Stolla Moritz, Fitzpatrick Lynda, Gettinger Irena, Bailey Shawn L, Pellham Esther, Christoffel Todd, Slichter Sherrill J
Platelet Transfusion Research Laboratory, Bloodworks Northwest Research Institute, Seattle, Washington.
Department of Medicine, Division of Hematology, University of Washington School of Medicine, Seattle, Washington.
Transfusion. 2018 Oct;58(10):2407-2413. doi: 10.1111/trf.14833. Epub 2018 Sep 10.
The current 5-day storage time of room temperature (22°C)-stored platelets (RSPs) severely limits platelet (PLT) availability. Extended cold (4°C)-stored PLTs (CSPs) are currently being investigated for actively bleeding patients. However, we currently do not know how to best store PLTs in the cold for extended periods of time. In this study, we investigate how storage in plasma and PLT additive solutions (PASs) affects PLT viability in vivo.
Twenty normal subjects had a 2-unit hyperconcentrated apheresis PLT collection. One unit was stored at 4°C in plasma for 3 days ("control unit"), and the CSP "test" unit was stored for 10 or 15 days in plasma or 10 days in 35% plasma with either 65% Intersol or Isoplate. After storage, all units were radiolabeled and transfused into their donors.
For 10-day storage, both the plasma and the Intersol units had significantly better PLT recoveries than the Isoplate units (24% ± 8% vs. 11% ± 3% [55% ± 11% vs. 21% ± 8% as percentage of control data], p = 0.002; and 18% ± 4% vs. 11% ± 3% [43% ± 6% vs. 21% ± 8% as percentage of control data], p = 0.004, respectively). There was a trend for lower PLT recoveries with Intersol compared to plasma (p = 0.056). PLT survivals and most in vitro measurements did not differ significantly among the units.
While the in vitro variables suggest largely comparable results between plasma and PASs, in vivo recoveries were higher with plasma compared with both Intersol and Isoplate (p = 0.057 and p = 0.002, respectively). Whether this difference leads to clinically relevant differences in hemostatic efficacy remains to be determined.
目前室温（22°C）保存的血小板（RSPs）5天的储存时间严重限制了血小板（PLT）的可用性。目前正在对大出血患者研究延长冷（4°C）保存的血小板（CSPs）。然而，我们目前尚不知道如何在低温下长时间最佳地保存血小板。在本研究中，我们研究了在血浆和血小板添加剂溶液（PASs）中储存如何影响体内血小板活力。
20名正常受试者进行了2单位高浓缩单采血小板采集。1单位在4°C血浆中保存3天（“对照单位”），CSP“测试”单位在血浆中保存10或15天，或在含65% Intersol或Isoplate的35%血浆中保存10天。储存后，所有单位均进行放射性标记并回输给其捐献者。
对于10天的储存，血浆和Intersol单位的血小板回收率均显著高于Isoplate单位（分别为24%±8%对11%±3%[55%±11%对21%±8%，以对照数据的百分比表示]，p = 0.002；以及18%±4%对11%±3%[43%±6%对21%±8%，以对照数据的百分比表示]，p = 0.004）。与血浆相比，Intersol的血小板回收率有降低趋势（p = 0.056）。各单位之间的血小板存活率和大多数体外测量结果无显著差异。
虽然体外变量表明血浆和PASs之间的结果在很大程度上具有可比性，但与Intersol和Isoplate相比，血浆的体内回收率更高（分别为p = 0.057和p = 0.002）。这种差异是否会导致止血效果在临床上的相关差异仍有待确定。
