Oikawa S, Minegishi M, Endo K, Kawashima W, Suzuki K, Shimizu H
Japanese Red Cross Tohoku Block Blood Center, Sendai, Japan.
Vox Sang. 2016 Jul;111(1):16-21. doi: 10.1111/vox.12389. Epub 2016 Feb 25.
Volume-reduced washed platelet (PLT) concentrates (PCs) can prevent circulatory overload and allergic reactions in patients undergoing PLT transfusions. For these reasons, they are in demand for paediatric settings and for patients at risk of circulatory overload. Here, we evaluated the quality of volume-reduced washed PCs stored for 5 days in a novel acetate-free PLT additive solution (PAS) containing glucose and bicarbonate (BRS-A) with <5% residual plasma protein.
PCs from two apheresis donations were mixed and divided equally into control and test units. For the test unit (volume-reduced washed PCs), PLTs were washed and stored in 90 ml BRS-A with <5% plasma protein. PLTs in the control unit were stored in 200 ml 100% plasma without any washing manipulations. The in vitro properties of PLTs in both units were compared over a 5-day storage period.
The procedure for volume-reduced washed PCs effectively removed >98% plasma protein in 100% plasma PCs and yielded an approximately twofold lower mean volume (91 ml) compared to that observed with the control units. Immediately after washing, the mean PLT concentration of the test units was 20·5 × 10(11) /l, twofold higher than that of the control units. The pH (37°C) levels in the test unit remained above 7·0 for 5 days. Glucose consumption and lactate production rates of the test units on days 1-3 were higher than those of the control units, leading to glucose exhaustion in the test unit by Day 3. Hypotonic shock responses and CD62P and CD42b expression levels in both units were comparable during 5-day storage.
Considering the pH buffering capacity of BRS-A, a 90-ml volume may be acceptable for maintaining the in vitro quality of washed PLTs for at least 2 days.
减量洗涤血小板（PLT）浓缩物（PCs）可预防接受PLT输血患者的循环超负荷及过敏反应。因此，它们在儿科环境及有循环超负荷风险的患者中很有需求。在此，我们评估了在一种新型不含醋酸盐、含葡萄糖和碳酸氢盐（BRS-A）且残余血浆蛋白<5%的PLT添加剂溶液中储存5天的减量洗涤PCs的质量。
将两份单采血小板捐赠的PCs混合并等分为对照单元和测试单元。对于测试单元（减量洗涤PCs），将PLTs洗涤并储存在90 ml含<5%血浆蛋白的BRS-A中。对照单元中的PLTs储存在200 ml 100%血浆中，未进行任何洗涤操作。在5天的储存期内比较两个单元中PLTs的体外特性。
减量洗涤PCs的程序有效去除了100%血浆PCs中>98%的血浆蛋白，且与对照单元相比，平均体积（91 ml）降低了约两倍。洗涤后立即测定，测试单元的平均PLT浓度为20.5×10¹¹/l，比对照单元高两倍。测试单元在37°C时的pH水平在5天内保持在7.0以上。测试单元在第1 - 3天的葡萄糖消耗率和乳酸生成率高于对照单元，导致测试单元在第3天葡萄糖耗尽。在5天储存期内，两个单元的低渗休克反应以及CD62P和CD42b表达水平相当。
考虑到BRS-A的pH缓冲能力，90 ml的体积对于维持洗涤后PLTs的体外质量至少2天可能是可接受的。
