Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.
Platelets. 2012;23(4):299-308. doi: 10.3109/09537104.2011.618852. Epub 2012 Jan 24.
Several studies report that patients who are treated with selective serotonin reuptake inhibitors (SSRIs) for depression may have increased risk of bleeding, particularly from the gastrointestinal tract. This may be related to low intraplatelet serotonin concentrations. Several blood banks do not store platelets from donors using SSRIs for transfusion, although the possible effects of SSRIs on platelet storage are not documented. We conducted a case-control pilot study of apheresis platelet concentrates prepared from donors using SSRIs (n=8) and from donors without medication (n=10). The platelet concentrates were stored for 5 days. Light transmission aggregometry (LTA), thrombelastography (TEG), and flow cytometric analyses were preformed for in vitro measurements of platelet function. Platelet function and platelet serotonin content were investigated in whole blood and in platelet concentrates stored for up to 5 days. LTA, TEG, and flow cytometric analysis of glycoprotein expression did not reveal any significant differences between the two groups. All 18 platelet concentrates performed well according to the standards set for platelet quality in relation to transfusion. Blood donors using SSRIs had significantly lower platelet serotonin compared to blood donors without medication. The results from our pilot study indicate that platelets from donors using SSRIs may be suitable for transfusion after storage for 5 days, but further laboratory and clinical studies are necessary to confirm this.
一些研究报告称,接受选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗抑郁症的患者可能有更高的出血风险,特别是胃肠道出血。这可能与血小板内 5-羟色胺浓度降低有关。尽管目前尚无关于 SSRIs 对血小板储存影响的相关记录,但一些血库不储存使用 SSRIs 的供者的血小板用于输血。我们对使用 SSRIs 的供者(n=8)和未用药供者(n=10)制备的单采血小板浓缩物进行了病例对照的初步研究。血小板浓缩物储存 5 天。进行体外血小板功能检测,包括光透射聚集试验(LTA)、血栓弹力图(TEG)和流式细胞术分析。在全血和储存长达 5 天的血小板浓缩物中研究血小板功能和血小板 5-羟色胺含量。LTA、TEG 和糖蛋白表达的流式细胞术分析未显示两组之间存在任何显著差异。所有 18 份血小板浓缩物均根据与输血相关的血小板质量标准良好地发挥作用。使用 SSRIs 的献血者的血小板 5-羟色胺明显低于未用药的献血者。我们的初步研究结果表明,使用 SSRIs 的供者的血小板在储存 5 天后可能适合输血,但需要进一步的实验室和临床研究来证实这一点。