Department of Clinical Immunology and Transfusion Medicine (KITM), Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute Stockholm, Sweden.
Blood Transfus. 2023 Mar;21(2):137-145. doi: 10.2450/2022.0279-21. Epub 2022 Feb 28.
Amotosalen treatment of plasma and cryopreservation of platelets affect the quality and potentially the interplay between platelets and coagulation factors. We set up an experimental clot formation study to test the hypothesis that amotosalen treatment of plasma affects the interaction with different platelet preparations.
Pooled plasma units (n=16) were subjected to coagulation tests before and after pathogen inactivation with amotosalen treatment (PI) and aliquots were frozen at -80°C. Fresh and cryopreserved platelets were analyzed for phenotypic and activity markers. Finally, coagulation properties of different combinations of platelets and plasma, before and after PI, were analyzed by viscoelastography (ROTEM).
PI of plasma reduced the concentration of several coagulation factors (p<0.01). Cryopreservation altered phenotypic expression and reduced the platelets' ability to respond to agonists (p<0.0001). The interplay between all plasma derivatives and cryopreserved platelets resulted in shortened coagulation time (p<0.0001) but prolonged clot formation time and reduced clot strength (p<0.0001) as compared to the interaction between fresh platelets with different plasma variants. PI of the plasma does not seem to have a major impact on coagulation time, clot formation time or clot strength.
Our data show that the reduced concentration of coagulation factors after PI treatment of plasma are negligible measured by viscoelastography, with fresh and cryopreserved platelets in this experimental clot formation setup, and that platelets play a more pronounced role. Cryopreserved platelets are more activated and result in reduced clot stability.
氨甲环酸处理血浆和血小板的冷冻保存会影响血小板的质量和潜在的相互作用与凝血因子。我们建立了一个实验性凝块形成研究,以测试氨甲环酸处理血浆会影响与不同血小板制剂相互作用的假设。
将 16 个混合的血浆单位进行凝血试验,在氨甲环酸处理(PI)前后进行,并将等分试样冷冻在-80°C。新鲜和冷冻保存的血小板进行表型和活性标志物分析。最后,通过粘弹性测定法(ROTEM)分析不同组合的血小板和血浆在 PI 前后的凝血特性。
PI 降低了几种凝血因子的浓度(p<0.01)。冷冻保存改变了表型表达,并降低了血小板对激动剂的反应能力(p<0.0001)。与新鲜血小板与不同血浆变体的相互作用相比,所有血浆衍生物与冷冻保存的血小板的相互作用导致凝血时间缩短(p<0.0001),但凝血形成时间延长和凝块强度降低(p<0.0001)。PI 对血浆的凝血时间、凝块形成时间或凝块强度似乎没有重大影响。
我们的数据表明,在这种实验性凝块形成设置中,PI 处理血浆后凝血因子浓度的降低通过粘弹性测定法可忽略不计,新鲜和冷冻保存的血小板均如此,而血小板则发挥更明显的作用。冷冻保存的血小板更活跃,导致凝块稳定性降低。