Hoxworth Blood Center, University of Cincinnati Academic Health Center.
Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati.
Curr Opin Hematol. 2018 Nov;25(6):500-508. doi: 10.1097/MOH.0000000000000456.
Platelet transfusion is a widely used therapy in treating or preventing bleeding and haemorrhage in patients with thrombocytopenia or trauma. Compared with the relative ease of platelet transfusion, current practice for the storage of platelets is inefficient, costly and relatively unsafe, with platelets stored at room temperature (RT) for upto 5-7 days.
During storage, especially at cold temperatures, platelets undergo progressive and deleterious changes, collectively termed the 'platelet storage lesion', which decrease their haemostatic function and posttransfusion survival. Recent progress in understanding platelet activation and host clearance mechanisms is leading to the consideration of both old and novel storage conditions that use refrigeration and/or cryopreservation to overcome various storage lesions and significantly extend platelet shelf-life with a reduced risk of pathogen contamination.
A review of the advantages and disadvantages of alternative methods for platelet storage is presented from both a clinical and biological perspective. It is anticipated that future platelet preservation involving cold, frozen and/or pathogen reduction strategies in a proper platelet additive solution will enable longer term and safer platelet storage.
血小板输注是治疗或预防血小板减少症或创伤患者出血和出血的常用疗法。与血小板输注相对容易相比,目前血小板的储存效率低下、成本高且相对不安全,血小板在室温(RT)下储存长达 5-7 天。
在储存过程中,尤其是在低温下,血小板会发生渐进性和有害的变化,统称为“血小板储存损伤”,这会降低其止血功能和输注后的存活。对血小板激活和宿主清除机制的理解的最新进展正在促使人们考虑使用冷藏和/或冷冻保存来克服各种储存损伤并显著延长血小板的货架寿命,同时降低病原体污染的风险的旧的和新的储存条件。
从临床和生物学的角度介绍了血小板储存的替代方法的优缺点。预计未来涉及适当血小板添加剂溶液中的低温、冷冻和/或病原体减少策略的血小板保存将能够实现更长时间和更安全的血小板储存。