCs) by the Impact-R (DiaMed). This device evaluates PLT adhesion and aggregation recorded as surface coverage (%) and size of aggregates (AS microm(2)). P-selectin expression was determined by flow cytometry.
The PCs were stored for a median of 70 hours before transfusion. An analysis stratified by the median storage of PCs (<70 hr or >70 hr) showed no differences in the SC, the AS, and P-selectin expression between these concentrates' groups. Transfusion resulted in an increase of adhering PLTs in the patients after transfusion. There were no differences in the AS and in P-selectin expression before and after transfusion, but the AS increased after transfusion upon ex vivo exposure to adenosine 5'-diphosphate. P-selectin expression was significantly lower in the patient group receiving PCs stored for more than 70 hours.
The current trial shows the feasibility of using the Impact-R to assess the function of transfused PLTs in the patient's blood stream.
血小板（PLT）输注是预防或治疗血小板减少症患者出血事件的主流治疗方法。疗效通常根据输注后 PLT 的校正计数增加来估计，但不评估 PLT 功能。因此，我们评估了输注前后血小板减少症患者的血液样本中的 PLT 功能。
通过 Impact-R（DiaMed）评估了 24 例化疗治疗患者和 PLT 浓缩物（PC）中的 PLT 功能。该设备评估 PLT 粘附和聚集，记录为表面覆盖率（%）和聚集物的大小（AS microm(2)）。通过流式细胞术测定 P-选择素表达。
PC 在输注前中位数储存了 70 小时。对 PC 中位数储存（<70 小时或>70 小时）进行分层分析显示，这些浓缩物组之间的 SC、AS 和 P-选择素表达没有差异。输注后，患者的粘附 PLT 增加。输注前后的 AS 和 P-选择素表达没有差异，但 AS 在体外暴露于二磷酸腺苷后输注后增加。储存超过 70 小时的 PC 组患者的 P-选择素表达明显降低。
本研究表明，使用 Impact-R 评估输注 PLT 在患者血流中的功能是可行的。
