Department of Integrated Engineering, University of British Columbia and MistyWest Research and Engineering Lab, Vancouver, British Columbia, Canada.
Department of Pathology, Division of Transfusion Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Transfusion. 2020 Sep;60(9):2067-2078. doi: 10.1111/trf.15934. Epub 2020 Jul 29.
The microparticle content (MP%) of apheresis platelets-a marker of platelet activation-is influenced by donor factors and by external stressors during collection and storage. This study assessed the impact of apheresis technology and other factors on the activation status (MP%) of single-donor apheresis platelets.
Data from six US hospitals that screened platelets by measuring MP% through dynamic light scattering (ThromboLUX) were retrospectively analyzed. Relative risks (RRs) were derived from univariate and multivariable regression models, with activation rate (MP% ≥15% for plasma-stored platelets; ≥10% for platelet additive solution [PAS]-stored platelets) and MP% as outcomes. Apheresis platform (Trima Accel vs Amicus), storage medium (plasma vs PAS), pathogen reduction, storage time, and testing location were used as predictors.
Data were obtained from 7511 platelet units collected using Trima (from 16 suppliers, all stored in plasma, 20.0% were pathogen-reduced) and 2456 collected using Amicus (from four different collection facilities of one supplier, 65.0% plasma-stored, 35.0% PAS-stored, none pathogen-reduced). Overall, 30.0% of Trima platelets were activated compared to 45.6% of Amicus platelets (P < .0001). Multivariable analysis identified apheresis platform as significantly associated with platelet activation, with a lower activation rate for Trima than Amicus (RR: 0.641, 95% confidence interval [CI]: 0.578; 0.711, P < .0001) and a 6.901% (95% CI: 5.926; 7.876, P < .0001) absolute reduction in MP%, when adjusting for the other variables.
Trima-collected platelets were significantly less likely to be activated than Amicus-collected platelets, irrespective of the storage medium, the use of pathogen reduction, storage time, and testing site.
血小板微颗粒含量(MP%)是血小板活化的标志物,受供体因素和采集及储存过程中的外部应激因素的影响。本研究评估了 单采血小板的采集技术和其他因素对其激活状态(MP%)的影响。
回顾性分析了六家美国医院的数据,这些医院通过动态光散射(ThromboLUX)测量 MP% 来筛选血小板。使用单变量和多变量回归模型得出相对风险(RR),激活率(血浆储存血小板 MP%≥15%;血小板添加剂溶液[PAS]储存血小板 MP%≥10%)和 MP% 为结局。采集平台(Trima Accel 与 Amicus)、储存介质(血浆与 PAS)、病原体减少、储存时间和检测地点用作预测因子。
从使用 Trima(来自 16 家供应商,均储存于血浆中,20.0%进行了病原体减少处理)采集的 7511 个血小板单位和使用 Amicus(来自一个供应商的四个不同采集设施,65.0%储存于血浆中,35.0%储存于 PAS 中,均未进行病原体减少处理)采集的 2456 个血小板单位中获得了数据。总体而言,与使用 Amicus 采集的血小板相比,使用 Trima 采集的血小板的激活率为 30.0%,而 Amicus 为 45.6%(P<0.0001)。多变量分析确定采集平台与血小板激活显著相关,与 Amicus 相比,Trima 的激活率更低(RR:0.641,95%置信区间[CI]:0.578;0.711,P<0.0001),调整其他变量后,MP%绝对值降低了 6.901%(95% CI:5.926;7.876,P<0.0001)。
无论储存介质、病原体减少的使用、储存时间和检测地点如何,使用 Trima 采集的血小板与使用 Amicus 采集的血小板相比,激活的可能性显著降低。