Vostal Jaroslav G, Gelderman Monique P, Skripchenko Andrey, Xu Fei, Li Ying, Ryan Johannah, Cheng Chunrong, Whitley Pam, Wellington Michael, Sawyer Sherrie, Hanley Shalene, Wagner Stephen J
Laboratory of Cellular Hematology, DBCD, OBRR, CBER, FDA, Silver Spring, Maryland.
Office of Biostatistics and Epidemiology, CBER, FDA, Silver Spring, Maryland.
Transfusion. 2018 Jan;58(1):25-33. doi: 10.1111/trf.14392. Epub 2017 Nov 8.
Room temperature (RT) storage of platelets (PLTs) can support bacterial proliferation in contaminated units, which can lead to transfusion-transmitted septic reactions. Cold temperature storage of PLTs could reduce bacterial proliferation but cold exposure produces activation-like changes in PLTs and leads to their rapid clearance from circulation. Cold-induced changes are reversible by warming and periodic rewarming during cold storage (temperature cycling [TC]) has been proposed to alleviate cold-induced reduction in PLT circulation.
A clinical trial in healthy human volunteers was designed to compare in vivo recovery, survival, and area under the curve (AUC) of radiolabeled autologous apheresis PLTs stored for 7 days at RT or under TC or cold conditions. Paired comparisons of RT versus TC and TC versus cold PLTs were conducted.
Room temperature PLTs had in vivo recovery of 55.7 ± 13.9%, survival of 161.3 ± 28.8 hours, and AUC of 5031.2 ± 1643.3. TC PLTs had recovery of 42.6 ± 16.4%, survival of 48.1 ± 14.4% hours, and AUC of 1331.3 ± 910.2 (n = 12, p < 0.05). In a separate paired comparison, cold PLTs had recovery of 23.1 ± 8.8%, survival of 33.7 ± 14.7 hours, and AUC of 540.2 ± 229.6 while TC PLTs had recovery of 36.5 ± 12.9%, survival of 49.0 ± 17.3 hours, and AUC of 1164.3 ± 622.2 (n = 4, AUC had p < 0.05).
TC storage for 7 days produced PLTs with better in vivo circulation kinetics than cold storage but is not equivalent to RT storage.
血小板（PLT）在室温（RT）下储存会促使污染单位中的细菌增殖，这可能导致输血传播的败血症反应。血小板的低温储存可以减少细菌增殖，但冷暴露会使血小板产生类似激活的变化，并导致它们从循环中快速清除。冷诱导的变化可通过复温逆转，并且有人提出在冷藏期间进行周期性复温（温度循环[TC]）可缓解冷诱导的血小板循环减少。
设计了一项针对健康人类志愿者的临床试验，以比较在室温、温度循环或冷藏条件下储存7天的放射性标记自体单采血小板的体内回收率、存活率和曲线下面积（AUC）。对室温与温度循环血小板以及温度循环与冷藏血小板进行了配对比较。
室温血小板的体内回收率为55.7±13.9%，存活率为161.3±28.8小时，AUC为5031.2±1643.3。温度循环血小板的回收率为42.6±16.4%，存活率为48.1±14.4小时，AUC为1331.3±910.2（n = 12，p < 0.05）。在另一项配对比较中，冷藏血小板的回收率为23.1±8.8%，存活率为33.7±14.7小时，AUC为540.2±229.6，而温度循环血小板的回收率为36.5±12.9%，存活率为49.0±17.3小时，AUC为1164.3±622.2（n = 4，AUC有p < 0.05）。
7天的温度循环储存产生的血小板在体内循环动力学方面比冷藏储存更好，但并不等同于室温储存。
