Johnson Lacey, Roan Christopher, Lei Pearl, Spinella Philip C, Marks Denese C
Research and Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia.
Trauma and Transfusion Medicine Research Center, Department of Surgery and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Transfusion. 2023 May;63 Suppl 3:S126-S137. doi: 10.1111/trf.17328. Epub 2023 Apr 17.
Cold-stored platelets are increasingly being used to treat bleeding. Differences in manufacturing processes and storage solutions can affect platelet quality and may influence the shelf life of cold-stored platelets. PAS-E and PAS-F are approved platelet additive solutions (PAS) in Europe and Australia, or the United States respectively. Comparative data are required to facilitate international transferability of laboratory and clinical data.
Single apheresis platelets from matched donors (n = 8) were collected using the Trima apheresis platform and resuspended in either 40% plasma/60% PAS-E or 40% plasma/60% PAS-F. In a secondary study, platelets in PAS-F were supplemented with sodium citrate, to match the concentration in PAS-E. Components were refrigerated (2-6°C) and tested over 21 days.
Cold-stored platelets in PAS-F had a lower pH, a greater propensity to form visible (and micro-) aggregates, and higher activation markers compared to PAS-E. These differences were most pronounced during extended storage (14-21 days). While the functional capacity of cold-stored platelets was similar, the PAS-F group displayed minor improvements in ADP-induced aggregation and TEG parameters (R-time, angle). Supplementation of PAS-F with 11 mM sodium citrate improved the platelet content, maintained the pH above specifications and prevented aggregate formation.
In vitro parameters were similar during short-term cold storage of platelets in PAS-E and PAS-F. Storage in PAS-F beyond 14 days resulted in poorer metabolic and activation parameters. However, the functional capacity was maintained, or even enhanced. The presence of sodium citrate may be an important constituent in PAS for extended cold storage of platelets.
冷藏血小板越来越多地用于治疗出血。制造工艺和储存溶液的差异会影响血小板质量，并可能影响冷藏血小板的保质期。PAS-E和PAS-F分别是在欧洲和澳大利亚或美国获批的血小板添加剂溶液（PAS）。需要比较数据以促进实验室和临床数据的国际可转移性。
使用Trima血细胞分离平台收集来自匹配供体（n = 8）的单采血小板，并将其重悬于40%血浆/60% PAS-E或40%血浆/60% PAS-F中。在一项二次研究中，向PAS-F中的血小板补充柠檬酸钠，使其浓度与PAS-E中的浓度相匹配。将成分冷藏（2-6°C）并在21天内进行检测。
与PAS-E相比，PAS-F中的冷藏血小板pH值较低，形成可见（和微小）聚集体的倾向更大，激活标志物更高。这些差异在延长储存（14-21天）期间最为明显。虽然冷藏血小板的功能能力相似，但PAS-F组在ADP诱导的聚集和血栓弹力图参数（R时间、角度）方面有轻微改善。向PAS-F中补充11 mM柠檬酸钠可改善血小板含量，将pH值维持在规格以上并防止聚集体形成。
在PAS-E和PAS-F中对血小板进行短期冷藏期间，体外参数相似。在PAS-F中储存超过14天会导致代谢和激活参数较差。然而，功能能力得以维持，甚至增强。柠檬酸钠的存在可能是PAS中血小板延长冷藏的重要成分。
